1
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Neumann SE, Kwon J, Gropp C, Ma L, Giovine R, Ma T, Hanikel N, Wang K, Chen T, Jagani S, Ritchie RO, Xu T, Yaghi OM. The propensity for covalent organic frameworks to template polymer entanglement. Science 2024; 383:1337-1343. [PMID: 38513024 DOI: 10.1126/science.adf2573] [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: 10/09/2022] [Accepted: 02/14/2024] [Indexed: 03/23/2024]
Abstract
The introduction of molecularly woven three-dimensional (3D) covalent organic framework (COF) crystals into polymers of varying types invokes different forms of contact between filler and polymer. Whereas the combination of woven COFs with amorphous and brittle polymethyl methacrylate results in surface interactions, the use of the liquid-crystalline polymer polyimide induces the formation of polymer-COF junctions. These junctions are generated by the threading of polymer chains through the pores of the nanocrystals, thus allowing for spatial arrangement of polymer strands. This offers a programmable pathway for unthreading polymer strands under stress and leads to the in situ formation of high-aspect-ratio nanofibrils, which dissipate energy during the fracture. Polymer-COF junctions also strengthen the filler-matrix interfaces and lower the percolation thresholds of the composites, enhancing strength, ductility, and toughness of the composites by adding small amounts (~1 weight %) of woven COF nanocrystals. The ability of the polymer strands to closely interact with the woven framework is highlighted as the main parameter to forming these junctions, thus affecting polymer chain penetration and conformation.
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Affiliation(s)
- S Ephraim Neumann
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
| | - Junpyo Kwon
- Department of Mechanical Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Cornelius Gropp
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
| | - Le Ma
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Materials Science & Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
| | - Raynald Giovine
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
| | - Tianqiong Ma
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
| | - Nikita Hanikel
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
| | - Kaiyu Wang
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
| | - Tiffany Chen
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Shaan Jagani
- Department of Materials Science & Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
| | - Robert O Ritchie
- Department of Mechanical Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Materials Science & Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
| | - Ting Xu
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Materials Science & Engineering, University of California-Berkeley, Berkeley, CA 94720, USA
| | - Omar M Yaghi
- Department of Chemistry, University of California-Berkeley, Berkeley, CA 94720, USA
- Kavli Energy NanoSciences Institute, Berkeley, CA 94720, USA
- Bakar Institute of Digital Materials for the Planet, Division of Computing, Data Science, and Society, University of California-Berkeley, Berkeley, CA 94720, USA
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2
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Wieland Goetzke F, Gropp C, Schwab A, Donckèle EJ, Thilgen C, Diederich F. Enantiopure Alleno‐Acetylenic Cage Receptors for Molecular Recognition in Aqueous Medium. Helv Chim Acta 2022. [DOI: 10.1002/hlca.202200130] [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: 11/23/2022]
Affiliation(s)
- F. Wieland Goetzke
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
| | - Cornelius Gropp
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
| | - Anatol Schwab
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
| | - Etienne J. Donckèle
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
| | - Carlo Thilgen
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
| | - François Diederich
- Laboratorium für Organische Chemie ETH Zurich Vladimir-Prelog-Weg 1–5/10 CH-8093 Zurich Switzerland
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3
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Nguyen HL, Gropp C, Hanikel N, Möckel A, Lund A, Yaghi OM. Hydrazine-Hydrazide-Linked Covalent Organic Frameworks for Water Harvesting. ACS Cent Sci 2022; 8:926-932. [PMID: 35912353 PMCID: PMC9336147 DOI: 10.1021/acscentsci.2c00398] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a postsynthetic strategy and its implementation to make covalent organic frameworks (COFs) with irreversible hydrazide linkages. This involved the synthesis of three 2D and 3D hydrazine-linked frameworks and their partial oxidation. The linkage synthesis and functional group transformation-hydrazine and hydrazide-were evidenced by 15N multi-CP-MAS NMR. In addition, the isothermal water uptake profiles of these frameworks were studied, leading to the discovery of one hydrazine-hydrazide-linked COF suitable for water harvesting from air in arid conditions. This COF displayed characteristic S-shaped water sorption profiles, a steep pore-filling step below 18% relative humidity at 25 °C, and a total uptake capacity of 0.45 g g-1. We found that even small changes made on the molecular level can lead to major differences in the water isotherm profiles, therefore pointing to the utility of water sorption analysis as a complementary analytical tool to study linkage transformations.
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Affiliation(s)
- Ha L. Nguyen
- Department
of Chemistry, University of California−Berkeley,
Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global
Science Institute, Berkeley, California 94720, United States
- Joint
UAEU−UC Berkeley Laboratories for Materials Innovations, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
| | - Cornelius Gropp
- Department
of Chemistry, University of California−Berkeley,
Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global
Science Institute, Berkeley, California 94720, United States
| | - Nikita Hanikel
- Department
of Chemistry, University of California−Berkeley,
Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global
Science Institute, Berkeley, California 94720, United States
| | - Anna Möckel
- Department
of Chemistry, University of California−Berkeley,
Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global
Science Institute, Berkeley, California 94720, United States
| | - Alicia Lund
- Department
of Chemistry, University of California−Berkeley, Berkeley, California 94720, United States
| | - Omar M. Yaghi
- Department
of Chemistry, University of California−Berkeley,
Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global
Science Institute, Berkeley, California 94720, United States
- Joint
UAEU−UC Berkeley Laboratories for Materials Innovations, United Arab Emirates University, Al-Ain 15551, United Arab Emirates
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4
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Jaworowski S, Abramov C, Malka M, Gropp C. Factitious disorder of a 17-year-old female during COVID-19 pandemic. J Paediatr Child Health 2021; 57:1701-1702. [PMID: 33527607 PMCID: PMC8013856 DOI: 10.1111/jpc.15362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 12/02/2020] [Accepted: 01/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Sol Jaworowski
- Department of Consultation PsychiatryShaare Zedek Medical Centre, Hebrew UniversityJerusalemIsrael
| | - Chava Abramov
- Department of Social WorkShaare Zedek Medical Centre, Hebrew UniversityJerusalemIsrael
| | - Moria Malka
- Department of Consultation PsychiatryShaare Zedek Medical Centre, Hebrew UniversityJerusalemIsrael
| | - Cornelius Gropp
- Department of Consultation PsychiatryShaare Zedek Medical Centre, Hebrew UniversityJerusalemIsrael
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5
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Oberbaum M, Jaworowski S, Malka M, Gropp C. [DOES A PRISONER HAVE THE RIGHT TO AUTONOMY? A CASE REPORT]. Harefuah 2021; 160:4-7. [PMID: 33474871] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The case presented discusses a prisoner, Y, in his mid-sixties with longstanding medical conditions, who was sentenced to prolonged incarceration. Y refused conventional medicine because he believed that his medical condition was exacerbated by this treatment and only complementary alternative medicine (CAM) would be helpful. He therefore demanded to be treated only by CAM. He was ready to pay for the treatment out of his own pocket. In the prison where Y was previously incarcerated over the course of 12 years, he had access to CAM remedies which were purchased by his family. After being transferred to the current facility, Y was denied access to these remedies by the prison physicians. He appealed in court against this decision and was supported by a CAM specialist, who ascertained that the remedies under consideration were not hazardous to Y's health. This case report discusses the ethical aspects of a prisoner's autonomy to choose medical treatment even when his/her autonomy has been severely curtailed by virtue of the incarceration.
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Affiliation(s)
- Menachem Oberbaum
- The Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Jerusalem
| | | | - Moria Malka
- Psychiatric Service, Shaare Zedek Medical Center, Jerusalem
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6
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Nguyen HL, Gropp C, Ma Y, Zhu C, Yaghi OM. 3D Covalent Organic Frameworks Selectively Crystallized through Conformational Design. J Am Chem Soc 2020; 142:20335-20339. [PMID: 33186498 DOI: 10.1021/jacs.0c11064] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We present a strategy whereby selective formation of imine covalent organic frameworks (COFs) based on linking of triangles and squares into the fjh topology was achieved by the conformational design of the building units. 1,3,5-Trimethyl-2,4,6-tris(4-formylphenyl)benzene (TTFB, triangle) and 1,1,2,2-tetrakis(4-aminophenyl)ethene (ETTA, square) were reticulated into [(TTFB)4(ETTA)3]imine, termed COF-790, which was fully characterized by spectroscopic, microscopic, and X-ray diffraction techniques. COF-790 exhibits permanent porosity and a Brunauer-Emmett-Teller (BET) surface area of 2650 m2 g-1. Key to the formation of this COF in crystalline form is the pre-designed conformation of the triangle and the square units to give dihedral angles in the range of 75-90°, without which the reaction results in the formation of amorphous product. We demonstrate the versatility of our strategy by also reporting the synthesis and characterization of two isoreticular forms of COF-790, COF-791 and COF-792, based on other square building units.
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Affiliation(s)
- Ha L Nguyen
- Department of Chemistry, University of California Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global Science Institute, Berkeley, California 94720, United States
- Joint UAEU-UC Berkeley Laboratories for Materials Innovations
| | - Cornelius Gropp
- Department of Chemistry, University of California Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global Science Institute, Berkeley, California 94720, United States
| | - Yanhang Ma
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Chenhui Zhu
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Omar M Yaghi
- Department of Chemistry, University of California Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; and Berkeley Global Science Institute, Berkeley, California 94720, United States
- Joint UAEU-UC Berkeley Laboratories for Materials Innovations
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7
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Gropp C, Ma T, Hanikel N, Yaghi OM. Design of higher valency in covalent organic frameworks. Science 2020; 370:370/6515/eabd6406. [DOI: 10.1126/science.abd6406] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/03/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Cornelius Gropp
- Department of Chemistry, University of California–Berkeley, Berkeley, CA 94720, USA
- Kavli Energy Nanoscience Institute at UC Berkeley, Berkeley, CA 94720, USA
| | - Tianqiong Ma
- Department of Chemistry, University of California–Berkeley, Berkeley, CA 94720, USA
- Kavli Energy Nanoscience Institute at UC Berkeley, Berkeley, CA 94720, USA
| | - Nikita Hanikel
- Department of Chemistry, University of California–Berkeley, Berkeley, CA 94720, USA
- Kavli Energy Nanoscience Institute at UC Berkeley, Berkeley, CA 94720, USA
| | - Omar M. Yaghi
- Department of Chemistry, University of California–Berkeley, Berkeley, CA 94720, USA
- Kavli Energy Nanoscience Institute at UC Berkeley, Berkeley, CA 94720, USA
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Jaworowski S, Weiser M, Gropp C, Malka M. Three Cases of COVID-19-related First Onset Brief Reactive Psychosis. Isr Med Assoc J 2020; 22:612. [PMID: 33070483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Sol Jaworowski
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Cornelius Gropp
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
| | - Moria Malka
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
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Abstract
Reticular chemistry is a growing field of science with a multitude of practitioners with diverse frames of thinking, making the need for standard practices and quality indicators ever more compelling.
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Affiliation(s)
- Cornelius Gropp
- Department of Chemistry, University of California-Berkeley, Kavli Energy Nanoscience
Institute at UC Berkeley, Berkeley, California 94720, United States
- (C.G.)
| | - Stefano Canossa
- EMAT, University
of Antwerp, Groenenborgerlaan
171, 2020 Antwerp, Belgium
- (S.C.)
| | - Stefan Wuttke
- BCMaterials, Basque Center for Materials,
UPV/EHU Science Park, 48940 Leioa, Spain
- (S.W.)
| | - Felipe Gándara
- Instituto de Ciencia de
Materiales de Madrid (ICMM)—Consejo Superior de Investigaciones
Científicas (CSIC), C/Sor Juana Ineś de la Cruz, 3, Madrid 28049, Spain
- (F.G.)
| | - Qiaowei Li
- Department of Chemistry and Shanghai Key Laboratory of
Molecular Catalysis and Innovative Materials, iChEM (Collaborative
Innovation Center of Chemistry for Energy Materials), Fudan University, Shanghai 200433, China
- (Q.L.)
| | - Laura Gagliardi
- Department
of Chemistry, Minnesota Supercomputing Institute, and Chemical Theory
Center, University of Minnesota, Minneapolis, Minnesota 55455, United States
- (L.G.)
| | - Omar M. Yaghi
- Department of Chemistry, University of California-Berkeley, Kavli Energy Nanoscience
Institute at UC Berkeley, Berkeley, California 94720, United States
- (O.M.Y.)
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10
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Jaworowski S, Gropp C, Malka M. Simulation training in addiction psychiatry. Evid Based Ment Health 2020; 23:88. [PMID: 32139443 PMCID: PMC10231621 DOI: 10.1136/ebmental-2020-300144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/05/2020] [Accepted: 02/14/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Sol Jaworowski
- Psychiatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Cornelius Gropp
- Psychiatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Moria Malka
- Psychiatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
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11
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Gropp C, Fischer S, Husch T, Trapp N, Carreira EM, Diederich F. Molecular Recognition and Cocrystallization of Methylated and Halogenated Fragments of Danicalipin A by Enantiopure Alleno-Acetylenic Cage Receptors. J Am Chem Soc 2020; 142:4749-4755. [PMID: 32114766 DOI: 10.1021/jacs.9b13217] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Enantiopure (P)4- and (M)4-configured alleno-acetylenic cage (AAC) receptors offer a highly defined interior for the complexation and structure elucidation of small molecule fragments of the stereochemically complex chlorosulfolipid danicalipin A. Solution (NMR), solid state (X-ray), and theoretical investigations of the formed host-guest complexes provide insight into the conformational preferences of 14 achiral and chiral derivatives of the danicalipin A chlorohydrin core in a confined, mostly hydrophobic environment, extending previously reported studies in polar solvents. The conserved binding mode of the guests permits deciphering the effect of functional group replacements on Gibbs binding energies ΔG. A strong contribution of conformational energies toward the binding affinities is revealed, which explains why the denser packing of larger apolar domains of the guests does not necessarily lead to higher association. Enantioselective binding of chiral guests, with energetic differences ΔΔG293 K up to 0.7 kcal mol-1 between diastereoisomeric complexes, is explained by hydrogen- and halogen-bonding, as well as dispersion interactions. Calorimetric studies (ITC) show that the stronger binding of one enantiomer is accompanied by an increased gain in enthalpy ΔH but at the cost of a larger entropic penalty TΔS stemming from tighter binding.
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Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
| | - Stefan Fischer
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
| | - Tamara Husch
- Laboratorium für Physikalische Chemie, ETH Zurich, Vladimir-Prelog-Weg 2, CH-8093 Zurich, Switzerland.,Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, California 91125, United States
| | - Nils Trapp
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
| | - Erick M Carreira
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
| | - François Diederich
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
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Jaworowski S, Gropp C. A contextual approach to routinely elicit a trauma-oriented history. Br J Psychiatry 2020; 216:166. [PMID: 32345405 DOI: 10.1192/bjp.2019.231] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Ha L. Nguyen
- Department of Chemistry, University of California—Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; Berkeley Global Science Institute; and Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Cornelius Gropp
- Department of Chemistry, University of California—Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; Berkeley Global Science Institute; and Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
| | - Omar M. Yaghi
- Department of Chemistry, University of California—Berkeley; Kavli Energy Nanoscience Institute at UC Berkeley; Berkeley Global Science Institute; and Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, United States
- UC Berkeley-KACST Joint Center of Excellence for Nanomaterials for Clean Energy Applications, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
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Jaworowski S, Golmard JL, Engelberg M, Prijs S, Twizer L, Gropp C, Mergui J. Case-Control Retrospective Study of Child Sexual Abuse History among Psychiatric Consultations in a General Hospital Emergency Room. Isr Med Assoc J 2019; 21:77-81. [PMID: 30772955] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND A history of childhood sexual abuse (CSA) has been linked to a variety of physical and psychiatric illnesses, including ischemic heart disease and post-traumatic stress disorder (PTSD). OBJECTIVES To determine the prevalence of past CSA and re-traumatization among hospital psychiatric consultations and to determine whether a CSA group in a hospital setting shared characteristics with community samples described in the literature. METHODS We divided 228 consecutive psychiatric consultations into two groups. One group comprised patients with a past history of CSA while the other group had no such history. Both groups were further divided into a subgroup that presented with features of re-traumatization. RESULTS In the cohort, 38% described a history of CSA. Twenty patients were identified as presenting with features of re-traumatization. There were significant differences between the two groups. The patients with a history of CSA were more likely to have arrived at the emergency department (ED) during the preceding 12 months with a diagnosis of PTSD, personality disorder, and substance use disorder. There was a greater proportion of patients in the CSA group who had grown up in an ultra-Orthodox Jewish household and who currently identified as being secular. CONCLUSIONS The characteristics of the patients with past CSA in this study are similar to community-based samples, except for a significant gender difference. To the best of our knowledge, this study is the first to investigate CSA history during hospital ED psychiatric consultations. A history of CSA should be considered during psychiatric consultations in a general hospital ED admission.
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Affiliation(s)
- Sol Jaworowski
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Jerusalem, Israel
- Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Jean-Louis Golmard
- Department of Biostatistics, Pitié-Salpêtrière (Assistance Publique-Hôpitaux de Paris), Université UPMC, Paris, France
| | - Morag Engelberg
- Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Sarah Prijs
- Department of Psychology, BPP University, London, United Kingdom
| | - Lital Twizer
- Department of Psychology, Hunter College, New York, NY, USA
| | - Cornelius Gropp
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Jerusalem, Israel
- Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Joseph Mergui
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Jerusalem, Israel
- Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
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15
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Gropp C, Husch T, Trapp N, Reiher M, Diederich F. Wasserstoffbrücken-Netzwerke: molekulare Erkennung zyklischer Alkohole in enantiomerenreinen alleno-acetylenischen Käfigrezeptoren. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201810562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3 8093 Zürich Schweiz
| | - Tamara Husch
- Laboratorium für Physikalische Chemie; ETH Zürich; Vladimir-Prelog-Weg 2 8093 Zürich Schweiz
| | - Nils Trapp
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3 8093 Zürich Schweiz
| | - Markus Reiher
- Laboratorium für Physikalische Chemie; ETH Zürich; Vladimir-Prelog-Weg 2 8093 Zürich Schweiz
| | - François Diederich
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3 8093 Zürich Schweiz
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16
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Gropp C, Husch T, Trapp N, Reiher M, Diederich F. Hydrogen-Bonded Networks: Molecular Recognition of Cyclic Alcohols in Enantiopure Alleno-Acetylenic Cage Receptors. Angew Chem Int Ed Engl 2018; 57:16296-16301. [DOI: 10.1002/anie.201810562] [Citation(s) in RCA: 6] [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] [Received: 09/13/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3 8093 Zurich Switzerland
| | - Tamara Husch
- Laboratorium für Physikalische Chemie; ETH Zurich; Vladimir-Prelog-Weg 2 8093 Zurich Switzerland
| | - Nils Trapp
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3 8093 Zurich Switzerland
| | - Markus Reiher
- Laboratorium für Physikalische Chemie; ETH Zurich; Vladimir-Prelog-Weg 2 8093 Zurich Switzerland
| | - François Diederich
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3 8093 Zurich Switzerland
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Mergui J, Raveh-Brawer D, Ben-Ishai M, Prijs S, Gropp C, Barash I, Golmard JL, Jaworowski S. Psychopathology of Israeli Soldiers Presenting to a General Hospital Emergency Department: Lessons for the Attending Physician and Psychiatrist. Isr Med Assoc J 2018; 20:561-566. [PMID: 30221870] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is scant research on the psychopathology of Israeli soldiers who present to a general hospital emergency department (ED). OBJECTIVES To assess the psychopathology among a cohort of Israeli soldiers who presented to a general hospital ED for mental health assessment. METHODS The demographic and clinical characteristics of 124 consecutive soldiers who presented to the ED for psychiatric assessment between January 2008 and September 2012 were reviewed. Twenty-seven soldiers from the cohort were contacted for follow-up by telephone on average 52 months later. RESULTS The reasons for presentation to the ED, usually during the early stages of military service, included self-harming behavior, suicidal ideation, somatoform complaints, and dissatisfaction with their military service. Psychiatric diagnoses included adjustment disorder and personality disorder. Self-harming behavior/suicidal ideation was significantly correlated with unspecified adjustment disorder (P = 0.02) and personality disorder (P = 0.001). At follow-up, there was a lack of substantial psychopathology: none of the subjects engaged in self-harming behavior/suicidal ideation and a consistent trend was observed toward clinical improvement. CONCLUSIONS Psychiatric intervention of soldiers who present to a general hospital ED because of emotional difficulties may provide the opportunity for crisis intervention and validation of the soldier's distress. To the best of our knowledge this is the first Israeli study of psychopathology among soldiers who presented to an ED.
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Affiliation(s)
- Joseph Mergui
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
| | - David Raveh-Brawer
- Unit of Infectious Diseases, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
| | - Meydan Ben-Ishai
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | | | - Cornelius Gropp
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
| | - Igor Barash
- Jerusalem Mental Health Center Eitanim-Kfar Shaul, Jerusalem, Israel
| | - Jean-Louis Golmard
- Department of Biostatistics, Pitié-Salpêtrière (Assistance Publique-Hôpitaux de Paris), Université UPMC, Paris, France
| | - Sol Jaworowski
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel
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Gropp C, Trapp N. Complexation and Structure Elucidation of the Axial Conformers of Mono- and (±)-trans-1,2-Disubstituted Cyclohexanes by Enantiopure Alleno-Acetylenic Cage Receptors. Chimia (Aarau) 2018; 72:245-248. [DOI: 10.2533/chimia.2018.245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland.
| | - Nils Trapp
- Laboratorium für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, CH-8093 Zurich, Switzerland
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Gropp C, Quigley BL, Diederich F. Molecular Recognition with Resorcin[4]arene Cavitands: Switching, Halogen-Bonded Capsules, and Enantioselective Complexation. J Am Chem Soc 2018; 140:2705-2717. [DOI: 10.1021/jacs.7b12894] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratory of Organic Chemistry,
Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg
3, 8093 Zürich, Switzerland
| | - Brendan L. Quigley
- Laboratory of Organic Chemistry,
Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg
3, 8093 Zürich, Switzerland
| | - François Diederich
- Laboratory of Organic Chemistry,
Department of Chemistry and Applied Biosciences, ETH Zürich, Vladimir-Prelog-Weg
3, 8093 Zürich, Switzerland
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20
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Jaworowski S, Raveh-Brawer D, Gropp C, Haber PS, Golmard JL, Mergui J. Alcohol Related Harm: Knowledge Assessment of Medical and Nursing Staff in a General Hospital. Isr J Psychiatry 2018; 55:32-36. [PMID: 30351278] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The prevalence of alcohol related harm (ARH) in Israel has traditionally been low. The lack of familiarity with ARH may derive from the fact that in the past there was limited clinical exposure to these harms. However, ARH is becoming more common in Israel but it is unclear whether the medical and nursing workforce's knowledge is adequate to manage these problems. Our main objective was to assess knowledge regarding ARH among medical and nursing staff (MNS) in an Israeli university affiliated general hospital. We also aimed to compare knowledge of different MNS groups Methods: One hundred and twenty-seven MNS including consultants (senior physicians), residents, interns and nursing staff completed the Knowledge of Psychiatric Aspects of Alcohol Questionnaire (KPAAQ), a validated measure of knowledge concerning ARH comprised of five categories. RESULTS There was no significant difference between the four MNS groups in overall mean KPAAQ scores that varied from 45% (nurses) to 54% (interns). However, direct comparisons indicate that physicians scored higher than nurses (p=0.02). overall. The mean score for the KPAAQ category "alcohol withdrawal syndrome" was below 40% for all MNS groups. Physicians scored significantly higher than nursing staff (p=0.005). All MNS mean scores were greater than 63% for the category "alcohol in pregnancy." This was the highest category score. CONCLUSIONS Assessment of knowledge regarding ARH among MNS in a general hospital with a standardized instrument demonstrated no significant difference in knowledge of ARH among nursing staff, interns, residents and consultants apart from knowledge about alcohol withdrawal. However, the overall score of the physicians as a whole was significantly higher than the nursing group. These findings suggest a need to implement educational interventions in MNS to increase knowledge of ARH so as to promote the provision of brief interventions for patients with ARH.
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Affiliation(s)
- Sol Jaworowski
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - David Raveh-Brawer
- Unit of Infectious Diseases, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Cornelius Gropp
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Paul S Haber
- Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW and University of Sydney, Australia
| | | | - Joseph Mergui
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
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Jaworowski S, Raveh-Brawer D, Gropp C, Haber PS, Golmard JL, Mergui J. Preliminary results of a controlled educational intervention on alcohol related harm among medical students with a 12-month follow-up. Isr J Psychiatry 2018; 55:37-39. [PMID: 30351279] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND There are no studies that use validated questionnaires on Alcohol Related Harm (ARH) in order to assess retention of educational programs among medical students. Objective of study to assess retention of an educational inter-vention on ARH among medical students. METHOD Seventeen fifth year medical students were assessed with the Knowledge of Psychiatric Aspects of Alcohol Questionnaire (KPAAQ) 12 months after an educational intervention on ARH and compared with a control group. RESULTS Significant retention was found in the study group. CONCLUSIONS This preliminary research is the first controlled study on medical student retention of an ARH educational intervention using a validated questionnaire.
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Affiliation(s)
- Sol Jaworowski
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - David Raveh-Brawer
- Unit of Infectious Diseases, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Cornelius Gropp
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Paul S Haber
- Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW and University of Sydney, Australia
| | | | - Joseph Mergui
- Department of Consultation and Liaison Psychiatry, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
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22
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Gropp C, Husch T, Trapp N, Reiher M, Diederich F. Dispersion and Halogen-Bonding Interactions: Binding of the Axial Conformers of Monohalo- and (±)-trans-1,2-Dihalocyclohexanes in Enantiopure Alleno-Acetylenic Cages. J Am Chem Soc 2017; 139:12190-12200. [DOI: 10.1021/jacs.7b05461] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratorium
für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, 8093 Zurich, Switzerland
| | - Tamara Husch
- Laboratorium
für Physikalische Chemie, ETH Zurich, Vladimir-Prelog-Weg 2, 8093 Zurich, Switzerland
| | - Nils Trapp
- Laboratorium
für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, 8093 Zurich, Switzerland
| | - Markus Reiher
- Laboratorium
für Physikalische Chemie, ETH Zurich, Vladimir-Prelog-Weg 2, 8093 Zurich, Switzerland
| | - François Diederich
- Laboratorium
für Organische Chemie, ETH Zurich, Vladimir-Prelog-Weg 3, 8093 Zurich, Switzerland
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23
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Affiliation(s)
- Cornelius Gropp
- From the Psychiatry Service, Shaare Zedek Medical Center, Jerusalem
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24
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Massenkeil G, Gropp C, Kreipe H, Hussein K. [Analysis of therapy-relevant receptors in bone marrow carcinosis : Comparison of pathological and clinical parameters]. Pathologe 2017; 38:317-323. [PMID: 28577052 DOI: 10.1007/s00292-017-0300-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bone marrow carcinosis is a sign of advanced tumor stage with nonspecific clinical and hematological symptoms. Diagnosis is based on bone marrow biopsy and histopathology, but biopsies are not part of the standard work-up in oncological diseases and data on the correlation between clinical presentation and pathological findings are sparse. MATERIAL AND METHODS In a retrospective single-center study, data from 20 tumor patients with bone marrow carcinosis were analyzed. Bone marrow biopsies were re-evaluated regarding quantity of tumor cells, fibrosis/necrosis, and bone changes. Immunohistochemistry of potential therapy-relevant receptors and PD-L1 was performed. RESULTS The median age in these 20 patients (13 women, 7 men) was 65 years. The most frequent diagnoses were breast (n = 8) and lung cancer (n = 5). Anemia (94% of patients), thrombocytopenia (72%), and elevated LDH (83%) were frequent findings. The degree of bone marrow infiltration was highly variable and accounted for between 1 and 95% of biopsy space. Significant bone remodeling was present in 14/20 biopsies. No correlation could be found between histological and radiological findings. Treated patients showed some clinical and biochemical improvement, but the overall survival was poor (median 4.5 months, range < 0.5 to 21.5 months). DISCUSSION Anemia and thrombocytopenia are frequently associated with bone marrow carcinosis, but are nonspecific. The extent of tumor cell infiltration and osteolytic/osteoblastic changes did not correlate with radiological findings. Therapy-relevant target factors should be evaluated, but therapeutic options are often limited and the prognosis is bad.
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Affiliation(s)
- G Massenkeil
- Klinik für Innere Medizin, Klinikum Gütersloh, Reckenberger Straße 19, 33332, Gütersloh, Deutschland.
| | - C Gropp
- Onkologische Gemeinschaftspraxis, Gütersloh, Deutschland
| | - H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
| | - K Hussein
- Institut für Pathologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
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25
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Gropp C, Trapp N, Diederich F. Alleno-Acetylenic Cage (AAC) Receptors: Chiroptical Switching and Enantioselective Complexation oftrans-1,2-Dimethylcyclohexane in a Diaxial Conformation. Angew Chem Int Ed Engl 2016; 55:14444-14449. [DOI: 10.1002/anie.201607681] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3, CH- 8093 Zurich Switzerland
| | - Nils Trapp
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3, CH- 8093 Zurich Switzerland
| | - François Diederich
- Laboratorium für Organische Chemie; ETH Zurich; Vladimir-Prelog-Weg 3, CH- 8093 Zurich Switzerland
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26
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Gropp C, Trapp N, Diederich F. Alleno-acetylenische Käfigrezeptoren (AAKs) - chiroptische Schaltung und enantioselektive Komplexierung vontrans-1,2-Dimethylcyclohexan in einer diaxialen Konformation. Angew Chem Int Ed Engl 2016. [DOI: 10.1002/ange.201607681] [Citation(s) in RCA: 8] [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: 11/08/2022]
Affiliation(s)
- Cornelius Gropp
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3, CH- 8093 Zürich Schweiz
| | - Nils Trapp
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3, CH- 8093 Zürich Schweiz
| | - François Diederich
- Laboratorium für Organische Chemie; ETH Zürich; Vladimir-Prelog-Weg 3, CH- 8093 Zürich Schweiz
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27
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Oberbaum M, Gropp C. Update on hormesis and its relation to homeopathy. HOMEOPATHY 2015; 104:227-33. [DOI: 10.1016/j.homp.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 11/15/2022]
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28
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Oberbaum M, Frass M, Gropp C. Unequal brothers : are homeopathy and hormesis linked? HOMEOPATHY 2015; 104:97-100. [DOI: 10.1016/j.homp.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 01/27/2015] [Accepted: 02/03/2015] [Indexed: 10/23/2022]
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Mergui J, Raveh D, Gropp C, Golmard JL, Jaworowski S. Prevalence and characteristics of cluster B personality disorder in a consultation-liaison psychiatry practice. Int J Psychiatry Clin Pract 2015; 19:65-70. [PMID: 25363196 DOI: 10.3109/13651501.2014.981543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Quantitative studies on cluster B-personality disorder (PD) in the general hospital are scarce. The aim of this study is to examine the prevalence and characteristics of cluster B-PD patients in a consultation-liaison practice. METHODS Files of 258 consecutive patients referred for psychiatric consultation were examined. Cluster B patients were compared with the remaining patients. RESULTS Eleven point six percent of these patients were diagnosed with a cluster B-PD. On univariate analysis, cluster B patients were more likely to be younger (P < 0.001), unmarried (P = 0.005), and without organic medical illness (P < 0.001).These patients had a shorter admission (P < 0.0001), and were more frequently treated in the emergency room (66.6% versus 37.5%, P = 0.02).There was a trend toward comorbid substance use disorder (P = 0.09). On multivariate analysis, cluster B patients presented significantly with self-harming behavior/ideation (80% versus 18%, OR = 12.07; 95% CI = 4.37-33.31; P < 0.0001). CONCLUSIONS In view of the high prevalence of cluster B-PD in our preliminary study, general hospital staff requires practical skills for managing these high-maintenance patients. We believe that this study and further research will promote evidence-based recommendations for consultation-liaison psychiatrists.
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Affiliation(s)
- Joseph Mergui
- Department of Consultation Liaison Psychiatry, Shaare Zedek Medical Center affiliated with the Hebrew University Medical School , Jerusalem , Israel
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30
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Oberbaum M, Gropp C. [Martin Heidegger, beneficence, health, and evidence based medicine--contemplations regarding ethics and complementary and alternative medicine]. Harefuah 2015; 154:192-210. [PMID: 25962251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Beneficence is considered a core principle of medical ethics. Evidence Based Medicine (EBM) is used almost synonymously with beneficence and has become the gold standard of efficiency of conventional medicine. Conventional modern medicine and EBM in particular are based on what Heidegger called calculative thinking, whereas complementary medicine (CM) is often based on contemplative thinking according to Heidegger's distinction of different thinking processes. A central issue of beneficence is the striving for health and wellbeing. EBM is little concerned directly with wellbeing, though it does claim to aim at improving quality of life by correcting pathological processes and conditions like infectious diseases, ischemic heart disease but also hypertension and hyperlipidemia. On the other hand, wellbeing is central to therapeutic efforts of CM. Scientific methods to gauge results of EBM are quantitative and based on calculative thinking, while results of treatments with CM are expressed in a qualitative way and based on meditative thinking. In order to maximize beneficence it seems important and feasible to use both approaches, by combining EBM and CM in the best interest of the individual patient.
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Pochorovski I, Milić J, Kolarski D, Gropp C, Schweizer WB, Diederich F. Evaluation of Hydrogen-Bond Acceptors for Redox-Switchable Resorcin[4]arene Cavitands. J Am Chem Soc 2014; 136:3852-8. [DOI: 10.1021/ja411429b] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Igor Pochorovski
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
| | - Jovana Milić
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
| | - Dušan Kolarski
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
| | - Cornelius Gropp
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
| | - W. Bernd Schweizer
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
| | - François Diederich
- Laboratorium für Organische
Chemie, ETH Zürich, Hönggerberg, HCI, 8093 Zürich, Switzerland
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Jaworowski S, Walter G, Soh N, Freier Dror Y, Mergui J, Gropp C, Haber PS. A validated questionnaire to assess the knowledge of psychiatric aspects of alcohol use disorder. Subst Abus 2014; 35:147-152. [PMID: 24821351 DOI: 10.1080/08897077.2013.822053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND To the best of our knowledge, there is no validated instrument for measuring knowledge of psychiatric aspects of alcohol use disorder (AUD) amongst medical students. Our aim was to develop an instrument for this purpose and to describe the instrument's psychometric properties. We also investigated whether the instrument could demonstrate a significant change in scores following an educational intervention consisting of a 60-minute PowerPoint lecture on AUD, associated handouts, and role-plays. METHODS The Knowledge of Psychiatric Aspects of Alcohol Questionnaire (KPAAQ) was developed from the Kaplan and Saddock textbook synopsis chapter on alcohol related disorders. The questionnaire included 6 categories of clinically relevant material: metabolism of alcohol, short-term effects of alcohol, long-term effects of alcohol, AUD, alcohol withdrawal, and alcohol use in pregnancy. The KPAAQ was administered to 75 medical students in Years 4 and 5 from the Hebrew University in Jerusalem, Israel, during a relevant clinical rotation. Following the initial administration of the KPAAQ, the students attended a 60-minute lecture (in Hebrew) based on material from the University of Sydney's learning module on alcohol. The KPAAQ was readministered to the students immediately following the lecture. RESULTS The KPAAQ demonstrated good reliability (Cronbach α =.92 for all questions) and validity r(209) =.674, P <.001. Knowledge of alcohol and alcoholism significantly increased after the educational intervention (F(2, 154) = 151.60, P <.001). Post hoc comparisons using the Scheffe test revealed a significant positive change in knowledge after students received the intervention (mean difference = 33, P <.001). CONCLUSIONS These initial findings suggest that the KPAAQ is a reliable and valid instrument for assessing medical student knowledge of psychiatric aspects of AUD over 6 clinical categories.
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Affiliation(s)
- Sol Jaworowski
- a Department of Consultation and Liaison Psychiatry , Shaare Zedek Medical Centre, Hebrew University , Jerusalem , Israel
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33
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Affiliation(s)
- Cornelius Gropp
- Psychiatric Service, Shaare Zedek Medical Center, Jerusalem, Israel.
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34
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Jaworowski S, Raveh D, Golmard JL, Gropp C, Mergui J. Alcohol use disorder in an Israeli general hospital: sociodemographic, ethnic and clinical characteristics. Isr Med Assoc J 2012; 14:294-298. [PMID: 22799060] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alcohol consumption in Israel has increased over the last 20 years. Patients with alcohol use disorder (AUD) who present at a hospital enable early intervention. OBJECTIVES To examine, for the first time, the characteristics of AUD patients in an Israel general hospital, and whether their alcohol use was documented in their files. METHODS A group of 178 consecutive patients referred for psychiatric consultation was compared to a second group of 105 hospitalized patients who were not referred. These two groups were studied to compare risk factors for AUD. Patients in both groups were prospectively interviewed using a CAGE questionnaire, demonstrated as an effective screening instrument for AUD. Patients' files in both groups were examined for documentation of alcohol use. RESULTS There was no significant difference between the prevalence of AUD in the two groups. The groups were then merged since no significant difference in the risk factor effects between the two groups was found. The risk factors for AUD in the final statistical analysis were lower educational status, living alone, being born in the Former Soviet Union and weaker religious observance. Post-traumatic stress disorder (PTSD), cigarette smoking and substance use were found to be independent risk factors. Soldier status was associated with significant alcohol misuse and AUD (CAGE1-4). Alcohol consumption was documented in the files of AUD patients in 48% of the first group and 21% of the second. CONCLUSIONS Physicians often neglect to take a history of alcohol consumption. Routine use of the CAGE questionnaire is recommended in Israeli general hospitals. Special attention should be given to PTSD patients and to soldiers.
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Affiliation(s)
- Sol Jaworowski
- Department of Consultation Liaison Psychiatry, Shaare Zedek Medical Center, affiliated with Hebrew University Medical School, Jerusalem, Israel.
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35
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Oberbaum M, Lysy J, Gropp C. [From Nebuchadnezzar to the randomized controlled trial--milestones in the development of clinical research]. Harefuah 2011; 150:668-686. [PMID: 21939122] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The first clinical experiment is described in the bible: The prophet Daniel is reported being nourished during ten days by seeds and water only, in order to check if his physical state would deteriorate as a result of this minimal nutrition. In the 15th century, French surgeon Ambroise Parí experimented with a mixture of turpentine, egg protein and rose oil to treat combat wounds, which is thought to be the first clinical study to be reported. In the 19th century British scientist James Lind designed the first controlled prospective study with parallel groups, proving that ingesting citrus fruit prevents scurvy. A short time afterwards British scientist John Haygarth was the first to use a placebo drug in a clinical study. Important work on placebo was conducted by the American scientists Austin Flint and later by Henry K. Beecher, who showed that placebo itself has biological properties. The importance of comparative studies was first understood by French psychologist CLaude Bernard. He is considered the founder of the modern scientific method based on observation, analysis of data and examination of hypotheses. Bernard's work was based on the work of fellow Frenchman Pierre Charles Alexandre Louis, who is justly considered a founding father of modern epidemiology, and who was the first to use statistics in clinical experiments. Random distributions in clinical studies were reported even before this time, for instance in the work of the Flemish physician Johannes Baptista van Helmont. Danish Nobel prize winner Johannes Fibiger pioneered the use of selection bias in his work with diphtheria serum.
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Affiliation(s)
- Menachem Oberbaum
- The Center for integrative Complementary Medicine, Shaare Zedek Medical Center, Jerusalem.
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Abstract
A patient suffering from Hodgkin's disease exhibiting acute allergic reaction to vincristine sulfate with mild to moderate dermatologic and cardiovascular signs is described. The change of therapy to vindesine sulfate led to relief of all symptoms. The therapeutic effectiveness of the altered protocol remained unchanged and no other or amplified side effects appeared.
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Abstract
The use of complementary and alternative medicine (CAM) is on the rise, especially among psychiatric patients. Acupuncture is considered a safe and effective treatment modality, and traditional Chinese medicine teaches that acupuncture harmonizes the body's energies. Scientific research has found that acupuncture increases a number of central nervous system hormones (ACTH, beta-endorphins, serotonin, and noradrenaline) and urinary levels of MHPG-sulfate, an adrenergic metabolite inversely related to the severity of illness in schizophrenics. Acupuncture can have positive effects on depression and anxiety, although evidence is still lacking as to its true efficacy for these conditions. To the authors' knowledge, no trials have been conducted for schizophrenia, and researchers evaluating acupuncture in cases of substance abuse have found conflicting results. Further research is warranted.
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Affiliation(s)
- Noah Samuels
- The Center for Integrative Complementary Medicine, Jerusalem, Israel.
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Mergui J, Raveh D, Golmard JL, Fuer A, Gropp C, Jaworowski S. Demographic and clinical parameters of patients with high risk behavior in a general hospital: the use of constant observation. Isr Med Assoc J 2008; 10:681-685. [PMID: 19009945] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND General hospital staff are often required to care for physically ill patients who arouse concern regarding risk of harm to themselves or others. Some of these patients,will be placed under one-to-one "constant observation." This is the first Israeli study of general hospital patients with high risk behavior. OBJECTIVES To examine a population of general hospital patients whose behavioral management required the use of constant observation. Demographic and clinical parameters including physical diagnoses were examined, and risk factors for constant observation were identified. The findings of this study were compared to those of previous studies. METHODS This prospective observational study examined 714 inpatients referred for psychiatric consultation; 150 were found to require constant observation, and 156 who did not served as a control group. RESULTS In this study younger age, suicidal concerns and alcohol/substance abuse were identified as risk factors for ordering constant observation. Ischemic heart disease and chronic obstructive pulmonary disease were the only physical diagnoses found to be significantly correlated with a longer duration of observation, regardless of admission duration. Constant observation was less frequently used in the management of organic brain syndrome patients in this study compared to other studies. CONCLUSIONS Some of our results (predictive factors for constant observation) confirmed the findings of overseas studies. Our finding that a diagnosis of organic brain syndrome was not a predictive factor for constant observation was unexpected and requires further investigation. The correlation between a diagnosis of ischemic heart disease or COPD and duration of observation has not been reported previously and warrants further studies.
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Affiliation(s)
- Joseph Mergui
- Department of Consultation, Shaare Zedek Medical Center, Jerusalem, Israel
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Jaworowski S, Raveh D, Lobel E, Fuer A, Gropp C, Mergui J. Constant Observation in the general hospital: a review. Isr J Psychiatry Relat Sci 2008; 45:278-284. [PMID: 19439833] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The role of Constant Observation (COb) in the general hospital is addressed. The difficulties of managing acute psychological disturbance in the general hospital are described. Concerns about confused behavior and suicidal risk appear to be the most common reasons for ordering COb. Organic brain syndrome is the most common diagnosis made in patients receiving COb. Medico-legal, ethical and therapeutic aspects of COb are noted. To our knowledge there is no research evidence that COb significantly decreases the rate of suicide in the general hospital. It appears that the role of COb is enshrined in the general hospital as a result of medico-legal process in addition to its therapeutic role. Further research in this area is needed.
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Affiliation(s)
- Sol Jaworowski
- Department of Consultation/Liaison Psychiatry, Shaare Zedek Medical Center, Jerusalem, Israel.
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Melnik B, Hariry H, Vakilzadeh F, Gropp C, Sitzer G. [Malignant atrophic papulosis (Köhlmeier-Degos disease). Failure to respond to interferon alpha-2a, pentoxifylline and aspirin]. Hautarzt 2002; 53:618-21. [PMID: 12207267 DOI: 10.1007/s00105-002-0347-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A 45 year old female patient presented with the cutaneous manifestations of malignant atrophic papulosis (Köhlmeier-Degos disease) for two years. The typical papules with central porcelain-white atrophy correspond histologically to wedge-shaped necrosis of the connective tissue due to thrombotic occlusion of small vessels in the corium. The pathogenesis of malignant atrophic papulosis and effective treatment modalities are unknown. A slow virus infection has been suggested by some authors. Therefore, we attempted an immune therapy with interferon alpha-2a over a period of 11 months, but failed to cause a significant effect on the appearance and progression of the skin lesions. Furthermore, we could not confirm the effectiveness of a recently reported treatment modality with pentoxifylline and aspirin administered to our patient over a period of 5 months.
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Affiliation(s)
- B Melnik
- Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück, Germany.
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41
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Köppler H, Pflüger KH, Eschenbach I, Pfab R, Birkmann J, Zeller W, Holle R, Steinhauer UE, Gropp C, Oehl S. Randomised comparison of CHOEP versus alternating hCHOP/IVEP for high-grade non-Hodgkin's lymphomas: treatment results and prognostic factor analysis in a multi-centre trial. Ann Oncol 1994; 5:49-55. [PMID: 8172793 DOI: 10.1093/oxfordjournals.annonc.a058690] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [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: 01/29/2023] Open
Abstract
BACKGROUND With CHOP, the standard protocol of recent decades, about 30% of long-term survival has been reported. A number of studies using more aggressive multidrug regimens or alternating chemotherapies have recently suggested higher CR rates and increased survival. In 1989 we reported similar results with a combined-modality treatment administering 6 cycles of CHOP supplemented with etoposide and an involved field irradiation for patients in PR or CR. PATIENTS AND METHODS To confirm the efficacy of this approach, we initiated a prospective randomised trial comparing 4 cycles of CHOP-VP16 (CHOEP) with 4 cycles of two alternating regimens, 'hCHOP and IVEP'. One hundred seventy-five patients with high-grade non-Hodgkin's lymphomas stages II-IV were stratified for age, stage and LDH and randomised to receive either four cycles of cyclophosphamide, doxorubicin, vincristine, etoposide, prednisolone (CHOEP) in arm A or four cycles of chemotherapy with a dose-intensified CHOP (hCHOP) alternating with ifosfamide, etoposide, vindesine, prednisolone (IVEP) in arm B. After four cycles of chemotherapy an involved field irradiation with a total dose of 35 Gy was given to all patients demonstrated to be in complete or partial remission. RESULTS Of the 185 randomised patients, 175 were eligible and 171 evaluable for response and survival. One hundred forty-six of the 171 patients (85%) achieved complete remission (CR) with 87% and 84% CRs in arms A and B, respectively. With a median follow-up of 36 months the estimated overall survival at 2 years is 66% and 73% for arms A and B, respectively. The percentage of all patients in first CR is estimated to be 59% and 55% at 2 years for arms A and B, respectively. None of the differences in CR rate, survival, or relapse-free survival are statistically significant. Multivariate analysis of subgroups incorporating the factors of sex, age, performance status, stage, B symptoms, bulky disease, LDH and histology revealed that only stage and LDH were factors which independently affected outcome. The estimated 2-year survival rate of patients with stages II, III and IV is predicted to be 84%, 62% and 52%, respectively. Patients with LDH > 250 U/l have an estimated survival of 52% at 2 years versus 84% for patients with LDH < or = 250 U/l. According to the newly proposed international score system, the 2-year survival was 81% for low-risk-, 64% for low intermediate risk-, 50% for high intermediate risk-, and 43% for high-risk patients. The toxicity in both arms was tolerable. Three patients died of treatment-related causes (2 in arm A, 1 in arm B). The main toxicity was haematological with 75% of patients suffering from grades 3 or 4 neutropenia at some point during treatment. CONCLUSIONS We observed no superior benefit for alternating regimens, and conclude that both are effective treatment protocols for aggressive histologic-type malignant lymphomas. The results obtained with four cycles of poly-chemotherapy followed by an involved field irradiation are comparable to programs using more aggressive and/or prolonged chemotherapy.
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Affiliation(s)
- H Köppler
- Department of Internal Medicine, Philipps-University, Marburg, Germany
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42
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Abstract
Prolactin (PRL) and cortisol responses to oral administration of d-1 fenfluramine hydrochloride (60 mg) and placebo were examined in patients with endogenous major depressive disorder on three separate occasions: prior to treatment with clomipramine (CMI), after 4 weeks of CMI administration (175-250) mg/day), and 3 weeks after addition of lithium (Li) carbonate (serum level 0.5-0.9 mmol) to the treatment regimen. CMI significantly increased baseline PRL levels which were further elevated following Li supplementation. PRL response to fenfluramine (minus elevated baseline PRL levels) but not to placebo, was significantly increased by CMI administration, reflected over the 6-hr time course examined and in peak minus baseline values. Following addition of Li, the degree of enhancement was diminished although the peak minus baseline value remained significant relative to the pretreatment response. Cortisol levels were not increased by fenfluramine and were not altered by CMI or CMI + Li administration. The effect of CMI extends previous observations regarding the action of antidepressant treatment on serotenergically mediated hormone release. Methodological considerations relevant to the effect of CMI + Li are discussed.
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Affiliation(s)
- B Shapira
- Depression Treatment Unit, Herzog Hospital, Jerusalem, Israel
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Abstract
Depressed patients (n = 10), schizophrenics (n = 6), and normal control subjects was (n = 9) were administered fenfluramine hydrochloride (FF) (60 mg/os) or placebo in the context of a randomized, double-blind crossover trial. No effect of FF on mood or activation was detected over a 6-hr period. A previous report claiming acute antidepressant effects of FF in depressed subjects was not confirmed.
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Affiliation(s)
- P Lichtenberg
- Department of Research, Ezrath Nashim Hospital, Jerusalem, Israel
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Shapira B, Lerer B, Kindler S, Lichtenberg P, Gropp C, Cooper T, Calev A. Enhanced serotonergic responsivity following electroconvulsive therapy in patients with major depression. Br J Psychiatry 1992; 160:223-9. [PMID: 1540763 DOI: 10.1192/bjp.160.2.223] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prolactin release in response to fenfluramine hydrochloride (60 mg orally) and placebo was evaluated in 18 medication-free patients with RDC major depressive disorder, endogenous subtype, before and after a series of bilateral treatments with ECT. Before ECT, fenfluramine induced a twofold increase in plasma prolactin levels. This response was significantly enhanced after the ECT series, while baseline prolactin levels and response to the placebo challenge were not altered. There was no significant difference in plasma fenfluramine and norfenfluramine levels during the pre- and post-ECT challenges. These findings suggest that ECT enhances central serotonergic responsivity and extend to depressed patients pre-clinical observations regarding the effect of electroconvulsive shock on serotonergic function.
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Affiliation(s)
- B Shapira
- Depression Treatment Unit, Ezrath Nashim Hospital, Jerusalem, Israel
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Köppler H, Pflüger KH, Eschenbach I, Pfab R, Birkmann J, Zeller W, Steinhauer EU, Gropp C, Oehl S, Lötzke E. Sequential versus alternating chemotherapy for high grade non-Hodgkin's lymphomas: a randomized multicentre trial. Hematol Oncol 1991; 9:217-23. [PMID: 1743624 DOI: 10.1002/hon.2900090407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 12/28/2022]
Abstract
In a multicentre phase III trial 146 previously untreated patients with high grade non-Hodgkin's lymphomas stage II-IV were randomized to receive either four cycles of CHOEP (cyclophosphamide 750 mg/m2 iv d 1, doxorubicin 50 mg/m2 iv d 1, vincristine 2 mg iv d 1, etoposide 100 mg/m2 iv d 3-5, prednisolone 100 mg po d 1-5) (treatment arm A), or four cycles of chemotherapy with hCHOP (cyclophosphamide 1200 mg/m2 iv d 1, doxorubicin 40 mg/m2 iv d 1 + 2, vincristine 2 mg iv d 1, prednisolone 100 mg po d 1-5) alternating with IVEP (ifosfamide 1500 mg/m2 iv d 1-5, vindesine 3 mg/m2 iv d 1, etoposide 120 mg/m2 iv d 3-5, prednisolone 100 mg po d 1-5) (treatment arm B). After four cycles of chemotherapy an involved field irradiation with a total dose of 35 Gy was given to all patients in complete or partial remission without persisting extranodal disease. A complete response (CR) was seen in 124/146 patients (86 per cent) with 87 per cent CR in arm A versus 83 per cent CR in arm B. During a median follow-up of 17 months (range 2-40) 30 patients relapsed (16 patients arm A, 14 patients arm B). The overall survival at 40 months is projected to be 71 per cent versus 70 per cent for arm A and B, respectively. Disease-free survival is projected to be 68 per cent in arm A and 59 per cent in arm B at 40 months. So far, the differences in CR, survival and disease-free survival are not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Köppler
- Abt Hämatologie/Onkologie, Philipps-Universität, Marburg, Germany
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46
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Gropp C. [Tumor markers, significance for clinical diagnosis]. Pneumologie 1991; 45:137-9. [PMID: 1876589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A wide variety of tumour markers has been described in bronchial carcinoma. Clinical studies have been most frequently conducted with the substances CEA, NSE, CK-BB and for the peptid hormones ACTH, calcitonin and ADH. The serum levels for CEA, NSE and CK-BB correlate to a certain extent with the stage of the tumour disease, the prognosis and the survival time. On the other hand, the peptid hormones have no clinical significance on account of their low sensitivity and specificity. Outside of clinical studies the determination of tumour markers in bronchial carcinoma is clinically irrelevant.
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Affiliation(s)
- C Gropp
- Medizinische Klinik, Städtisches Krankenhaus Gütersloh
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Wolf M, Drings P, Hans K, Schroeder M, Flechtner H, Becker H, Goerg R, Gropp C, Pritsch M, Havemann K. Alternating chemotherapy with adriamycin/ifosfamide/vincristin (AIO) and either cisplatin/etoposide (PE) or carboplatin/etoposide (JE) in Small Cell Lung Cancer (SCLC). Lung Cancer 1991. [DOI: 10.1016/0169-5002(91)91879-g] [Citation(s) in RCA: 5] [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: 11/27/2022]
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Köppler H, Pflüger K, Eschenbach I, Pfab R, Birkmann J, Zeller W, Steinhauer E, Gropp C, Oehl S, Lötzke E, Kuhn H, Drings P, Großmann H, Lennert K, Stein H, Khoury M, Heinzelmann W, Havemann K. CHOEP versus Alternating hCHOP/IVEP for High Grade Non-Hodgkin’s Lymphomas: A Randomized Multicentre Trial. Oncol Res Treat 1991. [DOI: 10.1159/000216968] [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: 11/19/2022]
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49
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Köppler H, Pflüger KH, Eschenbach I, Pfab R, Bruntsch U, Zeller W, Steinhauer EU, Gropp C, Oehl S, Lötzke E. Sequential versus alternating chemotherapy for high-grade non-Hodgkin's lymphomas: preliminary results of a phase III multicentre trial. Onkologie 1990; 13:28-32. [PMID: 2186321 DOI: 10.1159/000216715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In a multicentre phase III trial 105 previously untreated patients with high-grade non-Hodgkin's lymphomas stage II-IV were randomized to receive either 4 cycles of CHOEP (cyclophosphamide 750 mg/m2 i.v. day 1, doxorubicin 50 mg/m2 i.v. day 1, vincristine 2 mg i.v. day 1, etoposide 100 mg/m2 i.v. days 3-5, prednisolone 100 mg p.o. days 1-5) (treatment arm A), or 4 cycles of chemotherapy with hCHOP (cyclophosphamide 1,200 mg/m2 i.v. day 1, doxorubicin 40 mg/m2 i.v. days 1 + 2, vincristine 2 mg i.v. day 1, prednisolone 100 mg p.o. days 1-5) alternating with IVEP (ifosfamide 1,500 mg/m2 i.v. days 1-5, vindesine 3 mg/m2 i.v. day 1, etoposide 120 mg/m2 i.v. days 3-5, prednisolone 100 mg p.o. days 1-5) in treatment arm B. After 4 cycles of chemotherapy an involved field irradiation with a total dose of 35 Gy was given to all patients demonstrated to be in complete or partial remission without persisting extranodal disease. A complete response (CR) was seen in 86/105 patients (82%) with 88% CR in arm A vs. 76% CR in arm B. During a median follow-up of 11 months (range 2-31 months) 13 patients relapsed (6 patients arm A, 7 patients arm B). The overall survival at 30 months is projected to be 72% vs. 83% for arm A and B respectively. Disease-free survival is projected to be 78% in arm A and 45% in arm B at 28 months. So far, the differences in CR, survival and disease-free survival are not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Köppler
- Abt. Hämatologie/Onkologie, Philipps-Universität, Marburg, FRG
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50
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Wolf M, Havemann K, Stalleicken D, Gropp C, Maasberg M, Hans K, von Bültzingslöwen F, Klasen H, Becker H, Schroeder M. [Results of 2 multicenter therapy studies in inoperable non-small cell bronchial cancer]. Onkologie 1988; 11:222-31. [PMID: 2849078 DOI: 10.1159/000216529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A total of 166 patients with non-small cell lung cancer (NSCLC) were included in two multicenter trials testing different treatment regimens. In study I, 116 patients received 4 cycles of aggressive polychemotherapy consisting of cis-platinum 100 mg/m2 (day 1), etoposide 100 mg/m2 (days 4-6), and vindesine 3 mg/m2 (day 1) (CEV); patients without distant metastases subsequently received chest irradiation with 50 Gy. In study II, 50 patients were treated with monochemotherapy consisting of etoposide 250 mg/m2 (days 1-3), and ifosfamide 5 g/m2 as 24-h infusion (day 29). While this program was repeated in responders with extensive disease (ED), patients with limited disease (LD) subsequently received chest irradiation with 50 Gy using 20 mg/m2 cis-platinum weekly as a radiosensitizer. Response rates (CR + PR) to chemotherapy were higher in study I than in study II, and were 26% (CR 3%) vs. 8% (CR 0%) for all patients, 18% (CR 0%) vs. 4% (CR 0%) for ED, and 45% (CR 11%) vs. 13% (CR 0%) for LD. The increase in response rates by radiotherapy was marginal in study I (CR + PR 47%, CR 18%), but remarkable in study II (CR + PR 42%, CR 29%). While median survival was slightly longer in study I than in study II for ED (7.7 vs. 6.6 months) and LD (14.4 vs. 12.0 months), the 2-year survival rate was in favor of study II (10% vs. 25%). Toxicity was clearly more pronounced in study I, including 3 lethal complications and 16 discontinuations of therapy due to side effects or refusal. Thus, while in ED the efficacy of both treatment regimens was very restricted, in LD radiotherapy with cis-platinum as a radiosensitizer achieved a relatively high 2-year survival rate which justifies further testing of this treatment strategy.
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Affiliation(s)
- M Wolf
- Abteilung Hämatologie/Onkologie, Philipps-Universität, Marburg
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