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Reindl E, Völter CJ, Civelek Z, Duncan L, Lugosi Z, Felsche E, Herrmann E, Call J, Seed AM. The shifting shelf task: a new, non-verbal measure for attentional set shifting. Proc Biol Sci 2023; 290:20221496. [PMID: 36651050 PMCID: PMC9845975 DOI: 10.1098/rspb.2022.1496] [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: 01/19/2023] Open
Abstract
Attentional set shifting is a core ingredient of cognition, allowing for fast adaptation to changes in the environment. How this skill compares between humans and other primates is not well known. We examined performance of 3- to 5-year-old children and chimpanzees on a new attentional set shifting task. We presented participants with two shelves holding the same set of four boxes. To choose the correct box on each shelf, one has to switch attention depending on which shelf one is currently presented with. Experiment 1 (forty-six 3- to 5-year olds, predominantly European White) established content validity, showing that the majority of errors were specific switching mistakes indicating failure to shift attention. Experiment 2 (one hundred and seventy-eight 3- to 6-year olds, predominantly European White) showed that older children made fewer mistakes, but if mistakes were made, a larger proportion were switching mistakes rather than 'random' errors. Experiment 3 (52 chimpanzees) established suitability of the task for non-human great apes and showed that chimpanzees' performance was comparable to the performance of 3- and 4-year olds, but worse than 5-year olds. These results suggest that chimpanzees and young children share attentional set shifting capacities, but that there are unique changes in the human lineage from 5 years of age.
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Affiliation(s)
- E. Reindl
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK,Department of Anthropology, Durham University, Durham DH1 3LE, UK
| | - C. J. Völter
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK,Messerli Research Institute, University of Veterinary Medicine Vienna Medical University of Vienna, University of Vienna, Vienna 1210, Austria
| | - Z. Civelek
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK
| | - L. Duncan
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Z. Lugosi
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK,Division of Psychology, University of Stirling, Stirling FK9 4LA, UK,Faculty of Social Sciences and Public Policy, School of Education, Communication and Society, King's College London, London WC2R 2LS, UK
| | - E. Felsche
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK,Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig 04103, Germany
| | - E. Herrmann
- Department of Psychology, University of Portsmouth, Portsmouth PO1 2UP, UK
| | - J. Call
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK
| | - A. M. Seed
- School of Psychology and Neuroscience, University of St Andrews, St Andrews KY16 9JP, UK
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Mas-Peiro S, Faerber G, Herrmann E, Bauer T, Bleiziffer S, Bekeredjian R, Boening A, Frerker C, Beckmann A, Moellmann H, Ensminger S, Hamm C, Beyersdorf F, Fichtlscherer S, Walther T. TAVI versus SAVR in intermediate-risk patients with severe aortic stenosis and chronic kidney disease: a matched comparison in a subcohort from the GARY registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
According to American and recent European guidelines, both transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) may be used to treat severe aortic stenosis in a subgroup of patients with intermediate surgical risk, in spite of slight differences in recommended age limits (ACC/AHA: 65–80 years and ESC/EACTS: <75 years). A shared therapeutic decision is made with the patient, based on a heart team assessment. For this, individual factors should be taken into account. Concomitant chronic kidney disease (CKD) is a prognostic factor in such patients, and CKD stage ≥3a and ≥3b has been shown to be a significant independent risk factor for SAVR and TAVI, respectively.
Purpose
To compare TAVI vs. SAVR outcomes in a subgroup of patients for whom both therapies could possibly be considered according to current guidelines.
Methods
The large nation-wide German Aortic Valve Registry (GARY) includes data from patients treated with TAVI or SAVR. A subcohort of patients from GARY with intermediate surgical risk (age ≤80 years, STS-score 4–8) and moderate-to-severe chronic kidney disease (CKD stages 3a, 3b, and 4) was selected. A matched analysis of 704 patients undergoing TAVI and 374 undergoing SAVR was carried out using a propensity score method. Primary endpoint was 1-year survival. Clinical complications and specifically the need for postprocedural new-onset dialysis were secondary endpoints.
Results
TAVI and SAVR showed similar survival results at 1 year in a Kaplan-Meier analysis (HR [95% CI] for TAVI: 1.271 [0.795,2.031], p=0.316). Despite a numerically higher post-procedural short-term survival in TAVI patients and a numerically higher 1-year survival in SAVR patients, such differences did not reach statistical significance (96.4% vs. 94.2%, p=0.199, and 86.2% vs. 81.2%, p=0.316, respectively). In weighted analyses, need for permanent pacemaker, vascular complications, and moderate-to-severe valvular regurgitation were significantly more common with TAVI, whereas patients undergoing SAVR had significantly higher rates of myocardial infarction, and transient ischaemic attack, needed more transfusions for bleeding, and had a significantly longer intensive care unit stay and overall hospital stay. The need for new-onset dialysis for a limited time was more common after SAVR (p<0.0001); however, very few patients required chronic dialysis either after TAVI or after SAVR.
Conclusion
In a matched analysis of intermediate-risk patients with severe aortic stenosis and a concomitant moderate-to-severe CKD, for whom both TAVI and SAVR could possibly be considered, both approaches showed excellent and comparable results.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The registry receives financial support in the form of unrestricted grants by medical device companies (Edwards Lifesciences, JenaValve Technology, Medtronic, Sorin, St. Jude Medical, Symetis S.A.).In addition, there is unrestricted support by funding statisticians by the DZHK (Deutsches Zentrum für Herz-Kreislaufforschung).
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Affiliation(s)
- S Mas-Peiro
- Wolfgang Goethe University , Frankfurt am Main , Germany
| | - G Faerber
- University Hospital Jena , Jena , Germany
| | - E Herrmann
- Wolfgang Goethe University , Frankfurt am Main , Germany
| | - T Bauer
- Sana Clinic Offenbach , Offenbach , Germany
| | - S Bleiziffer
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum , Bad Oeynhausen , Germany
| | | | - A Boening
- University Hospital Giessen and Marburg , Giessen , Germany
| | - C Frerker
- Heart Center at the University of Cologne , Cologne , Germany
| | - A Beckmann
- German Society for Thoracic and Cardiovascular Surgery , Berlin , Germany
| | | | - S Ensminger
- Schleswig-Holstein University Clinic, Lubeck Campus , Luebeck , Germany
| | - C Hamm
- University Hospital Giessen and Marburg , Giessen , Germany
| | - F Beyersdorf
- University Heart Center Freiburg-Bad Krozingen , Freiburg , Germany
| | | | - T Walther
- Wolfgang Goethe University , Frankfurt am Main , Germany
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Neuhaus E, Hattingen E, Breuer S, Steidl E, Polomac N, Rosenow F, Rüber T, Herrmann E, Ecker C, Kushan L, Lin A, Vajdi A, Bearden CE, Jurcoane A. Heterotopia in Individuals with 22q11.2 Deletion Syndrome. AJNR Am J Neuroradiol 2021; 42:2070-2076. [PMID: 34620586 PMCID: PMC8583271 DOI: 10.3174/ajnr.a7283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/19/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging studies and neuropathologic findings in individuals with 22q11.2 deletion syndrome show anomalous early brain development. We aimed to retrospectively evaluate cerebral abnormalities, focusing on gray matter heterotopia, and to correlate these with subjects' neuropsychiatric impairments. MATERIALS AND METHODS Three raters assessed gray matter heterotopia and other morphologic brain abnormalities on 3D T1WI and T2*WI in 75 individuals with 22q11.2 deletion syndrome (27 females, 15.5 [SD, 7.4] years of age) and 53 controls (24 females, 12.6 [SD, 4.7] years of age). We examined the association among the groups' most frequent morphologic findings, general cognitive performance, and comorbid neuropsychiatric conditions. RESULTS Heterotopia in the white matter were the most frequent finding in individuals with 22q11.2 deletion syndrome (n = 29; controls, n = 0; between-group difference, P < .001), followed by cavum septi pellucidi and/or vergae (n = 20; controls, n = 0; P < .001), periventricular cysts (n = 10; controls, n = 0; P = .007), periventricular nodular heterotopia (n = 10; controls, n = 0; P = .007), and polymicrogyria (n = 3; controls, n = 0; P = .3). However, individuals with these morphologic brain abnormalities did not differ significantly from those without them in terms of general cognitive functioning and psychiatric comorbidities. CONCLUSIONS Taken together, our findings, periventricular nodular heterotopia or heterotopia in the white matter (possibly related to interrupted Arc cells migration), persistent cavum septi pellucidi and/or vergae, and formation of periventricular cysts, give clues to the brain development disorder induced by the 22q11.2 deletion syndrome. There was no evidence that these morphologic findings were associated with differences in psychiatric or cognitive presentation of the 22q11.2 deletion syndrome.
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Affiliation(s)
- E Neuhaus
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
| | - E Hattingen
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - S Breuer
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - E Steidl
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - N Polomac
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
| | - F Rosenow
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
| | - T Rüber
- Department of Neurology and Epilepsy Center Frankfurt Rhine-Main (E.N., F.R., T.R.)
- LOEWE Center for Personalized Translational Epilepsy Research (E.N., F.R., T.R.)
- Department of Epileptology (T.R.), University Hospital Bonn, Bonn, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling (E. Herrmann)
| | - C Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (C.E.), Goethe University Frankfurt, Frankfurt am Main, Germany
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience (C.E.), King's College, London, UK
| | - L Kushan
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - A Lin
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - A Vajdi
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences (L.K., A.L., A.V., C.E.B.), Semel Institute for Neuroscience and Human Behavior
- Department of Psychology (C.E.B.), University of California, Los Angeles, Los Angeles, California
| | - A Jurcoane
- From the Institute of Neuroradiology (E.N., E. Hattingen, S.B., E.S., N.P., A.J.)
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Leha A, Huber C, Friede T, Bauer T, Beckmann A, Bekeredjian R, Bleiziffer S, Herrmann E, Moellmann H, Walther T, Kutschka I, Hasenfuss G, Ensminger S, Frerker C, Seidler T. Refined prediction and validation of individual risk using machine learning in transcatheter aortic valve implantation: TAVI Risk Machine (TRIM) scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Given the recent option for treatment using TAVI irrespective of surgical risk, general surgical risk scores have become less relevant, while TAVI-specific scores require refinement. Additionally, post-TAVI risk models are lacking; however, such risk models can support decision between post-TAVI treatment approaches, such as early discharge or close surveillance.
Purpose
This study aimed to predict 30-day mortality following transcatheter aortic valve implantation (TAVI) based on machine learning (ML) using data from the German Aortic Valve Registry.
Methods
Mortality risk was determined using a random forest ML model that was condensed in the newly developed TAVI Risk Machine (TRIM) scores, designed to represent clinically meaningful risk modelling before (TRIMpre) and after (TRIMpost) TAVI. Algorithm was trained and cross-validated on data of 24,452 patients and generalisation was examined on data of 5,889 patients.
Results
TRIMpost demonstrated significantly better performance than traditional scores (C-statistics value, 0.79; 95% confidence interval [CI] [0.74; 0.83]). An abridged TRIMpost score comprising 25 features (calculated using a web interface) exhibited significantly higher performance than traditional scores (C-statistics value, 0.74; 95% CI [0.70; 0.78]).
Conclusion
TRIM scores have high performance for risk estimation before and after TAVI. Together with clinical judgement, they may support standardised and objective decision-making before and after TAVI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Leha
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - C Huber
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - T Friede
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - T Bauer
- Sana Klinikum Offenbach, Offenbach, Germany
| | - A Beckmann
- German Society for Thoracic and Cardiovascular Surgery, Berlin, Germany
| | | | - S Bleiziffer
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - E Herrmann
- Johann Wolfgang Goethe University, Frankfurt, Germany
| | | | - T Walther
- Johann Wolfgang Goethe University, Frankfurt, Germany
| | - I Kutschka
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - G Hasenfuss
- University Medical Center of Göttingen (UMG), Göttingen, Germany
| | - S Ensminger
- University Medical Center of Schleswig-Holstein, Luebeck, Germany
| | - C Frerker
- University Medical Center of Schleswig-Holstein, Luebeck, Germany
| | - T Seidler
- University Medical Center of Göttingen (UMG), Göttingen, Germany
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5
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Fix M, Mueller S, Frei D, Volken W, Terribilini D, Frauchiger D, Joosten A, Henzen A, Herrmann E, Aebersold D, Manser P. PD-0304: Treatment plan comparisons between dynamic trajectory radiotherapy and HyperArc. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00328-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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6
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Schmidhalter D, Henzen D, Herrmann E, Volken W, Mackeprang P, Ermis E, Hemmatazad H, Honegger J, Haas B, Fix M, Manser P. PO-1501: Frameless workflow for radiosurgery of arteriovenous malformations - A new software prototype. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01519-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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7
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Schuettfort G, Boekenkamp L, Cabello A, Cotter AG, De Leuw P, Doctor J, Górgolas M, Hamzah L, Herrmann E, Kann G, Khaykin P, Mallon PW, Mena A, Del Palacio Tamarit M, Sabin CA, Stephan C, Wolf T, Haberl AE. Antiretroviral treatment outcomes among late HIV presenters initiating treatment with integrase inhibitors or protease inhibitors. HIV Med 2020; 22:47-53. [PMID: 33047484 DOI: 10.1111/hiv.12962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/08/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the efficacy and safety of first-line antiretroviral therapy (ART) with integrase inhibitor (INI) or protease inhibitor (PI)-based regimens in patients with low CD4 cell counts and/or an AIDS-defining disease. METHODS We conducted a retrospective, multicentre analysis to investigate discontinuation proportions and virological response in patients with CD4 cell counts < 200 cells/µL and/or AIDS-defining disease when starting first-line ART. Proportions of those discontinuing ART were compared using univariate analysis. Virological response was analysed using the Food & Drug Administration (FDA) snapshot analysis (HIV-1 RNA < 50 HIV-1 RNA copies/mL at week 48). RESULTS Two hundred and eighteen late presenters were included in the study: 13.8% were women and 23.8% were of non-European ethnicity, and the mean baseline CD4 count was 91 cells/µL (standard deviation 112 cells/µL). A total of 131 late presenters started on INI- and 87 on PI-based treatment. It was found that 86.1% of patients treated with INIs and 81.1% of patients treated with PIs had a viral load < 50 copies/mL at week 48; proportions of discontinuation because of adverse events were 6.1% in the INI group and 11.5% in the PI group. No significant differences in discontinuation proportions were observed at week 12 or 48 between INI- and PI-based regimens (P = 0.76 and 0.52, respectively). Virological response was equally good in those receiving INIs and those receiving PIs (86.1% vs. 81.1%, respectively; P = 0.36). CONCLUSIONS In a European cohort of late presenters starting first-line INI or PI-based ART regimens, there were no significant differences in discontinuation proportions or virological response at week 48.
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Affiliation(s)
- G Schuettfort
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - L Boekenkamp
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - A Cabello
- Infectious Diseases Outpatient Clinic, Hospital Fundación Jiménez Díaz, University Autónoma of Madrid, Madrid, Spain
| | - A G Cotter
- Department of Infectious Diseases, HIV Molecular Research Group, University College Dublin (UCD) School of Medicine, Mater Misericordae University Hospital, Dublin, Ireland
| | - P De Leuw
- Infektiologikum Frankfurt, Frankfurt, Germany
| | - J Doctor
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Górgolas
- Infectious Diseases Outpatient Clinic, Hospital Fundación Jiménez Díaz, University Autónoma of Madrid, Madrid, Spain
| | - L Hamzah
- St George's Hospital NHS Foundation Trust, London, UK
| | - E Herrmann
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - G Kann
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - P Khaykin
- MainFacharzt Frankfurt, Frankfurt, Germany
| | - P W Mallon
- Department of Infectious Diseases, HIV Molecular Research Group, University College Dublin (UCD) School of Medicine, Mater Misericordae University Hospital, Dublin, Ireland
| | - A Mena
- Department of Infectious Diseases, A Coruña University Hospital, A Coruña, Spain
| | - M Del Palacio Tamarit
- Infectious Diseases Outpatient Clinic, Hospital Fundación Jiménez Díaz, University Autónoma of Madrid, Madrid, Spain
| | - C A Sabin
- University College London, London, UK
| | - C Stephan
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - T Wolf
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - A E Haberl
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
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Herrmann E, Weschenfelder F, Schleußner E, Groten T. Untersuchung der prädiktiven Faktoren für den Geburtsmodus bei Schwangeren mit Typ 1 Diabetes mellitus. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717926] [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: 10/23/2022] Open
Affiliation(s)
- E Herrmann
- Universitätsklinikum Jena, Klinik für Geburtsmedizin
| | | | - E Schleußner
- Universitätsklinikum Jena, Klinik für Geburtsmedizin
| | - T Groten
- Universitätsklinikum Jena, Klinik für Geburtsmedizin
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9
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Schüttfort G, Philipp K, de Leuw P, Herrmann E, Kann G, Khaykin P, Stephan C, Wolf T, Haberl A. Sex and Gender Differences in Rilpivirine based ART - Data from the HIVCENTER Frankfurt. Curr HIV Res 2020; 17:368-374. [PMID: 31686639 DOI: 10.2174/1570162x17666191104112557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/22/2019] [Accepted: 10/29/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE While Rilpivirine has shown high overall response rates in treatment-naïve patients without sex and gender specific differences in clinical trials, Sex and gender specific data in treatment experienced patients receiving rilpivirine are still limited. We conducted a 48 week efficacy and safety analysis in naïve and treatment experienced men and women using retrospective data from the HIVCENTER Frankfurt. MATERIALS AND METHODS In this retrospective observational study data of all patients who received a rilpivirine based regimen at the HIVCENTER between March 2011 and December 2015 were analyzed. Primary endpoint was the proportion of patients with any discontinuation until week 48. Virologic response rates (FDA snapshot analysis; HIV-1 RNA <50 copies/mL) were assessed at week 48. RESULTS 194 patients (34% female) were included in the analysis. 74% were treatment-experienced and 26% naïve, respectively. Discontinuations were observed in 31 (15.9%) patients. Regarding sex differences, the proportion of discontinuations was significantly higher in women than in men (24.2% vs. 11.7%; p=0.024; ODDS-Ratio = 2.41; CI 1.12 - 5.18). Virologic failure occurred in 8 PLWHIV (4.1%). CONCLUSION While virologic overall response rates to rilpivirine based ART were high for both treatment-experienced and -naïve patients the proportion of discontinuations was significantly higher in women (24.2% vs. 11.7%; p = 0.024; ODDS-Ratio = 2.41; CI 1.12 - 5.18). Although the total number of patients with virologic failure was low (4.1%), the higher rate of ART discontinuations in female patients receiving RPV require close monitoring in the first months of treatment addressing special needs of women living with HIV.
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Affiliation(s)
- G Schüttfort
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - K Philipp
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - P de Leuw
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - E Herrmann
- Department of Biostatistics and Mathematical Modelling, Frankfurt, Germany
| | - G Kann
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | | | - C Stephan
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - T Wolf
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
| | - A Haberl
- HIVCENTER, Department of Infectious Diseases, University Hospital Frankfurt, Frankfurt, Germany
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10
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Dreßler M, Fussbroich D, Böhler L, Herrmann E, Benker N, Tytyk M, Schulze J, Schubert R, Beermann C, Zielen S. Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial. Lipids Health Dis 2020; 19:167. [PMID: 32660564 PMCID: PMC7359229 DOI: 10.1186/s12944-020-01343-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA. METHODS In this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model. PRIMARY OUTCOME MEASURE Decrease in FEV1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo. RESULTS Ninety-nine patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. Seventy-three patients fulfilled the inclusion criteria of a FEV1 decrease > 15% and were treated double-blind placebo-controlled for 4 weeks either with sc-LCPUFA or placebo. Thirty-two patients in each group completed the study. Mean FEV1 decrease after cold air exercise challenge and eNO were unchanged after 4 weeks sc-LCPUFA supplementation. CONCLUSION Supplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective and anti-inflammatory effects on EIA. TRIAL REGISTRATION Clinical trial registration number: NCT02410096. Registered 7 February 2015 at Clinicaltrial.gov.
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Affiliation(s)
- M Dreßler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - D Fussbroich
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany.,Department of Food Technology, University of Applied Science, Fulda, Germany.,Faculty of Biological Sciences, Goethe-University, Frankfurt/Main, Germany
| | - L Böhler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe-University, Frankfurt/Main, Germany
| | - N Benker
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - M Tytyk
- Department of Food Technology, University of Applied Science, Fulda, Germany
| | - J Schulze
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - R Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - C Beermann
- Department of Food Technology, University of Applied Science, Fulda, Germany
| | - S Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany.
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11
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Brandt MP, Gust KM, Bon D, Tsaur I, Thomas C, Neisius A, Haferkamp A, Herrmann E, Bartsch G. Trend analysis and regional tumor incidence in Germany for testicular cancer between 2003 and 2014. Andrology 2020; 7:408-414. [PMID: 31310057 DOI: 10.1111/andr.12666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/12/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Testicular germ cell tumor (TGCT) is one the most common solid tumors in men between the age of 15 and 35 with an overall incidence rate of 1-1.5 %. Epidemiologic studies have demonstrated different incidence patterns in western civilized countries with overall rising incidence trends. OBJECTIVE To analyze differences in regional tumor incidence rates for TGCT and perform a trend analysis for TGCT between 2003 and 2014 in Germany. MATERIAL AND METHODS TGCT cases in Germany which were diagnosed between 2003 and 2014 were provided by the Robert-Koch-Institute, Berlin. For statistical analysis, cluster and spatial scan tests according to Kulldorff were used for cases with seminoma and non-seminoma. Results are presented in administrative districts and graphically illustrated. We performed a trend-analysis in order to evaluate age-adjusted incidence trends in Germany. Tests were two-sided with a level of significance of α=0.05. RESULTS In total we included 35,066 patients. Overall, 22,634 cases had newly diagnosed seminoma and 12,432 were diagnosed as non-seminoma. Maximum incidence of seminoma and non-seminoma was observed for age-group 38-40 years and 26-28 years, respectively. No second peak for the incidences of seminoma and non-seminoma with respect to age were observed. Cluster analysis revealed areas with high and low incidence rates as well as slightly different spatial distribution in Germany between seminoma and nonseminoma. Furthermore, there was no significant increase in age-adjusted incidence rates over the reviewed time period in both cohorts. DISCUSSION In this study differences in reginal tumor incidence rates for seminoma and non-seminoma are reported with both tumor entities revealing distinct clusters. Furthermore, tumor incidence trends for seminoma and nonseminoma between 2003 and 2014 were stable which might indicate the beginning of a plateau phase for TGCT incidence rates in Germany. CONCLUSION In this analysis we were able to identify regions with significantly higher tumor incidence rates for both seminoma and non-seminoma which were specific for these two subtypes. Furthermore, trend analysis revealed a steady incidence rate for testicular cancer in Germany.
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Affiliation(s)
- M P Brandt
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - K M Gust
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - D Bon
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - I Tsaur
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - C Thomas
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - A Neisius
- Department of Urology and Pediatric Urology, Hospital Barmherzige Brüder, Trier, Germany
| | - A Haferkamp
- Department of Urology, Mainz University Medical Center, Mainz, Germany
| | - E Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - G Bartsch
- Department of Urology, Mainz University Medical Center, Mainz, Germany
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Dieterich C, Herrmann E, Parzeller M. Tod bei der Arbeit – eine Analyse tödlicher Arbeitsunfälle von 2005 bis 2016 im Obduktionsgut des Instituts für Rechtsmedizin in Frankfurt am Main. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00372-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Zusammenfassung
Hintergrund
Das genaue Wissen um die Umstände eines jeden tödlichen Arbeitsunfalls ist Voraussetzung für die Identifizierung von Unfallschwerpunkten und ermöglicht eine effektive Präventionsarbeit. Mit dieser rechtsmedizinischen Studie zum Arbeitsunfallgeschehen soll ein Beitrag dazu geleistet werden, die Zahl tödlicher Arbeitsunfälle in Deutschland zu senken.
Material und Methode
Zur Untersuchung kamen die tödlichen Arbeitsunfälle, die sich im Einzugsbereich des rechtsmedizinischen Instituts Frankfurt am Main in den Jahren von 2005 bis 2016 ereigneten. Ausgewertet wurden Obduktionsprotokolle sowie die dem Institut zur Verfügung gestellten staatsanwaltschaftlichen Ermittlungsakten.
Ergebnisse
Es fanden sich 87 tödliche Arbeitsunfälle in dem genannten Zwölfjahreszeitraum. Die Altersstruktur reichte vom jugendlichen Alter bis in das Rentenalter. Betroffen waren zum größten Teil männliche Arbeiter (96,6 %, p < 0,0001), verhältnismäßig häufig ausländischer Nationalität (34,5 %). Die meisten Unfälle ereigneten sich in der 2. Jahreshälfte (58,6 %), an Montagen (26,4 %), kurz vor und nach der Mittagspause. In 3 Fällen lag die Blutalkoholkonzentration über 0,5‰. Die Baubranche (55,2 %) war der unfallträchtigste Wirtschaftszweig. Der Absturz (28,7 %) war der häufigste Unfallmechanismus und das Polytrauma (39,1 %) gemeinsam mit dem Schädel-Hirn-Trauma (24,1 %) gemäß dem ISS die häufigste Todesursache.
Diskussion
Nach den Ergebnissen dieser Studie sollten Alter der Arbeiter sowie die Tages‑, Wochen- und Jahreszeit bei der Ausführung risikoreicher Arbeiten im Baugewerbe berücksichtigt werden. Besonderes Augenmerk sollten Arbeitgeber auf die Kontrolle von Sicherheitsvorkehrungen bei Arbeiten in der Höhe sowie auf die Durchsetzung der Helmpflicht gerade auch bei ausländischen Arbeitnehmern legen.
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Kündig A, Fung C, Scherz A, Ochsenbein A, Herrmann E, Ermis E, Schmid R, Hewer E, Berezowska S. P1.04-05 PD-L1 Expression (SP263) in Lung Cancer and Paired Brain Metastases – A Single Center Study in 211 Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.908] [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: 11/26/2022]
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14
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Ermis E, Anschuetz L, Leiser D, Wagner F, Raabe A, Abu-Isa J, Caversaccio M, Aebersold D, Herrmann E. Impact of Vestibule Dose on Dizziness after Radiosurgery for the Treatment of Vestibular Schwannoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Weschenfelder F, Herrmann E, Battefeld W, Schleußner E, Groten T. Untersuchung der prädiktiven Faktoren für den Geburtsmodus bei Schwangeren mit Typ 1 Diabetes mellitus. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1692054] [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: 10/26/2022] Open
Affiliation(s)
| | - E Herrmann
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
| | - W Battefeld
- Medizinisches Versorgungszentrum Kempten – Allgäu
| | - E Schleußner
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
| | - T Groten
- Klinik für Geburtsmedizin, Universitätsklinikum Jena
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16
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Bachmann N, Leiser D, Ermis E, Vulcu S, Schucht P, Raabe A, Aebersold DM, Herrmann E. Impact of regular magnetic resonance imaging follow-up after stereotactic radiotherapy to the surgical cavity in patients with one to three brain metastases. Radiat Oncol 2019; 14:45. [PMID: 30871597 PMCID: PMC6417038 DOI: 10.1186/s13014-019-1252-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Administering stereotactic radiotherapy to the surgical cavity and thus omitting postoperative whole brain radiotherapy (WBRT) is a favored strategy in limited metastatic brain disease. Little is known about the impact of regular magnetic resonance imaging follow-up (MRI FU) in such patient cohorts. The aim of this study is to examine the impact of regular MRI FU and to report the oncological outcomes of patients with one to three brain metastases (BMs) treated with stereotactic radiosurgery (SRS) or hypo-fractionated stereotactic radiotherapy (HFSRT) to the surgical cavity. METHODS We retrospectively analyzed patients who received SRS or HFSRT to the surgical cavity after resection of one to two BMs. Additional, non-resected BMs were managed with SRS alone. Survival was estimated by the Kaplan-Meier method. Prognostic factors were examined with the log-rank test and Cox proportional hazards model. Regular MRI FU was defined as performing a brain MRI 3 months after radiotherapy (RT) and/or performing ≥1 brain MRI per 180 days. Primary endpoint was local control (LC). Secondary endpoints were distant brain control (DBC), overall survival (OS) and the correlation between regular MRI FU and overall survival (OS), symptom-free survival (SFS), deferment of WBRT and WBRT-free survival (WFS). RESULTS Overall, 75 patients were enrolled. One, 2 and 3 BMs were seen in 63 (84%), 11 (15%) and 1 (1%) patients, respectively. Forty (53%) patients underwent MRI FU 3 months after RT and 38 (51%) patients received ≥1 brain MRI per 180 days. Median OS was 19.4 months (95% CI: 13.2-25.6 months). Actuarial LC, DBC and OS at 1 year were 72% (95% CI: 60-83%), 60% (95% CI: 48-72%) and 66% (95% CI: 53-76%), respectively. A planning target volume > 15 cm3 (p = 0.01), Graded Prognostic Assessment (GPA) score (p = 0.001) and residual tumor after surgery (p = 0.008) were prognostic for decreased OS in multivariate analysis. No significant correlation between MRI FU at 3 months and OS (p = 0.462), SFS (p = 0.536), WFS (p = 0.407) or deferment of WBRT (p = 0.955) was seen. Likewise, performing ≥1 MRI per 180 days had no significant impact on OS (p = 0.954), SFS (p = 0.196), WFS (p = 0.308) or deferment of WBRT (p = 0.268). CONCLUSION Our results regarding oncological outcomes consist with the current data from the literature. Surprisingly, regular MRI FU did not result in increased OS, SFS, WFS or deferment of WBRT in our cohort consisting mainly of patients with a single and resected BM. Therefore, the impact of regular MRI FU needs prospective evaluation. TRIAL REGISTRATION Project ID: 2017-00033, retrospectively registered.
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Affiliation(s)
- N Bachmann
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland
| | - D Leiser
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland
| | - E Ermis
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland
| | - S Vulcu
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - P Schucht
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - A Raabe
- Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - D M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland
| | - E Herrmann
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland.
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Herrmann E, Ermiş E, Meier R, Blatti-Moreno M, Knecht U, Aebersold D, Manser P, Mauricio R. Fully Automated Segmentation of the Brain Resection Cavity for Radiation Target Volume Definition in Glioblastoma Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Herrmann E, Ermis E, Jungo A, Blatti-Moreno M, Knecht U, Aebersold DM, Manser P, Reyes M. P01.088 Brain resection cavity delineation for radiation target volume definition in glioblastoma patients using deep learning. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- E Herrmann
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerl
| | - E Ermis
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerl
| | - A Jungo
- Institute for Surgical Technology and Biomechanics, Bern, Switzerl
| | - M Blatti-Moreno
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerl
| | - U Knecht
- Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, Bern, Switzerl
| | - D M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerl
| | - P Manser
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - M Reyes
- Institute for Surgical Technology and Biomechanics, Bern, Switzerl
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19
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Dinc N, Quick-Weller J, Tritt S, Konczalla J, Mersmann J, Bruder M, Herrmann E, Seifert V, Senft C. Vasospasm of the basilar artery following spontaneous SAH-clinical observations and implications for vascular research. Neurosurg Rev 2018; 42:983-989. [PMID: 30088111 DOI: 10.1007/s10143-018-1015-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 10/28/2022]
Abstract
The basilar artery (BA), as a reference vessel for laboratory investigations of cerebral vasospasm (CVS) in many experimental models, warrants a sufficient blood supply despite hemodynamic changes during CVS. In a prospective evaluation study, we analyzed patients who were admitted to our department with subarachnoid hemorrhage (SAH) for the occurrence and sequelae of CVS. Specifically, we sought to identify patients with CVS of the BA. As per institutional protocol, all patients with CVS detected in the posterior circulation had magnetic resonance imaging (MRI) examinations instead of CTA. Between January and December 2016, 74 patients were treated for spontaneous SAH. CVS occurred in 45 (61%) patients, and 31 (42%) patients developed associated cerebral infarctions (CI). CVS was significantly associated with CI (p < 0.0001; OR 44). In 18 (24.3%) patients, CVS significantly affected the basilar artery. Poor admission clinical state, younger age, and treatment modalities were significantly associated with BACVS. BACVS was more often detected in patients with severe CVS (p < 0.046; OR 4.4). Patients with BACVS developed cerebral infarction in a frequency comparable to other patients with CVS (61% vs. 70%, p = 0.7), but none of these infarctions occurred in the brain stem or pons even though vessel diameter was dramatically reduced according to CT- and/or MR-angiography. BACVS does not appear to be followed by cerebral infarction in the BA territory, presumably due to a vascular privilege of this vessel and its perforating branches. In contrast, brain ischemia can frequently be observed in the territories of other major arteries affected by CVS.
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Affiliation(s)
- Nazife Dinc
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.
| | - J Quick-Weller
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
| | - S Tritt
- Department of Neuroradiology, Goethe University Hospital, Frankfurt, Germany
| | - J Konczalla
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
| | - J Mersmann
- Department of Anesthesiology, Goethe University Hospital, Frankfurt, Germany
| | - M Bruder
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
| | - E Herrmann
- Department of Biostatistics and Mathematical Modeling, Goethe University Hospital, Frankfurt, Germany
| | - V Seifert
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
| | - C Senft
- Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
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Silverio A, De Rosa R, Baldi C, Di Maio M, Prota C, Radano I, Herrmann E, Rey J, Citro R, Piscione F, Galasso G. P5098Percutaneous repair of functional mitral regurgitation in heart failure patients: a meta-analysis of 23 studies on mitraclip implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5098] [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: 11/14/2022] Open
Affiliation(s)
- A Silverio
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - R De Rosa
- Chair of Cardiology, J.W. Goethe University Hospital of Frankfurt, Frankfurt, Germany
| | - C Baldi
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - M Di Maio
- Division of Cardiology, Department of Cardiothoracic and Respiratory Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, A.O.R.N. “Ospedali dei Colli”, Naples, Italy
| | - C Prota
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - I Radano
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - E Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - J Rey
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - R Citro
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - F Piscione
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Galasso
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
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Herrmann E, Terribilini D, Manser P, Fix MK, Toporek G, Candinas D, Weber S, Aebersold DM, Loessl K. Accuracy assessment of a potential clinical use of navigation-guided intra-operative liver metastasis brachytherapy-a planning study. Strahlenther Onkol 2018; 194:1030-1038. [PMID: 30022277 PMCID: PMC6208950 DOI: 10.1007/s00066-018-1334-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 06/28/2018] [Indexed: 11/29/2022]
Abstract
For patients with inoperable liver metastases, intra-operative liver high dose-rate brachytherapy (HDR-BT) is a promising technology enabling delivery of a high radiation dose to the tumor, while sparing healthy tissue. Liver brachytherapy has been described in the literature as safe and effective for the treatment of primary or secondary hepatic malignancies. It is preferred over other ablative techniques for lesions that are either larger than 4 cm or located in close proximity to large vessels or the common bile duct. In contrast to external beam radiation techniques, organ movements do not affect the size of the irradiated volume in intra-operative HDR-BT and new technical solutions exist to support image guidance for intra-operative HDR-BT. We have retrospectively analyzed anonymized CT datasets of 5 patients who underwent open liver surgery (resection and/or ablation) in order to test whether the accuracy of a new image-guidance method specifically adapted for intra-operative HDR-BT is high enough to use it in similar situations and whether patients could potentially benefit from navigation-guided intra-operative needle placement for liver HDR-BT.
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Affiliation(s)
- E Herrmann
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstr., 3010, Bern, Switzerland.
| | - D Terribilini
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - P Manser
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M K Fix
- Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - G Toporek
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - D Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital, University of Berne, Bern, Switzerland
| | - S Weber
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - D M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstr., 3010, Bern, Switzerland
| | - K Loessl
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Freiburgstr., 3010, Bern, Switzerland
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22
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Mueller S, Manser P, Volken W, Frei D, Kueng R, Herrmann E, Elicin O, Aebersold DM, Stampanoni MFM, Fix MK. Part 2: Dynamic mixed beam radiotherapy (DYMBER): Photon dynamic trajectories combined with modulated electron beams. Med Phys 2018; 45:4213-4226. [PMID: 29992574 DOI: 10.1002/mp.13085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a treatment technique for dynamic mixed beam radiotherapy (DYMBER) utilizing increased degrees of freedom (DoF) of a conventional treatment unit including different particle types (photons and electrons), intensity and energy modulation and dynamic gantry, table, and collimator rotations. METHODS A treatment planning process has been developed to create DYMBER plans combining photon dynamic trajectories (DTs) and step and shoot electron apertures collimated with the photon multileaf collimator (pMLC). A gantry-table path is determined for the photon DTs with minimized overlap of the organs at risk (OARs) with the target. In addition, an associated dynamic collimator rotation is established with minimized area between the pMLC leaves and the target contour. pMLC sequences of photon DTs and electron pMLC apertures are then simultaneously optimized using direct aperture optimization (DAO). Subsequently, the final dose distribution of the electron pMLC apertures is calculated using the Swiss Monte Carlo Plan (SMCP). The pMLC sequences of the photon DTs are then re-optimized with a finer control point resolution and with the final electron dose distribution taken into account. Afterwards, the final photon dose distribution is calculated also using the SMCP and summed together with the one of the electrons. This process is applied for a brain and two head and neck cases. The resulting DYMBER dose distributions are compared to those of dynamic trajectory radiotherapy (DTRT) plans consisting only of photon DTs and clinically applied VMAT plans. Furthermore, the deliverability of the DYMBER plans is verified in terms of dosimetric accuracy, delivery time and collision avoidance. For this purpose, The DYMBER plans are delivered to Gafchromic EBT3 films placed in an anthropomorphic head phantom on a Varian TrueBeam linear accelerator. RESULTS For each case, the dose homogeneity in the target is similar or better for DYMBER compared to DTRT and VMAT. Averaged over all three cases, the mean dose to the parallel OARs is 16% and 28% lower, D2% to the serial OARs is 17% and 37% lower and V10% to normal tissue is 12% and 4% lower for the DYMBER plans compared to the DTRT and VMAT plans, respectively. The DYMBER plans are delivered without collision and with a 4-5 min longer delivery time than the VMAT plans. The absolute dose measurements are compared to calculation by gamma analysis using 2% (global)/2 mm criteria with passing rates of at least 99%. CONCLUSIONS A treatment technique for DYMBER has been successfully developed and verified for its deliverability. The dosimetric superiority of DYMBER over DTRT and VMAT indicates utilizing increased DoF to be the key to improve brain and head and neck radiation treatments in future.
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Affiliation(s)
- S Mueller
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - P Manser
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - W Volken
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - D Frei
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - R Kueng
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - E Herrmann
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - O Elicin
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - D M Aebersold
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
| | - M F M Stampanoni
- Institute for Biomedical Engineering, ETH Zürich and PSI, CH-5232, Villigen, Switzerland
| | - M K Fix
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, CH-3010, Bern, Switzerland
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Schmidhalter D, Henzen D, Malthaner M, Herrmann E, Angelmann S, Hemmatazad H, Stieb S, Fix M, Manser P. EP-2185: Evaluation of the CK-11 version for the Cyberknife M6. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32494-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Grünewaldt A, Hügel C, Herrmann E, Rohde G. Risikofaktoren für respiratorische Ereignisse während endobronchialer Ultraschalluntersuchung. Pneumologie 2018. [DOI: 10.1055/s-0037-1619228] [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: 10/28/2022]
Affiliation(s)
- A Grünewaldt
- Medizinische Klinik I, Innere Medizin und Pneumologie, Klinikum der Johann Wolfgang Goethe Universität Frankfurt
| | - C Hügel
- Universitätsklinikum Frankfurt
| | - E Herrmann
- Institut für Biostatistik und Mathematische Modellierung, Universitätsklinikum Frankfurt
| | - G Rohde
- Zentrum für Innere Medizin, Schwerpunkt Pneumologie/Allergologie, Universitätsklinikum Frankfurt
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Wacha H, Domsel G, Herrmann E. Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience. Eur J Trauma Emerg Surg 2018; 44:457-469. [PMID: 29344706 DOI: 10.1007/s00068-017-0895-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND An arthroplasty registry in Germany has been recently established but long-term results for most short-stem innovations are missing. Short-stem hip arthroplasty is usually indicated in young active patients. Our indication was extended to older age groups, femoral neck fractures (FNF), and dysplasia. We evaluated all total hip arthroplasties (THAs) in this population with a collum femoris preserving stem (CFP) performed from 2003 to 2013. METHODS A consecutive cohort of 1217 CFP THAs with a mean age of 68.7 years was followed retrospectively for a median of 4.8 years (patient follow-up interquartile range from 3.0 to 6.9 years). A questionnaire, which we used in two previous studies, was answered by 89.15% of patients and included information regarding complaints, grade of satisfaction, re-operations, and dislocation. Of the 1217 patients, 77 had died. Survival of the stem and the cup was assessed using a competing risks approach according to an Aalen-Johanson estimator with revision for septic or aseptic loosening or death as a competing endpoint. RESULTS Of the patients who answered the questionnaire, 92.5% had no complaints related to the procedures. In all 1217 patients, there were 43 revisions (4.2%) as follows: stem and cup revisions due to aseptic loosening of the stem (n = 10), infections (n = 6), pain (n = 4), or trauma (n = 3); cup revisions due to aseptic loosening (n = 3), dislocation (n = 5), and offset revisions (n = 12). Survivorship was 96% for the stem and 99% for the cup 9 years postoperatively. Statistical analysis confirmed a higher risk for revision in patients with a younger age (p = 0.033), male sex (p = 0.040), dysplasia (p = 0.032), and undersized or extra-large stems for stem revisions (p = 0.001) and female sex (p = 0.036) for cup revisions. FNF (p > 0.20) and age ≥ 80 years (p = 0.114) had no higher risk for loosening of the stem. Our data is also compared with the current literature, especially with the available CFP studies. CONCLUSION The survival rate of the CFP stem was as high as 96% after 9 years of followup which compares well-to-previously published long-term survival rates. There is no higher risk for revision in patients 80 years old or older and in cases with femoral neck fractures. The CFP preserves also allowed using standard stems in the rare cases of revision.
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Affiliation(s)
- H Wacha
- Department of Surgery, Hospital zum Heiligen Geist, Academic Hospital of the Goethe University, Frankfurt am Main, Germany.
| | - G Domsel
- Department of Surgery, Hospital zum Heiligen Geist, Academic Hospital of the Goethe University, Frankfurt am Main, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt/M, Frankfurt am Main, Germany
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Chalkin WA, Herrmann E. Fortschrittsberichte Stand Und EntwicklungStendenzen Auf Dem Gebiet Der Radio Chemic Und Chemischen Kerntechink Chemic Radioaktiyer Element. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/102560175011952156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- W. A. Chalkin
- a Vereinigtcs Institut für Kernforschung Dubna, Laboratorium für Kernprobleme und Technische Universität Dresden, Sektion Chemic 1
| | - E. Herrmann
- a Vereinigtcs Institut für Kernforschung Dubna, Laboratorium für Kernprobleme und Technische Universität Dresden, Sektion Chemic 1
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Retz M, Bedke J, Herrmann E, Grimm MO, Zimmermann U, Müller L, Leiber C, Teber D, Wirth M, Bolenz C, van Alphen R, De Santis M, Beeker A, Frank M, Gschwend J. Phase III randomized, sequential, open-label study to evaluate the efficacy and safety of sorafenib-pazopanib versus pazopanib-sorafenib in the treatment of metastatic renal cell carcinoma (SWITCH-II). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Meybohm P, Goehring M, Choorapoikayil S, Fischer D, Rey J, Herrmann E, Mueller M, Geisen C, Schmitz-Rixen T, Zacharowski K. Feasibility and efficiency of a preoperative anaemia walk-in clinic: secondary data from a prospective observational trial. Br J Anaesth 2017; 118:625-626. [DOI: 10.1093/bja/aex024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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29
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Bogdanou D, Penna-Martinez M, Filmann N, Chung TL, Moran-Auth Y, Wehrle J, Cappel C, Huenecke S, Herrmann E, Koehl U, Badenhoop K. T-lymphocyte and glycemic status after vitamin D treatment in type 1 diabetes: A randomized controlled trial with sequential crossover. Diabetes Metab Res Rev 2017; 33. [PMID: 27764529 DOI: 10.1002/dmrr.2865] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/19/2016] [Accepted: 10/16/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Type 1 diabetes mellitus (T1D) is mediated by autoaggressive T effector cells with an underlying regulatory T-cell (Treg) defect. Vitamin D deficiency is highly prevalent in T1D, which can aggravate immune dysfunction. High-dose vitamin D treatment may enhance Tregs and improve metabolism in T1D patients. METHODS In a randomized double-blind placebo-controlled trial with crossover design, patients received either for 3 months cholecalciferol 4000 IU/d followed by 3 months placebo or the sequential alternative. Thirty-nine T1D patients (19 women and 20 men) completed the trial. RESULTS Primary outcome was a change of Tregs, secondary HbA1C, and insulin demand. Effects were evaluated based on intra-individual changes between treatment and placebo periods for outcome measures. Exploratory analyses included vitamin D system variant genotyping and C-peptide measurements. Median 25(OH)D3 increased to 38.8 ng/ml with males showing a significantly stronger increase (p = .003). T-lymphocyte profiles did not change significantly (p > 2); however, the intra-individual change of Tregs between males and females was different with a significantly stronger increase in men (p = .017), as well as between genotypes of the vitamin D receptor (Apa, Taq, and Bsm: genotypes aa, TT, and bb; p = .004-0.015). Insulin demands declined significantly (p = .003-.039) and HbA1C improved (p < .001). Random C-peptide levels were low but rising (median, 0.125 ng/ml; range, 0.02-0.3) in 6 patients. No toxicity was observed. CONCLUSION A daily vitamin D dose of 4000 IU for 3 months was well tolerated and enhanced Tregs in males. Glucometabolic control improved in all. Subsequent larger trials need to address ß-cell function and genotyping for individualized vitamin D doses.
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Affiliation(s)
- D Bogdanou
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - M Penna-Martinez
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - N Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - T L Chung
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - Y Moran-Auth
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - J Wehrle
- Pharmacy of the Goethe University Hospital, Frankfurt am Main, Germany
| | - C Cappel
- Laboratory for Stem Cell Transplantation and Immunotherapy, Clinic for Pediatric and Adolescent Medicine, University Hospital Frankfurt, Germany
| | - S Huenecke
- Laboratory for Stem Cell Transplantation and Immunotherapy, Clinic for Pediatric and Adolescent Medicine, University Hospital Frankfurt, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Germany
| | - U Koehl
- Institute of Cellular Therapeutics, Hanover Medical School, Germany
| | - K Badenhoop
- Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany
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Herrmann E, Anderson M. Foraging Behaviour of Damage-causing Birds in Table Grape Vineyards in the Orange River Valley, South Africa. S AFR J ENOL VITIC 2016. [DOI: 10.21548/28-2-1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Herrmann E, Fichtlscherer S, Hohnloser SH, Zeiher AM, Aßmus B. [Implantable sensors for outpatient assessment of ventricular filling pressure in advanced heart failure : Which telemonitoring design is optimal?]. Herzschrittmacherther Elektrophysiol 2016; 27:371-377. [PMID: 27844194 DOI: 10.1007/s00399-016-0472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Patients with advanced heart failure suffer from frequent hospitalizations. Non-invasive hemodynamic telemonitoring for assessment of ventricular filling pressure has been shown to reduce hospitalizations. We report on the right ventricular (RVP), the pulmonary artery (PAP) and the left atrial pressure (LAP) sensor for non-invasive assessment of the ventricular filling pressure. METHODS A literature search concerning the available implantable pressure sensors for noninvasive haemodynamic telemonitoring in patients with advanced heart failure was performed. RESULTS Until now, only implantation of the PAP-sensor was able to reduce hospitalizations for cardiac decompensation and to improve quality of life. The right ventricular pressure sensor missed the primary endpoint of a significant reduction of hospitalizations, clinical data using the left atrial pressure sensor are still pending. CONCLUSION The implantation of a pressure sensor for assessment of pulmonary artery filling pressure is suitable for reducing hospitalizations for heart failure and for improving quality of life in patients with advanced heart failure.
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Affiliation(s)
- E Herrmann
- Universitätsklinikum Frankfurt, Med. Klinik III, Kardiologie, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland.
| | - S Fichtlscherer
- Universitätsklinikum Frankfurt, Med. Klinik III, Kardiologie, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - S H Hohnloser
- Universitätsklinikum Frankfurt, Med. Klinik III, Kardiologie, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - A M Zeiher
- Universitätsklinikum Frankfurt, Med. Klinik III, Kardiologie, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
| | - B Aßmus
- Universitätsklinikum Frankfurt, Med. Klinik III, Kardiologie, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland
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Knop V, Hoppe D, Welzel T, Vermehren J, Herrmann E, Vermehren A, Friedrich-Rust M, Sarrazin C, Zeuzem S, Welker MW. Regression of fibrosis and portal hypertension in HCV-associated cirrhosis and sustained virologic response after interferon-free antiviral therapy. J Viral Hepat 2016; 23:994-1002. [PMID: 27500382 DOI: 10.1111/jvh.12578] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023]
Abstract
It is still controversial, whether and to what amount cirrhosis and portal hypertension are reversible in patients with hepatitis C virus (HCV)-associated cirrhosis and sustained virologic response (SVR) after interferon-free antiviral therapy. In this study, we prospectively evaluated dynamics of liver and spleen stiffness in HCV-infected patients with advanced liver disease and SVR after interferon-free treatment. A total of 54 patients with HCV-associated cirrhosis and SVR were included. Liver and spleen stiffness was measured at therapy baseline (BL), end of treatment (EOT) and 24 weeks after EOT (FU24) by transient liver elastography (L-TE) as well as by acoustic radiation force impulse of the liver (L-ARFI) and spleen (S-ARFI), as well as biochemical, virologic and clinical data. Improvement of liver and spleen stiffness was found in 44 of 50 (88%), 31 of 54 (57%) and 25 of 54 (46%) of patients assessed by L-TE, L-ARFI and S-ARFI between baseline and FU24. Liver stiffness assessed by L-TE improved between BL [median (range), 32.5 (9.1-75) kPa] and EOT [median (range), 21.3 (6.7-73.5) kPa; (P<.0001)], and between BL and FU24 [median (range), 21.2 (5.4-70) kPa; (P<.0001)]. Liver stiffness assessed by L-ARFI improved between BL [median (range), 2.7 (1.2-4.1) m/s] and FU24 [median (range), 2.4 (1.2-3.9) m/s; P=.002), while spleen stiffness remained unchanged. Our data suggest that improvement of liver stiffness may be rather due to reduced necroinflammation and may be due to a less extent to regression of cirrhosis, as dynamics of liver stiffness improvement was more pronounced between BL and EOT than BL and FU24.
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Affiliation(s)
- V Knop
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - D Hoppe
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - T Welzel
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - J Vermehren
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - E Herrmann
- Institut für Biostatistik und mathematische Modellierung, Goethe-Universität Frankfurt, Frankfurt am Main, Germany
| | - A Vermehren
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - M Friedrich-Rust
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - C Sarrazin
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - S Zeuzem
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - M-W Welker
- Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, 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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Langer J, Penna-Martinez M, Bon D, Herrmann E, Wallasch M, Badenhoop K. Insufficient Vitamin D Response to Solar Radiation in German Patients with Type 2 Diabetes or Gestational Diabetes. Horm Metab Res 2016; 48:503-8. [PMID: 27525476 DOI: 10.1055/s-0042-111685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Vitamin D deficiency is highly prevalent in all forms of diabetes mellitus. Recently, we reported how ultraviolet B (UVB) radiation affected vitamin D [25(OH)D3] concentrations in patients with type 1 diabetes. Our aim was to analyze whether patients with non-autoimmune diabetes, such as type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) also show the same vitamin D profile in relation to environmental factors including ambient temperature as an indirect parameter for outdoor activities. We analyzed 25(OH)D3 concentrations of T2DM (n=349) and GDM patients (n=327) at the University Hospital Frankfurt from 2005 to 2007. Additionally, daily UVB and monthly outside air temperature measurements for Frankfurt/Germany were obtained. We detected a positive correlation between UVB irradiation and 25(OH)D3 concentrations of T2DM and GDM patients (rho=0.50 and rho=0.63, p=0.003 and p<0.0001, respectively). UVB irradiation was in summer (April-October) higher than in winter (November-March) (5.6 kJ/m² vs. 0.5 kJ/m², p<0.0001). However, the prevalence of vitamin D deficiency in summer remained high with 76% in T2DM and 59% in GDM. In a stepwise regression analysis for the 25(OH)D3 concentration, significant predictors were outdoor temperature (estimate=0.02, p<0.0001), UVB radiation (estimate=-0.0015, p=0.02), year (2006 vs. 2005 estimate=-0.06, p>0.05, 2007 vs. 2005: estimate=-0.13, p<0.0001) and diabetes type (estimate=0.06, p=0.03). In conclusion, the strong correlation between UVB radiation and 25(OH)D3 concentrations in T2DM and GDM patients determines the seasonal variation. Additional determinants for the 25(OH)D3 concentrations were outdoor temperature, year, and diabetes type. Despite the effects of solar radiation both patients groups remain largely vitamin D deficient during summers.
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Affiliation(s)
- J Langer
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Penna-Martinez
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - D Bon
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - M Wallasch
- German Federal Environmental Agency, Air Monitoring Network, Langen, Germany
| | - K Badenhoop
- Department of Internal Medicine I, Division of Endocrinology and Diabetology, University Hospital Frankfurt, Frankfurt am Main, Germany
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35
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Peveling-Oberhag J, Arcaini L, Bankov K, Zeuzem S, Herrmann E. The anti-lymphoma activity of antiviral therapy in HCV-associated B-cell non-Hodgkin lymphomas: a meta-analysis. J Viral Hepat 2016; 23:536-44. [PMID: 26924533 DOI: 10.1111/jvh.12518] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/15/2015] [Indexed: 12/29/2022]
Abstract
Many epidemiological studies provide solid evidence for an association of chronic hepatitis C virus (HCV) infection with B-cell non-Hodgkin's lymphoma (B-NHL). However, the most convincing evidence for a causal relationship between HCV infection and lymphoma development is the observation of B-NHL regression after HCV eradication by antiviral therapy (AVT). We conducted a literature search to identify studies that included patients with HCV-associated B-NHL (HCV-NHL) who received AVT, with the intention to treat lymphoma and viral disease at the same time. The primary end point was the correlation of sustained virological response (SVR) under AVT with lymphoma response. Secondary end points were overall lymphoma response rates and HCV-NHL response in correlation with lymphoma subtypes. We included 20 studies that evaluated the efficacy of AVT in HCV-NHL (n = 254 patients). Overall lymphoma response rate through AVT was 73% [95%>confidence interval, (CI) 67-78%]. Throughout studies there was a strong association between SVR and lymphoma response (83% response rate, 95%>CI, 76-88%) compared to a failure in achieving SVR (53% response rate, 95%>CI, 39-67%, P = 0.0002). There was a trend towards favourable response for AVT in HCV-associated marginal zone lymphomas (response rate 81%, 95%>CI, 74-87%) compared to nonmarginal zone origin (response rate 71%, 95%>CI, 61-79%, P = 0.07). In conclusion, in the current meta-analysis, the overall response rate of HCV-NHL under AVT justifies the recommendation for AVT as first-line treatment in patients who do not need immediate conventional treatment. The strong correlation of SVR and lymphoma regression supports the hypothesis of a causal relationship of HCV and lymphomagenesis.
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Affiliation(s)
- J Peveling-Oberhag
- Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany
| | - L Arcaini
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - K Bankov
- Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany
| | - S Zeuzem
- Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany
| | - E Herrmann
- Institute for Biostatistics and Mathematical Modelling, Goethe-University, Frankfurt, Germany
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Friedrich-Rust M, Vorlaender C, Dietrich CF, Kratzer W, Blank W, Schuler A, Broja N, Cui XW, Herrmann E, Bojunga J. Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study. Ultraschall Med 2016; 37:262-270. [PMID: 27070127 DOI: 10.1055/s-0042-104647] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Many patients with thyroid nodules are presently referred to surgery for not only therapeutic but also diagnostic purposes. The aim of noninvasive diagnostic methods is to optimize the selection of patients for surgery. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for the differentiation of thyroid nodules in a prospective multicenter study. MATERIALS AND METHODS The study was registered at clinicaltrials.gov and was approved by the local ethics committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including color Doppler US. In addition, all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of color distribution (SE-ES), strain value and strain ratio. RESULTS Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. The sensitivity, specificity, NPV, PPV, +LR were 21 %, 73 %, 86 %, 11 %, 0.8, respectively, for color Doppler US; 69 %, 75 %, 94 %, 30 %, 2.9, respectively, for SE-ES; 56 %, 81 %, 92 %, 32 %, 2.9, respectively, for SE-strain value; and 58 %, 78 %, 92 %, 30 %, 2.6, respectively, for SE-strain ratio. The diagnostic accuracy was 71 % for both strain value and strain ratio of nodules. CONCLUSION SE as an additional ultrasound tool improves the value of ultrasound for the work-up of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biopsy, Fine-Needle
- Diagnosis, Differential
- Elasticity Imaging Techniques/methods
- Female
- Germany
- Goiter, Nodular/diagnostic imaging
- Goiter, Nodular/pathology
- Goiter, Nodular/surgery
- Humans
- Image Interpretation, Computer-Assisted
- Male
- Middle Aged
- Prospective Studies
- Sensitivity and Specificity
- Societies, Medical
- Thyroid Gland/diagnostic imaging
- Thyroid Gland/pathology
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/pathology
- Thyroid Neoplasms/surgery
- Thyroid Nodule/diagnostic imaging
- Thyroid Nodule/pathology
- Thyroid Nodule/surgery
- Ultrasonography, Doppler, Color
- Young Adult
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Affiliation(s)
- M Friedrich-Rust
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - C Vorlaender
- Department of General Surgery, Buergerhospital Frankfurt, Germany
| | - C F Dietrich
- Innere Medizin 2, Caritas Hospital, Bad Mergentheim, Germany
| | - W Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Germany
| | - W Blank
- Medizinische Klinik 1, Hospital am Steinenberg, Reutlingen, Germany
| | - A Schuler
- Department of Internal Medicine, Helfenstein Hospital, Geislingen, Germany
| | - N Broja
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - X W Cui
- Innere Medizin 2, Caritas Hospital, Bad Mergentheim, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J.W. Goethe-University, Frankfurt, Germany
| | - J Bojunga
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
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Bianchi F, Tröstl J, Junninen H, Frege C, Henne S, Hoyle CR, Molteni U, Herrmann E, Adamov A, Bukowiecki N, Chen X, Duplissy J, Gysel M, Hutterli M, Kangasluoma J, Kontkanen J, Kürten A, Manninen HE, Münch S, Peräkylä O, Petäjä T, Rondo L, Williamson C, Weingartner E, Curtius J, Worsnop DR, Kulmala M, Dommen J, Baltensperger U. New particle formation in the free troposphere: A question of chemistry and timing. Science 2016; 352:1109-12. [PMID: 27226488 DOI: 10.1126/science.aad5456] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 03/29/2016] [Indexed: 11/02/2022]
Abstract
New particle formation (NPF) is the source of over half of the atmosphere's cloud condensation nuclei, thus influencing cloud properties and Earth's energy balance. Unlike in the planetary boundary layer, few observations of NPF in the free troposphere exist. We provide observational evidence that at high altitudes, NPF occurs mainly through condensation of highly oxygenated molecules (HOMs), in addition to taking place through sulfuric acid-ammonia nucleation. Neutral nucleation is more than 10 times faster than ion-induced nucleation, and growth rates are size-dependent. NPF is restricted to a time window of 1 to 2 days after contact of the air masses with the planetary boundary layer; this is related to the time needed for oxidation of organic compounds to form HOMs. These findings require improved NPF parameterization in atmospheric models.
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Affiliation(s)
- F Bianchi
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland. Institute for Atmospheric and Climate Science, ETH Zurich, 8092 Zurich, Switzerland. Department of Physics, University of Helsinki, 00014 Helsinki, Finland.
| | - J Tröstl
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - H Junninen
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - C Frege
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - S Henne
- Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland
| | - C R Hoyle
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland. WSL (Swiss Federal Institute for Forest, Snow and Landscape Research) Institute for Snow and Avalanche Research SLF, 7260 Davos, Switzerland
| | - U Molteni
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - E Herrmann
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - A Adamov
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - N Bukowiecki
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - X Chen
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - J Duplissy
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland. Helsinki Institute of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - M Gysel
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | | | - J Kangasluoma
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - J Kontkanen
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - A Kürten
- Institute for Atmospheric and Environmental Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - H E Manninen
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - S Münch
- Institute for Atmospheric and Environmental Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - O Peräkylä
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - T Petäjä
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - L Rondo
- Institute for Atmospheric and Environmental Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - C Williamson
- Institute for Atmospheric and Environmental Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - E Weingartner
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - J Curtius
- Institute for Atmospheric and Environmental Sciences, Goethe University Frankfurt, 60438 Frankfurt am Main, Germany
| | - D R Worsnop
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland. Aerodyne Research, Billerica, MA 01821, USA
| | - M Kulmala
- Department of Physics, University of Helsinki, 00014 Helsinki, Finland
| | - J Dommen
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - U Baltensperger
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland.
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Knodel MM, Nägel A, Reiter S, Rupp M, Vogel A, Targett-Adams P, McLauchlan J, Herrmann E, Wittum G. Mechanistic dynamics of Hepatitis C virus replication in single liver cells. Z Gastroenterol 2015. [DOI: 10.1055/s-0035-1568111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Siederdissen CHZ, Rinker F, Falk C, Filmann N, Maasoumy B, Deterding K, Port K, Mix C, Herrmann E, Wedemeyer H, Manns M, Kraft A, Cornberg M. HBsAg decline after interrupting nucleos(t)ide analogue therapy in HVeAg-negative chronic hepatitis B. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Buslau A, Voss S, Herrmann E, Schubert R, Zielen S, Schulze J. Can we predict allergen-induced asthma in patients with allergic rhinitis? Clin Exp Allergy 2015; 44:1494-502. [PMID: 25270425 DOI: 10.1111/cea.12427] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/16/2014] [Accepted: 09/22/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND A high percentage of patients with allergic rhinitis (AR) exhibit signs of bronchial hyperreactivity (BHR), and approximately 30% may develop asthma later in life. OBJECTIVE The aim of this study was to identify predictors for allergen-induced asthma in patients with AR. METHODS Hundred patients with AR selected by public posting and 20 healthy controls were enrolled. Twenty-three patients with concomitant physician-diagnosed asthma and four with a negative allergy test were excluded from further analysis. The remaining 73 subjects with AR underwent bronchial allergen provocation (BAP), which is considered the gold standard for the diagnosis of clinically relevant allergen-specific asthma. The following parameters were measured to explore predictors for an early and late asthmatic response (EAR and LAR): standardised questionnaire, skin prick test (SPT), total IgE, specific IgE to grass pollen, FEV1, PD20FEV1 methacholine, exhaled nitric oxide (eNO) and eosinophils. RESULTS Early asthmatic reaction was equally distributed between patients with and without signs of possible asthma by questionnaire (56.8% vs. 48.3%). The following cut-off values showed the best combination of sensitivity and specificity for an EAR: specific IgE grass pollen 18.5 kU/L (AUC 0.83), SPT 8.5 mm (AUC 0.76), total IgE 95.5 kU/L (AUC 0.73), FEV1 102.4% (AUC 0.69), PD20FEV1 methacholine 1.67 mg (AUC 0.74), eNO 18.05 ppB (AUC 0.64) and eosinophils 115/mm(3) (AUC 0.58). CONCLUSIONS AND CLINICAL RELEVANCE There is a considerable discordance between reported asthma signs and diagnosed disease by BAP. Simple measurement of allergen-specific IgE for grass pollen was the best predictor of allergen-induced asthma in patients with AR.
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Affiliation(s)
- A Buslau
- Department of Pediatric Pulmonology, Allergy and Cystic fibrosis, Children's Hospital, Goethe-University, Frankfurt, Germany
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Herrmann E, Seeger S. Chronisch entzündliche Darmerkrankung in graviditate – eine aktuelle Literaturübersicht. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Friedrich-Rust M, Lupsor M, de Knegt R, Dries V, Buggisch P, Gebel M, Maier B, Herrmann E, Sagir A, Zachoval R, Shi Y, Schneider MD, Badea R, Rifai K, Poynard T, Zeuzem S, Sarrazin C. Point Shear Wave Elastography by Acoustic Radiation Force Impulse Quantification in Comparison to Transient Elastography for the Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C: A Prospective International Multicenter Study. Ultraschall Med 2015; 36:239-247. [PMID: 25970201 DOI: 10.1055/s-0034-1398987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of the present prospective European multicenter study was to demonstrate the non-inferiority of point shear wave elastography (pSWE) compared to transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis C. MATERIALS AND METHODS 241 patients with chronic hepatitis C were prospectively enrolled at 7 European study sites and received pSWE, TE and blood tests. Liver biopsy was performed with histological staging by a central pathologist. In addition, for inclusion of cirrhotic patients, a maximum of 10 % of patients with overt liver cirrhosis confirmed by imaging methods were allowed by protocol (n = 24). RESULTS Owing to slower than expected recruitment due to a reduction of liver biopsies, the study was closed after 4 years before the target enrollment of 433 patients with 235 patients in the 'intention to diagnose' analysis and 182 patients in the 'per protocol' analysis. Therefore, the non-inferiority margin was enhanced to 0.075 but non-inferiority of pSWE could not be proven. However, Paired comparison of the diagnostic accuracy of pSWE and TE revealed no significant difference between the two methods in the 'intention to diagnose' and 'per protocol' analysis (0.81 vs. 0.85 for F ≥ 2, p = 0.15; 0.88 vs. 0.92 for F ≥ 3, p = 0.11; 0.89 vs. 0.94 for F = 4, p = 0.19). Measurement failure was significantly higher for TE than for pSWE (p = 0.030). CONCLUSION Non-inferiority of pSWE compared to TE could not be shown. However, the diagnostic accuracy of pSWE and TE was comparable for the noninvasive staging of liver fibrosis in patients with chronic hepatitis C.
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Affiliation(s)
- M Friedrich-Rust
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - M Lupsor
- Department of Ultrasound, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R de Knegt
- Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Netherlands
| | - V Dries
- Institute of Pathology, Institute of Pathology, Mannheim, Germany
| | - P Buggisch
- Hepatology, Institute for Interdisciplinary Medicine, Hamburg, Germany
| | - M Gebel
- Department of Internal Medicine, Medical School Hannover, Germany
| | - B Maier
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe-University, Frankfurt, Germany
| | - A Sagir
- Department of Gastroenterology and Infectious Disease, University Hospital Düsseldorf, Germany
| | - R Zachoval
- Department of Medicine II, Campus Grosshadern, University Hospital Munich, Germany
| | - Y Shi
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe-University, Frankfurt, Germany
| | - M D Schneider
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - R Badea
- Imaging, University Iuliu Hatieganu, Cluj, Romania
| | - K Rifai
- Gastroenterology and Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - T Poynard
- Hôpital Pitié-Salpêtrière, Université Pierre et Marie Curie, Paris, France
| | - S Zeuzem
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
| | - C Sarrazin
- Department of Internal Medicine 1, J. W. Goethe-University Hospital, Frankfurt, Germany
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Radeloff D, Lempp T, Herrmann E, Kettner M, Bennefeld-Kersten K, Freitag CM. National total survey of German adolescent suicide in prison. Eur Child Adolesc Psychiatry 2015; 24:219-25. [PMID: 24952897 DOI: 10.1007/s00787-014-0568-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 05/26/2014] [Indexed: 01/23/2023]
Abstract
Incarcerated adolescents are a high-risk group for suicidal behaviour, but data on completed suicide are scarce in this population. The present study aimed at calculating relative risks (RR) of suicide in detention and identifying age-related risk factors. We compared data of a German national total survey of completed suicide of young detainees (14 to <21 years, N = 79) during the years 2000-2010 with age- and gender-adjusted suicide deaths in non-incarcerated adolescents (N = 3,484) and incarcerated adults (N = 781). Prison suicide accounted for 2.3% of all suicide deaths in adolescents, but only 0.1% of this age group was detained. The RR = 23.0 for adolescent suicide in detention exceeded the RR = 7.7 of adults by far. In adults, suicide rates in pre-trial detention was fivefold higher than in criminal detention; suicide rates were more balanced in adolescent detainees. Our results underline the need for age-specific suicide prevention strategies in detention.
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Affiliation(s)
- D Radeloff
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University of Frankfurt, Deutschordenstrasse 50, 60528, Frankfurt, Germany,
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Woike M, Bergmann L, Steiner T, Goebell P, Göhler T, Harich H, Herrmann E, Rebmann U, Kalanovic D. Evaluation of Safety, Tolerability and Activity of Temsirolimus in Patients (Pts) with Advanced or Metastatic Renal Cell Carcinoma (A/Mrcc) in Routine Clinical Practice. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grammatikos G, Farnik H, Bon D, Böhlig A, Bader T, Berg T, Zeuzem S, Herrmann E. The impact of antihyperlipidemic drugs on the viral load of patients with chronic hepatitis C infection: a meta-analysis. J Viral Hepat 2014; 21:533-41. [PMID: 24943517 DOI: 10.1111/jvh.12274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 05/25/2014] [Indexed: 12/16/2022]
Abstract
Several studies investigating the role of statins and fibrates in chronic hepatitis C virus (HCV) infection offered so far conflicting evidence regarding the antiviral potency of these medications, whereas combination of these drugs with pegylated interferon and ribavirin improved in some trials therapeutic outcome. We conducted a literature search to identify trials that included monoinfected HCV patients, treated with statins or fibrates as monotherapy with the primary end point of our meta-analysis being the quantitative change of HCV-RNA induced by these medications. Logarithmic changes of the viral load (ΔlogVL) and confidence intervals (CIs) were calculated according to the DerSimonian-Laird estimate. Statistical heterogeneity was assessed with the I² statistic. We identified eight observational studies that evaluated the potency of bezafibrate and different statins as monotherapy to induce a significant reduction of HCV-RNA in HCV-monoinfected patients (n = 281). Overall, a significant reduction of viral load with mean 0.19 [log10 IU/mL] (95%-confidence interval, (CI) 0.11-0.28) could be observed when antihyperlipidemic medications were administered. Bezafibrate featured the highest antiviral efficacy (0.45 log10 reduction, 95%-CI, 0.17-0.72) among all medications and fluvastatin (0.20 log10 reduction, 95%-CI, 0.09-0.31) among all statins tested. Based on meta-analysis, fibrates and statins induce a reduction of HCV viral load. We suggest that the addition of statins and fibrates to antiviral regimes, especially in HCV patients with concomitant dyslipidemia, could beside the established reduction of cardiovascular risk increase the potency of antiviral therapy.
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Affiliation(s)
- G Grammatikos
- University Hospital Frankfurt, Frankfurt am Main, Germany
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Bogdanou D, Penna-Martinez M, Chung TL, Moran-Auth Y, Wehrle J, Brehm C, Huenecke S, Herrmann E, Koehl U, Badenhoop K. Glycaemic and T-lymphocyte markers after Vitamin D3(VD) treatment in type 1 diabetes mellitus (T1D). DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zangos S, Reiter A, Louwen F, Schollenberger A, Eichler K, Schulz B, Herrmann E, Vogl T. MR-Pelvimetrie im Viefüßerstand und in Rückenlage: Welche Position schafft mehr Platz für das Baby? ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Reitter A, Stücker AU, Linde R, Königs C, Knecht G, Herrmann E, Schlößer R, Louwen F, Haberl A. Pregnancy complications in HIV-positive women: 11-year data from the Frankfurt HIV Cohort. HIV Med 2014; 15:525-36. [PMID: 24602285 DOI: 10.1111/hiv.12142] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was to assess pregnancy complications in HIV-positive women and changes in the rates of such complications over 11 years in the Frankfurt HIV Cohort. METHODS There were 330 pregnancies in HIV-positive women between 1 January 2002 and 31 December 2012. The rate of pregnancy-related complications, such as gestational diabetes mellitus (GDM), pre-eclampsia and preterm delivery, the mode of delivery and obstetric history were analysed. Maternal and neonatal morbidity/mortality as well as HIV mother-to-child transmission (MTCT) were evaluated. RESULTS In our cohort, GDM was diagnosed in 38 of 330 women (11.4%). Five women (1.5%) developed pre-eclamspia or hypertension. In 16 women (4.8%), premature rupture of membranes (PROM) occurred and 46 women (13.7%) were admitted with preterm contractions. The preterm delivery rate was 36.5% (n = 122), and 26.9% of deliveries (n = 90) were between 34+0 and 36+6 weeks of gestation. Over the observation period, the percentage of women with undetectable HIV viral load (VL) increased significantly (P < 0.001), from 26.1% to 75%, leading to obstetric changes, including an increase in the rate of vaginal deliveries (P < 0.001), from no vaginal births to 50%. The preterm delivery rate decreased significantly (P < 0.001), from 79.2% to 8.3%. There were no significant changes in the rate of GDM, pre-eclampsia, PROM or preterm contractions. CONCLUSIONS In the 11 years of our analysis, there was a significant reduction in the rate of preterm deliveries and an increase in the vaginal delivery rate, possibly reflecting changes in treatment policies in the same period and the availability of more effective antiretroviral therapy options. The rates of complications such as GDM, pre-eclampsia, preterm contractions, PROM and postnatal complications were stable over the 11 years, but were still increased compared with the general population.
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Affiliation(s)
- A Reitter
- Department of Obstetrics and Gynaecology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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Abstract
Facial expressions have long been proposed to be important agents in forming and maintaining cooperative interactions in social groups. Human beings are inordinately cooperative when compared with their closest-living relatives, the great apes, and hence one might expect species differences in facial expressivity in contexts in which cooperation could be advantageous. Here, human children and chimpanzees were given an identical task designed to induce an element of frustration (it was impossible to solve). In children, but not chimpanzees, facial expressions associated with effort and determination positively correlated with persistence at the task. By contrast, bodily indicators of stress (self-directed behaviour) negatively correlated with task persistence in chimpanzees. Thus, children exhibited more behaviour as they persisted, and chimpanzees exhibited less. The facial expressions produced by children, could, therefore, function to solicit prosocial assistance from others.
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Affiliation(s)
- B M Waller
- Centre for Comparative and Evolutionary Psychology, University of Portsmouth, , Portsmouth PO1 2DY, UK
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