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Milling TJ, Middeldorp S, Xu L, Koch B, Demchuk A, Eikelboom JW, Verhamme P, Cohen AT, Beyer-Westendorf J, Michael Gibson C, Lopez-Sendon J, Crowther M, Shoamanesh A, Coppens M, Schmidt J, Albaladejo P, Connolly SJ, Bastani A, Clark C, Concha M, Cornell J, Dombrowski K, Fermann G, Fulmer J, Goldstein J, Kereiakes D, Milling T, Pallin D, Patel N, Refaai M, Rehman M, Schmaier A, Schwarz E, Shillinglaw W, Spohn M, Takata T, Venkat A, Welker J, Welsby I, Wilson J, Van Keer L, Verschuren F, Blostein M, Eikelboom J, Althaus K, Berrouschot J, Braun G, Doeppner T, Dziewas R, Genth-Zotz S, Greinacher P, Hamann F, Hanses F, Heide W, Kallmuenzer B, Kermer P, Poli S, Royl G, Schellong S, Schnupp S, Schwarze J, Spies C, Thomalla G, von Mering M, Weissenborn K, Wollenweber F, Gumbinger C, Jaschinski U, Maschke M, Mochmann HC, Pfeilschifter W, Pohlmann C, Zahn R, Bouzat P, Schmidt J, Vallejo C, Floccard B, Coppens M, van Wissen S, Arellano-Rodrigo E, Valles E, Alikhan R, Breen K, Hall R, Crowther M, Albaladejo P, Cohen A, Demchuk A, Schmidt J, Wyse D, Garcia D, Prins M, Nakamya J, Büller H, Mahaffey KW, Alexander JH, Cairns J, Hart R, Joyner C, Raskob G, Schulman S, Veltkamp R, Meeks B, Zotova E, Ahmad S, Pinto T, Baker K, Dykstra A, Holadyk-Gris I, Malvaso A, Demchuk A. Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors. Circulation 2023; 147:1026-1038. [PMID: 36802876 DOI: 10.1161/circulationaha.121.057844] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, single-group cohort study that evaluated andexanet alfa in patients with acute major bleeding. The results of the final analyses are presented. METHODS Patients with acute major bleeding within 18 hours of FXa inhibitor administration were enrolled. Co-primary end points were anti-FXa activity change from baseline during andexanet alfa treatment and excellent or good hemostatic efficacy, defined by a scale used in previous reversal studies, at 12 hours. The efficacy population included patients with baseline anti-FXa activity levels above predefined thresholds (≥75 ng/mL for apixaban and rivaroxaban, ≥40 ng/mL for edoxaban, and ≥0.25 IU/mL for enoxaparin; reported in the same units used for calibrators) who were adjudicated as meeting major bleeding criteria (modified International Society of Thrombosis and Haemostasis definition). The safety population included all patients. Major bleeding criteria, hemostatic efficacy, thrombotic events (stratified by occurring before or after restart of either prophylactic [ie, a lower dose, for prevention rather than treatment] or full-dose oral anticoagulation), and deaths were assessed by an independent adjudication committee. Median endogenous thrombin potential at baseline and across the follow-up period was a secondary outcome. RESULTS There were 479 patients enrolled (mean age, 78 years; 54% male, 86% White; 81% anticoagulated for atrial fibrillation at a median time of 11.4 hours since last dose, with 245 (51%) on apixaban, 176 (37%) on rivaroxaban, 36 (8%) on edoxaban, and 22 (5%) on enoxaparin. Bleeding was predominantly intracranial (n=331 [69%]) or gastrointestinal (n=109 [23%]). In evaluable apixaban patients (n=172), median anti-FXa activity decreased from 146.9 ng/mL to 10.0 ng/mL (reduction, 93% [95% CI, 94-93]); in rivaroxaban patients (n=132), it decreased from 214.6 ng/mL to 10.8 ng/mL (94% [95% CI, 95-93]); in edoxaban patients (n=28), it decreased from 121.1 ng/mL to 24.4 ng/mL (71% [95% CI, 82-65); and in enoxaparin patients (n=17), it decreased from 0.48 IU/mL to 0.11 IU/mL (75% [95% CI, 79-67]). Excellent or good hemostasis occurred in 274 of 342 evaluable patients (80% [95% CI, 75-84]). In the safety population, thrombotic events occurred in 50 patients (10%); in 16 patients, this occurred during treatment with prophylactic anticoagulation that began after the bleeding event. No thrombotic episodes occurred after oral anticoagulation restart. Specific to certain populations, reduction of anti-FXa activity from baseline to nadir significantly predicted hemostatic efficacy in patients with intracranial hemorrhage (area under the receiver operating characteristic curve, 0.62 [95% CI, 0.54-0.70]) and correlated with lower mortality in patients <75 years of age (adjusted P=0.022; unadjusted P=0.003). Median endogenous thrombin potential was within the normal range by the end of andexanet alfa bolus through 24 hours for all FXa inhibitors. CONCLUSIONS In patients with major bleeding associated with the use of FXa inhibitors, treatment with andexanet alfa reduced anti-FXa activity and was associated with good or excellent hemostatic efficacy in 80% of patients. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02329327.
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Affiliation(s)
- Truman J Milling
- Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin (T.J.M.)
| | - Saskia Middeldorp
- Department of Internal Medicine and Radboud Institute of Health Sciences, Nijmegenthe Netherlands (S.M.)
| | - Lizhen Xu
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Bruce Koch
- Alexion, AstraZeneca Rare Disease, BostonMA (B.K.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary, AlbertaCanada (A.D.)
| | - John W Eikelboom
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, University of Leuven, Belgium (P.V.)
| | | | - Jan Beyer-Westendorf
- Department of Medicine I, Division of Hematology and Hemostasis, University Hospital Dresden, Germany (J.B-W.)
| | | | - Jose Lopez-Sendon
- Instituto de Investigación Hospital Universitario, La PazMadridSpain (J. L-S.)
| | - Mark Crowther
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Ashkan Shoamanesh
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M. Coppens)
| | - Jeannot Schmidt
- Centre Hospitalier Universitaire de Clermont-Ferrand, France (J.S.)
| | | | - Stuart J Connolly
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
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Breuss A, Vonau N, Ungricht C, Schwarz E, Irion M, Bradicich M, Grewe FA, Liechti S, Thiel S, Kohler M, Riener R, Wilhelm E. Sleep Position Detection for Closed-Loop Treatment of Sleep-Related Breathing Disorders. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176089 DOI: 10.1109/icorr55369.2022.9896559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Reliable detection of sleep positions is essential for the development of technical aids for patients with position-dependent sleep-related breathing disorders. We compare personalized and generalizable sleeping position classifiers using unobtrusive eight-channel pressure-sensing mats. Data of six male patients with confirmed position-dependent sleep apnea was recorded during three subsequent nights. Personalized position classifiers trained using leave-one-night-out cross-validation on average reached an F1-score of 61.3% for supine/non-supine and an F1-score of 46.2% for supine/lateral-left/lateral-right classification. The generalizable classifiers reached average F1-scores of 62.1% and 49.1% for supine/non-supine and supine/lateral-left/lateral-right classification, respectively. In-bed presence ("bed occupancy") could be detected with an average F1-score of 98.1%. This work shows that personalized sleep-position classifiers trained with data from two nights have comparable performance to classifiers trained with large interpatient datasets. Simple eight-channel sensor mattresses can be used to accurately detect in-bed presence required for closed-loop systems but their use to classify sleep-positions is limited.
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ToxIC Fentalog Study Group, Levine M, Meyn A, Krotulski A, Logan B, Amaducci A, Hughes A, Schwarz E, Pizon A, Wax P, Brent J, Manini A. 71 Adulteration of Illicit Drugs in Emergency Department Patients With Acute Opioid Overdose: A Multicenter Cohort. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lehmann JAM, Schwarz E, Rahmani Azad Z, Gritzka S, Seifried-Dübon T, Diebig M, Gast M, Kilian R, Nater U, Jarczok M, Kessemeier F, Braun S, Balint E, Rothermund E, Junne F, Angerer P, Gündel H. Effectiveness and cost effectiveness of a stress management training for leaders of small and medium sized enterprises - study protocol for a randomized controlled-trial. BMC Public Health 2021; 21:468. [PMID: 33685418 PMCID: PMC7938293 DOI: 10.1186/s12889-021-10398-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leaders in small and medium-sized enterprises (SMEs) are exposed to increased stress as a result of a range of challenges. Moreover, they rarely have the opportunity to participate in stress management trainings. Therefore, KMU-GO (ger: Kleine und mittlere Unternehmen - Gesundheitsoffensive; en: small and medium-sized enterprises - health campaign) aims at conducting and evaluating such a stress management training. The focus of evaluation does not only lie on the effects on leaders participating but also on their employees. METHODS The study is planned as a 2 × 3 mixed design with two groups (intervention and waiting control group) as a between factor and point in time (at baseline, 6 and 12 months later) as a within factor. We aim at collecting data from N = 200 leaders. Based on the results of a preceding assessment, an already successfully implemented stress management training was adapted to SME needs and now serves as the framework of this intervention. The stress management training comprises one and a half days and is followed by two booster sessions (each 180 min) about 3 and 6 months after the training. The main focus of this intervention lies on specifying leaders stress reactivity while at the same time investigating its effects on employees' mental health. Further dependent variables are leaders´ depression and anxiety scores, effort-reward imbalance, sick days and psychophysiological measures of heart rate variability, hair cortisol, and salivary alpha-amylase. Cost-effectiveness analyses will be conducted from a societal and employers' point of view. DISCUSSION Stress management is a highly relevant issue for leaders in SMEs. By providing an adequate occupational stress management training, we expect to improve leaders´ and also employees` mental health, thereby preventing economic losses for SMEs and the national economy. However, collecting data from employees about the success of a stress management training of their leader is a highly sensitive topic. It requires a carefully planned proceeding ensuring for example a high degree of transparency, anonymity, and providing team incentives. TRIAL REGISTRATION The KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (05.11.2020).
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Affiliation(s)
- J. A. M. Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Schwarz
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Z. Rahmani Azad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - S. Gritzka
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - T. Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - M. Diebig
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - M. Gast
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - R. Kilian
- Department of Psychiatry II, Ulm University and Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - U. Nater
- Department for Clinical and Health Psychology, Wien University, Liebiggasse 5, 1010 Wien, Austria
| | - M. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - F. Kessemeier
- Section of Health Care Research and Rehabilitation Research, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110 Freiburg, Germany
| | - S. Braun
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - F. Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - P. Angerer
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - H. Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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Gariepy A, Dove M, Lewis C, Zuckerman D, Tancredi D, McDonald-Mosley R, Sonalkar S, Hathaway M, Nunez-Eddy C, Schwarz E. P75 Rates of procedural complications and patient-centered outcomes after publicly-funded hysteroscopic or laparoscopic sterilization in California. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.096] [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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Schlesinger N, Jablonski K, Schwarz E, Young N. AB0933 PHYSICAL ACTIVITY DECREASES PAIN AND INFLAMMATION IN GOUT PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Despite the high prevalence of gout, there has been little investigation into the relationship between physical activity and gout.Objectives:To investigate whether physically active gout patients, as assessed by the International Physical Activity Questionnaire (IPAQ) long form, have lower pain scores, decreased inflammation, assessed by C-reactive protein (CRP) levels and less flares.Methods:During scheduled appointments, gout patients not experiencing a flare at the time of visit were recruited from our clinics and consented to participate in the study. IPAQ were completed. Clinical data collected during the visit included age, years since diagnosis, flares per year, perceived pain at the time of visit and in the past 4 weeks, and C-reactive protein (CRP) levels.Results:Thirty gout patients were recruited. Ages 31-86 (mean 61); duration of gout: one- 43 years (mean 9). IPAQ, separated gout patients into physically active (n=16) and physically inactive cohorts (n=14) (p<0.001. Physically active gout patients had over 12-fold fewer gout flares per year (p<0.01); 10-fold less CRP (p<0.01, a 4.6-fold decrease in perceived pain at the time of visit (p<0.01), and a 2.8-fold decrease in perceived pain over the past 4-week period (p<0.05).Conclusion:This is the first study using a validated physical activity tool, IPAQ, to assess physical activity in gout patients. In this study, physically active gout patients were found to have lower CRP levels, less flares per year, and decreased pain perception compared to those that are not physically active, highlighting, the importance of incorporating physical activity as a possible adjunct treatment option during intervals between flares.References:[1]Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases-myokine regulation. Nat Rev Rheumatol 2015;11:86-97.[2]Hagströmer M, Oja P, Sjöström M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr 2006;9:755-62.[3]Young NA, Jablonski K, Sharma J, Thomas E, Snoad B, Hampton J, et al. Low and Moderate Intensity Exercise Suppresses Inflammatory Responses in an Acute Mouse Model of Gout and Suggests Therapeutic Efficacy [abstract]. Arthritis Rheumatol. 2017;69 (suppl 10).Disclosure of Interests:Naomi Schlesinger Grant/research support from: Pfizer, AMGEN, Consultant of: Novartis, Horizon Pharma, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Speakers bureau: Takeda, Horizon, Kyle jablonski: None declared, Emmy schwarz: None declared, Nicholas Young: None declared
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Roy-Dufresne E, Lurgi M, Brown SC, Wells K, Cooke B, Mutze G, Peacock D, Cassey P, Berman D, Brook BW, Campbell S, Cox T, Daly J, Dunk I, Elsworth P, Fletcher D, Forsyth DM, Hocking G, Kovaliski J, Leane M, Low B, Kennedy M, Matthews J, McPhee S, Mellin C, Mooney T, Moseby K, Read J, Richardson BJ, Schneider K, Schwarz E, Sinclair R, Strive T, Triulcio F, West P, Saltré F, Fordham DA. The Australian National Rabbit Database: 50 yr of population monitoring of an invasive species. Ecology 2019; 100:e02750. [PMID: 31034589 DOI: 10.1002/ecy.2750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/30/2019] [Accepted: 04/03/2019] [Indexed: 11/09/2022]
Abstract
With ongoing introductions into Australia since the 1700s, the European rabbit (Oryctolagus cuniculus) has become one of the most widely distributed and abundant vertebrate pests, adversely impacting Australia's biodiversity and agroeconomy. To understand the population and range dynamics of the species and its impacts better, occurrence and abundance data have been collected by researchers and citizens from sites covering a broad spectrum of climatic and environmental conditions in Australia. The lack of a common and accessible repository for these data has, however, limited their use in determining important spatiotemporal drivers of the structure and dynamics of the geographical range of rabbits in Australia. To meet this need, we created the Australian National Rabbit Database, which combines more than 50 yr of historical and contemporary survey data collected from throughout the range of the species in Australia. The survey data, obtained from a suite of complementary monitoring methods, were combined with high-resolution weather, climate, and environmental information, and an assessment of data quality. The database provides records of rabbit occurrence (689,265 records) and abundance (51,241 records, >120 distinct sites) suitable for identifying the spatiotemporal drivers of the rabbit's distribution and for determining spatial patterns of variation in its key life-history traits, including maximum rates of population growth. Because all data are georeferenced and date stamped, they can be coupled with information from other databases and spatial layers to explore the potential effects of rabbit occurrence and abundance on Australia's native wildlife and agricultural production. The Australian National Rabbit Database is an important tool for understanding and managing the European rabbit in its invasive range and its effects on native biodiversity and agricultural production. It also provides a valuable resource for addressing questions related to the biology, success, and impacts of invasive species more generally. No copyright or proprietary restrictions are associated with the use of this data set other than citation of this Data Paper.
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Affiliation(s)
- Emilie Roy-Dufresne
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia
| | - Miguel Lurgi
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia.,Centre for Biodiversity Theory and Modelling, Theoretical and Experimental Ecology Station, CNRS-Paul Sabatier University, 09200, Moulis, France
| | - Stuart C Brown
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia
| | - Konstans Wells
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia.,Department of Biosciences, Swansea University, SA2 8PP, Wales, UK
| | - Brian Cooke
- Institute for Applied Ecology, University of Canberra, Australian Capital Territory, 2617, Australia
| | - Greg Mutze
- Biosecurity SA, Department of Primary Industries and Regions South Australia, South Australia, 5064, Australia
| | - David Peacock
- Biosecurity SA, Department of Primary Industries and Regions South Australia, South Australia, 5064, Australia.,School of Animal and Veterinary Sciences, University of Adelaide, South Australia, 5005, Australia
| | - Phill Cassey
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia
| | - Dave Berman
- University of Southern Queensland, Queensland, 4350, Australia
| | - Barry W Brook
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia.,School of Natural Sciences, University of Tasmania, Private Bag 55, Tasmania, 7001, Australia
| | - Susan Campbell
- Department of Primary Industries and Regional Development, Washington, 6330, Australia
| | - Tarnya Cox
- Vertebrate Pest Research Unit, New South Wales Department of Primary Industries, New South Wales, 2800, Australia
| | - Joanne Daly
- CSIRO Agriculture and Food, Australian Capital Territory, 2601, Australia
| | - Iain Dunk
- Department of Environment, Water, and Natural Resources, South Australia, 5000, Australia
| | - Peter Elsworth
- Department of Agriculture and Fisheries, Biosecurity Queensland, Queensland, 4350, Australia
| | - Don Fletcher
- Department of Environment and Planning Directorate, Australian Capital Territory, 2602, Australia
| | - David M Forsyth
- Vertebrate Pest Research Unit, New South Wales Department of Primary Industries, New South Wales, 2800, Australia.,Department of Environment, Land, Water and Planning, Arthur Rylah Institute for Environmental Research, Victoria, 3084, Australia
| | - Greg Hocking
- Department of Primary Industries, Parks, Water and Environment, Tasmania, 7001, Australia.,Agricultural Technical Services P/L, South Australia, 5576, Australia
| | - John Kovaliski
- Biosecurity SA, Department of Primary Industries and Regions South Australia, South Australia, 5064, Australia
| | - Michael Leane
- Riverina Local Land Service, New South Wales, 2722, Australia
| | - Bill Low
- Low Ecological Services, Northern Territory, 0871, Australia
| | - Malcolm Kennedy
- Department of Primary Industries and Regional Development, Washington, 6151, Australia
| | - John Matthews
- Agricultural Services and Biosecurity Operations Division, Department of Economic Development, Jobs, Training and Resources, Victoria, 3300, Australia
| | - Steve McPhee
- Department of Environment, Land, Water and Planning, Arthur Rylah Institute for Environmental Research, Victoria, 3084, Australia
| | - Camille Mellin
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia.,Australian Institute of Marine Science, Queensland, 4810, Australia
| | - Trish Mooney
- Department of Environment, Water, and Natural Resources, South Australia, 5000, Australia
| | - Katherine Moseby
- Centre for Ecosystem Science, University of New South Wales, New South Wales, 2052, Australia
| | - John Read
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia
| | | | | | - Eric Schwarz
- Department of Primary Industries, Parks, Water and Environment, Tasmania, 7001, Australia
| | - Ronald Sinclair
- Biosecurity SA, Department of Primary Industries and Regions South Australia, South Australia, 5064, Australia
| | - Tanja Strive
- CSIRO Health and Biosecurity, Australian Capital Territory, 2601, Australia
| | - Frank Triulcio
- Department of Planning, Transport and Infrastructure, South Australia, 5000, Australia
| | - Peter West
- Vertebrate Pest Research Unit, New South Wales Department of Primary Industries, New South Wales, 2800, Australia
| | - Frederik Saltré
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia.,Global Ecology, College of Science and Engineering, Flinders University,, GPO Box 2100, South Australia, 5001, Australia
| | - Damien A Fordham
- The School of Biological Sciences, University of Adelaide, South Australia, 5005, Australia
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Schwarz E, Reinisch G, Brandauer A, Aharinejad S, Scharf W, Trieb K. Load transfer and periprosthetic fractures after total hip arthoplasty: Comparison of periprosthetic fractures of femora implanted with cementless distal-load or proximal-load femoral components and measurement of the femoral strain at the time of implantation. Clin Biomech (Bristol, Avon) 2018; 54:137-142. [PMID: 29587147 DOI: 10.1016/j.clinbiomech.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/18/2017] [Revised: 01/07/2018] [Accepted: 03/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Little is known about the causes and mechanisms underlying periprosthetic fractures around femoral components particularly in relation to the stem design. In an in vitro study 20 pairs of fresh cadaveric femora were loaded to fracture axially and transversally. FINDINGS When proximal femoral strain was measured at the time of impaction of cementless stems the load transfer was determined by the underlying anatomy rather than by the shape of the stem, so that the so-called "load transfer" properties - proximal or distal - ascribed to stem designs are a myth. The axial-load and the transverse-load model were then exposed to loads to failure (fracture) and showed a biphasic pattern throughout independent of the impact direction. In the second phase, the fracture phase proper, the bone behaved like a brittle solid. Failure occurred very rapidly within less than 5 milliseconds. The forces to failure were between 2 and 11 kN. Most of the fractures (82.5%) occurred above the stem tip. INTERPRETATION Note that the study was confined to early preosteointegration fractures. Neither the stem design nor the impact direction, i.e. on the knee or on the side of the hip, was related to the fracture morphology.
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Affiliation(s)
- E Schwarz
- Trauma Unit, Hanusch-Krankenhaus, Vienna, Austria
| | - G Reinisch
- Biomechanische Forschungs-Gesellschaft m.b.H., Vienna, Austria; Department of Micro-Technique and Precision Engineering, Vienna University of Technology, Austria
| | - A Brandauer
- Department of Micro-Technique and Precision Engineering, Vienna University of Technology, Austria
| | - S Aharinejad
- Anatomy and Cellular Biology Division, Vienna Medical School, Austria
| | - W Scharf
- Trauma Unit, Hanusch-Krankenhaus, Vienna, Austria
| | - K Trieb
- Department of Orthopedics, Klinikum Wels-Grieskirchen, Austria.
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Abstract
This is a description of a case of depression associated with post-encephalitic Parkinsonism, with signs predominating on the left side, treated by unilateral (right) prefrontal leucotomy.
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Hering T, Andres J, Mohrlang C, Redeker M, Schwarz E. [The Aut-idem Rule and the Importance of Patient-Individual Selection of Inhalers for the Therapy of Airway Diseases in Practices of Pneumologists and General Practitioners - Assessment and Implementation by Pneumologists and General Practitioners]. Pneumologie 2017; 72:197-206. [PMID: 29212108 DOI: 10.1055/s-0043-118401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Drug therapy of obstructive airway diseases mainly relies on inhaled medication. The success of this therapy depends primarily on the selection of the appropriate inhaler considering patient's choice and the correct application. The aut-idem-rule, an active exclusion of the optional substitution by the pharmacist, allows prescribing physicians to ensure the delivery of a particular inhaler, which was selected for that patient, who was trained to use specifically that inhaler. This survey shows that pneumologists and, to a greater extent general practitioners, do not consistently make use of this option, although they unanimously agree on the importance of targeted inhaler selection. As a result, patients may receive different inhalers in the pharmacy, where the inhaler is chosen under consideration of market-driven aspects such as rebate contracts or stock. This causes that patients get confused by the exchange of their inhaler. Thus the exchange of the inhaler by the pharmacist leads to uncertainty and application problems in patients. Hence, the success of the comparatively complex inhaled therapy is endangered. This could be prevented, if prescribing physicians were informed and supported consistently regarding the use of aut-idem exclusion to ensure an optimal therapy for each individual patient.
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Affiliation(s)
- T Hering
- Wissenschaftliches Institut des Bundesverbandes der Pneumologen/BdP (WinPneu).,Lungenarztpraxis Tegel, Berlin Tegel
| | - J Andres
- Wissenschaftliches Institut des Bundesverbandes der Pneumologen/BdP (WinPneu).,MedWiss GmbH, Weinitzen bei Graz, Österreich
| | | | - M Redeker
- GlaxoSmithKline GmbH & Co. KG, München
| | - E Schwarz
- GlaxoSmithKline GmbH & Co. KG, München
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Gaisl T, Bregy L, Stebler N, Gaugg M, Bruderer T, García-Gómez D, Möller A, Singer F, Schwarz E, Benden C, M-L Sinues P, Zenobi R, Kohler M. P205 Real-time exhaled breath analysis identifies altered metabolic signature in cystic fibrosis. Chest 2017. [DOI: 10.1016/j.chest.2017.04.110] [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: 10/19/2022] Open
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13
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Bartenstein P, Saxer S, Appenzeller P, Schwarz E, Lichtblau M, Ulrich S. P216 Real-life data on the medical therapy of pulmonary arterial and chronic thromboembolic pulmonary hypertension. Chest 2017. [DOI: 10.1016/j.chest.2017.04.121] [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: 11/30/2022] Open
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Abstract
Two drowning incidents in large municipal swimming pools were studied. In both, a similar process was observed in which an attempt was made to restore the “sentimental order” which had been fractured by the drownings. This was accomplished through discussion by staff members. This continued until a consensus was reached that generally absolved staff of blame and assigned it elsewhere. Two factors may have influenced this process in the incidences observed; the degree of outside validation, and the social value of the victims.
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Bumb JM, Enning F, Mueller JK, van der List T, Rohleder C, Findeisen P, Noelte I, Schwarz E, Leweke FM. Differential melatonin alterations in cerebrospinal fluid and serum of patients with major depressive disorder and bipolar disorder. Compr Psychiatry 2016; 68:34-9. [PMID: 27234180 DOI: 10.1016/j.comppsych.2016.03.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 12/11/2015] [Revised: 03/19/2016] [Accepted: 03/24/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Melatonin, which plays an important role for regulation of circadian rhythms and the sleep/wake cycle has been linked to the pathophysiology of major depressive and bipolar disorder. Here we investigated melatonin levels in cerebrospinal fluid (CSF) and serum of depression and bipolar patients to elucidate potential differences and commonalities in melatonin alterations across the two disorders. METHODS Using enzyme-linked immunosorbent assays, CSF and serum melatonin levels were measured in 108 subjects (27 healthy volunteers, 44 depressed and 37 bipolar patients). Covariate adjusted multiple regression analysis was used to investigate group differences in melatonin levels. RESULTS In CSF, melatonin levels were significantly decreased in bipolar (P<0.001), but not major depressive disorder. In serum, we observed a significant melatonin decrease in major depressive (P=0.003), but not bipolar disorder. No associations were found between serum and CSF melatonin levels or between melatonin and measures of symptom severity or sleep disruptions in either condition. CONCLUSION This study suggests the presence of differential, body fluid specific alterations of melatonin levels in bipolar and major depressive disorder. Further, longitudinal studies are required to explore the disease phase dependency of melatonin alterations and to mechanistically explore the causes and consequences of site-specific alterations.
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Affiliation(s)
- J M Bumb
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - F Enning
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J K Mueller
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Till van der List
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - C Rohleder
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - P Findeisen
- Institute for Clinical Chemistry, Medical Faculty Mannheim, Heidelberg University, Germany
| | - I Noelte
- Department of Neuroradiology, University Hospital Mannheim, Mannheim, Germany
| | - E Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F M Leweke
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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van Beveren NJM, Schwarz E, Noll R, Guest PC, Meijer C, de Haan L, Bahn S. Evidence for disturbed insulin and growth hormone signaling as potential risk factors in the development of schizophrenia. Transl Psychiatry 2014; 4:e430. [PMID: 25158005 PMCID: PMC4150237 DOI: 10.1038/tp.2014.52] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 05/07/2014] [Accepted: 05/21/2014] [Indexed: 01/03/2023] Open
Abstract
Molecular abnormalities in metabolic, hormonal and immune pathways are present in peripheral body fluids of a significant subgroup of schizophrenia patients. The authors have tested whether such disturbances also occur in psychiatrically ill and unaffected siblings of schizophrenia patients with the aim of identifying potential contributing factors to disease vulnerability. The subjects were recruited as part of the Genetic Risk and OUtcome of Psychosis (GROUP) study. The authors used multiplexed immunoassays to measure the levels of 184 molecules in serum from 112 schizophrenia patients, 133 siblings and 87 unrelated controls. Consistent with the findings of previous studies, serum from schizophrenia patients contained higher levels of insulin, C-peptide and proinsulin, decreased levels of growth hormone and altered concentrations of molecules involved in inflammation. In addition, significant differences were found in the levels of some of these proteins in siblings diagnosed with mood disorders (n=16) and in unaffected siblings (n=117). Most significantly, the insulin/growth hormone ratio was higher across all groups compared with the controls. Taken together, these findings suggest the presence of a molecular endophenotype involving disruption of insulin and growth factor signaling pathways as an increased risk factor for schizophrenia.
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Affiliation(s)
- N J M van Beveren
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands,Department 'Nieuwe Kennis', Delta Center for Mental Health Care, Rotterdam, The Netherlands,Department of Neuroscience, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands. E-mail: or
| | - E Schwarz
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - R Noll
- Department of Psychology, DeSales University, Center Valley, PA, USA
| | - P C Guest
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - C Meijer
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - L de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - S Bahn
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands,Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK,Department of Neuroscience, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands. E-mail: or
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Ramsey J, Schwarz E, Guest P, Van Beveren N, Leweke M, Rothermundt M, Bogerts B, Steiner J, Bahn S. EPA-1234 – Distinct molecular phenotypes in male and female schizophrenia patients. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
The introduction of blood-based biomarkers for psychiatric disorders faces numerous challenges. The goal of research efforts is the improvement of the current more or less subjective diagnosis, treatment and patient management. So far attempts to introduce molecular analyses have faced considerable resistance. There is an urgent need for a paradigm shift so that peripheral markers may also deliver insights into pathological states of the brain. Health regulators have called for a reform of research and development approaches, with the goal to enhance the safety and efficiency of future antipsychotic drugs using biomarker-based methods. Here we discuss the potential of the biomarker sector in this context, as exemplified by the recent introduction of Veripsych™, the first blood test aiding the diagnosis of schizophrenia.
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Affiliation(s)
- M G Gottschalk
- Department of Chemical Engineering and Biotechnology, University of Cambridge, UK
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Borrero S, Grady C, Schwarz E, Emeremni C, Moore C, Zite N. Is prior unintended pregnancy associated with less sterilization regret? Contraception 2012. [DOI: 10.1016/j.contraception.2012.05.141] [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: 11/24/2022]
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Borrero S, Schwarz E, Zhao X, Mor M, Gellad W. Contraceptive adherence in the VA Healthcare System. Contraception 2012. [DOI: 10.1016/j.contraception.2012.05.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rapkin R, Baldauf E, Parisi S, Berkhoudt K, Updike G, Schwarz E. Effect of structured contraceptive counseling on contraceptive knowledge and use following walk-in visits for pregnancy testing or emergency contraception. Contraception 2012. [DOI: 10.1016/j.contraception.2012.05.089] [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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Affiliation(s)
- MB Forrester
- Epidemiology and Disease Surveillance Unit, Texas Department of State Health Services, Austin, TX, USA
| | - K Kleinschmidt
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E Schwarz
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A Young
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Schwarz E, Guest PC, Rahmoune H, Harris LW, Wang L, Leweke FM, Rothermundt M, Bogerts B, Koethe D, Kranaster L, Ohrmann P, Suslow T, McAllister G, Spain M, Barnes A, van Beveren NJM, Baron-Cohen S, Steiner J, Torrey FE, Yolken RH, Bahn S. Identification of a biological signature for schizophrenia in serum. Mol Psychiatry 2012; 17:494-502. [PMID: 21483431 DOI: 10.1038/mp.2011.42] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [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: 12/23/2022]
Abstract
Biomarkers are now used in many areas of medicine but are still lacking for psychiatric conditions such as schizophrenia (SCZ). We have used a multiplex molecular profiling approach to measure serum concentrations of 181 proteins and small molecules in 250 first and recent onset SCZ, 35 major depressive disorder (MDD), 32 euthymic bipolar disorder (BPD), 45 Asperger syndrome and 280 control subjects. Preliminary analysis resulted in identification of a signature comprised of 34 analytes in a cohort of closely matched SCZ (n=71) and control (n=59) subjects. Partial least squares discriminant analysis using this signature gave a separation of 60-75% of SCZ subjects from controls across five independent cohorts. The same analysis also gave a separation of ~50% of MDD patients and 10-20% of BPD and Asperger syndrome subjects from controls. These results demonstrate for the first time that a biological signature for SCZ can be identified in blood serum. This study lays the groundwork for development of a diagnostic test that can be used as an aid for distinguishing SCZ subjects from healthy controls and from those affected by related psychiatric illnesses with overlapping symptoms.
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Affiliation(s)
- E Schwarz
- Institute of Biotechnology, University of Cambridge, Cambridge, UK
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Goland S, Siegel RJ, Burton K, De Robertis MA, Rafique A, Schwarz E, Zivari K, Mirocha J, Trento A, Czer LSC. Changes in left and right ventricular function of donor hearts during the first year after heart transplantation. Heart 2011; 97:1681-6. [DOI: 10.1136/hrt.2010.220871] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Patel J, Moriguchi J, Stimpson E, Reinsmoen N, Reed E, Kawano M, Goldstein Z, Rafiei M, Hamilton M, Schwarz E, Kobashigawa J. 518 Success of Desensitization Protocol in Reducing Calculated Panel Reactive Antibodies in a Large Cohort of Sensitized Heart Transplant Candidates. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Patel J, Kittleson M, Kawano M, Goldstein Z, Rafiei M, Barry O, Hamilton M, Schwarz E, Esmailian F, Kobashigawa J. 528 Does Gender Mismatch Increase the Risk of Antibody-Mediated Rejection (AMR) after Heart Transplantation? J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Phan A, Czer L, Rafiei M, Pixton J, Mirocha J, Schwarz E, De Robertis M, Coleman B, Luthringer D, Vespignani R, Ruzza A, Yanagida R, Kass R, Trento A. 416 Anti-Thymocyte Globulin Induction Therapy after Heart Transplantation: Impact on Rejection Rates, Survival, and CMV Infection. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kittleson M, Patel J, Kawano M, Goldstein Z, Rafiei M, Reinsmoen N, Reed E, Hage A, Schwarz E, Esmailian F, Kobashigawa J. 44 Timing of the Development of Donor Specific Antibody after Heart Transplantation Impacts Long-Term Outcome. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.051] [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: 11/24/2022] Open
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Morrissey R, Czer L, Kittleson M, Patel J, Schwarz E, Jamero G, Kawano M, Rafiei M, Azarbal B, Trento A, Kobashigawa J. 147 Induction vs. Non-Induction in Heart Transplantation: The Controversy Continues. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Weber FP, Schwarz E, Hellenschmied R. SPONTANEOUS INOCULATION OF MELANOTIC SARCOMA FROM MOTHER TO FOETUS: REPORT OF A CASE. Br Med J 2011; 1:537-9. [PMID: 20775346 DOI: 10.1136/bmj.1.3611.537] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Curtis B, Warren E, Pollicino C, Evans RW, Schwarz E, Sbaraini A. The Monitor Practice Programme: is non-invasive management of dental caries in private practice cost-effective? Aust Dent J 2011; 56:48-55. [PMID: 21332740 DOI: 10.1111/j.1834-7819.2010.01286.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The objective of this research was to assess the efficacy and cost-effectiveness of a non-invasive approach to dental caries management in private dental practice. METHODS Private dental practices from a variety of locations in New South Wales were randomly allocated to either non-invasive management of caries, or continue with usual care. Patients were followed for three years and caries incidence assessed. A patient-level decision analytic model was constructed to assess the cost-effectiveness of the intervention at two years, three years, and hypothetical lifetime. RESULTS Twenty-two dental practices and 920 patients were recruited. Within the clinical trial there was a significant difference in caries increment favouring non-invasive therapy at both two and three years. Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations both urban and rural. Cost per DMFT avoided estimate was A$1287.07 (two years), A$1148.91 (three years) decreasing to A$702.52 in (medium) and A$545.93 (high) risk patients (three years). CONCLUSIONS A joint preventive and non-invasive therapeutic approach appears to be cost-effective in patients at medium and high risk of developing dental caries when compared to the standard care provided by private dental practice.
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Affiliation(s)
- B Curtis
- Community Oral Health and Epidemiology, Faculty of Dentistry, The University of Sydney, Australia.
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Schwarz E, McCann E. Citizen Schools' partner-dependent expanded learning model. New Dir Youth Dev 2011; 2011:93-106. [PMID: 22028083 DOI: 10.1002/yd.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Citizen Schools, a national nonprofit organization, shares lessons learned through years of experience developing and sustaining effective partnerships with schools around the country.
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Schwarz E, Grauel † EL, Wauer R. Kein Anstieg von Inzidenz, Therapie- und Erblindungsrate der Retinopathia praematurorum in einem universitären Perinatalzentrum Level 1 – eine prospektive Beobachtungsstudie von 1978 – 2007. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0029-1245984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schwarz E, Grauel † EL, Wauer R. Kein Anstieg von Inzidenz, Therapie- und Erblindungsrate der Retinopathia praematurorum in einem universitären Perinatalzentrum Level 1 - eine prospektive Beobachtungsstudie von 1978 - 2007. Klin Monbl Augenheilkd 2010; 228:208-19. [DOI: 10.1055/s-0029-1245553] [Citation(s) in RCA: 2] [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: 10/19/2022]
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Schwarz Z, Kössel H, Schwarz E, Bogorad L. A gene coding for tRNA is located near 5' terminus of 16S rRNA gene in Zea mays chloroplast genome. Proc Natl Acad Sci U S A 2010; 78:4748-52. [PMID: 16593071 PMCID: PMC320240 DOI: 10.1073/pnas.78.8.4748] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A region of 635 base pairs preceding a gene for 16S rRNA in the Zea mays chloroplast genome has been mapped and its sequence has been determined. Screening for structural elements common to tRNAs reveals a gene coding for tRNA(Val) (GU(U) (C)) positioned 303 base pairs proximal to the 5' end of the 16S rRNA gene. Both the tRNA(Val) and the 16S rRNA are coded in the same DNA strand. The tRNA nucleotide sequence predicted from the DNA sequence meets all structural characteristics common to tRNA primary and secondary structures. In a quantitative comparison with primary structures of the 14 known tRNA(Val) species the chloroplast isoaceptor shows much higher homology with that from prokaryotic than that from eukaryotic species. Regions that Escherichia coli RNA polymerase protects from nuclease attack are observed 25 and 100 base pairs upstream of the tRNA(Val) gene and 105 base pairs upstream of the 16S rRNA gene. Within these regions are short sequences that are very similar to those in the -35 region of E. coli rrn and that may therefore represent all or parts of transcription initiation signals of the respective genes.
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Affiliation(s)
- Z Schwarz
- Institut für Biologic III der Universität Freiburg, Schaenzle-Strasse 1, D78 Freiburg, Federal Republic of Germany
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Oelschläger W, Feyler L, Schwarz E. Fluorgehalte in Weichgeweben, Blut und Milch von Wiederkäuern außerhalb und in Fluoremissionsgebieten. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1439-0442.1972.tb00527.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Herberth M, Krzyszton DN, Koethe D, Craddock MR, Bulger E, Schwarz E, Guest P, Leweke FM, Bahn S. Differential effects on T-cell function following exposure to serum from schizophrenia smokers. Mol Psychiatry 2010; 15:364-71. [PMID: 19002140 DOI: 10.1038/mp.2008.120] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cigarette smoking is more prevalent in subjects with schizophrenia compared to those with other psychiatric disorders or the general population and could therefore affect molecular pathways that impact the pathophysiology of this disorder. As smoking is also known to suppress immune responses, we investigated the effects of 'smoking-conditioned' serum obtained from schizophrenia and control subjects on healthy T cell in vitro. We found that T-cell proliferation was significantly increased following exposure to serum from smoking schizophrenia patients whereas no effect was observed when using serum from smoking control subjects or non-smoking patients and controls. We eliminated the possibility that these effects were due to quantitative differences in cigarette consumption as serum levels of the stable nicotine metabolite cotinine were similar in schizophrenic and control smokers. Molecular characterization showed that serum from patient smokers increased expression of T-cell activation markers CD69(high), CD25(high), co-stimulatory molecules CD26+, CD27+ and CD28+, and decreased T-cell receptor complex components TCRalpha/beta and CD3. Moreover, analysis of supernatants collected after T-cell exposure to serum from smoking patients showed a time-dependent decline in interleukin (IL)-2 levels, suggesting that the proliferation effect is promoted by enhanced IL-2 processing. These results suggest that cigarette smoking has selective effects on serum components that, in turn, lead to altered immune function in schizophrenia patients relative to healthy subjects. Further studies aimed at characterizing these components could result in a better understanding of the onset and aetiology of schizophrenia and potentially lead to novel therapeutic strategies.
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Affiliation(s)
- M Herberth
- Institute of Biotechnology, University of Cambridge, Cambridge CB2 1QT, UK
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Wang L, Lockstone HE, Guest PC, Levin Y, Palotás A, Pietsch S, Schwarz E, Rahmoune H, Harris LW, Ma D, Bahn S. Expression profiling of fibroblasts identifies cell cycle abnormalities in schizophrenia. J Proteome Res 2010; 9:521-7. [PMID: 19916557 DOI: 10.1021/pr900867x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Many previous studies have attempted to gain insight into the underlying pathophysiology of schizophrenia by studying postmortem brain tissues of schizophrenia patients. However, such analyses can be confounded by artifactual features of this approach such as lengthy agonal state and postmortem interval times. As several aspects of schizophrenia are also manifested at the peripheral level in proliferating cell types, we have studied the disorder through systematic transcriptomic and proteomic analyses of skin fibroblasts biopsied from living patients. We performed comparative transcriptomic and proteomic profiling to characterize skin fibroblasts from schizophrenia patients compared to healthy controls. Transcriptomic profiling using cDNA array technology showed that pathways associated with cell cycle regulation and RNA processing were altered in the schizophrenia subjects (n = 12) relative to controls (n = 12). LC-MS(E) proteomic profiling led to identification of 16 proteins that showed significant differences in expression between schizophrenia (n = 11) and control (n = 11) subjects. Analysis in silico revealed that these proteins were also associated with proliferation and cell growth pathways. To validate these findings at the protein level, fibroblast protein extracts were analyzed by Western blotting which confirmed the differential expression of three key proteins associated with these pathways. At the functional level, we confirmed the decreased proliferation phenotype by showing that cultured fibroblasts from schizophrenia subjects (n = 5) incorporated less (3)H-thymidine into their nuclei compared to those from controls (n = 6) by day 4 over an 8 day time course study. Similar abnormalities in cell cycle and growth pathways have been reported to occur in the central nervous system in schizophrenia. These studies demonstrate that fibroblasts obtained from living schizophrenia subjects show alterations in cellular proliferation and growth pathways. Future studies aimed at characterizing such pathways in fibroblasts and other proliferating cell types from schizophrenia patients could elucidate the molecular mechanisms associated with the pathophysiology of schizophrenia and provide a useful model to support drug discovery efforts.
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Affiliation(s)
- L Wang
- Institute of Biotechnology, University of Cambridge, Cambridge, UK
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von Einem S, Schwarz E, Rudolph R. A novel TWO-STEP renaturation procedure for efficient production of recombinant BMP-2. Protein Expr Purif 2010; 73:65-9. [PMID: 20302941 DOI: 10.1016/j.pep.2010.03.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 03/15/2010] [Accepted: 03/15/2010] [Indexed: 11/16/2022]
Abstract
Bone morphogenetic proteins (BMPs) stimulate bone formation and thus constitute important protein therapeutics. Here, a novel procedure is presented which allows fast and efficient production of biologically active BMP-2 via a TWO-STEP procedure: the conditions are designed such that the first step favors formation of monomeric species with the correct intramolecular disulfide bridges, the conditions of the second folding reaction stimulate the formation of the intermolecular disulfide bridge. The short processing times and increased yields compared to previously published procedures allow low-cost production of this important protein drug.
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Affiliation(s)
- S von Einem
- Institute for Biochemistry and Biotechnology, Kurt-Mothes-Str. 3, Martin-Luther University Halle-Wittenberg, 06120 Halle, Germany
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Rüther KW, Hinz B, Schwarz E. Operative Behandlung des Retraktionssyndroms nach Stilling-Türk-Duane. Klin Monbl Augenheilkd 2009. [DOI: 10.1055/s-0029-1243692] [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]
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Reeves M, Borrero S, Schwarz E, Behringer T, Noguchi L, Roberts M, Creinin M. O790 Pregnancy after tubal sterilization in the United States. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bauer A, Schwarz E, Mai C. Environmental medicine or psychiatry? Int J Hyg Environ Health 2009; 212:569-70; author reply 571-3. [DOI: 10.1016/j.ijheh.2008.12.004] [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] [Received: 10/29/2008] [Accepted: 12/28/2008] [Indexed: 11/26/2022]
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Horwitz D, Schwarz E, Scott M, Lewis L. 382: Glycemic Control Is Improved in Emergency Department Patients With an Identifiable Primary Care Provider. Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.421] [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]
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Curtis B, Evans RW, Sbaraini A, Schwarz E. The Monitor Practice Programme: is non-invasive management of dental caries in private practice effective? Aust Dent J 2009; 53:306-13. [PMID: 19133945 DOI: 10.1111/j.1834-7819.2008.00071.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This paper reviews the efficacy of an intensive, preventive-based, non-invasive approach to the management of dental caries within a randomized controlled trial. METHODS The primary efficacy measure was the two-year DMFS increment. Changes in risk status, fluoride history, number of emergency visits and toothaches, along with demographic variables such as age, gender, health problems, and the location of the dental practice attended were measured. Regression analysis was undertaken to adjust for potential confounding variables. RESULTS Nine hundred and two patients were recruited within 22 dental practices between May 2005 and March 2006. Baseline DMFS did not differ significantly between the control and study groups (p = 0.83). Age (p < 0.001), health status (p = 0.005), baseline risk (p < 0.001) and fluoride history (p < 0.001) were all independent significant predictors of two-year DMFS increment. Gender approached significance (p = 0.08). There were no statistically significant differences between the groups in the incidence of toothaches (p = 0.1) or number of treatment visits required (p = 0.35). There was a significant difference in the two-year incremental DMFS score in the study group compared to the control group (mean difference 2.2; p < 0.001). After adjusting for confounding variables the difference in the DMFS increment between the control and study groups remained significant (mean difference 1.7; p < 0.001). CONCLUSIONS The results indicate efficacy of the preventive programme. Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations, on a relatively short-term basis (two years). While encouraging, it will be essential that these results are followed over a longer period of time in order to determine whether the benefits are maintained.
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Affiliation(s)
- B Curtis
- Faculty of Dentistry, The University of Sydney, New South Wales.
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Rüther K, Hinz B, Zappe H, Schwarz E. Operative Behandlung des Strabismus sursoadductorius und der N. trochlearis-Parese. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-0028-1110067] [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: 10/21/2022]
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