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Gerwing M, Hoffmann E, Geyer C, Helfen A, Maus B, Schinner R, Wachsmuth L, Heindel W, Eisenblaetter M, Faber C, Wildgruber M. Intratumoral heterogeneity after targeted therapy in murine cancer models with differing degrees of malignancy. Transl Oncol 2023; 37:101773. [PMID: 37666208 PMCID: PMC10483060 DOI: 10.1016/j.tranon.2023.101773] [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: 06/30/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Conventional morphologic and volumetric assessment of treatment response is not suitable for adequately assessing responses to targeted cancer therapy. The aim of this study was to evaluate changes in tumor composition after targeted therapy in murine models of breast cancer with differing degrees of malignancy via non-invasive magnetic resonance imaging (MRI). MATERIALS AND METHODS Mice bearing highly malignant 4T1 tumors or low malignant 67NR tumors were treated with either a combination of two immune checkpoint inhibitors (ICI, anti-PD1 and anti-CTLA-4) or the multi-tyrosine kinase inhibitor sorafenib, following experiments with macrophage-depleting clodronate-loaded liposomes and vessel-stabilizing angiopoietin-1. Mice were imaged on a 9.4 T small animal MRI system with a multiparametric (mp) protocol, comprising T1 and T2 mapping and diffusion-weighted imaging. Tumors were analyzed ex vivo with histology. RESULTS AND DISCUSSIONS All treatments led to an increase in non-viable areas, but therapy-induced intratumoral changes differed between the two tumor models and the different targeted treatments. While ICI treatment led to intratumoral hemorrhage, sorafenib treatment mainly induced intratumoral necrosis. Treated 4T1 tumors showed increasing and extensive areas of necrosis, in comparison to 67NR tumors with only small, but also increasing, necrotic areas. After either of the applied treatments, intratumoral heterogeneity, was increased in both tumor models, and confirmed ex vivo by histology. Apparent diffusion coefficient with subsequent histogram analysis proved to be the most sensitive MRI sequence. In conclusion, mp MRI enables to assess dedicated therapy-related intratumoral changes and may serve as a biomarker for treatment response assessment.
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Affiliation(s)
- M Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany.
| | - E Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany
| | - C Geyer
- Clinic of Radiology, University of Münster, Münster, Germany
| | - A Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
| | - B Maus
- Clinic of Radiology, University of Münster, Münster, Germany
| | - R Schinner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - L Wachsmuth
- Clinic of Radiology, University of Münster, Münster, Germany
| | - W Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
| | - M Eisenblaetter
- Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - C Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - M Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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Hoffmann E, Andersen PT, Mogensen CB, Prinds C, Primdahl J. Relatives' negotiations with healthcare professionals during older people's admission in an emergency department: An ethnographic study. Nurs Open 2023; 10:6381-6389. [PMID: 37312450 PMCID: PMC10416047 DOI: 10.1002/nop2.1886] [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: 10/22/2021] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Relatives are recognised as important for older patients' care and treatment. Variations in relatives' opportunities to negotiate the quality and continuity of older people's care and treatment can potentially lead to inequality in older people's access to care and treatment. AIM This study aimed to examine relatives' opportunities and strategies for negotiation with health care professionals (HCPs) during the admission of older people to emergency departments in Denmark. MATERIALS AND METHODS We planned a qualitative ethnographical study employing a hermeneutic approach. Observations focused on social situations and interactions between relatives and HCPs. The analysis was guided by qualitative content analysis. RESULTS The analysis derived one main theme, attitude to action, containing three subthemes: frustration obtaining access, presenting the case and a powerful relationship. Being active appeared to be essential to achieving possibilities for negotiation with HCPs. DISCUSSION Inspired by Bourdieu, habitus, doxical values and institutional logics of relatives seem to affect their opportunities to negotiate with HCPs during older people's admission to an emergency department. CONCLUSION Active and proactive relatives seem to have better opportunities to negotiate with HCPs during older people's acute hospital admission than reactive, passive and hesitant relatives. The logic of public management and the medical profession seem to dominate and influence doxa in the EDs and put special demands on the relatives. This imbalance constitutes a risk of inequality in older people's access to health.
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Affiliation(s)
- Eva Hoffmann
- University College South DenmarkAabenraaDenmark
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- OPEN, Open Patient data ExplorativeRegion of Southern DenmarkOdenseDenmark
| | | | - Christian Backer Mogensen
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
| | - Christina Prinds
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
- Research Unit of Obstetrics and GynaecologyUniversity of Southern DenmarkOdenseDenmark
| | - Jette Primdahl
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
- Danish Hospital for Rheumatic DiseasesUniversity Hospital of Southern DenmarkSønderborgDenmark
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Pongratz J, Riess L, Hartl S, Brueck B, Tesche C, Ebersberger U, Helmberger T, Crispin A, Wankerl M, Dorwarth U, Hoffmann E, Straube F. Left atrial appendage volume is an independent predictor of atrial arrhythmia recurrence following cryoballoon pulmonary vein isolation in persistent atrial fibrillation. Front Cardiovasc Med 2023; 10:1190860. [PMID: 37404733 PMCID: PMC10315839 DOI: 10.3389/fcvm.2023.1190860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation in persistent AF (persAF), and cryoballoon PVI emerged as an initial ablation strategy. Symptomatic atrial arrhythmia recurrence following successful PVI in persAF is observed more frequently than in paroxysmal AF. Predictors for arrhythmia recurrence following cryoballoon PVI for persAF are not well described, and the role of left atrial appendage (LAA) anatomy is uncertain. Methods Patients with symptomatic persAF and pre-procedural cardiac computed tomography angiography (CCTA) images undergoing initial second-generation cryoballoon (CBG2) were enrolled. Left atrial (LA), pulmonary vein (PV) and LAA anatomical data were assessed. Clinical outcome and predictors for atrial arrhythmia recurrence were evaluated by univariate and multivariate regression analysis. Results From May 2012 to September 2016, 488 consecutive persAF patients underwent CBG2-PVI. CCTA with sufficient quality for measurements was available in 196 (60.4%) patients. Mean age was 65.7 ± 9.5 years. Freedom from arrhythmia was 58.2% after a median follow-up of 19 (13; 29) months. No major complications occurred. Independent predictors for arrhythmia recurrence were LAA volume (HR 1.082; 95% CI, 1.032 to 1.134; p = 0.001) and mitral regurgitation ≥ grade 2 (HR, 2.49; 95% CI 1.207 to 5.126; p = 0.013). LA volumes ≥110.35 ml [sensitivity: 0.81, specificity: 0.40, area under the curve (AUC) = 0.62] and LAA volumes ≥9.75 ml (sensitivity: 0.56, specificity 0.70, AUC = 0.64) were associated with recurrence. LAA-morphology, classified as chicken-wing (21.9%), windsock (52.6%), cactus (10.2%) and cauliflower (15.3%), did not predict outcome (log-rank, p = 0.832). Conclusion LAA volume and mitral regurgitation were independent predictors for arrhythmia recurrence following cryoballoon ablation in persAF. LA volume was less predictive and correlated with LAA volume. LAA morphology did not predict the clinical outcome. To improve outcomes in persAF ablation, further studies should focus on treatment strategies for persAF patients with large LAA and mitral regurgitation.
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Affiliation(s)
- J. Pongratz
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - L. Riess
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - S. Hartl
- Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany
- Department of Medicine, Witten/Herdecke University, Witten, Germany
| | - B. Brueck
- Kardiologie Praxis Erkelenz, Erkelenz, Germany
| | - C. Tesche
- Department of Cardiology, Clinic Augustinum Munich, Munich, Germany
| | | | - T. Helmberger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - A. Crispin
- Institute for Medical Information Processing, Biometry and Epidemiology of the Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
| | - M. Wankerl
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - U. Dorwarth
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - E. Hoffmann
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - F. Straube
- Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine, Munich Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
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Eckert F, Ganser K, Bender B, Schittenhelm J, Noell S, Stransky N, Hoffmann E, Zips D, Huber S, Paulsen F. P03.07.A MRI signature in preoperative imaging predicts mesenchymal stem cell features and radioresistance in primary glioblastoma stem cell cultures. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, a molecular signature describing the mesenchymal / proneural features of primary stem-cell-enriched glioblastoma cultures was identified correlating with invasiveness, radiation sensitivity and patient-outcome. However, generating and characterizing primary cultures is time-consuming and this might hamper translation into clinical concepts. The aim of this study was to evaluate the use of standard preoperative MR imaging (T1ce and T2FLAIR sequences) to predict the molecular signature and thus enable the development of clinical treatment concepts based on the molecular properties of the individual tumors.
Material and Methods
For 16 patients, for whom primary stem cell enriched cultures had been characterized for their mesenchymal / proneural signature and radiation sensitivity, tumor volume (hyperintense volume in T1ce), necrosis (hypointense volume inside the tumor volume) and edema (hyperintense volume in T2FLAIR) were contoured for volumetric analysis. Volume parameters were used to calculate ratios (edema/tumor and necrosis/tumor) and a MRI signature, which was then correlated with molecular parameters and patient outcome stratified by MGMT promoter methylation.
Results
As expected, the prognosis of patients with MGMT-promoter-methylated tumors was better (n.s.) compared to those with unmethylated MGMT promoters. Neither molecular nor imaging data were significantly different between these subgroups. In the subgroup of patients with unmethylated MGMT promoter, volumetric imaging parameters correlated with the molecular signature and cellular radiation sensitivity of the stem cell enriched cultures. This association was much weaker in the subgroup with methylated MGMT promoter.
Conclusion
In the subgroup of patients with unmethylated MGMT promoter, volumetric parameters on preoperative standard MR imaging might hint at the molecular properties of the respective tumor and its radiation sensitivity. This might be a clinically applicable method to stratify treatment according to molecular stem cell subtype without tissue culture and molecular analysis.
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Affiliation(s)
- F Eckert
- Medical University Vienna , Vienna , Austria
| | - K Ganser
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - B Bender
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - J Schittenhelm
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - S Noell
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - N Stransky
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - E Hoffmann
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - D Zips
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - S Huber
- Eberhard Karls University Tuebingen , Tuebingen , Germany
| | - F Paulsen
- Eberhard Karls University Tuebingen , Tuebingen , Germany
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Wang D, Hildorf S, Ntemou E, Dong L, Pors S, Mamsen L, Fedder J, Hoffmann E, Clasen-Linde E, Cortes D, Thorup J, Andersen C. P-468 Organotypic culture of testicular tissue from infant boys with cryptorchidism. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
Can organotypic culture support the survival and maturation of germ cells and niche-related cells within testicular tissue from infant boys with cryptorchidism?
Summary answer
The testicular structure and the number of germ cells were maintained during organotypic culture, whereas Sertoli cells and peritubular myoid cells (PTMCs) matured.
What is known already
Testicular tissue cryopreservation (TTC) is a strategy to safeguard the fertility of prepubertal boys who face a risk of infertility. Organotypic culture of immature testicular tissue from mice achieved production of spermatozoa. Similarly, the culture of human fetal gonads resulted in the generation of competent spermatids. However , in vitro spermatogenesis by organotypic culture of human prepubertal testicular tissue has not been achieved. It is also unknown whether germ cells as well as its niche-related cells, in testicular tissue from infant boys with cryptorchidism, can maintain and mature under in vitro conditions.
Study design, size, duration
Testicular tissue was cryopreserved from four infant boys with bilateral cryptorchidism undergoing orchidopexy (age range: 0.5-1.4 years), as part of a fertility preservation program. Culture media with and without retinoic acid were tested. Testicular fragments were harvested at 30 days and 60 days after culture and evaluated by histological assessment of tissue structure, germ cell development, and immunohistochemical staining for germ cell and somatic cell markers.
Participants/materials, setting, methods
Cryopreserved-thawed testicular tissue was cut into fragments (1-2 mm3) and placed on top of agarose gel stands and cultured at 34oC with 5% CO2 in Minimum Essential Medium-alpha supplemented with knockout serum replacement, human umbilical cord plasma, Activin A, hormones, growth factors, with or without retinoic acid. Immunohistochemical analyses were performed using germ cell markers (MAGE-A, GAGE, and VASA), Sertoli cell maturation markers (AMH, AR, SOX9), PTMC marker (alpha-SMA).
Main results and the role of chance
Following the 60-day culture, the lumen of the seminiferous tubules had developed. The number of germ cells per tubule remained stable during this period. However, no further germ cell maturation was observed. Germ cells showed different phenotypes of MAGEA, GAGE, and VASA expression with no significant difference in number. The number of SOX9-positive Sertoli cells was significantly increased from 30 days to 60 days of culture (p <0.0001). No difference in AMH expression was observed, while AR expression in Sertoli cells was induced during culture. Alpha-SMA expression was detected in the PTMCs surrounding the seminiferous tubules. The two different culture conditions, with and without retinoic acid in the culture media, did not affect cell survival or maturation.
Limitations, reasons for caution
The small number of testicular biopsies available is a limitation.
Wider implications of the findings
Our organotypic culture conditions support the long-term survival of germ cells in testicular tissue from infant boys with cryptorchidism. Thus, further studies are needed to induce the maturation of germ cells under similar experimental conditions.
Trial registration number
not applicable
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Affiliation(s)
- D Wang
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
| | - S Hildorf
- University Hospital of Copenhagen- Rigshospitalet, Department of Pediatric Surgery , Copenhagen, Denmark
| | - E Ntemou
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
| | - L Dong
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
| | - S Pors
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
| | - L Mamsen
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
| | - J Fedder
- Odense University Hospital, Centre of Andrology & Fertility Clinic- Department D , Odense, Denmark
| | - E Hoffmann
- Faculty of Health and Medical Sciences- University of Copenhagen, DNRF Center for Chromosome Stability- Department of Cellular and Molecular Medicine , Copenhagen, Denmark
| | - E Clasen-Linde
- Copenhagen University Hospital- Rigshospitalet, Department of Pathology , Copenhagen, Denmark
| | - D Cortes
- Copenhagen University Hospital Hvidovre, Department of Pediatrics and Adolescent Medicine , Copenhagen, Denmark
| | - J Thorup
- University Hospital of Copenhagen- Rigshospitalet, Department of Pediatric Surgery , Copenhagen, Denmark
| | - C Andersen
- University Hospital of Copenhagen- Rigshospitalet, Laboratory of Reproductive Biology , Copenhagen, Denmark
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Eckert F, Hoffmann E, Zips D, Paulsen F. PO-1163 Metaanalysis of fractionation schedules to hypothesize a benefit of dose escalation in glioblastoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03127-9] [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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Hoffmann E, Specht K, Elkjær M, Kjær M, Primdahl J. Relatives’ experiences of the hospitalisation of older people with COVID‐19: A qualitative interview study. Int J Older People Nurs 2022; 17:e12451. [PMID: 35156293 PMCID: PMC9115343 DOI: 10.1111/opn.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/03/2021] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
Background During the COVID‐19 pandemic, visitors were restricted from hospitals, separating them from hospitalised friends and family to reduce the infection risk. Objectives The objective was to explore how relatives of older people acutely admitted to hospital with COVID‐19 experienced being a relative, and how they felt about their contact with health care professionals (HCPs) when visitor restrictions prevented their physical presence in the ward. Method This study employed a qualitative design. We used individual qualitative semi‐structured interviews and the participants were relatives of acutely admitted older people from three COVID‐19 wards in Denmark. A total of 18 relatives participated, 14 female and 4 male, aged between 45 and 83 years. The analysis was guided by Graneheim and Lundman’s qualitative content analysis. Results The analysis derived the following three themes: (1) the importance of trust in a period of uncertainty; (2) the meaning of contact with HCPs, and (3) active but at a distance—a balancing act. The participants' feelings of uncertainty were prominent. The unknown nature of the disease and the unusual situation challenged relatives' trust in HCPs and the health care system. Conclusions and relevance to practice The findings highlight relatives' stress when the possibilities for visiting are restricted and the importance of trust in, and the relationship with HCPs. This study can strengthen HCPs' understanding of relatives' situation when older people are hospitalised during and after the COVID‐19 pandemic.
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Affiliation(s)
- Eva Hoffmann
- University College South Denmark Aabenraa Denmark
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- OPEN Odense Denmark
| | - Kirsten Specht
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Department of Orthopaedic Surgery Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Mette Elkjær
- Department of Emergency Medicine Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Maria Kjær
- University College South Denmark Aabenraa Denmark
| | - Jette Primdahl
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Danish Hospital for Rheumatic Diseases University Hospital of Southern Denmark Sønderborg Denmark
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Hoffmann E, Dillon S, Barahona A, McIntire DD, Nelson DB. Impact of Implementation of Maternal Fetal Triage Index on Patients Presenting with Decreased Fetal Movement. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hoffmann E, Dillon S, Barahona A, McIntire DD, Nelson DB. Impact of Implementation of Maternal Fetal Triage Index on Time-to-Management for Severe Hypertension. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.11.189] [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: 11/01/2022]
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Thude BR, Primdahl J, Jensen HI, Elkjær M, Hoffmann E, Boye LK, Specht K. How did nurses cope with the fast, comprehensive organisational changes at Danish hospital wards during the COVID-19 pandemic? An interview study based on nurses' experiences. BMJ Open 2021; 11:e049668. [PMID: 34949610 PMCID: PMC8704025 DOI: 10.1136/bmjopen-2021-049668] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has influenced hospital work and healthcare workers all over the world. We explored how Danish nurses coped with the fast, comprehensive organisational changes in their workplace and identified barriers to and facilitators for organisations ensuring the best possible conditions for nurses to meet these challenges. The study focuses on the organisational setting and how it did or did not support the nurses in their work. METHODS A qualitative explorative design was used in interviewing 23 nurses who had worked at a COVID-19 ward in one of three hospitals. Data were collected in the summer of 2020, and the analysis was inspired by Paul Ricoeur's theory of narratives and interpretation. RESULTS The presence of managers in the wards helped the nurses in the form of psychological and practical support. Working within an organisation that provides a safe environment was essential for nurses. The experience of a safe environment allowed nurses to ask questions, which supported them in finding solutions to specific tasks in the new and critical working environment. Barriers to handling the new situation were an absence of managers and a lack of a sense of belongingness and trust. CONCLUSION This study highlights the need for management to be present in the ward and for organisational support to be available to nurses so they can provide optimal treatment and care when working in new and unknown conditions during a pandemic. Practical assistance from managers to ease the job is beneficial. Furthermore, the presence of management is essential to provide psychological support and create a safe environment because this allows nurses to ask questions about how to better manage new and critical tasks.
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Affiliation(s)
- Bettina Ravnborg Thude
- Medical Research Unit, University Hospital of Southern Jutland, Region of Southern Denmark, Sonderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Jette Primdahl
- Hospital of Southern Jutland, University Hospital of Southern Denmark, Region of Southern Denmark, Sonderborg, Denmark
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark
| | - Hanne Irene Jensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Anaesthesiology and Intensive Care, Lillebaelt Hospital, Vejle, Denmark
| | - Mette Elkjær
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Emergency Medicine, Hospital Sonderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Eva Hoffmann
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Emergency Medicine, Hospital Sonderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Lilian Keene Boye
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Emergency Medicine, Hospital Sonderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Kirsten Specht
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Orthopaedic Surgery, University Hospital of Southern Denmark, Aabenraa, Denmark
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Capalbo A, Poli M, Rienzi L, Girardi L, Patassini C, Fabiani M, Cimadomo D, Benini F, Farcomeni A, Cuzzi J, Rubio C, Albani E, Sacchi L, Vaiarelli A, Figliuzzi M, Findikli N, Coban O, Boynukalin FK, Vogel I, Hoffmann E, Livi C, Levi-Setti PE, Ubaldi FM, Simón C. Mosaic human preimplantation embryos and their developmental potential in a prospective, non-selection clinical trial. Am J Hum Genet 2021; 108:2238-2247. [PMID: 34798051 PMCID: PMC8715143 DOI: 10.1016/j.ajhg.2021.11.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Chromosome imbalance (aneuploidy) is the major cause of pregnancy loss and congenital disorders in humans. Analyses of small biopsies from human embryos suggest that aneuploidy commonly originates during early divisions, resulting in mosaicism. However, the developmental potential of mosaic embryos remains unclear. We followed the distribution of aneuploid chromosomes across 73 unselected preimplantation embryos and 365 biopsies, sampled from four multifocal trophectoderm (TE) samples and the inner cell mass (ICM). When mosaicism impacted fewer than 50% of cells in one TE biopsy (low-medium mosaicism), only 1% of aneuploidies affected other portions of the embryo. A double-blinded prospective non-selection trial (NCT03673592) showed equivalent live-birth rates and miscarriage rates across 484 euploid, 282 low-grade mosaic, and 131 medium-grade mosaic embryos. No instances of mosaicism or uniparental disomy were detected in the ensuing pregnancies or newborns, and obstetrical and neonatal outcomes were similar between the study groups. Thus, low-medium mosaicism in the trophectoderm mostly arises after TE and ICM differentiation, and such embryos have equivalent developmental potential as fully euploid ones.
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Schleberger R, Metzner A, Kuck KH, Andresen D, Willems S, Hoffmann E, Deneke T, Eckardt L, Brachmann J, Hochadel M, Senges J, Rillig A. Antiarrhythmic drug therapy after catheter ablation for atrial fibrillation has no impact on recurrences, cardiovascular events and mortality – insights from the German Ablation Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0357] [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: 11/13/2022] Open
Abstract
Abstract
Background
Data on the optimal treatment strategy for antiarrhythmic drug therapy (AAD) after atrial fibrillation (AF) catheter ablation are inconsistent. While AAD potentially stabilizes sinus rhythm, it also increases the patients' treatment burden.
Methods
Patients from the prospective German Ablation Registry (n=3275) discharged with or without AAD after AF catheter ablation were compared regarding long-term success, cardiovascular events and patient reported outcome.
Results
In patients with paroxysmal AF (n=2138) recurrence and rehospitalization rates did not differ when discharged with (n=1051) or without (n=1087) AAD (recurrence: adjusted odds ratio (OR) 1.13, 95% confidence interval (CI) [0.95–1.35]; rehospitalization: OR 1.08, 95% CI [0.90–1.30]). The reablation rate was higher and reduced treatment satisfaction was reported more often in those discharged with AAD (reablation: OR 1.30, 95% CI [1.05–1.61]; reduced treatment satisfaction: OR 1.76, 95% CI [1.20–2.58]).
Similar rates of recurrences, rehospitalisations, reablations and treatment satisfaction were found in patients with persistent AF (n=1137) discharged with (n=641) or without (n=496) AAD (recurrence: OR 1.22, 95% CI [0.95–1.56]; rehospitalization: OR 1.16, 95% CI [0.90–1.50]; reablation: OR 1.21, 95% CI [0.91–1.61]; treatment satisfaction: OR 1.24, 95% CI [0.74–2.08]).
The incidence of cardiovascular events and mortality did not differ at follow-up in paroxysmal and persistent AF patients discharged with or without AAD.
Conclusion
The rates of recurrences, cardiovascular events and mortality did not differ between patients discharged with or without AAD after AF catheter ablation. However, AAD should be considered carefully in patients with paroxysmal AF, in whom it was associated with a higher reablation rate and reduced treatment satisfaction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Schleberger
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - A Metzner
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | | | | | - S Willems
- Asklepios Clinic St. Georg, Hamburg, Germany
| | | | - T Deneke
- Heart Center Bad Neustadt, Bad Neustadt a. d. Saale, Germany
| | - L Eckardt
- Muenster University Hospital, Muenster, Germany
| | | | - M Hochadel
- Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany
| | - J Senges
- Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany
| | - A Rillig
- University Heart & Vascular Center Hamburg, Hamburg, Germany
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Abstract
The introduction of chemical modifications into long RNA molecules at specific positions for visualization, biophysical investigations, diagnostic and therapeutic applications still remains challenging. In this review, we present recent approaches for covalent internal labeling of long RNAs. Topics included are the assembly of large modified RNAs via enzymatic ligation of short synthetic oligonucleotides and synthetic biology approaches preparing site-specifically modified RNAs via in vitro transcription using an expanded genetic alphabet. Moreover, recent approaches to employ deoxyribozymes (DNAzymes) and ribozymes for RNA labeling and RNA methyltransferase based labeling strategies are presented. We discuss the potentials and limits of the individual methods, their applicability for RNAs with several hundred to thousands of nucleotides in length and indicate future directions in the field.
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Affiliation(s)
- Hannah Depmeier
- University of CologneDepartment of ChemistryGreinstr. 450939CologneGermany
| | - Eva Hoffmann
- University of CologneDepartment of ChemistryGreinstr. 450939CologneGermany
| | - Lisa Bornewasser
- University of CologneDepartment of ChemistryGreinstr. 450939CologneGermany
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14
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Hoffmann E, Vahanian S, Martinelli VT, Chavez M, Mesbah M, Nezhat FR. Combined Medical and Minimally Invasive Robotic Surgical Approach to the Treatment and Repair of Cesarean Scar Pregnancies. JSLS 2021; 25:JSLS.2021.00039. [PMID: 34456552 PMCID: PMC8372987 DOI: 10.4293/jsls.2021.00039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives The rise in cesarean deliveries, has led to increase in maternal complications in subsequent pregnancies such as abnormal placental implantation, uterine rupture, hemorrhage and, less commonly, cesarean scar pregnancies (CSP). Our objective was to describe patient characteristics following a combined medical and surgical treatment approach to first trimester cesarean scar pregnancies. Methods This was a case series approved by the Institutional Review Board of cesarean scar pregnancies over a two-year period at a single academic institution. The study included five patients with diagnosed cesarean scar pregnancies opting for pregnancy termination with the desire for fertility preservation. Medical treatment involved intra-gestational sac injection of lidocaine followed by systemic injection of methotrexate. At a minimum of two months later, surgical resection of cesarean scar pregnancy and repair of the uterus was performed. Results Median patient age was 36 (range 34 - 42) years, with 4 (3 - 10) prior pregnancies and 2 (1 - 3) prior cesarean deliveries. 40% (2/5) were Hispanic, 20% (1/5) Caucasian, 20% (1/5) African-American, and 20% (1/5) South Asian. After medical intervention, patients waited on average 4.6 ± 2.3 months before surgery. No post-intervention complications or recurrences occurred. Two patients had a subsequent pregnancy. Conclusion This case series demonstrates an ideal management of cesarean scar pregnancy using combined medical and surgical approach in treating current ectopic pregnancy and repairing the uterine defect successfully without recurrence.
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Affiliation(s)
- Eva Hoffmann
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
| | - Sevan Vahanian
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
| | - Vanessa T Martinelli
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
| | - Martin Chavez
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
| | - Michael Mesbah
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
| | - Farr R Nezhat
- Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island, School of Medicine, Mineola, New York, USA
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15
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Spur G, Hoffmann E, Paluncic Z. Erweiterte Ansätze zur Beschreibung des Erwärmungs- und Abkühlungsvorgangs bei Werkzeugmaschinen-Hauptspindeln. ACTA ACUST UNITED AC 2021. [DOI: 10.1515/zwf-1988-831026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Specht K, Primdahl J, Jensen HI, Elkjaer M, Hoffmann E, Boye LK, Thude BR. Frontline nurses' experiences of working in a COVID-19 ward-A qualitative study. Nurs Open 2021; 8:3006-3015. [PMID: 34324267 PMCID: PMC8441898 DOI: 10.1002/nop2.1013] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 02/01/2021] [Revised: 06/03/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022] Open
Abstract
Aim To explore how nurses experienced working in a newly organized COVID‐19 ward with high‐risk patients during a new and unknown pandemic. Design A qualitative explorative study using a phenomenological‐hermeneutic approach. Methods Semi‐structured individual telephone interviews were conducted in June–July 2020 with 23 nurses working in COVID‐19 wards from three regional hospitals in Denmark. The nurses had been transferred from other departments at their hospital to the newly organized COVID‐19 wards. Data analysis was influenced by Paul Ricoeur's theory of narrative and interpretation, including three analytical levels: naïve reading, structural analysis and critical interpretation and discussion. Results During the structural analysis four themes were generated: (a) Challenging and uncertain situation, but also a positive experience (b) Professional and personal development (c) Lack of nurses' rights during a pandemic (d) Reward in itself or a desire for financial reward.
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Affiliation(s)
- Kirsten Specht
- Department of Orthopaedic Surgery, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.,Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Hanne Irene Jensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Anaesthesiology and Intensive Care, Kolding Hospital, University Hospital of Southern Denmark, Kolding, Denmark.,Department of Anaesthesiology and Intensive Care, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Mette Elkjaer
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Emergency Medicine, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.,Research Unit of Health Sciences, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Eva Hoffmann
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.,Department of Emergency Medicine, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.,University College South Denmark, Aabenraa, Denmark
| | - Lilian Keene Boye
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Emergency Medicine, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Bettina Ravnborg Thude
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Medical Research Unit, University Hospital of Southern Denmark, Sønderborg, Denmark
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17
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Hoffmann E, Andersen PT, Mogensen CB, Prinds C, Primdahl J. Relatives' negotiation power in relation to older people's acute hospital admission: A qualitative interview study. Scand J Caring Sci 2021; 36:1016-1026. [PMID: 34156115 DOI: 10.1111/scs.13012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/30/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Acutely admitted older people are potentially vulnerable and dependent on relatives to negotiate and navigate on their behalf. AIM This study aimed to explore relatives' experiences of their interactions with healthcare professionals during acute hospital admission of older people to derive themes of importance for relatives' negotiations with these professionals. METHOD A qualitative design was applied. Relatives of acutely admitted older people at two emergency departments in Denmark were interviewed (n = 17). The qualitative content analysis was guided by Graneheim and Lundman's concepts. RESULTS The analysis derived four themes: (a) Mandate, (b) Incentive, (c) Capability and (d) Attitude to taking action. These four sources of relatives' negotiation power can be illustrated in the MICA model. CONCLUSION Four themes were identified as important sources of relatives' negotiation power. Since the four sources of power potentially change according to the situation, relatives' negotiation power seems to be context dependent.
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Affiliation(s)
- Eva Hoffmann
- University College South Denmark, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,OPEN, Open Patient data Explorative, Region of Southern Denmark, Odense, Denmark
| | | | - Christian Backer Mogensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Christina Prinds
- University College South Denmark, Aabenraa, Denmark.,Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
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18
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Hunt ET, Muscat J, Hoffmann E, Akerman M, Vintzileos A. 527 Is there an association between postoperative cervical length after cerclage and gestational age at delivery? Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2020.12.548] [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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19
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Hassold T, Maylor-Hagen H, Wood A, Gruhn J, Hoffmann E, Broman KW, Hunt P. Failure to recombine is a common feature of human oogenesis. Am J Hum Genet 2021; 108:16-24. [PMID: 33306948 DOI: 10.1016/j.ajhg.2020.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
Failure of homologous chromosomes to recombine is arguably the most important cause of human meiotic nondisjunction, having been linked to numerous autosomal and sex chromosome trisomies of maternal origin. However, almost all information on these "exchangeless" homologs has come from genetic mapping studies of trisomic conceptuses, so the incidence of this defect and its impact on gametogenesis are not clear. If oocytes containing exchangeless homologs are selected against during meiosis, the incidence may be much higher in developing germ cells than in zygotes. To address this, we initiated studies of exchangeless chromosomes in fetal ovarian samples from elective terminations of pregnancy. In total, we examined more than 7,000 oocytes from 160 tissue samples, scoring for the number of foci per cell of the crossover-associated protein MLH1. We identified a surprisingly high level of recombination failure, with more than 7% of oocytes containing at least one chromosome pair that lacked an MLH1 focus. Detailed analyses indicate striking chromosome-specific differences, with a preponderance of MLH1-less homologs involving chromosomes 21 or 22. Further, the effect was linked to the overall level of recombination in the cell, with the presence of one or two exchangeless chromosomes in a cell associated with a 10%-20% reduction in the total number of crossovers. This suggests individuals with lower rates of meiotic recombination are at an increased risk of producing aneuploid offspring.
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20
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Mkrtchyan GV, Abdelmohsen K, Andreux P, Bagdonaite I, Barzilai N, Brunak S, Cabreiro F, de Cabo R, Campisi J, Cuervo AM, Demaria M, Ewald CY, Fang EF, Faragher R, Ferrucci L, Freund A, Silva-García CG, Georgievskaya A, Gladyshev VN, Glass DJ, Gorbunova V, de Grey A, He WW, Hoeijmakers J, Hoffmann E, Horvath S, Houtkooper RH, Jensen MK, Jensen MB, Kane A, Kassem M, de Keizer P, Kennedy B, Karsenty G, Lamming DW, Lee KF, MacAulay N, Mamoshina P, Mellon J, Molenaars M, Moskalev A, Mund A, Niedernhofer L, Osborne B, Pak HH, Parkhitko A, Raimundo N, Rando TA, Rasmussen LJ, Reis C, Riedel CG, Franco-Romero A, Schumacher B, Sinclair DA, Suh Y, Taub PR, Toiber D, Treebak JT, Valenzano DR, Verdin E, Vijg J, Young S, Zhang L, Bakula D, Zhavoronkov A, Scheibye-Knudsen M. ARDD 2020: from aging mechanisms to interventions. Aging (Albany NY) 2020; 12:24484-24503. [PMID: 33378272 PMCID: PMC7803558 DOI: 10.18632/aging.202454] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
Aging is emerging as a druggable target with growing interest from academia, industry and investors. New technologies such as artificial intelligence and advanced screening techniques, as well as a strong influence from the industry sector may lead to novel discoveries to treat age-related diseases. The present review summarizes presentations from the 7th Annual Aging Research and Drug Discovery (ARDD) meeting, held online on the 1st to 4th of September 2020. The meeting covered topics related to new methodologies to study aging, knowledge about basic mechanisms of longevity, latest interventional strategies to target the aging process as well as discussions about the impact of aging research on society and economy. More than 2000 participants and 65 speakers joined the meeting and we already look forward to an even larger meeting next year. Please mark your calendars for the 8th ARDD meeting that is scheduled for the 31st of August to 3rd of September, 2021, at Columbia University, USA.
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Affiliation(s)
- Garik V. Mkrtchyan
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kotb Abdelmohsen
- Laboratory of Genetics and Genomics, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
| | - Pénélope Andreux
- Amazentis SA, EPFL Innovation Park, Bâtiment C, Lausanne, Switzerland
| | - Ieva Bagdonaite
- Center for Glycomics, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Filipe Cabreiro
- Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital Campus, London, W12 0NN, UK
| | - Rafael de Cabo
- Experimental Gerontology Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Judith Campisi
- Buck Institute for Research on Aging, Novato, CA 94945, USA
| | - Ana Maria Cuervo
- Department of Developmental and Molecular Biology, Institute for Aging Studies, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Marco Demaria
- European Research Institute for the Biology of Ageing, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Collin Y. Ewald
- Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute for Technology Zürich, Switzerland
| | - Evandro Fei Fang
- Department of Clinical Molecular Biology, University of Oslo and Akershus University Hospital, 1478 Lørenskog, Norway
| | - Richard Faragher
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Adam Freund
- Calico Life Sciences, LLC, South San Francisco, CA 94080, USA
| | - Carlos G. Silva-García
- Department of Molecular Metabolism, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | | | - Vadim N. Gladyshev
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - David J. Glass
- Regeneron Pharmaceuticals, Inc. Tarrytown, NY 10591, USA
| | - Vera Gorbunova
- Departments of Biology and Medicine, University of Rochester, Rochester, NY 14627, USA
| | | | - Wei-Wu He
- Human Longevity Inc., San Diego, CA 92121, USA
| | - Jan Hoeijmakers
- Department of Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eva Hoffmann
- DNRF Center for Chromosome Stability, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steve Horvath
- Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Riekelt H. Houtkooper
- Laboratory Genetic Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Majken K. Jensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Alice Kane
- Blavatnik Institute, Department of Genetics, Paul F. Glenn Center for Biology of Aging Research at Harvard Medical School, Boston, MA 94107, USA
| | - Moustapha Kassem
- Molecular Endocrinology Unit, Department of Endocrinology, University Hospital of Odense and University of Southern Denmark, Odense, Denmark
| | - Peter de Keizer
- Department of Molecular Cancer Research, Center for Molecular Medicine, Division of Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Brian Kennedy
- Buck Institute for Research on Aging, Novato, CA 94945, USA
- Departments of Biochemistry and Physiology, Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Centre for Healthy Ageing, National University Healthy System, Singapore
| | - Gerard Karsenty
- Department of Genetics and Development, Columbia University Medical Center, New York, NY 10032, USA
| | - Dudley W. Lamming
- Department of Medicine, University of Wisconsin-Madison and William S. Middleton Memorial Veterans Hospital, Madison, WI 53792, USA
| | - Kai-Fu Lee
- Sinovation Ventures and Sinovation AI Institute, Beijing, China
| | - Nanna MacAulay
- Department of Neuroscience, University of Copenhagen, Denmark
| | - Polina Mamoshina
- Deep Longevity Inc., Hong Kong Science and Technology Park, Hong Kong
| | - Jim Mellon
- Juvenescence Limited, Douglas, Isle of Man, UK
| | - Marte Molenaars
- Laboratory Genetic Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alexey Moskalev
- Institute of Biology of FRC Komi Science Center of Ural Division of RAS, Syktyvkar, Russia
| | - Andreas Mund
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Laura Niedernhofer
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Brenna Osborne
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Heidi H. Pak
- Department of Medicine, University of Wisconsin-Madison and William S. Middleton Memorial Veterans Hospital, Madison, WI 53792, USA
| | | | - Nuno Raimundo
- Institute of Cellular Biochemistry, University Medical Center Goettingen, Goettingen, Germany
| | - Thomas A. Rando
- Department of Neurology and Neurological Sciences and Paul F. Glenn Center for the Biology of Aging, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lene Juel Rasmussen
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Christian G. Riedel
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | | | - Björn Schumacher
- Institute for Genome Stability in Ageing and Disease, Medical Faculty, University of Cologne, Cologne, Germany
| | - David A. Sinclair
- Blavatnik Institute, Department of Genetics, Paul F. Glenn Center for Biology of Aging Research at Harvard Medical School, Boston, MA 94107, USA
- Department of Pharmacology, School of Medical Sciences, The University of New South Wales, Sydney, NSW, Australia
| | - Yousin Suh
- Departments of Obstetrics and Gynecology, Genetics and Development, Columbia University, New York, NY 10027, USA
| | - Pam R. Taub
- Division of Cardiovascular Medicine, University of California, San Diego, CA 92093, USA
| | - Debra Toiber
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Jonas T. Treebak
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Verdin
- Buck Institute for Research on Aging, Novato, CA 94945, USA
| | - Jan Vijg
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Lei Zhang
- Institute on the Biology of Aging and Metabolism, Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Daniela Bakula
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Alex Zhavoronkov
- Insilico Medicine, Hong Kong Science and Technology Park, Hong Kong
| | - Morten Scheibye-Knudsen
- Center for Healthy Aging, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
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21
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Hoffmann E. The biopolitics of feeling: race, sex, and science in the nineteenth century by Kyla Schuller. Feminist Theory 2020. [DOI: 10.1177/1464700120967291c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Hoffmann E, Vintzileos WS, Akerman M, Vertichio R, Sicuranza GB, Vintzileos AM. Impact of cesarean delivery due to maternal choice on perinatal outcome in term nulliparous patients with a singleton fetus in a vertex presentation. J Matern Fetal Neonatal Med 2020; 35:4156-4161. [PMID: 33172330 DOI: 10.1080/14767058.2020.1847078] [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: 10/23/2022]
Abstract
OBJECTIVE The objectives of our study were to: (1) evaluate the prevalence of cesarean delivery due to maternal request among nulliparous, term, singleton, vertex (NTSV) patients; (2) identify the clinical profile, if any, of these patients; and (3) compare the perinatal outcomes between NTSV patients who requested a cesarean delivery versus patients who did not request cesarean delivery. STUDY DESIGN This was a retrospective case control study performed at a single institution between November 2018 and July 2019. All NTSV patients who had a cesarean delivery due to maternal choice were identified and compared to the next two NTSV patients in labor who delivered vaginally or by medically indicated cesarean delivery following a cesarean delivery by maternal choice. The primary outcome was composite neonatal morbidity. Secondary outcomes were individual components of composite neonatal and maternal morbidity. RESULTS Of 1138 NTSV patients, 61 (5.4%) patients opted for cesarean delivery by maternal choice. There were significant differences in the demographic/clinical profile between cases and controls including BMI (35.3 kg/m2 vs. 32.7 kg/m2, p < .01), birthweight (3552 gr vs. 3333 gr, p < .001) and documented mental illness (41.0% vs. 22.1% respectively, p < .01). There was no significant difference in composite neonatal morbidity between cases and controls (6.6% vs. 5.7%, adjusted odds ratio [aOR] 0.96, 95% CI 0.25-3.61). The risk for postpartum hemorrhage requiring blood transfusion was higher (but not statistically significant) in the study group (5.0% vs. 0.0%, aOR 6.43, 95% CI: 0.65-63.24). Patients who chose cesarean delivery during the intrapartum period had a higher (but not statistically significant) composite neonatal morbidity (14.3% vs. 5.7%, aOR 2.24, 95% CI 0.52-9.78) and composite maternal morbidity (28.6% vs.11.8%, aOR 2.90, 95% CI 0.92-9.16) and significantly higher transfusion rate (aOR 16.93, 95% CI 1.53-187.74). CONCLUSION Cesarean delivery by maternal choice in NTSV patients is not associated with improved neonatal outcomes; in contrast, it is associated with increased composite maternal morbidity and increased transfusion rate.
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Affiliation(s)
- Eva Hoffmann
- NYU Winthrop Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Long Island School of Medicine, Mineola, NY, USA
| | - William S Vintzileos
- NYU Winthrop Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Meredith Akerman
- NYU Winthrop Hospital, Department of Biostatistics, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Rosanne Vertichio
- NYU Winthrop Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Genevieve B Sicuranza
- NYU Winthrop Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Long Island School of Medicine, Mineola, NY, USA
| | - Anthony M Vintzileos
- NYU Winthrop Hospital, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Long Island School of Medicine, Mineola, NY, USA
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23
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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Anaesthesist 2020; 68:520-529. [PMID: 31396674 DOI: 10.1007/s00101-019-0622-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Vintzileos WS, Muscat J, Hoffmann E, John NS, Vo D, Vintzileos A. Reply. Am J Obstet Gynecol 2020; 223:471-472. [PMID: 32473115 PMCID: PMC7251412 DOI: 10.1016/j.ajog.2020.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 11/18/2022]
Affiliation(s)
- William S Vintzileos
- Department of Obstetrics and Gynecology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, Mineola, NY
| | - Jolene Muscat
- Department of Obstetrics and Gynecology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, Mineola, NY
| | - Eva Hoffmann
- Department of Obstetrics and Gynecology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, Mineola, NY
| | - Nicole S John
- Department of Obstetrics and Gynecology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, Mineola, NY
| | - Duc Vo
- Department of Pathology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, Mineola, NY
| | - Anthony Vintzileos
- Department of Obstetrics and Gynecology, New York University Winthrop Hospital, New York University Langone Health, New York University Long Island School of Medicine, 259 First Street, Mineola, NY 11501.
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Girardi L, Serdarogullari M, Patassini C, Poli M, Fabiani M, Caroselli S, Coban O, Findikli N, Boynukalin FK, Bahceci M, Chopra R, Canipari R, Cimadomo D, Rienzi L, Ubaldi F, Hoffmann E, Rubio C, Simon C, Capalbo A. Incidence, Origin, and Predictive Model for the Detection and Clinical Management of Segmental Aneuploidies in Human Embryos. Am J Hum Genet 2020; 106:525-534. [PMID: 32220293 DOI: 10.1016/j.ajhg.2020.03.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022] Open
Abstract
Despite next-generation sequencing, which now allows for the accurate detection of segmental aneuploidies from in vitro fertilization embryo biopsies, the origin and characteristics of these aneuploidies are still relatively unknown. Using a multifocal biopsy approach (four trophectoderms [TEs] and one inner cell mass [ICM] analyzed per blastocyst; n = 390), we determine the origin of the aneuploidy and the diagnostic predictive value of segmental aneuploidy detection in TE biopsies toward the ICM's chromosomal constitution. Contrary to the prevalent meiotic origin of whole-chromosome aneuploidies, we show that sub-chromosomal abnormalities in human blastocysts arise from mitotic errors in around 70% of cases. As a consequence, the positive-predictive value toward ICM configuration was significantly lower for segmental as compared to whole-chromosome aneuploidies (70.8% versus 97.18%, respectively). In order to enhance the clinical utility of reporting segmental findings in clinical TE biopsies, we have developed and clinically verified a risk stratification model based on a second TE biopsy confirmation and segmental length; this model can significantly improve the prediction of aneuploidy risk in the ICM in over 86% of clinical cases enrolled. In conclusion, we provide evidence of the predominant mitotic origin of segmental aneuploidies in preimplantation embryos and develop a risk stratification model that can help post-test genetic counseling and that facilitates the decision-making process on clinical utilization of these embryos.
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Cavenaghi A, Hoffmann E, Labed P, Chiche L, Koskas F, Davaine J. WITHDRAWN: Anterior cage migration during spine surgery: an unusual and severe complication. J Vasc Surg Cases Innov Tech 2020. [DOI: 10.1016/j.jvscit.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Chirurg 2019; 90:652-659. [PMID: 31359112 DOI: 10.1007/s00104-019-0993-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland.,Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Stamer UM, Stammschulte T, Erlenwein J, Koppert W, Freys S, Meißner W, Ahrens P, Brede EM, Lindig M, Dusch M, Heitfeld S, Hoffmann E, Lux EA, Müller E, Pauli-Magnus D, Pogatzki-Zahn E, Quaisser-Kimpfbeck C, Ringeler U, Rittner H, Ulma J, Wirz S. [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Schmerz 2019; 33:287-294. [PMID: 31342162 DOI: 10.1007/s00482-019-0389-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.
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Affiliation(s)
- U M Stamer
- Klinik für Anästhesiologie und Schmerztherapie, Universitätsklinik Bern, Inselspital, Universität Bern, Freiburgstraße, 3010, Bern, Schweiz.
| | - T Stammschulte
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - W Koppert
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Freys
- Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus Bremen, Bremen, Deutschland
| | - W Meißner
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland
| | - P Ahrens
- Abteilung Anästhesie und operative Intensivmedizin, Aller-Weser-Klinik, Verden, Deutschland
| | - E-M Brede
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - M Lindig
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Deutschland
| | - M Dusch
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - S Heitfeld
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsSchmerzCentrum Dresden, Dresden, Deutschland
| | - E Hoffmann
- Klinik für Anästhesie, operative Intensivmedizin, Notfall- und Schmerzmedizin, Evangelisches Krankenhaus Herne, Herne, Deutschland
| | - E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne, Lünen, Deutschland
| | - E Müller
- Klinik für Anästhesiologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - D Pauli-Magnus
- Klinik für Anästhesie, Schmerztherapie, Intensiv- und Notfallmedizin, DRK Kliniken Berlin Westend, Berlin, Deutschland
| | - E Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Quaisser-Kimpfbeck
- Abteilung für Anästhesie und Schmerztherapie, Klinikum Freising, Freising, Deutschland
| | - U Ringeler
- Abteilung für Anästhesiologie, Palliativ‑, Intensiv- und Schmerzmedizin, Paracelsus-Klinik Golzheim, Düsseldorf, Deutschland
| | - H Rittner
- Arzneimittelkommission der deutschen Ärzteschaft, Berlin, Deutschland
- Klinik und Poliklinik für Anästhesiologie, Zentrum Interdisziplinäre Schmerzmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Ulma
- Klinik für Schmerzmedizin und Schmerzambulanz, Rotes Kreuz Krankenhaus Bremen, Bremen, Deutschland
| | - S Wirz
- Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, Weaningzentrum, CURA-GFO Kliniken Bonn, Bad Honnef, Deutschland
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Hoffmann E. Feminist theory after Deleuze, Hannah Stark. Feminist Theory 2019. [DOI: 10.1177/1464700119861931b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Feltgen N, Mele B, Dietlein T, Erb C, Eckstein A, Hager A, Heiligenhaus A, Helbig H, Hoerauf H, Hoffmann E, Pauleikhoff D, Schittkowski M, Seitz B, Sucker C, Suffo S, Schaudig U, Tost F, Thurau S, Walter P, Koscielny J. [Management of anticoagulants in ophthalmic surgery-a survey among ophthalmic surgeons in Germany]. Ophthalmologe 2019; 115:585-591. [PMID: 29770858 DOI: 10.1007/s00347-018-0732-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo. A questionnaire was sent out and filled out by the different groups of specialists. RESULTS All four divisions of the DOG and four associated organizations returned completed questionnaires. Surgical interventions were listed that are carried out during anticoagulant therapy without exceptions, as well as interventions that were classified to require medical adjustment. Although the assessments varied, general consensus was achieved regarding interventions not requiring adjustments due to anticoagulants (i. e., intravitreal injection, cataract surgery, laser and corneal operations, simple muscle surgery), and those interventions requiring adjustments in medications (glaucoma operations, complex retina surgery, eye socket surgery, complex surgery of the lid). CONCLUSION Main result of this survey was the specification of serious bleeding complications which are permanent vision loss and re-operation. They could serve as endpoint parameters for essential future investigations. Nevertheless, this survey makes clear that the decision about an adjustment of anticoagulant medication in ophthalmic surgery is currently made individually and not based on established standards.
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Affiliation(s)
- N Feltgen
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
| | - B Mele
- DOG Geschäftsstelle, Platenstr. 1, 80336, München, Deutschland
| | - T Dietlein
- Klinik für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland
| | - C Erb
- Augenklinik am Wittenbergplatz, Berlin, Deutschland
| | - A Eckstein
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Essen, Deutschland
| | - A Hager
- Augenarztpraxis am Elsterplatz, Berlin, Deutschland
| | | | - H Helbig
- Klinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - H Hoerauf
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - E Hoffmann
- Klinik für Augenheilkunde, Universitätsklinikum Mainz, Mainz, Deutschland
| | - D Pauleikhoff
- St. Franziskus-Hospital Münster, Münster, Deutschland
| | - M Schittkowski
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - B Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - C Sucker
- Gerinnungszentrum Berlin Dr. Sucker, Berlin, Deutschland
| | - S Suffo
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - U Schaudig
- Augenklinik, Asklepios Klinik Barmbek, Hamburg, Deutschland
| | - F Tost
- Klinik für Augenheilkunde, Universitätsklinikum Greifswald, Greifswald, Deutschland
| | - S Thurau
- Klinik für Augenheilkunde, Universitätsklinikum München, LMU, München, Deutschland
| | - P Walter
- Klinik für Augenheilkunde, Universitätsklinikum Aachen, Aachen, Deutschland
| | - J Koscielny
- Gerinnungsambulanz und Hämophiliezentrum an der Charité, Berlin, Deutschland
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Eggert F, Kurscheidt K, Hoffmann E, Kath‐Schorr S. Cover Feature: Towards Reverse Transcription with an Expanded Genetic Alphabet (ChemBioChem 13/2019). Chembiochem 2019. [DOI: 10.1002/cbic.201900372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Frank Eggert
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Katharina Kurscheidt
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Eva Hoffmann
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Stephanie Kath‐Schorr
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
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Abstract
BACKGROUND The HÖRSTAT study conducted in Northwest Germany yielded hearing impairment in approximately 16% of adults according to the World Health Organization (WHO) criterion. However, the robustness of extrapolations on a national level might be questioned, as the epidemiological data were collected on a regional level. METHODS Independently from HÖRSTAT, the "Hearing in Germany" study examined adult hearing in Aalen, a town located in Southwest Germany. Both cross-sectional studies were based on stratified random samples from the general population. Pure-tone average at 0.5, 1, 2, and 4 kHz (PTA4), the prevalence of hearing impairment (WHO criterion: PTA4 in the better ear >25 dB HL), and hearing aid provision were compared. Data from the Aalen study and HÖRSTAT were pooled (n = 3105) to extrapolate the prevalence and degree of hearing impairment for the years 2015, 2020, and 2025. RESULTS Both studies show very similar results for PTA4. Weighted for official population statistics, the prevalence of hearing impairment according to the WHO criterion is 16.2% among adults, affecting 11.1 million persons in Germany. Due to demographic changes, the prevalence is expected to increase in the medium term by around 1% per 5‑year period. With a similar degree of hearing loss, hearing aid provision differs from place to place. CONCLUSION Adjusted for gender and age to the European Standard Population (ESP), the prevalence of hearing impairment observed both in HÖRSTAT and the Aalen sample is considerably lower than reported for international studies. Since the analysis refers to cross-sectional data only, possible cohort effects are not considered in the prevalence projection.
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Affiliation(s)
- P von Gablenz
- Institut für Hörtechnik und Audiologie, Jade Hochschule und Exzellenzcluster "Hearing4All", Ofener Str. 16/19, 26121, Oldenburg, Deutschland.
| | | | - I Holube
- Institut für Hörtechnik und Audiologie, Jade Hochschule und Exzellenzcluster "Hearing4All", Ofener Str. 16/19, 26121, Oldenburg, Deutschland
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Eggert F, Kurscheidt K, Hoffmann E, Kath‐Schorr S. Towards Reverse Transcription with an Expanded Genetic Alphabet. Chembiochem 2019; 20:1642-1645. [DOI: 10.1002/cbic.201800808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Frank Eggert
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Katharina Kurscheidt
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Eva Hoffmann
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
| | - Stephanie Kath‐Schorr
- LIMES Institute, Chemical Biology and Medicinal Chemistry UnitUniversity of Bonn Gerhard-Domagk-Strasse 1 53121 Bonn Germany
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Thoma M, Lin W, Hoffmann E, Sattes MM, Segets D, Damm C, Peukert W. Simple and Reliable Method for Studying the Adsorption Behavior of Aquivion Ionomers on Carbon Black Surfaces. Langmuir 2018; 34:12324-12334. [PMID: 30234996 DOI: 10.1021/acs.langmuir.8b02726] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A better understanding of the interactions of carbon black and perfluorinated sulfonic acid (PFSA) ionomer helps to improve the effectiveness of polymer electrolyte membrane fuel cells. We present a simple and fast method for quantitative PFSA ionomer analysis based on suspension density measurements. After validation of the reliability of our method by thermogravimetric analysis and isothermal titration calorimetry (ITC), we investigate the adsorption equilibrium of short-side-chain PFSA ionomers of different equivalent weights (EW) and polarities on carbon black. The measured adsorption isotherms exhibit a plateau in the ionomer surface concentration for ionomer equilibrium concentrations ≤2 g/L. In this concentration range, the adsorption isotherms are described by the Langmuir model, whereby the surface concentrations in the plateau region are between 0.041 and 0.070 g/g. The plateau value of the ionomer surface concentration increases with EW and therefore with decreasing number of side chains with terminal sulfonic acid group per ionomer molecule, while the amount of adsorbed sulfonic acid groups remains constant for all investigated ionomers, resulting in similar ζ-potentials and sedimentation stability of the suspensions. The free energies of adsorption Δ G calculated from the association constants of the adsorption isotherms agree well with Δ G values obtained by isothermal titration calorimetry (ITC) and thus validate the adsorption isotherm measurement method. From the values of adsorption enthalpy Δ H ((-7.3 ± 0.8) kJ/mol) and entropy Δ S (ca. 100 J/(mol K)), which were extracted from ITC, we conclude that the ionomer adsorption on carbon black is a spontaneous physisorption process.
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Affiliation(s)
- Martin Thoma
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Wei Lin
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Eva Hoffmann
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Maria-Melanie Sattes
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Doris Segets
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Cornelia Damm
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
| | - Wolfgang Peukert
- Institute of Particle Technology (LFG) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Cauerstraße 4 , D-91058 Erlangen , Germany
- Interdisciplinary Center for Functional Particle Systems (FPS) , Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) , Haberstraße 9a , D-90158 Erlangen , Germany
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Schroeder T, Krueger W, Hansen M, Hoffmann E, Dieterich H, Unertl K. Elimination of Meropenem by Continuous Hemo(Dia) Filtration: An in Vitro One-Compartment Model. Int J Artif Organs 2018. [DOI: 10.1177/039139889902200503] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Meropenem is a carbapenem antibiotic with a wide spectrum of activity against most gram positive and gram negative bacteria including anaerobes. Dose adjustments are necessary during continuous renal replacement therapies of acute renal failure. This in vitro study was conducted to investigate the influence of different filter materials, surface areas (AN-69 0.6 m2 and 0.9 m2, polysulfone 0.75 m2, polyamide 0.6 m2), and increasing flow rates (from 3.3 - 26.7 ml/min) on the elimination of meropenem in an in vitro continuous hemo(dia)filtration model. Meropenem was measured using HPLC with UV-detection. While the clearance increased proportionally to increasing dialysate flow rates in filters with a surface area of 0.9 m2, a peak clearance was reached in the small filters at flow rates of 10.0 ml/min (polyamide 0.6 m2) and 18.3 ml/min (AN-69 0.6 m2), when tested under the same conditions. This indicated incomplete dialysate saturation due to the diminished time available for meropenem to equilibrate with the dialysate solution. No adsorption to either of the tested membranes was detected. Dosage recommendations derived from clinical studies might be appropriate when different filter materials, but similar operational settings of the continuous replacement therapy, are applied. Reduction of the recommended dose might be necessary, when renal replacement therapies with lower flow rates and/or filters with smaller surface areas are carried out.
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Affiliation(s)
- T.H. Schroeder
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
| | - W.A. Krueger
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
| | - M. Hansen
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
| | - E. Hoffmann
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
| | - H.J. Dieterich
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
| | - K. Unertl
- Department of Anaesthesiology, Eberhard-Karls-University Tuebingen, Tuebingen - Germany
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Hoffmann E, Olsen PR. Like an ace up the sleeve: an interview study of nurses’ experiences of the contact with relatives in a somatic emergency ward. Scand J Caring Sci 2018; 32:1207-1214. [DOI: 10.1111/scs.12566] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 01/24/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Eva Hoffmann
- University College South Denmark; Aabenraa Denmark
| | - Pia Riis Olsen
- Department of Oncology; Aarhus University Hospital; Aarhus C Denmark
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Abstract
Linezolid is an oxazolidinone antibiotic with activity against important grampositive aerobic bacteria, including nosocomial pathogens. It is not known whether dosage adjustments are necessary in patients treated with continuous renal replacement therapies. This in vitro study was conducted to investigate the elimination of linezolid in an in vitro continuous hemo(dia)filtration model using different filter materials (polysulfone, polyacrylonitrile, polyamide), surface areas, and different modes of renal replacement therapies. Linezolid was measured using HPLC with UV-detection. No adsorption of linezolid to any of the tested membranes was detected. Recovery of linezolid in the ultrafiltrate was 98.2 ± 10.5% in the filtration mode. During dialysis, recovery was significantly less (87.6 ± 16.1%; p = 0.02). Linezolid elimination was not altered by filter size, when polysulfone filters with surface areas of 0.7 m2 and 1.3 m2 were tested. In conclusion, the dosage recommendations for linezolid are independent of the filter materials. However, the elimination is significantly higher during hemofiltration compared to dialysis.
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Affiliation(s)
- T H Schroeder
- Department of Anesthesiology and Intensive Care Medicine, Tuebingen University Hospital, Tuebingen, Germany.
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38
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Liss J, Pastuszek E, Pukszta S, Hoffmann E, Kuczynski W, Lukaszuk A, Lukaszuk K. Effect of next-generation sequencing in preimplantation genetic testing on live birth ratio. Reprod Fertil Dev 2018; 30:1720-1727. [DOI: 10.1071/rd17428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/24/2018] [Indexed: 01/17/2023] Open
Abstract
The present study analysed live birth ratios in frozen embryo transfer (FET) cycles where embryo ploidy status was determined with preimplantation genetic testing (PGT) using next-generation sequencing (NGS). PGT was performed on trophectoderm cells biopsied at the blastocyst stage. The present prospective cohort study included 112 women undergoing frozen embryo transfer, with NGS PGT. The control group consisted of 85 patients who underwent the IVF procedure with FET planned for a subsequent cycle. The live birth rate per cycle was higher by ~18.5 percentage points in the investigated compared with control group (42.0% vs 23.5% respectively; P = 0.012). The differences between the study and control groups were also significant for clinical pregnancy (42.0% vs 23.5% respectively; P = 0.012), implantation (41.2% vs 22.2% respectively; P = 0.001) and pregnancy loss rates (9.6% vs 28.6% respectively; P = 0.027). The results show that PGT NGS is a useful method for embryo selection and it may be implemented in routine clinical practice with propitious results.
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Sultan A, Lüker J, Andresen D, Kuck KH, Hoffmann E, Brachmann J, Hochadel M, Willems S, Eckardt L, Lewalter T, Senges J, Steven D. Predictors of Atrial Fibrillation Recurrence after Catheter Ablation: Data from the German Ablation Registry. Sci Rep 2017; 7:16678. [PMID: 29192223 PMCID: PMC5709464 DOI: 10.1038/s41598-017-16938-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022] Open
Abstract
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence. Furthermore, comorbidities such as valvular heart disease and renal failure as well as an early AF relapse were also predictors of AF recurrence during 1-y-FU. However, despite an AF recurrence rate of 45.9%, the majority of these pts (72.4%) reported a significant alleviation of clinical symptoms. In conclusion in pts with initially successful CA for AF female sex, AF type, in-hospital AF relapse and comorbidities such as renal failure and valvular heart disease are independent predictors for AF recurrence during 1-y-FU. However, the majority of pts deemed their interventions as successful with significant reduction of symptoms irrespective of AF.
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Affiliation(s)
- A Sultan
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany.
| | - J Lüker
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany
| | | | - K H Kuck
- Asklepios Hosp. St. Georg Hamburg, Hamburg, Germany
| | | | | | | | - S Willems
- University Heart Center Hamburg, Dept. of Electrophysiology, Hamburg, Germany
| | - L Eckardt
- University Hosp. Münster, Dept. of Electrophysiology, Münster, Germany
| | - T Lewalter
- Dept. of Medicine-Cardiology, P. Osypka Heart Center Munich, Munich, Germany
| | - J Senges
- IHF Ludwigshafen, Ludwigshafen, Germany
| | - D Steven
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany
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40
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Hoffmann E. Qualifikation und Weiterbildung in der Facharztausbildung. Ophthalmologe 2017; 114:885-889. [DOI: 10.1007/s00347-017-0532-9] [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]
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Kuśmierczyk-Michulec J, Krysta M, Kalinowski M, Hoffmann E, Baré J. Long-range transport of Xe-133 emissions under convective and non-convective conditions. J Environ Radioact 2017; 175-176:135-148. [PMID: 28544976 DOI: 10.1016/j.jenvrad.2017.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
To investigate the transport of xenon emissions, the Provisional Technical Secretariat (PTS) operates an Atmospheric Transport Modelling (ATM) system based on the Lagrangian Particle Dispersion Model FLEXPART. The air mass trajectory ideally provides a "link" between a radionuclide release and a detection confirmed by radionuclide measurements. This paper investigates the long-range transport of Xe-133 emissions under convective and non-convective conditions, with special emphasis on evaluating the changes in the simulated activity concentration values due to the inclusion of the convective transport in the ATM simulations. For that purpose a series of 14 day forward simulations, with and without convective transport, released daily in the period from 1 January 2011 to 30 June 2013, were analysed. The release point was at the ANSTO facility in Australia. The simulated activity concentrations for the period January 2011 to February 2012 were calculated using the daily emission values provided by the ANSTO facility; outside the aforementioned period, the median daily emission value was used. In the simulations the analysed meteorological input data provided by the European Centre for Medium-Range Weather Forecasts (ECMWF) were used with the spatial resolution of 0.5°. It was found that the long-range transport of Xe-133 emissions under convective conditions, where convection was included in the ATM simulation, led to a small decrease in the activity concentration, as compared to transport without convection. In special cases related to deep convection, the opposite effect was observed. Availability of both daily emission values and measured Xe-133 activity concentration values was an opportunity to validate the simulations. Based on the paired t-test, a 95% confidence interval for the true mean difference between simulations without convective transport and measurements was constructed. It was estimated that the overall uncertainty lies between 0.08 and 0.25 mBq/m3. The uncertainty for the simulations with the convective transport included is slighted shifted to the lower values and is in the range between 0.06 and 0.20 mBq/m3.
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Affiliation(s)
- J Kuśmierczyk-Michulec
- International Data Centre, Comprehensive Nuclear-Test-Ban Treaty Organization, PO Box 1200, 1400 Vienna, Austria.
| | - M Krysta
- International Data Centre, Comprehensive Nuclear-Test-Ban Treaty Organization, PO Box 1200, 1400 Vienna, Austria
| | - M Kalinowski
- International Data Centre, Comprehensive Nuclear-Test-Ban Treaty Organization, PO Box 1200, 1400 Vienna, Austria
| | - E Hoffmann
- Australian Nuclear Science and Technology Organisation (ANSTO), Locked Bag 2001, Kirrawee DC, NSW 2232, Australia
| | - J Baré
- International Data Centre, Comprehensive Nuclear-Test-Ban Treaty Organization, PO Box 1200, 1400 Vienna, Austria
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Moser J, Hoffmann B, Andresen D, Kuck KH, Brachmann J, Eckardt L, Hoffmann E, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P786Factors associated with acute pacemaker implantation after carvo- tricuspidal isthmus ablation - results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p786] [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: 11/12/2022] Open
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck KH, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P2672Which factors are associated with acute pacemaker implantation after ablation of atrial fibrillation? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2672] [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: 11/12/2022] Open
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck K, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P783Influencing factors of in-hospital pacemaker implantation after ablation of AV-nodal reentry- and AV-reentry tachycardia: results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p783] [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: 11/13/2022] Open
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Hoffmann E, Streichert K, Nischan N, Seitz C, Brunner T, Schwagerus S, Hackenberger CPR, Rubini M. Stabilization of bacterially expressed erythropoietin by single site-specific introduction of short branched PEG chains at naturally occurring glycosylation sites. Mol Biosyst 2017; 12:1750-5. [PMID: 26776361 DOI: 10.1039/c5mb00857c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The covalent attachment of polyethylene glycol (PEG) to therapeutic proteins can improve their physicochemical properties. In this work we utilized the non-natural amino acid p-azidophenylalanine (pAzF) in combination with the chemoselective Staudinger-phosphite reaction to install branched PEG chains to recombinant unglycosylated erythropoietin (EPO) at each single naturally occurring glycosylation site. PEGylation with two short 750 or 2000 Da PEG units at positions 24, 38, or 83 significantly decreased unspecific aggregation and proteolytic degradation while biological activity in vitro was preserved or even increased in comparison to full-glycosylated EPO. This site-specific bioconjugation approach permits to analyse the impact of PEGylation at single positions. These results represent an important step towards the engineering of site-specifically modified EPO variants from bacterial expression with increased therapeutic efficacy.
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Affiliation(s)
- E Hoffmann
- Department of Organic Chemistry, University of Konstanz, D-78464 Konstanz, Germany.
| | - K Streichert
- Leibniz Institute of Molecular Pharmacology, D-13125 Berlin and Humboldt Universität zu Berlin, D-12489 Berlin, Germany.
| | - N Nischan
- Leibniz Institute of Molecular Pharmacology, D-13125 Berlin and Humboldt Universität zu Berlin, D-12489 Berlin, Germany.
| | - C Seitz
- Department of Biochemical Pharmacology, University of Konstanz, D-78464 Konstanz, Germany
| | - T Brunner
- Department of Biochemical Pharmacology, University of Konstanz, D-78464 Konstanz, Germany
| | - S Schwagerus
- Leibniz Institute of Molecular Pharmacology, D-13125 Berlin and Humboldt Universität zu Berlin, D-12489 Berlin, Germany.
| | - C P R Hackenberger
- Leibniz Institute of Molecular Pharmacology, D-13125 Berlin and Humboldt Universität zu Berlin, D-12489 Berlin, Germany.
| | - M Rubini
- Department of Organic Chemistry, University of Konstanz, D-78464 Konstanz, Germany.
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Hartl S, Dorwarth U, Straube F, Wankerl M, Krieg J, Bunz B, Hoffmann E. P1382Age dependent patient characteristics and outcome of 2nd and 3rd generation cryoballoon AF ablation: large center experience. Europace 2017. [DOI: 10.1093/ehjci/eux158.010] [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: 11/14/2022] Open
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Abstract
Glaucoma is the second leading cause of blindness worldwide. The purpose of this paper is to give a review on the epidemiology of the disease, on the importance and the consequences of glaucoma for people regarding their daily life, their ability to work, and quality of life.
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Affiliation(s)
- I Oberacher-Velten
- Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - E Hoffmann
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - H Helbig
- Klinik und Poliklinik für Augenheilkunde, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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Caimi G, Hoffmann E, Montana M, Incalcaterra E, Canino B, Lo Presti R. Beta-Thromboglobulin and Platelet Factor 4 in Juvenile Myocardial Infarction. Clin Appl Thromb Hemost 2016; 13:108-9. [PMID: 17164501 DOI: 10.1177/1076029606296424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Schummer W, Schummer C, Hoffmann E, Gerold M. Persistent Left Superior Vena Cava: Clinical Implications for Central Venous Cannulation. Nutr Clin Pract 2016; 17:304-8. [PMID: 16215005 DOI: 10.1177/0115426502017005304] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In general, persistence of the left superior vena cava (LSVC), the most common anomaly of the venous circulation, is asymptomatic. Diagnosis of a catheter in a persistent LSVC is not straight forward, and a LSVC can create difficulties during central venous and pulmonary artery catheterization. We discuss the differential diagnosis of left-sided central venous catheters (CVC). Finally a directive is given to prevent dilator-induced vessel injuries. We report the cannulation of an unsuspected persistent LSVC in two patients. A dilator-induced vessel injury contributed significantly to the fatal outcome in the first case. On a plain chest X-ray, a catheter in a LSVC will run down the left mediastinal border and can be confused with other intravascular malpositions and extravascular malpositions. Contrast-enhanced lateral chest radiograph is an inexpensive and readily available method that can be used to determine exact position.
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Affiliation(s)
- Wolfram Schummer
- Clinic for Anesthesia and Intensive Care Medicine, Friedrich-Schiller University of Jena, Bachstrasse 18, 07743 Jena, Germany.
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Straeter A, Gramer B, Rasper M, Leber A, Rieber J, Hoffmann E, Vembar M, Rummeny E, Huber A. Vergleich der diagnostischen Aussagekraft der First Pass CT-Perfusionsbildgebung und der CT-Koronarangiografie im Hinblick auf die Beurteilung hämodynamisch relevanter Stenosen. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581359] [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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