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Carpio Vallejo E, Düker U, Meyer F, Berding U, Nogueira R. Microbiological water quality and derived health risks from exposure to ornamental water fountains in the city of Hannover. Risk Anal 2024; 44:24-39. [PMID: 37067226 DOI: 10.1111/risa.14145] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
Ornamental fountains are attractive urban infrastructures helping cities to cope with global warming, as water sprays have great cooling effects due to evaporative properties; however, exposure to microbiologically impaired water from ornamental fountains during recreational activities may result in adverse health outcomes for the exposed population. This study assesses the microbial water quality of four ornamental water fountains (Blätterbrunnen, Körtingbrunnen, Klaus-Bahlsen-Brunnen, and Marstallbrunnen) and performs a quantitative microbial risk assessment (QMRA) for children using Escherichia coli, Enterococci, and Salmonella to quantify the probability of gastrointestinal illnesses and Pseudomonas aeruginosa to quantify the risk of dermal infections. Samples were collected fortnightly in two campaigns in 2020 and 2021 and processed to determine bacterial concentrations. Data on exposure time were obtained during field observations on the selected fountains; a total of 499 people were observed of which 30% were children. Mean bacterial concentrations ranged from 1.6 × 101 to 6.1 × 102 most probable number (MPN)/100 mL for E. coli, 1.2 × 101 -1.2 × 103 MPN/100 mL for Enterococci, 8.6 × 103 -3.1 × 105 CFU/100 mL for Salmonella, and 2.5 × 103 -3.2 × 104 MPN/100 mL for P. aeruginosa. The results of the QMRA study showed that the USEPA illness rate of 36 NEEAR-gastrointestinal illnesses/1000 was exceeded for Enterococci at the Körtingbrunnen, Klaus-Bahlsen-Brunnen, and Marstallbrunnen fountains and for Salmonella and P. aeruginosa at the Körtingbrunnen fountain, suggesting that exposure to microbiologically contaminated water from ornamental fountains may pose a health risk to children. The scenario analysis shows the importance of keeping low bacterial concentrations in ornamental fountains so that the risk of illness/infection to children does not exceed the USEPA illness rate benchmark.
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Affiliation(s)
| | - Urda Düker
- Institut für Siedlungswasserwirtschaft und Abfalltechnik, Leibniz University, Hannover, Germany
| | - Franziska Meyer
- Institut für Siedlungswasserwirtschaft und Abfalltechnik, Leibniz University, Hannover, Germany
| | - Ulrich Berding
- Plan Zwei Stadtplanung und Architektur, Hannover, Germany
| | - Regina Nogueira
- Institut für Siedlungswasserwirtschaft und Abfalltechnik, Leibniz University, Hannover, Germany
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Cukoski S, Lindemann CH, Arjune S, Todorova P, Brecht T, Kühn A, Oehm S, Strubl S, Becker I, Kämmerer U, Torres JA, Meyer F, Schömig T, Hokamp NG, Siedek F, Gottschalk I, Benzing T, Schmidt J, Antczak P, Weimbs T, Grundmann F, Müller RU. Feasibility and impact of ketogenic dietary interventions in polycystic kidney disease: KETO-ADPKD-a randomized controlled trial. Cell Rep Med 2023; 4:101283. [PMID: 37935200 PMCID: PMC10694658 DOI: 10.1016/j.xcrm.2023.101283] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/13/2023] [Revised: 07/21/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023]
Abstract
Ketogenic dietary interventions (KDIs) are beneficial in animal models of autosomal-dominant polycystic kidney disease (ADPKD). KETO-ADPKD, an exploratory, randomized, controlled trial, is intended to provide clinical translation of these findings (NCT04680780). Sixty-six patients were randomized to a KDI arm (ketogenic diet [KD] or water fasting [WF]) or the control group. Both interventions induce significant ketogenesis on the basis of blood and breath acetone measurements. Ninety-five percent (KD) and 85% (WF) report the diet as feasible. KD leads to significant reductions in body fat and liver volume. Additionally, KD is associated with reduced kidney volume (not reaching statistical significance). Interestingly, the KD group exhibits improved kidney function at the end of treatment, while the control and WF groups show a progressive decline, as is typical in ADPKD. Safety-relevant events are largely mild, expected (initial flu-like symptoms associated with KD), and transient. Safety assessment is complemented by nuclear magnetic resonance (NMR) lipid profile analyses.
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Affiliation(s)
- Sadrija Cukoski
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christoph Heinrich Lindemann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sita Arjune
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Rare Diseases Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Cologne, Germany
| | - Polina Todorova
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Theresa Brecht
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Adrian Kühn
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Simon Oehm
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sebastian Strubl
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynecology, University Hospital of Würzburg, Würzburg, Germany
| | - Jacob Alexander Torres
- Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Franziska Meyer
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Thomas Schömig
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Nils Große Hokamp
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Florian Siedek
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Ingo Gottschalk
- University of Cologne, Faculty of Medicine and University Hospital, Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Cologne, Germany
| | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Rare Diseases Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Cologne, Germany
| | - Johannes Schmidt
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Bonacci GmbH, Cologne, Germany
| | - Philipp Antczak
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Cologne, Germany
| | - Thomas Weimbs
- Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Franziska Grundmann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Rare Diseases Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Cluster of Excellence on Cellular Stress Responses in Ageing-Associated Diseases, Cologne, Germany.
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Barth U, Lehmann M, Meyer F, Halloul Z. [Topicality of the fundamental and determining importance of chronic critical ischemia of the extremities and its restorative treatment using crural/pedal bypasses in Germany and in Saxony-Anhalt]. Chirurgie (Heidelb) 2023; 94:861-869. [PMID: 37610660 PMCID: PMC10522525 DOI: 10.1007/s00104-023-01933-7] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Currently, there is an increase in severe stages of peripheral arterial occlusive disease (PAOD) with critical ischemia. This seems to correspond to the general demographic change as well as a consequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic of the last 3 years. The now established and accepted interventional/endovascular approach for severe lower leg PAOD in experienced hands is still considered the first-line treatment but from the authors' perspective crural/pedal venous bypass is experiencing a renaissance. MATERIAL AND METHODS Compact narrative review of the current state of crural/pedal bypass surgery in Germany and Saxony-Anhalt (SA) combined with selective references from the current scientific medical literature and own clinical experiences. RESULTS The current statistics of case-related diagnosis-related groups (DRG) data show that, especially with the occurrence of the corona pandemic, a decrease in inpatient case numbers of patients with PAOD stage IIB can be observed nationwide and also in SA. The severe PAOD stages have remained approximately the same in case numbers but increased in SA. The risk stratification based on the wound, ischemia and foot infection (WIFI) classification offers the possibility to be able to make statements about the risk of amputation, benefits and type of revascularization measures. The length of the occlusion, occlusion site of the affected vessels and degree of calcification are taken into account in the global limb anatomic staging system (GLASS) to assess the prognosis. The evaluation of the case-based hospital statistics from 2015 to 2020 showed a constant use of femorocrural/femoropedal bypass surgery in Germany as well as a slight increase in reconstruction using femorocrural bypasses in SA, which seems to correlate with the tendency for an increase in the number of cases of severe PAOD. Parameter-based objectification of the severity of critical limb ischemia should be included in the indications for placement of a crural/pedal bypass. The WIFI classification and GLASS are suitable for this purpose as a relative prognosis of success is also possible. The treatment of critical limb ischemia by crural/pedal bypass surgery continues to find a constant application in Germany and SA.
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Affiliation(s)
- Udo Barth
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Gefäß- und Viszeralchirurgie, Helios Klinik Jerichower Land, August-Bebel-Straße 55a, 39288, Burg, Deutschland.
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland, Leipziger Str. 44, 39120.
| | - M Lehmann
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Gefäß- und Viszeralchirurgie, Helios Klinik Jerichower Land, August-Bebel-Straße 55a, 39288, Burg, Deutschland
| | - F Meyer
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland, Leipziger Str. 44, 39120
| | - Z Halloul
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland, Leipziger Str. 44, 39120
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Paasch C, Schildberg C, Lehmann M, Meyer F, Barth U. [Statutory provisions, aims, motives, attitudes and thinking on the outpatient operation profile of general and abdominal surgery]. Chirurgie (Heidelb) 2023; 94:850-860. [PMID: 37462682 PMCID: PMC10522497 DOI: 10.1007/s00104-023-01920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 09/28/2023]
Abstract
AIM The aim of the manuscript is to discuss and assess the implications and opportunities as well as dangers of "outpatientization" of surgical and inpatient services for general and abdominal surgery. METHOD Narrative overview with literature reference based on a PubMed search with the search terms: outpatient operations and inpatient interventions, AOP catalog, hybrid DRG, outpatient hernia surgery, outpatient proctological surgery, selective sector-equal reimbursement and day-care forms of care. RESULTS (KEY POINTS): - In the Anglo-American area, the treatment of inguinal hernias is predominantly carried out on an outpatient clinic basis. In the USA, Sweden and Denmark, for example, over 70% of all hernias are treated in an outpatient clinic setting, in Germany it is only 20%. In Germany, the catalog of operations that can be performed on an outpatient basis and other department-replacing interventions in hospitals defines outpatient interventions in accordance with § 115b Social Security Code (SGB) V (Germany). - The conversion from inpatient to outpatient hernia surgery has also failed so far due to an enormous difference in revenues. According to the will of the Federal Ministry of Health, the planned forms of semistationary care are intended to relieve the nursing staff in the hospitals and thus relieve the tense situation of nursing professionals. By the end of March 2023, a special industry-specific reimbursement, so-called hybrid DRGs, is to be agreed, which applies regardless of whether a paid service is provided on an outpatient or inpatient basis. - According to § 115b SGB V, whether a hernia can be performed under inpatient or outpatient conditions is also decided according to the location of the hernia. In the new AOP catalog, frailty is operationalized in the context factors via the degree of care and the Barthel index. If one compares the number of encryption procedures for the 5‑530 procedure (closure of an inguinal hernia) in 2005 (184,679) with the pre-corona year 2019 (179,851), it can be seen that the proportion of hernias treated in hospital remained approximately the same over a period of 14 years. - Most elective proctological procedures can be performed on an outpatient basis. For reasons of safety (bleeding) and practicality (pain management, dressing change of large abscesses), inpatient surgery is preferred: extensive hemorrhoidectomy in the case of massive findings, large abscesses, extensive perianal fistula corrections, particularly high transsphincteric or suprasphincteric fistulas. - Guidelines based on the British Guidelines for Ambulant Surgery should be required for comprehensive outpatient treatment in surgery. The introduction of corresponding hybrid DRGs seems to be the right way to cover the costs of outpatient surgery in hospitals. CONCLUSION The restructuring of the hospital landscape and the nationwide expansion of outpatient operations is an unavoidable requirement in view of rising costs in the healthcare system and impending financing bottlenecks, which will pose challenges for the surgical disciplines in the years to come. Outpatient surgery is already practiced in many areas but has not become established due to the different remuneration. The flat rates for the same branches can be a starting point here. Furthermore, evidence-based framework conditions must be created along the lines of the British Guidelines for Ambulant Surgery.
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Affiliation(s)
- C Paasch
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Brandenburg/Havel, Medizinische Hochschule Brandenburg, Brandenburg/Havel, Deutschland
| | - C Schildberg
- Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Brandenburg/Havel, Medizinische Hochschule Brandenburg, Brandenburg/Havel, Deutschland
| | - M Lehmann
- Klinik für Allgemein‑, Gefäß- und Viszeralchirurgie, HELIOS Klinik Jerichower Land, Burg, Deutschland
| | - F Meyer
- Kllinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, 39118, Magdeburg, Deutschland.
| | - U Barth
- Klinik für Allgemein‑, Gefäß- und Viszeralchirurgie, HELIOS Klinik Jerichower Land, Burg, Deutschland
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Ortiz PR, Lorenz E, Meyer F, Croner R, Lünse S, Hunger R, Mantke R, Benz-Weisser A, Zarras K, Huenerbein M, Paasch C. The effect of an abdominal binder on postoperative outcome after open incisional hernia repair in sublay technique: a multicenter, randomized pilot trial (ABIHR-II). Hernia 2023; 27:1263-1271. [PMID: 37466732 PMCID: PMC10533646 DOI: 10.1007/s10029-023-02838-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Although the evidence is minimal, an abdominal binder is commonly prescribed after open incisional hernia repair (IHR) to reduce pain. This study aimed to investigate this common postoperative treatment. METHODS The ABIHR-II trial was a national prospective, randomized, multicenter non-AMG/MPG pilot study with two groups of patients (wearing an abdominal binder (AB) for 2 weeks during daytime vs. not wearing an AB following open IHR with the sublay technique). Patient enrollment took place from July 2020 to February 2022. The primary endpoint was pain at rest on the 14th postoperative day (POD) using the visual analog scale (VAS). The use of analgesics was not systematically recorded. Mixed-effects linear regression models were used. RESULTS A total of 51 individuals were recruited (25 women, 26 men; mean age 61.4 years; mean body mass index 30.65 kg/m2). The per-protocol analysis included 40 cases (AB group, n = 21; No-AB group, n = 19). Neither group showed a significant difference in terms of pain at rest, limited mobility, general well-being, and seroma formation and rate. Patients among the AB group had a significantly lower rate of surgical site infection (SSI) on the 14th POD (AB group 4.8% (n = 1) vs. No-AB group 27.8% (n = 5), p = 0.004). CONCLUSION Wearing an AB did not have an impact on pain and seroma formation rate but it may reduce the rate of postoperative SSI within the first 14 days after surgery. Further trials are mandatory to confirm these findings.
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Affiliation(s)
- P. R. Ortiz
- Charité Universitätsmedizin-Berlin, Berlin, Germany
- Department of General, Abdominal and Cancer Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - E. Lorenz
- Department of General, Abdominal, Vascular and Transplant Surgery, Otto-Von-Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - F. Meyer
- Department of General, Abdominal, Vascular and Transplant Surgery, Otto-Von-Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - R. Croner
- Department of General, Abdominal, Vascular and Transplant Surgery, Otto-Von-Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - S. Lünse
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770 Brandenburg an der Havel, Germany
| | - R. Hunger
- Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - R. Mantke
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770 Brandenburg an der Havel, Germany
- Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - A. Benz-Weisser
- Department of General, Abdominal Vascular and Transplant Surgery, Westpfalz-Klinikum GmbH, Kaiserslautern, Germany
| | - K. Zarras
- Department of Abdominal Minimally Invasive and Cancer Surgery, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - M. Huenerbein
- Charité Universitätsmedizin-Berlin, Berlin, Germany
- Department of Surgery, Oberhavel Clinic Oranienburg, Oranienburg, Germany
| | - C. Paasch
- Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770 Brandenburg an der Havel, Germany
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Barth U, Meyer F, Halloul Z. [Lack of experienced surgeons in vascular surgery-A joint task]. Chirurgie (Heidelb) 2023; 94:780-788. [PMID: 37349542 PMCID: PMC10447598 DOI: 10.1007/s00104-023-01900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION An increasing shortage of specialists and training assistants is also being lamented in vascular surgery. Despite a continuous increase in the number of physicians and medical students in Germany in recent years, the need for specialists and training assistants in vascular surgery is enormous in a sustained manner. METHODS Professional policy analysis from a medical vascular surgery perspective including currently available statistics, especially from the Federal Statistical Office, the Federal Medical Association, the Saxony-Anhalt (SA) State Medical Association and selective references from current medical scientific literature on epidemiological topics. RESULTS In 2022, according to the basic data of the Federal Statistical Office 200 vascular surgery departments provided a total of 5706 beds for care. In 2021, 1574 physicians with the regional and specialist title in vascular surgery were registered by the medical associations. In the following years, there was an increase of 404 vascular surgeons. The recognition of the specialist title for vascular surgery fell from 166 in 2018 to 143 in 2021. There are 23 vascular surgery care units in Saxony-Anhalt (SA). At the SA Medical Association, there were 52 registered doctors with the specialist title in vascular surgery in the inpatient sector in 2021. In comparison, at the North Rhine Medical Association in 2021 there were 362 registered doctors with regional and specialist titles in vascular surgery overall and 292 in the inpatient sector. The age-standardized hospital incidence of peripheral arterial occlusive disease (PAOD) rose from approximately 190 to over 250 per 100,000 inhabitants in Germany between 2005 and 2016 and plateaued at this level. This corresponded to a relative increase of 33%. During the same observational period, the number of procedures performed doubled, mainly due to a strong increase in the number of endovascular interventions (approximately 140% increase) and interventions for arterial embolism/thrombosis (approximately + 80%). A research report commissioned by the German Hospital Society (DKG) in 2010 predicted a replacement requirement for physicians of approximately 108,000 by 2019 and an additional requirement of almost 31,000 physicians. While 14.6-27.2% of those employed in 2008 will have retired by 2020, between 45.6% and 68.5% will retire by 2030. Despite the statistically verifiable improvement in the staffing situation of specialists in vascular surgery in the inpatient and outpatient sectors in Germany, it can be assumed that there is a problem in recruiting young specialists. In order to target the recruitment of junior staff, it is first necessary to comprehensively record basic data on the staff situation and staff development in the area of residents in vascular surgery. In addition, further work should be done on implementing the recommendations for action already put forward years ago by scientific reports at state and federal levels.
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Affiliation(s)
- U Barth
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Gefäß- und Viszeralchirurgie, Helios Klinik Jerichower Land, Burg, Deutschland
| | - F Meyer
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Straße 44, 39120, Magdeburg, Deutschland.
| | - Z Halloul
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Straße 44, 39120, Magdeburg, Deutschland
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O'Keeffe D, Hanley S, McNearney O, Finn B, O'Halloran K, Broderick-Farrell C, Meyer F, Rey R, Trujillo J, Moore M. Clinical examination subtleties in diagnosing an unwitnessed foreign body ingestion. Ir Med J 2023; 116:817. [PMID: 37606517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
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Weber F, Eger KI, March C, Croner RS, Meyer F. Manifestation of acute appendicitis as known but paradox visceral side effect of ulcerative colitis anti-inflammatory therapy with januskinase-inhibitor Tofacitinib (Xeljanz™). Pathol Res Pract 2023; 248:154333. [PMID: 37393666 DOI: 10.1016/j.prp.2023.154333] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The etiopathogenesis of accompanying inflammatory phenomena and consequences of immunomodulation constitute a challenging and innovative field in the medical treatment of patients with autoimmune diseases. AIM Based on i) clinical management experience gained from this challenging clinical case and ii) selective references of reports published in the scientific medical literature, we present an unusual counterfactual scientific case report. A patient diagnosed with ulcerative colitis undergoing januskinase (JAK)-inhibitor therapy developed acuteappendicitis as an unusual complication or as a visceral side effect of immunosuppressive/anti-inflammatory therapy. METHOD Scientific case report. RESULTS (case description): Medical history: A 52-year-old male presented with spasmodic pain in the right lower abdomen lasting for two days (no fever, no bowel movement changes (no stool irregularities), no vomiting). MEDICATION USED TO DATE Steroid-resistant ulcerative colitis treated with immunosuppressive therapy (Adalimumab administered for 10 months [next generation anti-TNFα mAb], Vendolizumab for 9 months [α4β7 integrin antagonist], Tofacitinib for 6 months); fructose intolerance, no previous abdominal surgery; medication: XeljanzTM (Tofacitinib, 5 mg 2x1; JAK-inhibitor; PFIZER PHARMA GmbH, Berlin,Germany); MutaflorTM (1x1; Ardeypharm GmbH, Herdecke, Germany). CLINICAL FINDINGS Pressure pain in the right lower abdomen with local muscular defense (Mc-Burney's/Lanz's point positive), no peritonism, Psoas-muscle sign positive. DIAGNOSTIC MEASURES Laboratory parameters: standard value of white blood cell count, CrP: 25 mg/l.-Transabdominal ultrasound revealed hypertrophic 'appendix vermiformis' with detectable target-phenomenon and surrounding fluid. DECISION-MAKING Indication for laparoscopic exploration. THERAPY Under perioperative single-shot antibiotic administration with UnacidTM, the patient underwent emergency laparoscopic appendectomy due to confirmed acute appendicitis with additional lavage and placement of local drainage. CLINICAL COURSE The postoperative phase was uneventful (sufficient analgetic therapy, removal of local drainage on the 2nd postoperative day). The patient was discharged four days after surgery. Histopathology confirmed ulcero-phlegmonous, acute purulent appendicitis with fibrinous purulent mesenteriolitis. FURTHER MEASURES Immunosuppressive therapy was continued. CONCLUSION Based on the paradoxon of an acute inflammatory disease (acute appendicitis) seen in the case of a patient undergoing immunosuppressive/anti-inflammatory treatment using a JAK-Inhibitor for ulcerative colitis, we consider this case worthy of publication although this side effect has previously been described in patients with rheumatoid arthritis. This might be the manifestation of i) an immunomodulatory effect that reduced or at least altered mucosal defense, including an increased risk of opportunistic infections, presenting as a specific visceral 'side effect' of the JAK-Inhibitor and/or as a consequence; ii) an induced alternative inflammatory mechanism/proinflammatory signal transduction and - theoretically - an intestinal drainage defect in the segment of right colic artery with consecutive collection of necrotic cells and activation of inflammatory mediators.
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Affiliation(s)
- F Weber
- Dept. of General, Abdominal, Vascular and Transplant Surgery, Germany
| | | | - C March
- Dept. of Radiology and Nuclear Medicine, Otto-von-Guericke University with University Hospital, Magdeburg, Germany
| | - R S Croner
- Dept. of General, Abdominal, Vascular and Transplant Surgery, Germany
| | - F Meyer
- Dept. of General, Abdominal, Vascular and Transplant Surgery, Germany.
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Wendler JJ, Meyer F, March C, Cash H, Porsch M, Schostak M. [Traumatic injuries of the kidney and the urinary tract in blunt abdominal trauma]. Chirurgie (Heidelb) 2023:10.1007/s00104-023-01906-w. [PMID: 37428182 DOI: 10.1007/s00104-023-01906-w] [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] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND In the context of blunt abdominal trauma, injuries to the urinary tracts often occur, especially in polytrauma patients. Urotrauma is rarely immediately life-threatening but can lead to serious complications and chronic functional limitations during treatment. Therefore early urological involvement is crucial for adequate interdisciplinary treatment. METHODS The most important facts for the clinical routine on the consultant urological management of urogenital injuries in blunt abdominal trauma are discussed according to the European "EAU guidelines on Urological Trauma" and the German "S3 guidelines on Polytrauma/Treatment of Severely Injured Patients" as well as the relevant literature. RESULTS Urinary tract injuries can occur even with an initially inconspicuous status and always require explicit exclusion diagnostics by means of contrast medium tomography of the entire urinary tract and, if necessary, by means of urographic and endoscopic examinations. The most common urological intervention is catheterization of the urinary tract which is often required. Less common is urological surgery, which should be coordinated interdisciplinarily with visceral and trauma surgery. More than 90% of vitally threatening kidney injuries (usually up to the American Association for the Surgery of Trauma (AAST) grades 4-5) are now treated by interventional radiology. CONCLUSION Due to possible complex injury patterns in blunt abdominal trauma, these patients should ideally be directed to (certified) trauma centers with subspecialized or maximum care from the departments of visceral and vascular surgery, trauma surgery, interventional radiology and urology.
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Affiliation(s)
- Johann J Wendler
- Klinik für Urologie, Uroonkologie, robotergestützte und fokale Therapie, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg., Deutschland.
| | - F Meyer
- Klinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - C March
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - H Cash
- Klinik für Urologie, Uroonkologie, robotergestützte und fokale Therapie, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg., Deutschland
| | - M Porsch
- Klinik für Urologie, Uroonkologie, robotergestützte und fokale Therapie, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg., Deutschland
| | - M Schostak
- Klinik für Urologie, Uroonkologie, robotergestützte und fokale Therapie, Universitätsklinikum Magdeburg A.ö.R., Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg., Deutschland
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Schildberg C, Kropf S, Perrakis A, Croner RS, Meyer F. [Consultations by senior physicians in general and abdominal surgery for other medical disciplines over 10 years at a tertiary center-Is a fast time-consuming processing necessary? : Spectrum of clinical findings, diagnoses and treatment decision making]. Chirurgie (Heidelb) 2023; 94:625-634. [PMID: 36991159 PMCID: PMC10310552 DOI: 10.1007/s00104-023-01855-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND The challenges of an adequate, efficient and rational medical treatment and care of patients are always associated with an interprofessional activity of several specialist disciplines. AIM The spectrum of variable diagnoses and the profile of surgical decision-making with further surgical measures within the framework of senior physician consultation in general and visceral surgery for neighboring medical disciplines were analyzed on a representative patient cohort over a defined observational time period. PATIENTS AND METHODS All consecutive patients (n = 549 cases) were documented as part of a clinical systematic prospective single center observational study at a tertiary center using a computer-based patient registry over 10 years (1 October 2006-30 September 2016). The data were analyzed with respect to the spectrum of clinical findings, diagnoses, treatment decisions and the influencing factors as well as gender and age differences and time-dependent developmental trends using χ2-tests and U‑tests. RESULTS (KEY POINTS) The predominant discipline for requests for surgical consultation was cardiology (19.9%) followed by surgical disciplines (11.8%) and gastroenterology (11.3%). Disorders of wound healing (7.1%) and acute abdomen (7.1%) were predominant in the diagnostic profile. In 11.7% of the patients the indications for immediate surgery were derived, whereas in 12.9% elective surgery was recommended. The conformity rate of suspected and definitive diagnoses was only 58.4%. CONCLUSION The surgical consultation work is an important mainstay of a sufficient and especially timely clarification of surgically relevant questions in nearly all medical institutions and especially in a center. This serves i) the quality assurance of surgery in the clinical care of patients with need of additional interdisciplinary needs for surgical treatment in the daily practice of general and abdominal surgery in research on clinical care, ii) clinical marketing and monetary aspects in the sense of patient recruitment and iii) last but not least to provide emergency care of patients. Due to the high proportion of 12% of subsequent emergency operations, which were derived from requests for general and visceral surgical consultations, such requests must be processed promptly during working hours.
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Affiliation(s)
- C Schildberg
- Klinik für Allgemein und Viszeralchirurgie, Universitätsklinikum der MHB im Verbund Brandenburg an der Havel, Hochstraße 29, 14770, Brandenburg an der Havel, Deutschland.
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - A Perrakis
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - R S Croner
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - F Meyer
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
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Oehm S, Steinke K, Schmidt J, Arjune S, Todorova P, Heinrich Lindemann C, Wöstmann F, Meyer F, Siedek F, Weimbs T, Müller RU, Grundmann F. RESET-PKD: a pilot trial on short-term ketogenic interventions in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant 2023; 38:1623-1635. [PMID: 36423335 PMCID: PMC10435930 DOI: 10.1093/ndt/gfac311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Ketogenic dietary interventions (KDI) have been shown to be effective in animal models of polycystic kidney disease (PKD), but data from clinical trials are lacking. METHODS Ten autosomal dominant PKD (ADPKD) patients with rapid disease progression were enrolled at visit V1 and initially maintained a carbohydrate-rich diet. At V2, patients entered one of the two KDI arms: a 3-day water fast (WF) or a 14-day ketogenic diet (KD). At V3, they resumed their normal diet for 3-6 weeks until V4. At each visit, magnetic resonance imaging kidney and liver volumetry was performed. Ketone bodies were evaluated to assess metabolic efficacy and questionnaires were used to determine feasibility. RESULTS All participants [KD n = 5, WF n = 5; age 39.8 ± 11.6 years; estimated glomerular filtration rate 82 ± 23.5 mL/min/1.73 m2; total kidney volume (TKV) 2224 ± 1156 mL] were classified as Mayo Class 1C-1E. Acetone levels in breath and beta-hydroxybutyrate (BHB) blood levels increased in both study arms (V1 to V2 average acetone: 2.7 ± 1.2 p.p.m., V2 to V3: 22.8 ± 11.9 p.p.m., P = .0006; V1 to V2 average BHB: 0.22 ± 0.08 mmol/L, V2 to V3: 1.88 ± 0.93 mmol/L, P = .0008). Nine of 10 patients reached a ketogenic state and 9/10 evaluated KDIs as feasible. TKV did not change during this trial. However, we found a significant impact on total liver volume (ΔTLV V2 to V3: -7.7%, P = .01), mediated by changes in its non-cystic fraction. CONCLUSIONS RESET-PKD demonstrates that short-term KDIs potently induce ketogenesis and are feasible for ADPKD patients in daily life. While TLV quickly changed upon the onset of ketogenesis, changes in TKV may require longer-term interventions.
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Affiliation(s)
- Simon Oehm
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Konstantin Steinke
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Johannes Schmidt
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Sita Arjune
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Polina Todorova
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Christoph Heinrich Lindemann
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Fabian Wöstmann
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
| | - Franziska Meyer
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Florian Siedek
- University of Cologne, Faculty of Medicine and University Hospital, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Thomas Weimbs
- Department of Molecular, Cellular and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Roman-Ulrich Müller
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Franziska Grundmann
- University of Cologne, Faculty of Medicine and University Hospital, Department 2 of Internal Medicine and Center for Molecular Medicine, Cologne, Germany
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Wiese M, Gärtner S, von Essen N, Doller J, Frost F, Tran Q, Weiss F, Meyer F, Valentini L, Garbe LA, Metges C, Bannert K, Sautter L, Ehlers L, Jaster R, Lamprecht G, Steveling A, Lerch M, Aghdassi A. Impaired Muscle Function Is Rarely Seen In Malnourished Patients With Chronic Pancreatitis Despite Prominently Low Skeletal Muscle Mass. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.038] [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: 03/28/2023]
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13
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Meyer F, Bannert K, Wiese M, Sautter L, Esau S, Müller J, Ehlers L, Metges C, Garbe L, Aghdassi A, Lerch M, Jaster R, Lamprecht G, Valentini L. Predictors Of Fatigue In Patients With Liver Cirrhosis: Results From The Energie Project. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.097] [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: 03/28/2023]
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Mahmutovic M, Demarquet L, Meyer F, Klein M, Scheyer N. Traitement par pompe de Teriparatide à la phase aiguë d’une hypocalcémie sur hypoparathyroïdie : une alternative de choix. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Thomas MN, Datta RR, Wahba R, Buchner D, Chiapponi C, Kurschat C, Grundmann F, Urbanski A, Tolksdorf S, Müller R, Henze J, Petrescu-Jipa VM, Meyer F, Bruns CJ, Stippel DL. Introduction of laparoscopic nephrectomy for autosomal dominant polycystic kidney disease as the standard procedure. Langenbecks Arch Surg 2023; 408:8. [PMID: 36602631 PMCID: PMC9816232 DOI: 10.1007/s00423-022-02737-9] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder and accounts for 5-10% of all cases of kidney failure. 50% of ADPKD patients reach kidney failure by the age of 58 years requiring dialysis or transplantation. Nephrectomy is performed in up to 20% of patients due to compressive symptoms, renal-related complications or in preparation for kidney transplantation. However, due to the large kidney size in ADPKD, nephrectomy can come with a considerable burden. Here we evaluate our institution's experience of laparoscopic nephrectomy (LN) as an alternative to open nephrectomy (ON) for ADPKD patients. MATERIALS AND METHODS We report the results of the first 12 consecutive LN for ADPKD from August 2020 to August 2021 in our institution. These results were compared with the 12 most recent performed ON for ADPKD at the same institution (09/2017 to 07/2020). Intra- and postoperative parameters were collected and analyzed. Health related quality of life (HRQoL) was assessed using the SF36 questionnaire. RESULTS Age, sex, and median preoperative kidney volumes were not significantly different between the two analyzed groups. Intraoperative estimated blood loss was significantly less in the laparoscopic group (33 ml (0-200 ml)) in comparison to the open group (186 ml (0-800 ml)) and postoperative need for blood transfusion was significantly reduced in the laparoscopic group (p = 0.0462). Operative time was significantly longer if LN was performed (158 min (85-227 min)) compared to the open procedure (107 min (56-174 min)) (p = 0.0079). In both groups one postoperative complication Clavien Dindo ≥ 3 occurred with the need of revision surgery. SF36 HRQol questionnaire revealed excellent postoperative quality of life after LN. CONCLUSION LN in ADPKD patients is a safe and effective operative procedure independent of kidney size with excellent postoperative outcomes and benefits of minimally invasive surgery. Compared with the open procedure patients profit from significantly less need for transfusion with comparable postoperative complication rates. However significant longer operation times need to be taken in account.
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Affiliation(s)
- M N Thomas
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany.
| | - R R Datta
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - R Wahba
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - D Buchner
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - C Chiapponi
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - C Kurschat
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - F Grundmann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - A Urbanski
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - S Tolksdorf
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - R Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - J Henze
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - V-M Petrescu-Jipa
- Department of Transfusionsmedizin, University of Cologne, Cologne, Germany
| | - F Meyer
- Department of Radiology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - C J Bruns
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
| | - D L Stippel
- Department of General-, Visceral-, Tumor- and Transplantation Surgery, University of Cologne, Faculty of Medicine and University Hospital of Cologne, University Hospital of Cologne, Cologne, Germany
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Woznicki P, Siedek F, van Gastel MD, dos Santos DP, Arjune S, Karner LA, Meyer F, Caldeira LL, Persigehl T, Gansevoort RT, Grundmann F, Baessler B, Müller RU. Automated Kidney and Liver Segmentation in MR Images in Patients with Autosomal Dominant Polycystic Kidney Disease: A Multicenter Study. Kidney360 2022; 3:2048-2058. [PMID: 36591351 PMCID: PMC9802567 DOI: 10.34067/kid.0003192022] [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] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/19/2022] [Indexed: 12/31/2022]
Abstract
Background Imaging-based total kidney volume (TKV) and total liver volume (TLV) are major prognostic factors in autosomal dominant polycystic kidney disease (ADPKD) and end points for clinical trials. However, volumetry is time consuming and reader dependent in clinical practice. Our aim was to develop a fully automated method for joint kidney and liver segmentation in magnetic resonance imaging (MRI) and to evaluate its performance in a multisequence, multicenter setting. Methods The convolutional neural network was trained on a large multicenter dataset consisting of 992 MRI scans of 327 patients. Manual segmentation delivered ground-truth labels. The model's performance was evaluated in a separate test dataset of 93 patients (350 MRI scans) as well as a heterogeneous external dataset of 831 MRI scans from 323 patients. Results The segmentation model yielded excellent performance, achieving a median per study Dice coefficient of 0.92-0.97 for the kidneys and 0.96 for the liver. Automatically computed TKV correlated highly with manual measurements (intraclass correlation coefficient [ICC]: 0.996-0.999) with low bias and high precision (-0.2%±4% for axial images and 0.5%±4% for coronal images). TLV estimation showed an ICC of 0.999 and bias/precision of -0.5%±3%. For the external dataset, the automated TKV demonstrated bias and precision of -1%±7%. Conclusions Our deep learning model enabled accurate segmentation of kidneys and liver and objective assessment of TKV and TLV. Importantly, this approach was validated with axial and coronal MRI scans from 40 different scanners, making implementation in clinical routine care feasible.Clinical Trial registry name and registration number: The German ADPKD Tolvaptan Treatment Registry (AD[H]PKD), NCT02497521.
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Affiliation(s)
- Piotr Woznicki
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany,Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Maatje D.A. van Gastel
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daniel Pinto dos Santos
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany,Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Sita Arjune
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Larina A. Karner
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Franziska Meyer
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Liliana Lourenco Caldeira
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Ron T. Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Franziska Grundmann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Bettina Baessler
- Institute of Diagnostic and Interventional Radiology, University of Cologne, University Hospital Cologne, Cologne, Germany,Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Roman-Ulrich Müller
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Nardi V, Benson J, Saba L, Bois M, Meyer F, Lanzino G, Lilach L, Lerman A. Patients with carotid intraplaque hemorrhage have higher incidence of cerebral microbleeds. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1983] [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: 11/14/2022] Open
Abstract
Abstract
Background
Carotid intraplaque hemorrhage (IPH) is considered a strong marker of histologically defined plaque vulnerability leading to cerebrovascular ischemic events. Cerebral microbleeds (CMBs) represent hemorrhage-prone small vessel disease and they are a common finding on brain MRI in patients with cerebrovascular disease. However, the potential mechanism and the risk for CMBs are not clear. The characteristics of carotid lesions have been considered relevant in the relationship between carotid artery atherosclerosis and the presence of CMBs. The potential association between carotid IPH histologically defined and CMBs has not been investigated yet.
Purpose
We have previously reported the prevalence of IPH in patients with non-obstructive carotid disease in patients who underwent carotid endarterectomy (CEA). In this study, we aimed to investigate whether the presence and the extent of carotid IPH are related to the existence of CMBs. We hypothesized that patients with carotid IPH would have a higher risk of CMBs.
Methods
This retrospective study enrolled 101 consecutive patients undergoing CEA with symptomatic (including ischemic stroke, TIA, and amaurosis fugax) or asymptomatic ipsilateral carotid artery disease. Carotid plaque specimens were collected at CEA from all the patients and stained with Movat Pentachrome to identify the presence and the extent (%) of IPH. Neck CTA was obtained to measure the degree of carotid stenosis. Brain MRI was pre-surgically performed and CMBs were studied using T2*-weighted gradient-recalled echo (GRE) or susceptibility-weighted imaging (SWI) sequence. The CMBs were counted and localized. Clinical and biochemical data, comorbidities, and medications were recorded. The association between carotid IPH and CMBs was examined adjusted for other risk factors.
Results
The presence of carotid IPH was in 57 (56.4%) patients. CMBs were more observed in patients with carotid IPH compared to those without IPH [19 (33.3%) vs 5 (11.4%); p=0.010]. Logistic regression analysis demonstrated an association between the extent of IPH in the carotid atheroma and the presence of CMBs [OR 1.051 (95% CI 1.012–1.090); p=0.009]. Moreover, the carotid IPH extent was associated with the number of CMBs (p=0.004). In patients with CMBs, the median degree of ipsilateral carotid stenosis was 40% (35–65%) and it was 70% (50–80%) in those without CMBs, with a significant difference between the two groups (p=0.049).
Conclusions
In patients undergoing CEA, the histologically defined presence of carotid IPH and its extent are associated with CMBs on brain MR imaging. CMBs may be a potential mechanism for cerebrovascular events in patients with carotid atherosclerotic IPH and they may be an imaging marker that can distinguish the severity of the carotid artery disease.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Mayo Clinic Foundation
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Affiliation(s)
- V Nardi
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
| | - J Benson
- Mayo Clinic, Radiology , Rochester , United States of America
| | - L Saba
- University of Cagliari, Radiology , Cagliari , Italy
| | - M Bois
- Mayo Clinic, Laboratory Medicine and Pathology , Rochester , United States of America
| | - F Meyer
- Mayo Clinic, Neurologic Surgery , Rochester , United States of America
| | - G Lanzino
- Mayo Clinic, Neurologic Surgery , Rochester , United States of America
| | - L Lilach
- Mayo Clinic, Nephrology and Hypertension , Rochester , United States of America
| | - A Lerman
- Mayo Clinic, Cardiovascular Diseases , Rochester , United States of America
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Meyer F, Liese A, Skiborowski M, Bubenheim P, Waluga T. Modeling of an enzymatic reactive extraction centrifuge as part of a multi‐enzyme reaction cascade. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255105] [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: 11/09/2022]
Affiliation(s)
- F. Meyer
- Hamburg University of Technology Institute of Process Systems Engineering Am Schwarzenberg Campus 4 21073 Hamburg Germany
| | - A. Liese
- Hamburg University of Technology Institute of Technical Biocatalysis Denickestr. 15 21073 Hamburg Germany
| | - M. Skiborowski
- Hamburg University of Technology Institute of Process Systems Engineering Am Schwarzenberg Campus 4 21073 Hamburg Germany
| | - P. Bubenheim
- Hamburg University of Technology Institute of Technical Biocatalysis Denickestr. 15 21073 Hamburg Germany
| | - T. Waluga
- Hamburg University of Technology Institute of Process Systems Engineering Am Schwarzenberg Campus 4 21073 Hamburg Germany
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Velazquez-Garcia J, Basuroy K, Storozhuk D, Wong J, Demeshko S, Meyer F, Techert S. Rare low-spin to high-spin transition by cooling a desolvated [2×2] Fe(II) metallogrid revealed by crystallographic studies. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Garabedian NT, Schreiber PJ, Brandt N, Zschumme P, Blatter IL, Dollmann A, Haug C, Kümmel D, Li Y, Meyer F, Morstein CE, Rau JS, Weber M, Schneider J, Gumbsch P, Selzer M, Greiner C. Generating FAIR research data in experimental tribology. Sci Data 2022. [PMCID: PMC9203546 DOI: 10.1038/s41597-022-01429-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Solutions for the generation of FAIR (Findable, Accessible, Interoperable, and Reusable) data and metadata in experimental tribology are currently lacking. Nonetheless, FAIR data production is a promising path for implementing scalable data science techniques in tribology, which can lead to a deeper understanding of the phenomena that govern friction and wear. Missing community-wide data standards, and the reliance on custom workflows and equipment are some of the main challenges when it comes to adopting FAIR data practices. This paper, first, outlines a sample framework for scalable generation of FAIR data, and second, delivers a showcase FAIR data package for a pin-on-disk tribological experiment. The resulting curated data, consisting of 2,008 key-value pairs and 1,696 logical axioms, is the result of (1) the close collaboration with developers of a virtual research environment, (2) crowd-sourced controlled vocabulary, (3) ontology building, and (4) numerous – seemingly – small-scale digital tools. Thereby, this paper demonstrates a collection of scalable non-intrusive techniques that extend the life, reliability, and reusability of experimental tribological data beyond typical publication practices.
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Bluemke A, Ring AP, Immeyer J, Hoff A, Eisenberg T, Gerwat W, Meyer F, Breitkreutz S, Klinger LM, Brandner JM, Sandig G, Seifert M, Segger D, Rippke F, Schweiger D. Multidirectional activity of bakuchiol against cellular mechanisms of facial aging - Experimental evidence for a holistic treatment approach. Int J Cosmet Sci 2022; 44:377-393. [PMID: 35514037 PMCID: PMC9328396 DOI: 10.1111/ics.12784] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 11/29/2022]
Abstract
Objective Skin ageing is a multifactorial process involving formation of reactive oxygen species, consecutive inflammation with reduced epidermal and dermal cell viability and resulting damage to the extracellular matrix. Effective dermocosmetic treatment modalities should ideally address these hallmarks in a holistic approach. Here, we determined the corresponding activity profile of bakuchiol, a plant‐derived meroterpene, in an array of in vitro, ex vivo and in vivo studies and compared it to retinol, currently considered as gold standard in topical antiageing cosmetics. Methods The antioxidative capacity and power of bakuchiol and retinol were analysed by measuring 2,2′‐diphenyl‐1‐picrylhydrazyl (DPPH) reduction via its absorption decay and electron spin resonance spectroscopy, respectively. Effects on prostaglandin E2 (PGE2), macrophage migration inhibitory factor (MIF), fibroblast growth factor 7 (FGF7), collagen type I and VII (COL1A1, COL7A1), fibronectin (FN) levels as well as the metabolization of water‐soluble tetrazolium 1 (WST‐1) were determined in human dermal fibroblasts. Epidermal regeneration was assessed utilizing an in vitro wound healing model. FN protein levels were analysed ex vivo after treatment with a formulation containing bakuchiol, retinol or vehicle using suction blister fluid. Skin condition improvement was determined in vivo in a split‐face comparison study after application of bakuchiol or vehicle. Results In contrast to retinol, bakuchiol demonstrated high antioxidative efficacy. Levels of PGE2 and MIF were significantly decreased by both bakuchiol and retinol. Bakuchiol but not retinol significantly increased FGF7 protein levels. WST‐1 metabolization levels were significantly augmented by bakuchiol and retinol. Bakuchiol and retinol application led to a significant augmentation of COL1A1, COL7A1 and FN protein levels. Wounds supplemented with bakuchiol but not retinol displayed a significant increase in epidermis regeneration. Clinically, areas treated with a bakuchiol‐containing formulation showed a statistically significant increase in FN protein values after a 4‐week application compared to untreated areas and areas treated with vehicle. Conclusion These data provide evidence for the multidirectional efficacy of bakuchiol against cellular hallmarks of skin ageing. Its activity profile shares some common features with retinol but demonstrates several hitherto unknown biopositive effects in our studies, namely stimulation of the critical extracellular matrix component FN, and accelerated epidermal regeneration and wound healing.
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Affiliation(s)
- Anika Bluemke
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | - Annika P Ring
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | - Anke Hoff
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | - Wolfram Gerwat
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | | | - Lina M Klinger
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | - Johanna M Brandner
- Department of Dermatology and Venerology, University Hospital Hamburg- Eppendorf, Germany
| | | | | | | | - Frank Rippke
- Research and Development, Beiersdorf AG, Hamburg, Germany
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Oehm S, Steinke K, Arjune S, Todorova P, Lindemann C, Woestmann F, Meyer F, Siedek F, Weimbs T, Grundmann F, Mueller RU. MO016: Feasibility and Effectiveness of Short-Term Ketogenic Interventions in Autosomal Dominant Polycystic Kidney Disease (ADPKD): Results from the Reset-Pkd Study. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac061.011] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Over the last years, there has been increasing evidence that defects in the energy metabolism of polycystic kidney disease (PKD) cyst lining cells, especially increased glucose dependency and defects in fatty acid oxidation, may underlie the pathogenesis of ADPKD, Rowe et al. (Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy. Nat Med 2013; 19(4): 488–493). Based on these data, ketogenic dietary interventions have effectively been used in PKD animal models, Kipp et al. (A mild reduction of food intake slows disease progression in an orthologous mouse model of polycystic kidney disease. Am J Physiol Renal Physiol 2016;310(8):F726-F31), Torres et al. (Ketosis ameliorates renal cyst growth in polycystic kidney disease. Cell Metab 2019;30(6):1007–23 e5) and Warner et al. (Food restriction ameliorates the development of polycystic kidney disease. J Am Soc Nephrol 2016;27(5):1437–1447). As a first-in-human pilot study, the RESET-PKD study now strives to translate these promising results in the clinical setting.
METHOD
The present study enrolled 10 ADPKD patients with rapid disease progression. After a screening visit (V1), patients followed their usual carbohydrate-rich diet for up to 4 weeks. In a second visit (V2), patients chose to either perform a 3-day water fast (WF) or a 14-day ketogenic diet (KD) until a third study visit (V3), after which they returned to their normal high-carbohydrate diet for 3–6 weeks until a final visit (V4). At all visits, total kidney volume (TKV) and total liver volume (TLV) were monitored using MRI; anthropometric parameters, body composition and biochemical parameters (i.e. serum creatinine, complete blood cell count, glucose, β-hydroxybutyrate in fingerstick blood and acetone in breath) were measured. Ketone bodies were evaluated at all visits and in between. Feasibility was examined using respective questionnaires. Undesirable effects such as feelings of hunger and discomfort were documented in a study diary.
RESULTS
All participants (KD: n = 5, WF: n = 5; age: 39.8 ± 11.6 years; eGFR: 82 ± 23.5 mL/min; TKV: 2224 ± 1156 mL) were classified as Mayo Class 1C to 1E. Serum creatinine values were not altered by the ketogenic dietary interventions (V2: 1.17 ± 0.33 mg/dL versus V3: 1.20 ± 0.35 mg/dL, P = 0.826), but serum glucose levels decreased significantly (V2: 84 ± 3 mg/dL, V3: 70 ± 13 mg/dL, P = 0.004). BHB blood levels as well as acetone levels in breath increased in both study arms (V1 to V2 average acetone: 2.6 ± 1.18 ppm, V2 to V3: 22.8 ± 11.9 ppm, P < 0.0001; V1 to V2 average BHB: 0.22 ± 0.08 mmol/L, V2 to V3: 1.89 ± 0.92 mmol/L, P < 0.0001). Nine out of 10 patients reached a ketogenic state during the intervention and 90% evaluated ketogenic interventions as being feasible while 80% of patients both reached the metabolic endpoint and rated ketogenic dietary interventions as feasible. TKV changes during KD and WF did not show any significant differences compared to the period on carbohydrate-rich diet (ΔTKV V1 to V2: 0.75 ± 0.54%, ΔTKV V2 to V3: −1.06 ± 1.16%).
CONCLUSION
The RESET-PKD study demonstrates feasibility of short-term ketogenic interventions both regarding reliable attainment of ketosis and patient-reported feasibility of this intervention in everyday life. In this proof of principle study, short-term ketogenic interventions could not show a significant reduction in TKV. However, this endpoint is likely to require long-term exposure to ketogenesis. Future large-scale clinical trials examining such long-term dietary interventions—e.g. the KETO-ADPKD study—will be of great importance to further evaluate long-term feasibility and the therapeutic potential of ketogenic diets in ADPKD.
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Affiliation(s)
- Simon Oehm
- Department II for Internal Medicine, Uniklinik Köln, Köln, Germany
| | | | - Sita Arjune
- Department II for Internal Medicine, Uniklinik Köln, Köln, Germany
| | - Polina Todorova
- Department II for Internal Medicine, Uniklinik Köln, Köln, Germany
| | | | - Fabian Woestmann
- Department II for Internal Medicine, Uniklinik Köln, Köln, Germany
| | - Franziska Meyer
- Institute of Diagnostic and Interventional Radiology, Uniklinik Köln, KÖln, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Uniklinik Köln, Köln, Germany
| | - Thomas Weimbs
- >Department of Molecular, Cellular, and Developmental Biology, and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
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Hause S, Schönefuß R, Assmann A, Neumann J, Meyer F, Tautenhahn J, Schreiber S, Heinze HJ, Halloul Z, Goertler M. Relevance of Infarct Size, Timing of Surgery, and Peri-operative Management for Non-ischaemic Cerebral Complications After Carotid Endarterectomy. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2022.01.014] [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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Acciuffi S, Meyer F, Bauschke A, Croner R, Settmacher U, Altendorf-Hofmann A. Solitary colorectal liver metastasis: overview of treatment strategies and role of prognostic factors. J Cancer Res Clin Oncol 2021; 148:657-665. [PMID: 34914005 PMCID: PMC8881245 DOI: 10.1007/s00432-021-03880-4] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/07/2021] [Indexed: 12/09/2022]
Abstract
The following is an overview of the treatment strategies and the prognostic factors to consider in the therapeutic choice of patients characterized by solitary colorectal liver metastasis. Liver resection is the only potential curative option; nevertheless, only 25% of the patients are considered to be eligible for surgery. To expand the potentially resectable pool of patients, surgeons developed multidisciplinary techniques like portal vein embolization, two-stage hepatectomy or associating liver partition and portal vein ligation for staged hepatectomy. Moreover, mini-invasive surgery is gaining support, since it offers lower post-operative complication rates and shorter hospital stay with no differences in long-term outcomes. In case of unresectable disease, various techniques of local ablation have been developed. Radiofrequency ablation is the most commonly used form of thermal ablation: it is widely used for unresectable patients and is trying to find its role in patients with small resectable metastasis. The identification of prognostic factors is crucial in the choice of the treatment strategy. Previous works that focused on patients with solitary colorectal liver metastasis obtained trustable negative predictive factors such as presence of lymph-node metastasis in the primary tumour, synchronous metastasis, R status, right-sided primary colon tumor, and additional presence of extrahepatic tumour lesion. Even the time factor could turn into a predictor of tumour biology as well as further clinical course, and could be helpful to discern patients with worse prognosis.
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Affiliation(s)
- S Acciuffi
- Department of General, Abdominal and Vascular Surgery, University Hospital, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Meyer
- Department of General, Abdominal and Vascular Surgery, University Hospital, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - A Bauschke
- Department of General, Abdominal and Vascular Surgery, University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - R Croner
- Department of General, Abdominal and Vascular Surgery, University Hospital, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - U Settmacher
- Department of General, Abdominal and Vascular Surgery, University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - A Altendorf-Hofmann
- Department of General, Abdominal and Vascular Surgery, University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Cardot V, Campagne-Loiseau S, Roulette P, Peyrat L, Vidart A, Wagner L, Thuillier C, Klap J, Hurel S, Hermieu JF, Girard F, Even L, Donon L, Charles T, Tibi B, Bosset PO, Berrogain N, Meyer F, Cornu JN, Deffieux X. 2021 opinion from the CUROPF on THE efficacy and safety of mid-urethral slings used in women WITH urinary stress incontinence. Prog Urol 2021; 32:247-257. [PMID: 34920924 DOI: 10.1016/j.purol.2021.10.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/23/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the usefulness of mid-urethral slings (MUS) in the surgical management of women presenting with urinary stress incontinence (USI) METHOD: A consensus committee of multidisciplinary experts (CUROPF) was convened and focused on PICO questions concerning the efficacy and safety of MUS surgery compared to other procedures and concerning which approach (retropubic (RP) vs transobturator (TO)) should be proposed as a first-line MUS surgery for specific subpopulations (obese; intrinsic sphincteric deficiency (ISD); elderly) RESULTS: As compared to other procedures (urethral bulking agents, traditional slings and open colposuspension), the MUS procedure should be proposed as the first-line surgical therapy (strong agreement). MUS surgery can be associated with complications and proper pre-operative informed consent is mandatory (strong agreement). Mini-slings (SIS/SIMS) should only be proposed in clinical trials (strong agreement). Both RP and TO approaches may be proposed for the insertion of MUS (strong agreement). However, if the woman is willing to accept a moderate increase in per-operative risk, the RP approach should be preferred (strong agreement) since it is associated with higher very long-term cure rates and as it is possible to completely remove the sling surgically if a severe complication occurs. The RP approach should be used for the insertion of MUS in a woman presenting with ISD (strong agreement). Either the RP or TO approach should be used for the insertion of MUS in an obese woman presenting with USI (strong agreement). In very obese women (BMI ≥35-40kg/m2), weight loss should be preferred prior to MUS surgery and bariatric surgery should be discussed (strong agreement) CONCLUSION: The current Opinion provides an appropriate strategy for both the selection of patients and the best therapeutic approach in women presenting with USI.
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Affiliation(s)
- V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - S Campagne-Loiseau
- Service de gynécologie obstétrique, CHU Estaing, Clermont Ferrand, 1, place Lucie et Raymond-Aubrac, 63000 Clermont Ferrand, France
| | - P Roulette
- Service d'urologie, CH Cahors, 30, avenue de la voie Romaine, 06000 Nice, France
| | - L Peyrat
- Service d'urologie, Clinique de Turin, 13, rue de Turin, 75008 Paris, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Servie d'urologie, CHU Carémeau, place du Pr Robert Debré, 30029 Nîmes, France
| | - C Thuillier
- Service d'urologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | - J Klap
- Service d'urologie, hôpital Privé Claude Galien, 20, route de Boussy Saint-Antoine, 91480 Quincy sous Sénart, France
| | - S Hurel
- Service d'urologie, hôpital Européen Georges-Pompidou (AP-HP), 20, rue Leblanc, 75015 Paris, France
| | - J F Hermieu
- Service d'urologie, hôpital Bichat (AP-HP), 46, rue Henri-Huchard, 75018 Paris, France
| | - F Girard
- Service d'urologie, clinique oudinot fondation Cognacq-Jay, 2 rue Rousselet, 75007 Paris, France
| | - L Even
- Cabinet d'urologie, Espace Santé 3, 521, avenue de Rome, 83500 La Seyne-sur-Mer, France
| | - L Donon
- Service d'urologie, Polyclinique de la Côte Basque Sud, 7, rue Léonce Goyetche, 64500 Saint Jean de Luz, France
| | - T Charles
- Service d'urologie, CHU La Miletrie, 2, rue de la Milétrie, 86021 Poitiers, France
| | - B Tibi
- Service d'urologie, CH Cahors, 30, avenue de la voie Romaine, 06000 Nice, France
| | - P O Bosset
- Service d'urologie, Clinique de Turin, 13, rue de Turin, 75008 Paris, France
| | - N Berrogain
- Service d'URologie, Clinique Ambroise Pare, 387, route de Saint-Simon, 31100 Toulouse, France
| | - F Meyer
- Service d'urologie, hôpital Saint Louis (APHP), 1, avenue Claude Vellefaux, 75010 Paris, France
| | - J-N Cornu
- Service d'urologie, hôpital Charles-Nicolle, université de Rouen, 1, rue de Germont, 76000 Rouen, France
| | - X Deffieux
- Service de gynécologie obstétrique, hôpital Antoine-Béclère (APHP), 157, rue de la Porte de Trivaux, 92140 Clamart, France.
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Klindworth R, Kuennen S, Bischof C, Schmidt A, Feidieker I, Benzin W, Meyer F, Valentini L. Adults with severe visual impairments: challenges in purchasing and processing food. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.382] [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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Mueller J, Meyer F, Sautter L, Wiese M, Esau S, Bannert K, Ehlers L, Gaertner S, Aghdassi A, Lerch M, Jaster R, Lamprecht G, Valentini L. Feasibility of a 3-month supportive ambulant nutrition therapy (SANT) in malnourished patients with liver cirrhosis and chronic pancreatitis. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.335] [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: 11/17/2022]
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Bönisch J, Schwerinske J, Schindler L, Tolay S, Meyer F, Valentini L. Consumer behaviour and knowledge about organic food: a survey of university students in northeastern Germany. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.244] [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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Even L, Tibi B, Bentellis I, Treacy PJ, Berrogain N, Bosset PO, Campagne-Loiseau S, Cardot V, Charles T, Deffieux X, Donon L, Girard F, Hermieu JF, Hurel S, Klap J, Meyer F, Peyrat L, Thuillier C, Vidart A, Wagner L, Cornu JN. [Complications of mid-urethral sling - A review from the Committee for Female Urology and Pelviperineology for the French Association of Urology]. Prog Urol 2021; 31:1141-1166. [PMID: 34794867 DOI: 10.1016/j.purol.2021.09.007] [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: 07/19/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Placement of a mid-urethral sling is the gold standard in the surgical management of stress urinary incontinence in women in France. The cure rate of this material is no longer to be demonstrated, but the per- and post-operative complications are currently the subject of a growing controversy not only in Europe but also across the Channel and across the Atlantic, having led to the modification of operative indications. In France, recommendations are also evolving with a stricter framework for indications for surgery by multidisciplinary consultation meeting and an obligation for postoperative follow-up in the short and long term. OBJECTIVES In this context, CUROPF realized a review of the literature bringing together the available scientific evidence concerning the occurrence of per- and post-operative complications relating to the installation of mid urethral sling. The bibliographic search was carried out using the Medline database and 123 articles were selected. RESULTS Analysis of the data highlights various complications, depending on the implanted material, the patient and the indication for surgery. The retro-pubic mid urethral sling provides more bladder erosion during surgery (up to 14%), more suprapubic pain (up to 4%) and more acute urinary retention (up to 19,7%) and postoperative dysuria (up to 26%). The trans obturator mid-urethral sling is responsible for more vaginal erosion during the operation (up to 10,9%), more lower limb pain of neurological origin (up to 26,7%). The risk of developing over active bladder is similar in both procedures (up to 33%). But these risks of complications must be balanced by the strong impact of urinary incontinence surgery on the overall quality of life of these women. CONCLUSION Thus, surgical failure and long term complications exist but should not limit the surgical management of stress urinary incontinence with mid urethral tape. Women should be treated with individualized decision-making process and long-term follow -up is necessary.
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Affiliation(s)
- L Even
- Cabinet d'urologie, espace santé 3 83500 La Seyne sur Mer, clinique du Cap d'Or, 83500 La Seyne sur mer, Polyclinique Les Fleurs, 83190 Ollioules, France
| | - B Tibi
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - I Bentellis
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - P J Treacy
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - N Berrogain
- Clinique Ambroise-Paré, 31100 Toulouse, France
| | - P O Bosset
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - S Campagne-Loiseau
- Service de gynécologie-obstétrique, CHU Estaing, Clermont-Ferrand, France
| | - V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - T Charles
- Service d'urologie, CHU La Miletrie, 86000 Poitiers, France
| | - X Deffieux
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère (AP-HP), 92140 Clamart, France
| | - L Donon
- Clinique de la Côte Basque, 64100 Bayonne, France
| | - F Girard
- Service d'urologie, clinique Oudinot Fondation Cognac-Jay, 2, rue Rousselet, 75007 Paris, France
| | - J-F Hermieu
- Service d'urologie, hôpital Bichat, AP-HP, Paris, France
| | - S Hurel
- Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - J Klap
- Service d'urologie, hôpital Privé Claude Galien, 91480 Quincy-sous-Sénart, France
| | - F Meyer
- Service d'urologie, hôpital Saint-Louis, AP-HP, Paris, France
| | - L Peyrat
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - C Thuillier
- Service d'urologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Service d'urologie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France
| | - J N Cornu
- Service d'urologie, université de Rouen, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
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Strubl S, Oehm S, Torres JA, Grundmann F, Haratani J, Decker M, Vuong S, Kaur Bhandal A, Methot N, Haynie-Cion R, Meyer F, Siedek F, Korst U, Müller RU, Weimbs T. Ketogenic dietary interventions in autosomal dominant polycystic kidney disease-a retrospective case series study: first insights into feasibility, safety and effects. Clin Kidney J 2021; 15:1079-1092. [PMID: 35664270 PMCID: PMC9155228 DOI: 10.1093/ckj/sfab162] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Indexed: 01/13/2023] Open
Abstract
Background Our laboratory published the first evidence that nutritional ketosis, induced by a ketogenic diet (KD) or time-restricted diet (TRD), ameliorates disease progression in polycystic kidney disease (PKD) animal models. We reasoned that, due to their frequent use for numerous health benefits, some autosomal dominant PKD (ADPKD) patients may already have had experience with ketogenic dietary interventions (KDIs). This retrospective case series study is designed to collect the first real-life observations of ADPKD patients about safety, feasibility and possible benefits of KDIs in ADPKD as part of a translational project pipeline. Methods Patients with ADPKD who had already used KDIs were recruited to retrospectively collect observational and medical data about beneficial or adverse effects and the feasibility and safety of KDIs in questionnaire-based interviews. Results A total of 131 ADPKD patients took part in this study. About 74 executed a KD and 52 a TRD for 6 months on average. A total of 86% of participants reported that KDIs had improved their overall health, 67% described improvements in ADPKD-associated health issues, 90% observed significant weight loss, 64% of participants with hypertension reported improvements in blood pressure, 66% noticed adverse effects that are frequently observed with KDIs, 22 participants reported safety concerns like hyperlipidemia, 45 participants reported slight improvements in estimated glomerular filtration rate and 92% experienced KDIs as feasible while 53% reported breaks during their diet. Conclusions Our preliminary data indicate that KDIs may be safe, feasible and potentially beneficial for ADPKD patients, highlighting that prospective clinical trials are warranted to confirm these results in a controlled setting and elucidate the impact of KDIs specifically on kidney function and cyst progression.
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Affiliation(s)
- Sebastian Strubl
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA,Department II of Internal Medicine and Center for Molecular Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Simon Oehm
- Department II of Internal Medicine and Center for Molecular Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jacob A Torres
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Franziska Grundmann
- Department II of Internal Medicine and Center for Molecular Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jazmine Haratani
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Morgan Decker
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Sabrina Vuong
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Amrit Kaur Bhandal
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Nils Methot
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Rhianna Haynie-Cion
- Department of Molecular, Cellular, and Developmental Biology and Neuroscience Research Institute, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Franziska Meyer
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Uwe Korst
- PKD Familiäre Zystennieren e.V., Bensheim, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
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Meyer F, Kocbach J, Tjønnås J, Danielsen J, Seeberg TM, Austeng A, Sandbakk Ø. Temporal and kinematic patterns distinguishing the G2 from the G4 skating sub-technique. Sports Biomech 2021:1-18. [PMID: 34384336 DOI: 10.1080/14763141.2021.1959948] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
In cross-country ski skating, both the G2 and G4 sub-techniques involve one pole push for every second ski push but are used at largely different speed-slope ranges. The aim of this study was to compare temporal and kinematic patterns between G2 and G4 at both identical and different speed-slope conditions. A mixed model was used to analyse spatio-temporal parameters, while a combination of dynamic time warping and statistical parametric mapping was used to compare time traces. Main spatio-temporal parameters, such as cycle time, ski contact time and swing time, differed between G2 and G4 (all p < 0.01). Moreover, two forward and more pronounced acceleration phases of the centre of mass (CoM) were visible in G4 while only one acceleration phase was present in G2. The more continuous propulsion in G2 allows for maintaining a more constant speed at steep slopes and low speeds where this sub-technique is preferred. In contrast, the achievement of high speeds while skiing on flatter terrain seem to require more dynamic motion with shorter, more explosive propulsion periods allowed for in G4. In conclusion, G2 and G4 are two unique movements as characterised by fundamentally different CoM motion and should be denoted as two different sub-techniques.
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Affiliation(s)
- F Meyer
- Department of Informatics, Digital Signal Processing Group, University of Oslo, Oslo, Norway
| | - J Kocbach
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - J Tjønnås
- Mathematics and Cybernetics, SINTEF Digital, Oslo, Norway
| | - J Danielsen
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - T M Seeberg
- Smart Sensor Systems, SINTEF Digital, Oslo, Norway
| | - A Austeng
- Department of Informatics, Digital Signal Processing Group, University of Oslo, Oslo, Norway
| | - Ø Sandbakk
- Department of Neuromedicine and Movement Science, Centre for Elite Sports Research, Norwegian University of Science and Technology, Trondheim, Norway
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Meyer F, Engel A, Krause A, Wagner T, Poole L, Dubrovska A, Peitzsch C, Petersen C, Rothkamm K, Borgmann K. OC-0401 Avoidance of DNA Replication Stress Leads to Decreased Cytosolic DNA in Breast Cancer Stem Cells. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06888-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ninet L, Mérité PY, Meyer F, Coupier L, Kaci A, Guigou S. A case of tamoxifen retinopathy associated with intermediate uveitis. J Fr Ophtalmol 2021; 44:e533-e539. [PMID: 34244002 DOI: 10.1016/j.jfo.2020.12.028] [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] [Received: 11/15/2020] [Accepted: 12/10/2020] [Indexed: 10/20/2022]
Affiliation(s)
- L Ninet
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France.
| | - P-Y Mérité
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France
| | - F Meyer
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France
| | - L Coupier
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France
| | - A Kaci
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France
| | - S Guigou
- Clinique Axium, Aix-Vision, 21, avenue Alfred-Capus, 13100 Aix-en-Provence, France; Centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13100 Aix-en-Provence, France
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Paasch C, Franz M, March C, Croner R, Meyer F. [Acutely occurring upper abdominal pain : Rare cause in adulthood with instructive imaging computed tomography(CT)-based phenomenon]. Chirurg 2021; 92:1132-1137. [PMID: 34223918 DOI: 10.1007/s00104-021-01447-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 11/25/2022]
Affiliation(s)
- C Paasch
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität mit Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, Magdeburg, Deutschland
- Klinik für Chirurgie/Unfallchirurgie, Oberhavel Klinik Gransee GmbH, Gransee, Deutschland
| | - M Franz
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität mit Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, Magdeburg, Deutschland
| | - C March
- Universitätsklinik für Radiologie und Nuklearmedizin, Otto-von-Guericke-Universität mit Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - R Croner
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität mit Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, Magdeburg, Deutschland
| | - F Meyer
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität mit Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, Magdeburg, Deutschland.
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Guigou S, Michel T, Mérité PY, Coupier L, Meyer F. Home vision monitoring in patients with maculopathy: Real-life study of the OdySight application. J Fr Ophtalmol 2021; 44:873-881. [PMID: 34024655 DOI: 10.1016/j.jfo.2020.09.034] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/19/2020] [Accepted: 09/30/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The goal of the present study was to analyze the implementation and clinical efficacy of OdySight, a mobile medical application for the remote monitoring of patients with maculopathy. MATERIALS AND METHODS In all, 60 patients with edematous maculopathies receiving traditional clinical treatment (PRN or Treat & Extend) were provided with OdySight to detect changes in visual acuity from home. To determine both the feasibility and reliability of the application, its use by patients (both testing and game play), as well as the processing of alerts by the clinical team, were analyzed during the first year. RESULTS The female-to-male ratio was 3:2, with a mean age of 64 years. 52% of patients presented with age-related macular degeneration, 31% with high myopia, 11% with retinal vein occlusion, and 6% with diabetic maculopathy. The conversion rate (defined as the percentage of patients completing at least one test following prescription) and the nine-month retention rate (percentage of active patients) were 61% and 24% respectively. Patients aged 50 to 70 years and those whose use of the app included game play represent 75% of active patients at 9 months. The 22 active patients performed 483 visual acuity tests, completed 1,667 game sessions, and underwent 77 in-person consultations. During the trial period, the clinical team processed 19 alerts, on average in fewer than 6 days. Decreases in visual acuity were detected with a sensitivity of 92% and specificity of 99%. DISCUSSION The use of connected and mobile devices today is widespread, as is interest in mobile medical applications. Long-term treatments for maculopathies can be a difficult burden to bear, both for patients and healthcare practitioners. Overcoming the challenges associated with the successful remote detection of recurrences thus represents a significant opportunity for improving patient care. The implementation of novel digital tools requires the cooperation of the clinical team as a whole, to both inform and motivate patients. OdySight demonstrates satisfactory detection rates, thanks to reliable and reproducible home testing, and can thus serve as a supplementary tool for patients whose consultations are often spaced several months apart. Implementation can be nonetheless improved by facilitating alert processing, a goal which necessitates active adaptation of clinical practices. In general, active patients were very satisfied with this personalized service. CONCLUSION Improved medical support, plus the amusing nature of the tests and games, both bolster long-term use of the OdySight app. The application allows for the remote monitoring of changes in visual acuity and affords patients and practitioners an added level of protection, particularly during long intervals between treatments and at the end of a treatment course. To ensure proper implementation, clinics should focus on reinforcing and modernizing the clinical pathway, from patient intake to the injection room.
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Affiliation(s)
- S Guigou
- Aix Vision, collectif P1,5, 44, avenue Maréchal-de-Lattre-de-Tassigny, 13090 Aix-en-Provence, France.
| | - T Michel
- Service d'ophtalmologie, centre hospitalier du pays d'Aix, Aix-en-Provence, France
| | - P-Y Mérité
- Aix Vision, collectif P1,5, 44, avenue Maréchal-de-Lattre-de-Tassigny, 13090 Aix-en-Provence, France
| | - L Coupier
- Service d'ophtalmologie, centre hospitalier du pays d'Aix, Aix-en-Provence, France
| | - F Meyer
- Aix Vision, collectif P1,5, 44, avenue Maréchal-de-Lattre-de-Tassigny, 13090 Aix-en-Provence, France
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Meyer F, Dittmann A, Kornak U, Herbster M, Pap T, Lohmann CH, Bertrand J. Chondrocytes From Osteoarthritic and Chondrocalcinosis Cartilage Represent Different Phenotypes. Front Cell Dev Biol 2021; 9:622287. [PMID: 33981699 PMCID: PMC8107373 DOI: 10.3389/fcell.2021.622287] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
Basic calcium phosphate (BCP)-based calcification of cartilage is a common finding during osteoarthritis (OA) and is directly linked to the severity of the disease and hypertrophic differentiation of chondrocytes. Chondrocalcinosis (CC) is associated with calcium pyrophosphate dihydrate (CPPD) deposition disease in the joint inducing OA-like symptoms. There is only little knowledge about the effect of CPPD crystals on chondrocytes and the signaling pathways involved in their generation. The aim of this study was to investigate the chondrocyte phenotype in CC cartilage and the effect of CPPD crystals on chondrocytes. Cartilage samples of patients with CC, patients with severe OA, and healthy donors were included in this study. The presence of CC was evaluated using standard X-ray pictures, as well as von Kossa staining of cartilage sections. OA severity was evaluated using the Chambers Score on cartilage sections, as well as the radiological Kellgren–Lawrence Score. Patients with radiologically detectable CC presented calcification mainly on the cartilage surface, whereas OA patients showed calcification mainly in the pericellular matrix of hypertrophic chondrocytes. OA cartilage exhibited increased levels of collagen X and matrix metalloproteinase 13 (MMP13) compared with CC and healthy cartilage. This observation was confirmed by qRT-PCR using cartilage samples. No relevant influence of CPPD crystals on hypertrophic marker genes was observed in vitro, whereas BCP crystals significantly induced hypertrophic differentiation of chondrocytes. Interestingly, we observed an increased expression of p16 and p21 in cartilage samples of CC patients compared with OA patients and healthy controls, indicating cellular senescence. To investigate whether CPPD crystals were sufficient to induce senescence, we incubated chondrocytes with BCP and CPPD crystals and quantified senescence using β-gal staining. No significant difference was observed for the staining, but an increase of p16 expression was observed after 10 days of culture. Primary chondrocytes from CC patients produced CPPD crystals in culture. This phenotype was stabilized by mitomycin C-induced senescence. Healthy and OA chondrocytes did not exhibit this phenotype. BCP and CPPD crystals seem to be associated with two different chondrocyte phenotypes. Whereas BCP deposition is associated with chondrocyte hypertrophy, CPPD deposition is associated with cellular senescence.
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Affiliation(s)
- Franziska Meyer
- Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Annalena Dittmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Uwe Kornak
- Institut für Humangenetik, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Maria Herbster
- Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Thomas Pap
- Institute of Experimental Musculoskeletal Medicine, University Hospital Muenster, Münster, Germany
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Louvrier A, Terranova L, Meyer C, Meyer F, Euvrard E, Kroemer M, Rolin G. Which experimental models and explorations to use in regenerative endodontics? A comprehensive review on standard practices. Mol Biol Rep 2021; 48:3799-3812. [PMID: 33761086 DOI: 10.1007/s11033-021-06299-9] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/18/2021] [Indexed: 01/09/2023]
Abstract
Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.
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Affiliation(s)
- A Louvrier
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France.
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France.
| | - L Terranova
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - C Meyer
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - F Meyer
- UMR_S 1121 Biomatériaux et Bioingénierie, Université de Strasbourg, INSERM, FMTS, Strasbourg, France
| | - E Euvrard
- Chirurgie Maxillo-Faciale, stomatologie et odontologie hospitalière, CHU Besançon, 25000, Besançon, France
- Laboratoire Nano Médecine, Imagerie, Thérapeutique, Univ. Bourgogne Franche-Comté, EA 4662, 25000, Besançon, France
| | - M Kroemer
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- Pharmacie Centrale, CHU Besançon, 25000, Besançon, France
| | - G Rolin
- UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, 25000, Besançon, France
- INSERM CIC-1431, CHU Besançon, 25000, Besançon, France
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Gluschke JG, Seidl J, Lyttleton RW, Nguyen K, Lagier M, Meyer F, Krogstrup P, Nygård J, Lehmann S, Mostert AB, Meredith P, Micolich AP. Integrated bioelectronic proton-gated logic elements utilizing nanoscale patterned Nafion. Mater Horiz 2021; 8:224-233. [PMID: 34821301 DOI: 10.1039/d0mh01070g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A central endeavour in bioelectronics is the development of logic elements to transduce and process ionic to electronic signals. Motivated by this challenge, we report fully monolithic, nanoscale logic elements featuring n- and p-type nanowires as electronic channels that are proton-gated by electron-beam patterned Nafion. We demonstrate inverter circuits with state-of-the-art ion-to-electron transduction performance giving DC gain exceeding 5 and frequency response up to 2 kHz. A key innovation facilitating the logic integration is a new electron-beam process for patterning Nafion with linewidths down to 125 nm. This process delivers feature sizes compatible with low voltage, fast switching elements. This expands the scope for Nafion as a versatile patternable high-proton-conductivity element for bioelectronics and other applications requiring nanoengineered protonic membranes and electrodes.
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Affiliation(s)
- J G Gluschke
- School of Physics, University of New South Wales, Sydney, NSW 2052, Australia.
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Watzka FM, Meyer F, Staubitz JI, Fottner C, Schad A, Lang H, Musholt TJ. Prognostic Assessment of Non-functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk-Adapted Resection Strategies. World J Surg 2020; 44:594-603. [PMID: 31605171 DOI: 10.1007/s00268-019-05220-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND In contrast to exocrine pancreatic carcinomas, prognosis and treatment of pancreatic neuroendocrine neoplasms (PNEN) are significantly different. The variable growth pattern and associated clinical situation of functioning and non-functioning PNEN demand an individualized surgical approach. However, due to the scarce evidence associated with the rare disease, guidelines lack detailed recommendations for indication and for the required extent of surgical resection. METHODS In a retrospective single-center study from 1990 to 2018, 239 patients with PNEN were identified. Clinical data were collected in the MaDoc database of the University Medical Center Mainz. A total of 155 non-functional PNEN were selected for further analysis. RESULTS According to the classification of NET by the WHO in 2017, 28.8% (n = 40) of the tumors were G1, 61.9% (n = 86) G2, and 9.4% (n = 13) G3. In 73 patients, hepatic metastases were present. Sixty patients had lymph node metastasis. An R0 resection was achieved in 98 cases, an R1 situation in 10 cases. Five times, a tumor debulking was carried out (R2) and 5 times the operation was aborted without any resection because of the advanced tumor stage. A relapse occurred in 29 patients. Different prognostic factors (grade, tumor size, age) were analyzed. Grade-dependent 10-year overall survival rates were 79.5% (grade 1) and 60.1% (grade 2), respectively. The survival rate of grade 3 patients was limited to 66.7% after 13 months. CONCLUSION In our study, patients with non-functioning PNEN had a longer overall survival after successful R0 resection. The risk analysis confirmed a Ki-67 cutoff value of 5%, which divided a high- and low-risk group. Patients with a PNEC G3 (Ki-67 index > 50%) had a very poor prognosis.
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Affiliation(s)
- F M Watzka
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - F Meyer
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - J I Staubitz
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - C Fottner
- Endocrinology and Metabolic Diseases, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A Schad
- Institute of Pathology, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - H Lang
- Institute of Pathology, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - T J Musholt
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
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Meyer F, Bannert K, Wiese M, Esau S, Sautter L, Ehlers L, Aghdassi A, Jaster R, Metges C, Garbe L, Lerch M, Lamprecht G, Valentini L. Evaluation of fatigue in patients with liver cirrhosis and chronic pancreatitis in a multicentre cross-sectional study. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.326] [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: 10/23/2022]
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Arnaud Q, Masson Lecomte A, Desgrandchamps F, Mongiat Artus P, Meria P, Gaudez F, Meyer F, Lafaurie M, Goujon A. Impact infectiologique et organisationnel de l’examen cytobactériologique des urines (ECBU) systématique avant BCG d’induction. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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42
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Dobé T, Belhadj Y, Michel C, Djouadou M, Bouchardi A, Liron C, Bento C, Arégui A, Meyer F, Gaudez F, Meria P, Desgrandchamps F, Mongiat-Artus P, Masson-Lecomte A. Comparaison des résultats périopératoires de la cystectomie après chimiothérapie néoadjuvante en fonction de l’application d’un protocole de RAAC. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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Pesqué R, Meyer F, Gaudez F, Masson-Lecomte A, Mongiat-Artus P, Desgrandchamps F, Martelli N, Levert H. Utilisation d’endoprothèses urétérales magnétisées après transplantation rénale dans un centre hospitalo-universitaire : impacts d’un changement de pratiques. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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44
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Meyer F, Engel A, Riepen B, Schumacher U, Dubrovska A, Petersen C, Peitzsch C, Hein L, Werner S, Wikmann H, Rothkamm K, Borgmann K. OC-0207: Avoidance of DNA replication stress leads to radioresistance in stem cell-like TNBC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Clery R, Masson-Lecomte A, Desgrandchamps F, Bouda D, Pachev A, Mongiat-Artus P, Meria P, Goujon A, Meyer F, Gaudez F, De Kerviller E, Bebane S, Giwerc A, Santy A, Verrine J. Validation externe de la performance diagnostique du score VIRADS dans la stadification des tumeurs de la vessie : étude prospective. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.035] [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: 11/26/2022]
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46
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Linnenkamp U, Greiner G, Fehm T, Adamczewski H, Bizjak G, Borgmeier F, Dortmann O, Ensenauer R, Gräfe V, Hollmann T, Ihle P, Jüngling U, Kaltheuner M, Kerres T, Kuß O, Lange U, Lappe V, Leve V, Meier-Stiegen F, Meyer F, Müller-Bößmann D, Neuenschwander M, Ruckhäberle E, Rupprecht C, Schellhammer S, Schmitz-Losem I, Schneider M, Schumacher L, Tamayo M, Viehmann A, Westerhoff B, Wilm S, Icks A. GestDina – Analysis of the current aftercare situation for gestational diabetes. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- U Linnenkamp
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | - G Greiner
- IVG, Heinrich-Heine-Universität Düsseldorf/DDZ
| | - T Fehm
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | | | - G Bizjak
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | - F Borgmeier
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | | | - R Ensenauer
- Kinderklinik, Universitätsklinikum Düsseldorf
| | - V Gräfe
- Kassenärztliche Vereinigung Nordrhein
| | | | - P Ihle
- pmv Forschungsgruppe, Universität zu Köln
| | | | | | | | | | - U Lange
- Studienbereich Hebammenwissenschaft, HSG Bochum
| | - V Lappe
- pmv Forschungsgruppe, Universität zu Köln
| | - V Leve
- ifam, Heinrich-Heine-Universität Düsseldorf
| | - F Meier-Stiegen
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | | | | | | | - E Ruckhäberle
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf
| | | | | | | | | | | | - M Tamayo
- Kassenärztliche Vereinigung Nordrhein
| | - A Viehmann
- IVG, Heinrich-Heine-Universität Düsseldorf/DDZ
| | | | - S Wilm
- ifam, Heinrich-Heine-Universität Düsseldorf
| | - A Icks
- IVG, Heinrich-Heine-Universität Düsseldorf/DDZ
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Middelhoff J, Ptok H, Will U, Kandulski A, March C, Stroh C, Meyer L, Meyer F. Interventionelle Therapieoptionen der malignen intestinalen Obstruktion. coloproctology 2020. [DOI: 10.1007/s00053-020-00487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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48
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Lieutier-Colas F, Hasseine L, Machouart M, Vannini M, Emery S, Meyer F, Demoré B, Charmillon A, Simon L, Rabaud C. Fongémies à Candida spp : épidémiologie, sensibilité aux antifongiques et consommations d’antifongiques dans deux CHU français de 2015 à 2018. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.337] [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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Schlosser N, Espino Martínez J, Meyer F, Regestein L. Process development for the antifungal cyclic lipopeptide jagaricin. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055147] [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)
- N. Schlosser
- Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI) Bio Pilot Plant Beutenbergstr. 11a 07745 Jena Germany
| | - J. Espino Martínez
- Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI) Bio Pilot Plant Beutenbergstr. 11a 07745 Jena Germany
| | - F. Meyer
- Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI) Transfer Group Anti-infectives Beutenbergstr. 11a 07745 Jena Germany
| | - L. Regestein
- Leibniz Institute for Natural Product Research and Infection Biology – Hans Knöll Institute (HKI) Bio Pilot Plant Beutenbergstr. 11a 07745 Jena Germany
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D’huart E, Meyer F, Demoré B, Charmillon A. Efficacité clinique de la témocilline dans un centre hospitalier universitaire français. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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