1
|
Halfter K, Schubert-Fritschle G, Röder F, Kim M, Werner J, Belka C, Wolff H, Agha A, Fuchs M, Friess H, Combs S, Häussler B, Engel J, Schlesinger-Raab A. Advances in rectal cancer: Real-world evidence suggests limited gains in prognosis for elderly patients. Cancer Epidemiol 2023; 86:102440. [PMID: 37572415 DOI: 10.1016/j.canep.2023.102440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Rectal cancer treatment has improved considerably due to the introduction of total meso-rectal excision, radio-chemotherapy, and high-resolution imaging. The aim of this observational cohort study was to quantify the effectiveness of these advances using high-quality data from a representative cohort of patients. METHODS 20 281 non-metastasized cases retrieved from the Munich Cancer Registry database were divided into three time periods corresponding to before (1988-1997), partial (1998-2007), and full implementation (2008-2019) of clinical advances. Early-onset (<50 yrs.), middle-aged, elderly patient subgroups (> 70 yrs.) were compared. The overall effectiveness of evidence-based guideline adherence was also examined. RESULTS Median survival improved by 1.5 yrs. from the first to the last time period. Relative survival increased from 74.9% (5-yr 95%CI[73.3 - 76.6]) to 79.2% (95%CI[77.8 - 80.5]). The incidence of locoregional recurrences was reduced dramatically by more than half (5-yr 17.7% (95%CI[16.5 - 18.8]); 6.7% (95%CI[6.1 - 7.3])). Gains in 5-yr relative survival were limited to early-onset and middle-aged patients with no significant improvement seen in elderly patients (Female 68.6% [63.9 - 73.3] to 67.6% [64.0 - 71.2]; Male 71.7% [65.9 - 77.4] to 74.0% [70.8 - 77.2]). CONCLUSIONS Real-world evidence suggests that recent treatment advances have lead to an increase in prognosis for rectal cancer patients. However, more effort should be made to improve the implementation of new developments in elderly patients. Especially considering, that these cases represent a growing majority of diagnosed patients.
Collapse
Affiliation(s)
- K Halfter
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany.
| | - G Schubert-Fritschle
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - F Röder
- Department of Radiotherapy and Radiation Oncology, Paracelsus Medical University Salzburg, Landeskrankenhaus, Müller Hauptstraße 48, 5020 Salzburg, Austria
| | - M Kim
- Department of Surgery, Clinic Munich-Neuperlach Hospital, Oskar-Maria-Graf-Ring 51, 81737 Munich, Germany
| | - J Werner
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - C Belka
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - H Wolff
- Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, Burgstraße 7, 80331 Munich, Germany
| | - A Agha
- Department of General, Visceral, Endocrine and Minimal-Invasive Surgery, Clinic Munich-Bogenhausen, Englschalkinger Straße 77, 81925 Munich, Germany
| | - M Fuchs
- Department of Gastroenterology, Hepatology, and Gastrointestinal-Oncology, Clinic Munich-Bogenhausen, Englschalkinger Straße 77, 81925 Munich, Germany
| | - H Friess
- Department General Surgery, Klinikum rechts der Isar, Technical University Munich (TUM) School of Medicine, Ismaninger Straße 22, 81675 Munich, Germany
| | - S Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich (TUM) School of Medicine, Ismaninger Straße 22, 81675 Munich, Germany
| | - B Häussler
- Strahlentherapie Klinikum Harlaching, Sanatoriumsplatz 2, 81545 München, Germany
| | - J Engel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - A Schlesinger-Raab
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University (LMU), Marchioninistraße 15, 81377 Munich, Germany
| |
Collapse
|
2
|
Krammer S, Li Y, Jakob N, Boehm AS, Wolff H, Tang P, Lasser T, French LE, Hartmann D. Deep learning-based classification of dermatological lesions given a limited amount of labeled data. J Eur Acad Dermatol Venereol 2022; 36:2516-2524. [PMID: 35876737 DOI: 10.1111/jdv.18460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Artificial intelligence (AI) techniques are promising in early diagnosis of skin diseases. However, a precondition for their success is the access to large-scaled annotated data. Until now, obtaining this data has only been feasible with very high personnel and financial resources. OBJECTIVES The aim of this study was to overcome the obstacle caused by the scarcity of labeled data. METHODS To simulate the scenario of label shortage, we discarded a proportion of labels of the training set. The training set consisted of both labeled and unlabeled images. We then leveraged a self-supervised learning technique to pre-train the AI model on the unlabeled images. Next, we fine-tuned the pre-trained model on the labeled images. RESULTS When the images in the training dataset were fully labeled, the self-supervised pre-trained model achieved 95.7% of accuracy, 91.7% of precision and 90.7% of sensitivity. When only 10% of the data was labeled, the model could still yield 87.7% of accuracy, 81.7% of precision and 68.6% of sensitivity. In addition, we also empirically verified that the AI model and dermatologists are consistent in visually inspecting the skin images. CONCLUSIONS The experimental results demonstrate the great potential of the self-supervised learning in alleviating the scarcity of annotated data.
Collapse
Affiliation(s)
- S Krammer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Y Li
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - N Jakob
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A S Boehm
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - H Wolff
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - P Tang
- Department of Informatics, School of Computations, Information, and Technology, and Munich Institute of Biomedical Engineering, Technical University of Munich, Munich, Germany
| | - T Lasser
- Department of Informatics, School of Computations, Information, and Technology, and Munich Institute of Biomedical Engineering, Technical University of Munich, Munich, Germany
| | - L E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - D Hartmann
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
3
|
Hofman P, Ilié M, Chamorey E, Brest P, Schiappa R, Nakache V, Antoine M, Barberis M, Begueret H, Bibeau F, Bonnetaud C, Boström P, Brousset P, Bubendorf L, Carvalho L, Cathomas G, Cazes A, Chalabreysse L, Chenard MP, Copin MC, Côté JF, Damotte D, de Leval L, Delongova P, Thomas de Montpreville V, de Muret A, Dema A, Dietmaier W, Evert M, Fabre A, Forest F, Foulet A, Garcia S, Garcia-Martos M, Gibault L, Gorkiewicz G, Jonigk D, Gosney J, Hofman A, Kern I, Kerr K, Kossai M, Kriegsmann M, Lassalle S, Long-Mira E, Lupo A, Mamilos A, Matěj R, Meilleroux J, Ortiz-Villalón C, Panico L, Panizo A, Papotti M, Pauwels P, Pelosi G, Penault-Llorca F, Pop O, Poté N, Cajal SRY, Sabourin JC, Salmon I, Sajin M, Savic-Prince S, Schildhaus HU, Schirmacher P, Serre I, Shaw E, Sizaret D, Stenzinger A, Stojsic J, Thunnissen E, Timens W, Troncone G, Werlein C, Wolff H, Berthet JP, Benzaquen J, Marquette CH, Hofman V, Calabrese F. Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future. ESMO Open 2020; 6:100024. [PMID: 33399086 PMCID: PMC7780004 DOI: 10.1016/j.esmoop.2020.100024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. Materials and methods A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. Results Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. Conclusions The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe. Biosafety measures used in the first wave of the COVID-19 crisis were heterogeneous in 53 European pathology laboratories. A dramatic decrease of the workload in pathology laboratories was noted. No case of healthcare workers contaminated with SARS-CoV-2 associated with samples handling was identified.
Collapse
Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Chamorey
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - P Brest
- Team 4, IRCAN, INSERM, CNRS, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - R Schiappa
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - V Nakache
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - M Antoine
- Department of Pathology, Hôpital Tenon, AP-HP, Paris, France
| | - M Barberis
- Unit of Histopathology and Molecular Diagnostics, Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Begueret
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - F Bibeau
- Department of Pathology, CHU de Caen, Université de Caen Normandie, Caen, France
| | - C Bonnetaud
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - P Brousset
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - L Bubendorf
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - L Carvalho
- Institute of Anatomical and Molecular Pathology and University Hospital, University of Coimbra, Coimbra, Portugal
| | - G Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Cazes
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - M-P Chenard
- Department of Pathology, University Hospital of Strasbourg, Strasbourg, France
| | - M-C Copin
- Institut de Pathologie, CHU Lille, Université de Lille, Lille, France
| | - J-F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - D Damotte
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - P Delongova
- Institute of Pathology, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A de Muret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Dema
- Department of Pathology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - W Dietmaier
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - M Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - A Fabre
- Department of Histopathology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - A Foulet
- Department of Pathology, Centre Hospitalier, Le Mans, France
| | - S Garcia
- Department of Pathology, Hôpital Nord, AP-HM, Aix Marseille University, Marseille, France
| | - M Garcia-Martos
- Pulmonary Pathology Department, Gregorio Marañon University Hospital, Madrid, Spain
| | - L Gibault
- Department of Pathology, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, Paris, France
| | - G Gorkiewicz
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Jonigk
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - J Gosney
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, UK
| | - A Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - K Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - M Kossai
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - M Kriegsmann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - A Lupo
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - A Mamilos
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - R Matěj
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer Hospital and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - J Meilleroux
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - C Ortiz-Villalón
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - L Panico
- Unit of Pathology, Azienda Ospedaliera dei Colli, Monaldi-Cotugno-CTO, Naples, Italy
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Papotti
- Department of Oncology, University of Torino, Torino, Italy
| | - P Pauwels
- Centre for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, and IRCCS MultiMedica, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - O Pop
- Department of Pathology, University of Oradea, Oradea, Romania
| | - N Poté
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - S R Y Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J-C Sabourin
- Department of Pathology, Inserm 1245, Rouen University Hospital Normandy University, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - M Sajin
- Department of Pathology, Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - S Savic-Prince
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - H-U Schildhaus
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - P Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - I Serre
- Department of Biopathology, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - E Shaw
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Sizaret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - J Stojsic
- Department of Thoracic Pathology, Service of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - E Thunnissen
- Department of Pathology, Amsterdam University Medical Centres, Location VUmc, Amsterdam, The Netherlands
| | - W Timens
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G Troncone
- Department of Public Health, University of Naples Frederico II, Naples, Italy
| | - C Werlein
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - H Wolff
- Laboratory of Pathology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - J-P Berthet
- Department of Thoracic Surgery, FHU OnoAge, Louis Pasteur Hospital, University Côte d'Azur, Nice, France
| | - J Benzaquen
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - C-H Marquette
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Pathological Anatomy Section, University of Padova Medical School, Padova, Italy
| |
Collapse
|
4
|
Li Z, Gao S, Brand U, Hiller K, Wolff H. A MEMS nanoindenter with an integrated AFM cantilever gripper for nanomechanical characterization of compliant materials. Nanotechnology 2020; 31:305502. [PMID: 32289758 DOI: 10.1088/1361-6528/ab88ed] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This work presents the development of a MEMS nanoindenter that uses exchangeable AFM probes for quasi-static nanomechanical characterization of compliant and ultra-compliant materials. While the electrostatic micro-force transducer of the MEMS nanoindenter provides a maximum indentation depth up to 9.5 µm with a maximum output force of 600 µN, experimental investigations reveal that it can achieve a depth and force resolution better than 4 pm Hz-1/2 and 0.3 nN Hz-1/2, in air for f≥ 1 Hz. A passive AFM probe gripper is integrated into the MEMS nanoindenter, allowing the nanoindenter to utilize various AFM probes as an indenter for material testing. A proof-of-principle experimental setup has been built to investigate the performance of the MEMS nanoindenter prototype. In proof-of-principle experiments, the prototype with a clamped diamond AFM probe successfully identified an atomic step (∼0.31 nm) within a Si < 111 > ultraflat sample using the scanning probe microscopy mode. The nanomechanical measurement capability of the MEMS nanoindenter prototype has been verified by means of measurements of reference polymer samples using a silicon AFM probe and by means of measurements of the elastic properties of a PDMS sample using a spherical diamond-coated AFM probe. Owing to its compact and low-cost but high-resolution capacitive readout system, this MEMS nanoindenter head can be further applied for in-situ quantitative nanomechanical measurements in AFMs and SEMs.
Collapse
Affiliation(s)
- Z Li
- Physikalisch-Technische Bundesanstalt, 38116, Braunschweig, Germany
| | | | | | | | | |
Collapse
|
5
|
Rijova N, Saraeva V, Gantchev K, Bakalov I, Wolff H, Arndt S. Analysis of the melt spreading and MCCI during the ex-vessel phase of a severe accident in WWER-1000. KERNTECHNIK 2019. [DOI: 10.3139/124.190010] [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: 11/20/2022]
Abstract
AbstractThe paper presents analysis results of melt spreading and core-concrete interactions in the containment of a WWER-1000 plant during the ex-vessel phase of a severe accident. The failure of the vessel takes place 8 h 35 min after the initiation of the accident. It has been assumed that the whole area of the containment floor is available for spreading, i.e. the door between the reactor cavity and the main part of the containment is not locked. The melt flow rate from the reactor pressure vessel was used as a boundary condition. The simulation of the melt spreading was performed with the LAVA code. The calculated spreading area varies from 60 to 100 m2 depending on the assumed values of the melt properties. The results from the LAVA calculations were used in parallel for COCOSYS and MELCOR calculations to study the core-concrete interactions. From the analyses it turned out: a larger spreading area leads to a faster cooling of the melt in the initial period of the accident, but in the long term the temperatures are the same. 60 h after start of the ex-vessel phase, the melt is not stabilised.
Collapse
Affiliation(s)
- N. Rijova
- 1ENPRO Consult, 107 Cherni Vrah blvd. Sofia, 1407 Bulgaria
| | - V. Saraeva
- 1ENPRO Consult, 107 Cherni Vrah blvd. Sofia, 1407 Bulgaria
| | - K. Gantchev
- 1ENPRO Consult, 107 Cherni Vrah blvd. Sofia, 1407 Bulgaria
| | - I. Bakalov
- 2Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, 200 Kurfürstendamm, 10719 Berlin, Germany
| | - H. Wolff
- 2Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, 200 Kurfürstendamm, 10719 Berlin, Germany
| | - S. Arndt
- 2Gesellschaft für Anlagen- und Reaktorsicherheit (GRS) gGmbH, 200 Kurfürstendamm, 10719 Berlin, Germany
| |
Collapse
|
6
|
Baggio S, Tran NT, Barnert ES, Gétaz L, Heller P, Wolff H. Lack of health insurance among juvenile offenders: a predictor of inappropriate healthcare use and reincarceration? Public Health 2018; 166:25-33. [PMID: 30439553 DOI: 10.1016/j.puhe.2018.09.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/15/2018] [Accepted: 09/30/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Relationships between the health insurance status and healthcare use among justice-involved youths transitioning into adulthood is an underexplored topic, even if transition to adulthood is a crucial time period for healthcare outcomes. To fill in these knowledge gaps, this study had two aims: (1) to examine trajectories of health insurance coverage and healthcare use among serious juvenile offenders transitioning into adulthood; and (2) to explore associations between the lack of health insurance, healthcare use and reincarceration. STUDY DESIGN We conducted a secondary analysis on the data of the US longitudinal Pathways to Desistance study between ages 20 and 23 years (2000-2010). METHODS Participant data on health insurance coverage, healthcare use, reincarceration and sociodemographic variables (n = 1215) were extracted and analysed using descriptive statistics, generalized linear regressions and cross-lagged panel models. RESULTS About half of the young offenders had no health insurance coverage or intermittent coverage between the age of 20 and 23 years. Emergency services were used (≥17.4%), notably more by insured participants and were increasingly used over time. Being uninsured at the age of 20 years was associated with reincarceration at the age of 23 years (b = -0.052, p = 0.014, odd-ratio = 0.95), but incarceration at the age of 20 years did not predict the insurance status at the age of 23 years (b = 0.009, p = 0.792). CONCLUSIONS Serious juvenile offenders, especially if uninsured, faced major barriers to accessing health care and often reported an inappropriate healthcare use. This likely led to reincarceration. The lack of continuity of care and of access to health care may, therefore, increase health disparities, and efforts are needed to mitigate detrimental outcomes, by effective in and out of detention coordination of health insurance coverage and among health services.
Collapse
Affiliation(s)
- S Baggio
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland; Life Course and Social Inequality Research Centre, University of Lausanne, Bâtiment Géopolis, 1015 Lausanne, Switzerland.
| | - N T Tran
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland; Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, PO Box 123, Broadway, NSW 2007, Australia.
| | - E S Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, 10833 Le Conte Ave, Los Angeles, CA, USA.
| | - L Gétaz
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland.
| | - P Heller
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland.
| | - H Wolff
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Chemin du Petit Bel Air 2, 1226 Thônex, Switzerland.
| |
Collapse
|
7
|
Lehto M, Wolff H, Leino R, Alenius H, Savolainen J. A novel glycocluster molecule prevents timothy-induced allergic airway inflammation in mice. Allergy 2018; 73:1700-1706. [PMID: 29377154 DOI: 10.1111/all.13419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (SIT) effectively alleviates type I allergic diseases characterized by T helper (Th)2-type immunity. Our recent studies have shown that a synthetic trivalent glycocluster, triacedimannose (TADM), suppresses the Th2-type allergic inflammation. The aim of this study was to compare TADM with two well-known adjuvants, unmethylated cytosine-phosphate-guanine oligodeoxynucleotide (CpG) and monophosphoryl lipid A (MPLA) in a grass allergen-induced chronic allergic inflammation model in mice. METHODS Female BALB/c mice were intranasally sensitized with 50 μL of timothy grass pollen extract (TE) twice a week for a period of 15 weeks. Therapeutic intranasal treatments were then performed once a week after the tenth intranasal TE instillation using TADM (10 or 25 μg/50 μL), CpG-ODN (20 μg/50 μL) or MPLA (2 μg/50 μL). Groups of 9-10 animals per treatment were killed 24 hours after the last timothy dosage. Blood, bronchoalveolar lavage (BAL) fluids and lung biopsies were taken for subsequent analysis. RESULTS When mice were repeatedly exposed to TE for 15 weeks, the number of eosinophils and lymphocytes increased in the BAL fluids. The eosinophil and lymphocyte counts decreased dose-dependently and were practically abolished in the mice treated with TADM. Treatments with MPLA or CpG significantly increased the numbers of neutrophils, while CpG nonsignificantly decreased eosinophilia compared to timothy exposure. CONCLUSIONS A novel synthetic glycocluster molecule inhibited the development of grass-induced eosinophilic pulmonary inflammation in mice when administrated in the airways. This compound could be a candidate to be used either as an adjuvant in SIT or as a topical anti-inflammatory treatment.
Collapse
Affiliation(s)
- M. Lehto
- Department of Occupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - H. Wolff
- Department of Pathology; Finnish Institute of Occupational Health; Helsinki Finland
| | - R. Leino
- Johan Gadolin Process Chemistry Centre; Laboratory of Organic Chemistry; Åbo Akademi University; Turku Finland
| | - H. Alenius
- Karolinska Institutet; Institute of Environmental Medicine; Stockholm Sweden
- Medical Faculty; University of Helsinki; Helsinki Finland
| | - J. Savolainen
- Department of Pulmonary Diseases and Clinical Allergology; University of Turku; Turku University Hospital; Turku Finland
| |
Collapse
|
8
|
Jackson Y, Paignon A, Wolff H, Delicado N. 7.5-O2Undocumented migrants in a primary care setting in Switzerland present multiple and long-term conditions requiring comprehensive health services. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.263] [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: 11/13/2022] Open
Affiliation(s)
- Y Jackson
- Geneva University Hospitals, Switzerland
| | - A Paignon
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Switzerland
| | - H Wolff
- Geneva University Hospitals, Switzerland
| | - N Delicado
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Switzerland
| |
Collapse
|
9
|
Villarroel-Torrico M, Montaño K, Flores-Arispe P, Jeannot E, Flores-León A, Cossio N, Valencia-Rivero C, Salcedo-Meneses A, Jiménez-Velasco M, Castro-Soto R, Gétaz-Jiménez G, Bermúdez-Paredes H, Wolff H, Gétaz L. Syphilis, human immunodeficiency virus, herpes genital and hepatitis B in a women's prison in Cochabamba, Bolivia: prevalence and risk factors. Rev Esp Sanid Penit 2018; 20:47-54. [PMID: 30231151 PMCID: PMC6279188] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 02/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the prevalence and factors associated with syphilis, human immunodeficiency virus (HIV), hepatitis B (HBV) and herpes type 2 (HSV2) among women in the prison of San Sebastian in Cochabamba (Bolivia). MATERIAL AND METHODS We carried out a cross-sectional study including a standardized questionnaire to assess socio-demographics characteristics and risk factors (sexual practices and exposure to blood); and serological tests for syphilis, HSV2, VIH, and HBV. We performed bivariate and multivariate analyses to test the associations between variables of interest and infections. RESULTS A total of 219 out of 220 prisoners (99.5%) participated in the study. For syphilis, 12.8% of participants had both reactive tests (RPR+/TPPA+). The prevalence of HSV2 and VIH was 62.6% and 1.4%, respectively. Anti-HBc, indicating a resolved or chronic HBV, was positive in 11.9% of participants and 0.5% had active HBV (HBsAg positive). A low level of education was associated with syphilis, HSV2 and HBV. Having occasional sexual partners was associated with syphilis and HSV2. Being over 36 years old and having more than 3 children were associated with HBV. The number of sexual partners, history of prostitution and rape, having sexual intercourses in prison and detention time were not associated with any of these infections. DISCUSSION The prevalence of syphilis, HIV, HSV2 and HBV was higher in this vulnerable female population than in the general population in Bolivia. Control measures in detention are needed to limit the spread of these infections both in prisons and in the community.
Collapse
Affiliation(s)
| | - K Montaño
- Labimed, Universidad Mayor de San Simón, Cochabamba (Bolivia)
| | | | - E Jeannot
- Faculty of Medicine, Institute of Global Health & School of Health Sciences, University of Applied Sciences and Arts of Western Switzerland, Geneva (Switzerland)
| | - A Flores-León
- Labimed, Universidad Mayor de San Simón, Cochabamba (Bolivia)
| | - N Cossio
- Unidad Médica, Régimen Penitenciario, Cochabamba (Bolivia)
| | - C Valencia-Rivero
- Programa Nacional ITS/VIH/SIDA/VH, Ministerio de Salud, La Paz (Bolivia)
| | - A Salcedo-Meneses
- Dirección General de Régimen Penitenciario, Ministerio de Gobierno, La Paz (Bolivia)
| | | | - R Castro-Soto
- Servicio de Enfermedades Infecciosas, Hospital Clínico VIEDMA, Cochabamba (Bolivia)
| | - G Gétaz-Jiménez
- Laboratory of Bacteriology, Department of Genetic and Laboratory Medicine, Geneva University Hospitals, Geneva (Switzerland)
| | | | - H Wolff
- Division of Penitentiary Medicine, Geneva University Hospitals and University of Geneva, Geneva (Switzerland)
| | - L Gétaz
- Division of Penitentiary Medicine, Geneva University Hospitals and University of Geneva, Geneva (Switzerland)
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva (Switzerland)
| |
Collapse
|
10
|
Suojalehto H, Lindström I, Wolff H, Puustinen A. Nasal protein profiles in work-related asthma caused by different exposures. Allergy 2018; 73:653-663. [PMID: 28960398 DOI: 10.1111/all.13325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The mechanisms of work-related asthma (WRA) are incompletely delineated. Nasal cell samples may be informative about processes in the lower airways. Our aim was to determine the nasal protein expression profiles of WRA caused by different kind of exposures. METHODS We collected nasal brush samples from 82 nonsmoking participants, including healthy controls and WRA patients exposed to (i) protein allergens, (ii) isocyanates and (iii) welding fumes the day after relevant exposure. The proteome changes in samples were analysed by two-dimensional difference gel electrophoresis, and the differentially regulated proteins found were identified by mass spectrometry. Immunological comparison was carried out using Western blot. RESULTS We detected an average of 2500 spots per protein gel. Altogether, 228 protein spots were chosen for identification, yielding 77 different proteins. Compared to the controls, exposure to protein allergens had the largest effects on the proteome. Hierarchical clustering revealed that protein allergen- and isocyanate-related asthma had similar profiles, whereas asthma related to welding fumes differed. The highly overrepresented functional categories in the asthma groups were defence response, protease inhibitor activity, inflammatory and calcium signalling, complement activation and cellular response to oxidative stress. Immunological analysis confirmed the found abundance differences in galectin 10 and protein S100-A9 between the groups. CONCLUSIONS Work-related asthma patients exposed to protein allergens and isocyanates elicit similar nasal proteome responses and the profiles of welders and healthy controls were alike. Revealed biological activities of the protein expression changes are associated with allergic inflammation and asthma.
Collapse
Affiliation(s)
- H. Suojalehto
- Occupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - I. Lindström
- Occupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - H. Wolff
- Work Environment Laboratories; Finnish Institute of Occupational Health; Helsinki Finland
| | - A. Puustinen
- Unit of Systems Toxicology; Finnish Institute of Occupational Health; Helsinki Finland
- Verifin; Department of Chemistry; University of Helsinki; Helsinki Finland
| |
Collapse
|
11
|
Tinsley J, Frank D, Dworzak J, Faelan C, Patterson-Kane J, Wolff H, Muntoni F. Collection of high quality muscle biopsies for use in DMD clinical trial analysis; process development and implementation. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.509] [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]
|
12
|
Wolff H. Haar- und Kopfhautprobleme bei Kindern. Akt Dermatol 2017. [DOI: 10.1055/s-0043-113987] [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]
|
13
|
Gasperi J, Sébastian C, Ruban V, Delamain M, Percot S, Wiest L, Mirande C, Caupos E, Demare D, Kessoo MD, Saad M, Schwartz J, Dubois P, Fratta C, Wolff H, Moilleron R, Chebbo G, Cren C, Millet M, Barraud S, Gromaire MC. Contamination des eaux pluviales par les micropolluants : avancées du projet INOGEV. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/tsm/201778051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
14
|
Getaz L, Da Silva-Santos L, Wolff H, Vitoria M, Serre-Delcor N, Lozano-Becerra JC, Chappuis F, Albajar-Viñas P. Persistent infectious and tropical diseases in immigrant correctional populations. Rev Esp Sanid Penit 2017; 18:57-66. [PMID: 27637104 DOI: 10.4321/s1575-06202016000200004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/23/2016] [Indexed: 11/11/2022]
Abstract
A number of infectious diseases amongst travelers and the immigrant populations are a major public health concern. Some have a long incubation period or remain asymptomatic or paucisymptomatic for many years before leading to significant clinical manifestations and/or complications. HIV, hepatitis B and C, tuberculosis or latent syphilis are among the most significant persistent diseases in migrants. Schistosomiasis and strongyloidiasis, for instance, are persistent helminthic infections that may cause significant morbidity, particularly in patients co-infected with HIV, hepatitis B and C. Chagas disease, which was initially confined to Latin America, must also now be considered in immigrants from endemic countries. Visceral leishmaniasis and malaria are other examples of parasitic diseases that must be taken into account by physicians treating incarcerated migrants. The focus of this review article is on the risk of neglected tropical diseases in particularly vulnerable correctional populations and on the risk of infectious diseases that commonly affect migrants but which are often underestimated.
Collapse
Affiliation(s)
- L Getaz
- Division of penitentiary medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals
| | - L Da Silva-Santos
- Division of Tropical and Humanitarian Medicine, Department of Community Medicine, Primary Care And Emergency Medicine, Geneva University Hospitals, Geneva
| | - H Wolff
- Division of penitentiary medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals
| | - M Vitoria
- Department of HIV/AIDS, World Health Organization, Geneva, Switzerland
| | - N Serre-Delcor
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, Programa de Salut Internacional de lInstitut Català de la Salut (PROSICS) Barcelona, Barcelona
| | - J C Lozano-Becerra
- Division of penitentiary medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals
| | - F Chappuis
- Division of Tropical and Humanitarian Medicine, Department of Community Medicine, Primary Care And Emergency Medicine, Geneva University Hospitals, Geneva
| | - P Albajar-Viñas
- Department of control of neglected tropical diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
15
|
Affiliation(s)
- H Wolff
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland.
| |
Collapse
|
16
|
|
17
|
Affiliation(s)
- R. Alharbi
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
- Department of Dermatology; King Abdulaziz University; Jeddah Saudi Arabia
| | - J. Peric
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
- Clinic of Dermatovenereology; Clinical Center of Serbia; Belgrade Serbia
| | - H. Wolff
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| | - A. Wollenberg
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| |
Collapse
|
18
|
Wolff H. Microgel-Synthese, von Batch to Conti. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650522] [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: 11/07/2022]
|
19
|
Laniauskaite I, Ezmerli M, von Braunmühl T, Ruzicka T, Flaig MJ, Wolff H. Frontal fibrosing alopecia with facial papules - three cases. J Eur Acad Dermatol Venereol 2016; 31:e69-e71. [PMID: 27225957 DOI: 10.1111/jdv.13730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- I Laniauskaite
- Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - M Ezmerli
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - T von Braunmühl
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - M J Flaig
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - H Wolff
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| |
Collapse
|
20
|
Kontny U, Franzen S, Behrends U, Bührlen M, Christiansen H, Delecluse H, Eble M, Feuchtinger T, Gademann G, Granzen B, Kratz C, Lassay L, Leuschner I, Mottaghy F, Schmitt C, Staatz G, Timmermann B, Vorwerk P, Wilop S, Wolff H, Mertens R. Diagnosis and Treatment of Nasopharyngeal Carcinoma in Children and Adolescents – Recommendations of the GPOH-NPC Study Group. Klin Padiatr 2016; 228:105-12. [DOI: 10.1055/s-0041-111180] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- U. Kontny
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University , Aachen, Germany
| | - S. Franzen
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University , Aachen, Germany
| | - U. Behrends
- Children’s Hospital München-Schwabing, Technische Universität, München, Germany
| | - M. Bührlen
- Prof.-Hess-Kinderklinik, Klinikum Bremen-Mitte, Bremen, Germany
| | - H. Christiansen
- Department of Radiotherapy and Radiation Oncology, Hannover Medical School, Hannover, Germany
| | - H. Delecluse
- Pathogenesis of Virus Associated Tumors (F100), German Cancer Research Center, Heidelberg, Germany
| | - M. Eble
- Medical Faculty, Department of Radiation Oncology, RWTH Aachen University, Aachen, Germany
| | - T. Feuchtinger
- Pediatric Hematology, Oncology and Stem Cell Transplantation, Dr. von Hauner’sches Kinderspital, Ludwig-Maximilians-University, München, Germany
| | - G. Gademann
- Department of Radiotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - B. Granzen
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, Netherlands
| | - C. Kratz
- Hannover Medical School, Pediatric Hematology/Oncology, Hannover, Germany
| | - L. Lassay
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University , Aachen, Germany
| | - I. Leuschner
- Kindertumorregister der GPOH, Sektion Kinderpathologie, Universitätsklinikum Schlewig-Holstein, Campus Kiel, Kiel, Germany
| | - F. Mottaghy
- Department of Nuclear Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - C. Schmitt
- Medical School Hannover, Institute of Virology, Hannover, Germany
| | - G. Staatz
- Section of Paediatric Radiology, University Medical Center Mainz, Mainz, Germany
| | - B. Timmermann
- University Essen, Westgerman Protontherapycenter Essen, Essen, Germany
| | - P. Vorwerk
- Pediatric Oncology, Otto von Guericke University Childrens Hospital, Magdeburg, Germany
| | - S. Wilop
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - H. Wolff
- Radiologie München, Burgstraße 7, München, Germany
| | - R. Mertens
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University , Aachen, Germany
| |
Collapse
|
21
|
Mäkinen K, Mukherjee C, Leino M, Panchadhayee R, Lehto M, Wolff H, Alenius H, Leino R, Savolainen J. A novel mannoside-glycocluster adjuvant: Compared in vitro to CpG ODN and MPL and tested in vivo in mouse asthma model. Allergol Immunopathol (Madr) 2016; 44:9-17. [PMID: 26395525 DOI: 10.1016/j.aller.2015.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 03/27/2015] [Accepted: 04/01/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy balances the Th2-biased immunity towards Th1 and Treg responses. Adjuvants are used in allergen preparations to intensify the immune responses. The increased prevalence of allergies in developed societies has been associated with decreased microbial load during childhood. This has initiated a search for microbial structures to be used as adjuvants. Our study has shown that a synthetic triacedimannose (TADM) may suppress the Th2-type allergic inflammatory response. The aim of this study was to compare the properties of TADM with capacities of other adjuvants, CpG ODN and MPL, to modulate cytokine production in PBMC and regulate sensitisation in an OVA-sensitised mouse asthma model. METHODS The effects of TADM were studied in vitro on birch stimulated PBMC cultures of birch allergic rhinitis patients with other known adjuvants. Cytokines in supernatants were measured by Luminex. Effects of TADM were analysed in vivo in a mouse model of OVA-induced allergic asthma by analysing BAL, cytokine mRNA and serum antibodies. RESULTS TADM was the only adjuvant that significantly suppressed the production of all birch induced Th2-type cytokines. In a murine model, TADM significantly suppressed the specific IgE production and enhanced IFN-γ production. CONCLUSIONS TADM suppresses the birch allergen induced Th2-type cytokine responses in allergic subjects more efficiently than the two other adjuvants, MPL and CpG ODN. TADM is immunomodulatory also in vivo and decreases the IgE levels and increases the IFN-γ responses in a murine model. These results suggest that TADM may be a promising candidate for novel adjuvants in immunotherapy.
Collapse
|
22
|
Wolff H. [A red hand - getting worse by corticosteroids]. MMW Fortschr Med 2015; 157:52. [PMID: 26977517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
23
|
Abstract
BACKGROUND Alopecia is the term used to describe hairless areas of the scalp. They can follow a specific pattern, be diffuse or circumscript. Androgenetic alopecia (AGA) follows a pattern: in men thinning of temples and vertex up to total baldness; in women thinning of the midline or parietal area. CAUSES Lack of iron or cytostatic drugs cause diffuse alopecia, while in autoimmune diseases such as alopecia areata or lichen planus bizarre shapes of hairless areas are observed. TREATMENT For therapy, the following medications are used: topical minoxidil solution for AGA of men and women; systemic finasteride 1 mg for men with AGA; topical diphencyprone immunotherapy for alopecia areata; systemic antimycotic agents for tinea capitis; antibiotics such as clindamycin and rifampicin for folliculitis decalvans; systemic corticosteroids and isotretinoin for folliculitis et perifolliculitis capitis abscedens et suffodiens; topical corticosteroids for lichen planus and Kossard's frontal fibrosing alopecia.
Collapse
Affiliation(s)
- H Wolff
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.
| |
Collapse
|
24
|
Tietze JK, Heppt MV, von Preußen A, Wolf U, Ruzicka T, Wolff H, Sattler EC. Oral isotretinoin as the most effective treatment in folliculitis decalvans: a retrospective comparison of different treatment regimens in 28 patients. J Eur Acad Dermatol Venereol 2015; 29:1816-21. [PMID: 25712452 DOI: 10.1111/jdv.13052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/19/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Folliculitis decalvans leads to scarring alopecia through inflammatory destruction of the hair follicle. Currently, antibiotics are most commonly used to treat this disease. However, treatment regimens with antibiotics feature a high relapse rate and encourage the development of resistant bacteria. OBJECTIVE To evaluate the outcome of different treatment options for folliculitis decalvans. METHODS Retrospective study to compare the efficacy of different treatment regimens in 28 patients with folliculitis decalvans. RESULTS The success of treatment with clindamycin and rifampicin, clarithromycin, dapsone and isotretinoin was analysed. The evaluation of the combination of clindamycin and rifampicin showed the lowest success rate in achieving long-term remission, since 80% of the patients relapsed shortly after end of treatment. Clarithromycin and dapsone were more successful with long-term and stable remission rates of 33% and 43% respectively. Treatment with isotretinoin was the most successful oral treatment in our analysis with 90% of the patients experiencing stable remission during and up to two years after cessation of the treatment. CONCLUSION The common use of antibiotics as first-line therapy in folliculitis decalvans needs to be re-evaluated critically and oral isotretinoin should be considered as valid treatment alternative.
Collapse
Affiliation(s)
- J K Tietze
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - M V Heppt
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - A von Preußen
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - U Wolf
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - H Wolff
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - E C Sattler
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| |
Collapse
|
25
|
Wolff H, Ruzicka T. Dermatologie – mehr als medizinische Kosmetik. Dtsch Med Wochenschr 2014; 139:1457-8. [DOI: 10.1055/s-0034-1370166] [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: 10/25/2022]
Affiliation(s)
- H. Wolff
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | - T. Ruzicka
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| |
Collapse
|
26
|
Schilling H, Wolff H, Dronskowski R, Lerch M. Fluorite-Type Solid Solutions in the System Y-Ta-O-N: A Nitrogen-Rich Analogue to Yttria-Stabilized Zirconia (YSZ). Zeitschrift für Naturforschung B 2014. [DOI: 10.1515/znb-2006-0604] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fluorite-type phases in the system Y-Ta-O-N have been prepared by ammonolysis of Y-Ta-O precursors. X-ray powder patterns show unusual asymmetrical reflection profiles explained by DFT and MD methods. The anion vacancy concentration of some of these oxynitrides is similar to that of yttria-doped zirconia, commercially used as solid electrolyte in fuel cells. Hence, these compounds are interesting candidates for mixed oxygen-nitrogen superion conductors
Collapse
Affiliation(s)
- H. Schilling
- Institut für Chemie, TU Berlin, Straße des 17. Juni 135, D-10623 Berlin
| | - H. Wolff
- Institut für Anorganische Chemie, RWTH Aachen, Landoldtweg 1, D-52056 Aachen
| | - R. Dronskowski
- Institut für Anorganische Chemie, RWTH Aachen, Landoldtweg 1, D-52056 Aachen
| | - M. Lerch
- Institut für Anorganische Chemie, RWTH Aachen, Landoldtweg 1, D-52056 Aachen
| |
Collapse
|
27
|
Redler S, Birch P, Drichel D, Hofmann P, Dobson K, Böhmer A, Becker J, Giehl K, Tazi-Ahnini R, Kruse R, Wolff H, Miesel A, Fischer T, Böhm M, Nuwayhid R, Garcia Bartels N, Lutz G, Becker T, Blume-Peytavi U, Nöthen M, Messenger A, Betz R. The oestrogen receptor 2 (ESR2) gene in female-pattern hair loss: replication of association with rs10137185 in German patients. Br J Dermatol 2014; 170:982-5. [DOI: 10.1111/bjd.12756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Redler
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - P. Birch
- Department of Dermatology; Royal Hallamshire Hospital; Sheffield U.K
| | - D. Drichel
- German Center for Neurodegenerative Diseases (DZNE); Bonn Germany
| | - P. Hofmann
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
- Department of Genomics, Life & Brain Center; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - K. Dobson
- Department of Dermatology; Royal Hallamshire Hospital; Sheffield U.K
| | - A.C. Böhmer
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
- Department of Genomics, Life & Brain Center; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - J. Becker
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
- Department of Genomics, Life & Brain Center; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - K.A. Giehl
- Department of Dermatology; University of Munich; Munich Germany
| | - R. Tazi-Ahnini
- Department of Infection and Immunity; University of Sheffield; Sheffield U.K
| | - R. Kruse
- Dermatological Practice; Paderborn Germany
| | - H. Wolff
- Department of Dermatology; University of Munich; Munich Germany
| | - A. Miesel
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - T. Fischer
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - M. Böhm
- Department of Dermatology; Laboratory for Neuroendocrinology of the Skin and Interdisciplinary Endocrinology; University of Münster; Münster Germany
| | - R. Nuwayhid
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - N. Garcia Bartels
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - G. Lutz
- Dermatological Practice, Hair & Nail; Wesseling Germany
| | - T. Becker
- German Center for Neurodegenerative Diseases (DZNE); Bonn Germany
- Institute for Medical Biometry Informatics and Epidemiology; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - U. Blume-Peytavi
- Clinical Research Center for Hair and Skin Science; Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - M.M. Nöthen
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
- Department of Genomics, Life & Brain Center; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| | - A.G. Messenger
- Department of Dermatology; Royal Hallamshire Hospital; Sheffield U.K
| | - R.C. Betz
- Institute of Human Genetics; University of Bonn; Sigmund-Freud-Street 25 D-53127 Bonn Germany
| |
Collapse
|
28
|
Gétaz L, Chappuis F, Lozano Becerra JC, Wolff H, Albajar-Viñas P. [Persistent tropical diseases among migrants]. Rev Med Suisse 2014; 10:827-832. [PMID: 24791430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Several infectious diseases may remain a- or pauci-symptomatic for many years before causing major clinical manifestations. Migrants are particularly vulnerable to several persistent infectious diseases due to exposure in their country of origin and their specific living conditions. This article emphasizes neglected parasitic diseases among migrants, such as schistosomiasis, strongyloidiasis and Chagas disease. In the case of co-infection with HIV, hepatitis B and C, some of these persistent parasitosis may induce more significant morbidity. These aspects are particularly important to know as these diseases, both viral and parasitic, are particularly common among migrants.
Collapse
|
29
|
Gasperi J, Sebastian C, Ruban V, Delamain M, Percot S, Wiest L, Mirande C, Caupos E, Demare D, Kessoo MDK, Saad M, Schwartz JJ, Dubois P, Fratta C, Wolff H, Moilleron R, Chebbo G, Cren C, Millet M, Barraud S, Gromaire MC. Micropollutants in urban stormwater: occurrence, concentrations, and atmospheric contributions for a wide range of contaminants in three French catchments. Environ Sci Pollut Res Int 2014; 21:5267-81. [PMID: 24323325 DOI: 10.1007/s11356-013-2396-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 11/25/2013] [Indexed: 05/14/2023]
Abstract
This study aimed at: (a) providing information on the occurrence and concentration ranges in urban stormwater for a wide array of pollutants (n = 77); (b) assessing whether despite the differences between various catchments (land use, climatic conditions, etc.), the trends in terms of contamination level are similar; and (c) analyzing the contribution of total atmospheric fallout (TAF) with respect to sources endogenous to this contamination. The studied contaminants include conventional stormwater contaminants (polycyclic aromatic hydrocarbons (PAHs), Zn, Cu, Pb, etc.), in addition to poorly or undocumented pollutants such as nonylphenol and octylphenol ethoxylates (NPnEO and OPnEO), bisphenol A (BPA), polybrominated diphenyl ethers (PBDEs), a wide variety of pesticides, and various metals of relevance (As, Ti, Sr, V). Sampling and analysis were performed using homogeneous methods on three urban catchments with different land use patterns located in three distinct French towns. For many of these pollutants, the results do not allow highlighting a significant difference in stormwater quality at the scale of the three urban catchments considered. Significant differences were, however, observed for several metals (As, Cr, Cu, Ni, Sr and Zn), PAHs, and PBDEs, though this assessment would need to be confirmed by further experiments. The pollutant distributions between dissolved and particulate phases were found to be similar across the three experimental sites, thus suggesting no site dependence. Lastly, the contributions of TAF to stormwater contamination for micropollutants were quite low. This finding held true not only for PAHs, as previously demonstrated in the literature, but also for a broader range of molecules such as BPA, NPnEO, OPnEO, and PBDEs, whose high local production is correlated with the leaching of urban surfaces, buildings, and vehicles.
Collapse
Affiliation(s)
- J Gasperi
- Université Paris-Est, LEESU, UMR-MA 102-AgroParisTech, 6-8 avenue Blaise Pascal Cité Descartes, 77455, Champs-sur-Marne, France,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Wolff H, Wolff E. Schwingungs- und Rotationsschwingungsbanden von Methyl- und N-Deutero-Methylamin. Grund- und Obertöne der NH- und ND-Valenzschwingungen. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/bbpc.19650690606] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
31
|
|
32
|
Wolff H, Horn D. Über die Fermi-Resonanz bei der Wasserstoffbrückenassoziation primärer aliphatischer Amine: (nach Ultrarotuntersuchungen an 2.2.2-Trifluoräthylamin). ACTA ACUST UNITED AC 2014. [DOI: 10.1002/bbpc.196800010] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
33
|
Kirkegaard K, Svane ASP, Hindkjaer JJ, Nielsen NC, Ingerslev HJ, Gook DA, Riordan K, Edgar DH, Sheedy JR, Gardner DK, Wolff H, Fredrickson J, Baumann N, Moyer T, Matern D, Morbeck D, Scalici E, Astruc K, Jimenez C, Duvillard L, Gautier T, Huot MN, Girod S, Schmutz E, Lagrost L, Sagot P, Drouineaud V, Drury SL, Taylor D, Gadd SC, Hartshorne GM. Session 15: Embryo and culture environment. Hum Reprod 2013. [DOI: 10.1093/humrep/det230] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
|
34
|
|
35
|
Wolff H. In Memoriam Medizinalrat Dr. med. Joachim Bernhard. Zentralbl Chir 2013. [DOI: 10.1055/s-0032-1328249] [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: 10/27/2022]
|
36
|
Wolff H, Bodenmann P. [Poor and sick: what is the role of the physician?]. Rev Med Suisse 2013; 9:263-266. [PMID: 23451596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- H Wolff
- Service de médecine de premier recours Unité de médecine pénitentiaire, HUG, 1211 Genève 14.
| | | |
Collapse
|
37
|
Redler S, Albert F, Brockschmidt F, Herold C, Hanneken S, Eigelshoven S, Giehl K, Kruse R, Lutz G, Wolff H, Blaumeiser B, Böhm M, Becker T, Nöthen M, Betz R. Investigation of selected cytokine genes suggests that
IL2RA
and the
TNF
/
LTA
locus are risk factors for severe alopecia areata. Br J Dermatol 2012; 167:1360-5. [DOI: 10.1111/bjd.12004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- S. Redler
- Institute of Human Genetics, University of Bonn, Sigmund‐Freud‐Str. 25, D‐53127 Bonn, Germany
| | - F. Albert
- Institute of Human Genetics, University of Bonn, Sigmund‐Freud‐Str. 25, D‐53127 Bonn, Germany
| | - F.F. Brockschmidt
- Institute of Human Genetics, University of Bonn, Sigmund‐Freud‐Str. 25, D‐53127 Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - C. Herold
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - S. Hanneken
- Department of Dermatology, University of Düsseldorf, Düsseldorf, Germany
| | - S. Eigelshoven
- Department of Dermatology, University of Düsseldorf, Düsseldorf, Germany
| | - K.A. Giehl
- Department of Dermatology, University of Munich, Munich, Germany
| | - R. Kruse
- Dermatological Practice, Paderborn, Germany
| | - G. Lutz
- Dermatological Practice, Hair & Nail, Wesseling, Germany
| | - H. Wolff
- Department of Dermatology, University of Munich, Munich, Germany
| | - B. Blaumeiser
- Department of Medical Genetics, University and University Hospital of Antwerp, Antwerp, Belgium
| | - M. Böhm
- Department of Dermatology, University of Münster, Münster, Germany
| | - T. Becker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - M.M. Nöthen
- Institute of Human Genetics, University of Bonn, Sigmund‐Freud‐Str. 25, D‐53127 Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - R.C. Betz
- Institute of Human Genetics, University of Bonn, Sigmund‐Freud‐Str. 25, D‐53127 Bonn, Germany
| |
Collapse
|
38
|
Guessous I, Gaspoz JM, Theler JM, Wolff H. High prevalence of forgoing healthcare for economic reasons in Switzerland: a population-based study in a region with universal health insurance coverage. Prev Med 2012; 55:521-7. [PMID: 22940614 DOI: 10.1016/j.ypmed.2012.08.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 07/18/2012] [Accepted: 08/16/2012] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the determinants and the 4-year evolution of the forgoing of healthcare for economic reasons in Switzerland. METHOD Population-based survey (2007-2010) of a representative sample aged 35-74 years in the Canton of Geneva, Switzerland. Healthcare forgone, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods. RESULTS A total of 2601 subjects were included in the analyses. Of the subjects, 13.8% (358/2601) reported having forgone healthcare for economic reasons, with the percentage varying from 3.7% in the group with a monthly income ≥ 13,000 CHF (1CHF ≈ 1$) to 30.9% in the group with a monthly income <3000 CHF. In subjects with a monthly income <3000 CHF, the percentage who had forgone healthcare increased from 22.5% in 2007/8 to 34.7% in 2010 (P trend=0.2). Forgoing healthcare for economic reasons was associated with lower income, female gender, smoking status, lower job position, having dependent children, being divorced and single, paying a higher deductible, and receiving a premium subsidy. CONCLUSION In a Swiss region with universal health insurance coverage, the reported prevalence of forgoing healthcare for economic reasons was high and greatly dependent on socioeconomic factors. Our data suggested an increasing trend among participants with the lowest income.
Collapse
Affiliation(s)
- I Guessous
- Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Switzerland.
| | | | | | | |
Collapse
|
39
|
Naxer S, Hille A, Wolff H, Schittkowski M. Reversible einseitige Erblindung. Klin Monbl Augenheilkd 2012; 229:1018-20. [DOI: 10.1055/s-0032-1315373] [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: 10/27/2022]
Affiliation(s)
- S. Naxer
- Abteilung Augenheilkunde; Bereich Strabologie, Neuroophthalmologie und okuloplastische Chirurgie, UMG Göttingen
| | - A. Hille
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universiätsmedizin Göttingen
| | - H. Wolff
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universiätsmedizin Göttingen
| | - M. Schittkowski
- Abteilung Augenheilkunde; Bereich Strabologie, Neuroophthalmologie und okuloplastische Chirurgie, UMG Göttingen
| |
Collapse
|
40
|
Redler S, Brockschmidt FF, Tazi-Ahnini R, Drichel D, Birch MP, Dobson K, Giehl KA, Herms S, Refke M, Kluck N, Kruse R, Lutz G, Wolff H, Böhm M, Becker T, Nöthen MM, Messenger AG, Betz RC. Investigation of the male pattern baldness major genetic susceptibility loci AR/EDA2R and 20p11 in female pattern hair loss. Br J Dermatol 2012; 166:1314-8. [PMID: 22309448 DOI: 10.1111/j.1365-2133.2012.10877.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The aetiology of female pattern hair loss (FPHL) is largely unknown. However, it is hypothesized that FPHL and male pattern baldness (AGA) share common susceptibility alleles. The two major susceptibility loci for AGA are the androgen receptor (AR)/ectodysplasin A2 receptor (EDA2R) locus on the X-chromosome, and a locus on chromosome 20p11, for which no candidate gene has yet been identified. OBJECTIVES To examine the role of the AR/EDA2R and 20p11 loci in the development of FPHL using 145 U.K. and 85 German patients with FPHL, 179 U.K. supercontrols and 150 German blood donors. METHODS Patients and controls were genotyped for 25 single nucleotide polymorphisms (SNPs) at the AR/EDA2R locus and five SNPs at the 20p11 locus. RESULTS Analysis of the AR/EDA2R locus revealed no significant association in the German sample. However, a nominally significant association for a single SNP (rs1397631) was found in the U.K. sample. Subgroup analysis of the U.K. patients revealed significant association for seven markers in patients with an early onset (P = 0·047 after adjustment for the testing of multiple SNPs by Monte Carlo simulation). No significant association was obtained for the five 20p11 variants, either in the overall samples or in the analysis of subgroups. CONCLUSIONS The observed association suggests that the AR/EDA2R locus confers susceptibility to early-onset FHPL. Our results do not implicate the 20p11 locus in the aetiology of FPHL.
Collapse
Affiliation(s)
- S Redler
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Chatelard S, Vaucher P, Wolff H, Bischoff T, Herzig L, Panese F, Vu F, Burnand B, Bodenmann P. [General practitioners facing social inequalities in health: which power to act?]. Rev Med Suisse 2012; 8:1061-1066. [PMID: 22730642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The link between social inequalities and health has been known for many years, as attested by Villermé's work on the "mental and physical status of the working class" (1840). We have more and more insight into the nature of this relationship, which embraces not only material deprivation, but also psychological mechanisms related to social and interpersonal problems. Defining our possible role as physicians to fight against these inequalities has become a public health priority. Instruments and leads, which are now available to help us in our daily practice, are presented here.
Collapse
Affiliation(s)
- S Chatelard
- Institut universitaire de médecine sociale et préventive, Faculté de biologie et médecine, Université de Lausanne, Lausanne.
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Wolff H, Jackson Y, Broers B, Guessous I, Bodenmann P, Madrid C, Cornuz J, Gaspoz JM. [Urban health: the irremediable urbanization of life and medicine]. Rev Med Suisse 2012; 8:282-286. [PMID: 22364078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Since 2007, the number of people living in cities exceeds that of rural areas. Thus, cities and their organizations have a major influence on all spheres of human life, especially health. This influence may generate inequality, suffering and disease, but also represent an opportunity for health and well-being. This paper introduces the concept of urban health, particularly in terms of primary care medicine and presents solutions that encompass a wide field (politics, urban planning, social inequality, education). Improving urban health requires collaboration of medical with non-medical actors, in order to become of development (re-) urban structure and promotes the health of all.
Collapse
Affiliation(s)
- H Wolff
- Service de médecine de premier recours, Département de médecine communautaire, de premier recours et des urgences, HUG, 1211 Genève 14.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Wolff H, Gétaz L. [Hunger strike and force feeding: therapeutical and ethical issues]. Rev Med Suisse 2012; 8:182-183. [PMID: 22338506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- H Wolff
- Unité de médecine pénitentiaire (UMP), Service de médecine de premier recours, Département de médecine communautaire, de premier recours et des urgences, HUG, 1211 Genève 14.
| | | |
Collapse
|
44
|
Redler S, Birch M, Drichel D, Dobson K, Brockschmidt F, Tazi-Ahnini R, Giehl K, Kluck N, Kruse R, Lutz G, Wolff H, Becker T, Nöthen M, Messenger A, Betz R. Investigation of variants of the aromatase gene (CYP19A1) in female pattern hair loss. Br J Dermatol 2011; 165:703-5. [DOI: 10.1111/j.1365-2133.2011.10456.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
45
|
|
46
|
Hansen PB, Hristovska A, Wolff H, Vanhoutte P, Jensen BL, Bie P. Uridine adenosine tetraphosphate affects contractility of mouse aorta and decreases blood pressure in conscious rats and mice. Acta Physiol (Oxf) 2010; 200:171-9. [PMID: 20384597 DOI: 10.1111/j.1748-1716.2010.02135.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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: 11/29/2022]
Abstract
AIM in the anaesthetized rat, uridine adenosine tetraphosphate (Up(4) A) is a circulating, endothelium-derived vasoconstrictor presumably operating as such in un-anaesthetized animals. The present study investigated the in vivo effects of Up(4) A in conscious mice and rats, and its direct vascular effects in the mouse aorta in vitro. METHODS in vivo, Up(4) A was given as step-up infusion at rates of 8-512 nmol min(-1) kg(-1) for 30 min periods in chronically catheterized rodents. In vitro, the effect of Up(4) A on rings of mouse aortae mounted in a myograph was tested. RESULTS high doses of Up(4) A (mice: 512 nmol min(-1) kg(-1) ; rats: 128 nmol min(-1) kg(-1) ) caused hypotension (99 (+/-)4 to 64 7(+/-) mmHg and 114 (+/-) 3 to 108 (+/-) 3 mmHg, respectively, both P < 0.01). In rats, Up(4) A significantly decreased sodium excretion by >75% and potassium excretion by approximately 60% without significant changes in urine flow. Exposure of phenylephrine-contracted rings to increasing concentrations of Up(4) A elicited contraction at 10(-7) and 10(-6) molL(-1) (18 ± 2% and 76 (+/-) 16% respectively); unexpectedly, 10(-5) molL(-1) caused a biphasic response with a contraction (19 6(+/-)2%) followed by a relaxation (-46 (+/-) 6%). No relaxation was observed when the concentration was increased further. Bolus exposure to 10(-5) molL(-1) of Up(4) A caused contraction (+80 (+/-) 2%). Added successively to untreated vessels, increasing concentrations of Up(4) A (10(-7) -10(-5) molL(-1) ) induced a biphasic response of contraction followed by relaxation. CONCLUSION up(4) A has direct biphasic effects on vascular smooth muscle of the mouse aorta but vasoconstriction dominates at low concentrations. In conscious rodents, step-up infusions of Up(4) A elicit hypotension and electrolyte retention.
Collapse
Affiliation(s)
- P B Hansen
- Cardiovascular and Renal Research, Institute of Medical Biology, University of Southern Denmark, Odense, Denmark.
| | | | | | | | | | | |
Collapse
|
47
|
Rieder JP, Gravier B, Bertrand D, Pasche C, Bodenmann P, Wolff H. [Health in prison: shared vulnerability between detainees and health professionals]. Rev Med Suisse 2010; 6:1462-1465. [PMID: 20806565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In prison, the health professional has to take the sanitary needs of a temporary of chronically vulnerable population. His practice has to meet laws and recommendations, as well as the field reality and its numerous constraints. This puts him in a "shared vulnerability and stigmatization". He attempts to maintain or restore a health status in a deteriorating environment, at least psychologically. He is in the penitentiary world's eye which he depends upon in many ways to achieve his mandate. His activity is scarcely known and recognised by his peers from whom he can be very out of touch. To ensure a humanistic, efficient and equivalent-of-care practice, the health professional must rely on sound knowledge of general healthcare, ethics, deontology and medical laws. Basic and continuous training is a mainspring, like networking and development of federal recommendations.
Collapse
Affiliation(s)
- J P Rieder
- Service de Médecine de Premier Recours, Unité de Médecine Pénitentiaire, Départment de Médecine Communautaire et de premier recours, HUG, Genève.
| | | | | | | | | | | |
Collapse
|
48
|
Haller DM, Sebo P, Cerutti B, Bertrand D, Eytan A, Niveau G, Wolff H, Narring F. Primary care services provided to adolescents in detention: a cross-sectional study using ICPC-2. Acta Paediatr 2010; 99:1060-4. [PMID: 20178509 DOI: 10.1111/j.1651-2227.2010.01716.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to provide a detailed description of the health problems for which primary care services are provided to adolescents in a juvenile detention facility in Europe. METHODS We reviewed the medical files of all detainees in a juvenile detention centre in Switzerland in 2007. The health problems for which primary care services were provided were coded using the International Classification for Primary Care, version 2. Analysis was descriptive, stratified by gender. RESULTS A total of 314 adolescents (18% female) aged 11-19 years were included. Most (89%) had a health assessment and 195 (62%) had consultations with a primary care physician; 80% of the latter had a physical health problem, and 60% had a mental health problem. The most commonly managed problems were skin (49.7%), respiratory (23.6%), behavioural (22.6%) and gynaecological problems (females: 23.9%); 13% females (no males) had sexually transmitted infections (STI), and 8.7% were pregnant. Substance abuse was common (tobacco: 64.6%, alcohol: 26.2%, cannabis: 31.3%). CONCLUSION In addition to health problems known to be more prevalent among young offenders, such as mental health problems and STI, these adolescent detainees required care for a range of common primary care problems. These data should inform the development of comprehensive primary care services in all juvenile detention facilities in Europe.
Collapse
Affiliation(s)
- D M Haller
- Department of Community Medicine and Primary Care, Geneva University Hospitals & University of Geneva, Geneva, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Wolff H, Höpfner A, Höpfner HM. Die Assoziation von Methyl-, Äthyl- undn-Propylamin in gesättigten aliphatischen Kohlenwasserstoffen (nach Dampfdruckmessungen). ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19640680414] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
50
|
Wolff H, Schmidt U. Ultrarotspektroskopische Untersuchungen an primären aliphatischen Aminen 2. Mitteilung. Untersuchungen an den NH-Valenzbanden der Methylaminhomologen und an den CH-Valenzbanden von Methylamin. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19640680611] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|