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Strohm JA, Schubert I, Schneidmüller D, Strohm PC. Is cross-sectional imaging necessary for fractures of the distal lower leg in children and adolescents: results of a nationwide survey. Eur J Trauma Emerg Surg 2023:10.1007/s00068-023-02379-6. [PMID: 37872263 DOI: 10.1007/s00068-023-02379-6] [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: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE In childhood and adolescence, cross-sectional imaging, most commonly computed tomography (CT), is often performed for advanced diagnosis of joint injuries of the distal lower leg and upper ankle. Due to radiation exposure, the need for CT remains controversial, as these injuries follow stereotypies and usually have a similar course. Alternatively, the performance of magnetic resonance imaging (MRI) is also discussed. Since radiation sensitivity at this young age is much higher than in adults, an effort must be to minimize radiation exposure according to as low as reasonably achievable (ALARA) principles. The aim of this survey is to evaluate the current procedure in Germany in the diagnosis of pediatric injuries of the distal lower leg and upper ankle. METHODS For data collection, a survey entitled "CT in fractures of the ankle joint in childhood and adolescence: subject of the survey are injuries between 8 and 15 years of age" of the Section of Pediatric Traumatology in the German Association of Trauma Surgery was sent to all members via the distribution list of the German Society of Orthopedics and Traumatology and the distribution list of the German Society of Pediatric Surgery in a period from September 20, 2022-December 21, 2022. The survey included a total of 21 questions. Target groups were trauma and pediatric surgeons and orthopedic surgeons working in the hospital and in practice. RESULTS A total of 525 participants took part in the survey: ultrasound diagnostics are used by almost 25% and the Ottawa Ankle Rules by over 50% always or in most cases. A conventional x-ray is always or most often used by over 90%. CT imaging is rarely used by 88.57%, mainly for surgical planning or analysis of fracture progression. 69.9% report that their radiology department uses a pediatric protocol for CT exams; 25.71% do not know if this is the case. MRI imaging is also used infrequently by 89.33%, mostly to identify associated injuries. Overall, CT imaging is chosen by 55.62% and MRI imaging by 35.24% as the sectional imaging modality for suspected fractures; 95.05% consider sectional imaging useful for a triplane fracture, 59.24% for a two-plane fracture, 41.71% for a Salter-Harris type III/IV injury, and 8% for a Salter-Harris type I/II injury. CONCLUSION The survey showed that the conventional X-ray is still the gold standard. Interestingly, more than half of the respondents regularly use the Ottawa Ankle Rules, and diagnostics using ultrasound are also used by almost a quarter. Awareness of radiation protection in children exists, although a quarter of all participants do not know the extent to which their radiology department has a specific pediatric protocol for CT imaging. Cross-sectional imaging is performed on a regular basis. Regarding the actual extent of imaging, there is a clear divergence between theory and practice.
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Affiliation(s)
- Jonas Alexander Strohm
- Department of Orthopedic and Trauma Surgery, University of Freiburg Medical Center, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Ilona Schubert
- Clinic for Orthopedics and Trauma Surgery, Klinikum Bamberg, Buger Straße 80, 96049, Bamberg, Germany
| | - Dorien Schneidmüller
- Department of Trauma Surgery, BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418, Murnau Am Staffelsee, Germany
| | - Peter Christian Strohm
- Department of Orthopedic and Trauma Surgery, University of Freiburg Medical Center, Hugstetter Str. 55, 79106, Freiburg, Germany
- Clinic for Orthopedics and Trauma Surgery, Klinikum Bamberg, Buger Straße 80, 96049, Bamberg, Germany
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Schubert I, Moers K, Fernandez FF, Zwingmann J, Schneidmüller D, Schmittenbecher PP, Strohm PC. [Clavicle shaft fractures in childhood and adolescence : Consensus report of the Pediatric Traumatology Section of the German Society for Trauma Surgery]. Unfallchirurgie (Heidelb) 2023; 126:244-251. [PMID: 36576537 DOI: 10.1007/s00113-022-01275-9] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Clavicle shaft fractures are among the most common fractures in childhood and adolescence. In the past they were almost exclusively treated conservatively but in recent years there has been an increase in surgical treatment. Nevertheless, exact recommendations for the choice of diagnostics and for the treatment regimen do not yet exist. MATERIAL AND METHODS Therefore, our aim was to develop a consensus within the 7th scientific working meeting of the section for pediatric traumatology in the German Society for Trauma Surgery based on expert opinion. RESULTS Single-plane radiographic imaging is considered the gold standard diagnostic tool. Children younger than 10 years are primarily treated conservatively, and the type of immobilization is secondary. In girls older than 12 years and boys older than 14 years, fractures dislocated by more than the shaft width and shortened by > 2 cm should be treated by open reduction and stabilized by osteosynthesis, followed by free-functional follow-up treatment. CONCLUSION In addition to X‑rays, diagnostics using ultrasound must be further established. Treatment continues to be primarily conservative, but surgical treatment is also important, especially in adolescents. If the indications are correct, a good outcome can be expected regardless of the choice of treatment.
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Affiliation(s)
- Ilona Schubert
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.
| | - Katharina Moers
- Universitätsklinikum Frankfurt: Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt, Deutschland
| | | | | | - Dorien Schneidmüller
- Kindertraumatologie und Kinderorthopädie, BG Unfallklinik Murnau, Murnau, Deutschland
| | | | - Peter C Strohm
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland
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Schubert I, Strohm PC. [Assessment of osteosynthesis in X-ray images]. Radiologie (Heidelb) 2023; 63:57-68. [PMID: 36598525 DOI: 10.1007/s00117-022-01106-3] [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] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 01/05/2023]
Abstract
Osteosynthesis refers to various surgical procedures, closed or open, for the treatment of fractures of any age. To document and control the osteosynthesis and the healing process X‑ray controls of the affected skeletal segment are performed during the operation and at regular intervals. To assess the quality of an osteosynthesis or to identify a complication, a comprehensive and systematic image review is useful. This includes the assessment of the restoration of the functional anatomy, the position of the material in relation to the surrounding structures, an evaluation of the stability as far as this is possible, and a control of the bone healing in a functionally correct position.
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Affiliation(s)
- I Schubert
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.
| | - P C Strohm
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland
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Schneider P, Keller P, Schubert I, Bender M, Trautmann C, Dürr M. Bond-specific fragmentation of oligopeptides via electronic stopping of swift heavy ions in molecular films. Sci Rep 2022; 12:17975. [PMID: 36289262 PMCID: PMC9605986 DOI: 10.1038/s41598-022-21744-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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
Highly bond-specific fragmentation of oligopeptides induced by swift heavy ion (SHI) irradiation was investigated by means of mass spectrometry. In pronounced contrast to measurements of samples irradiated with keV ions, oligopeptides which were exposed to 946 MeV Au ions show a high abundance of specific fragments. The highly bond-specific nature of SHI-induced fragmentation is attributed to electronic stopping as the most relevant energy loss mechanism for SHI in the oligopeptide samples in combination with the subsequent coupling between the excited electronic and the atomic subsystem. Fragmentation induced by SHI is observed to be further influenced by the structure of the oligopeptides, suggesting that electronic excitation and/or the electronic-vibrational coupling depend on the details of the molecular structure.
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Affiliation(s)
- P. Schneider
- grid.8664.c0000 0001 2165 8627Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - P. Keller
- grid.8664.c0000 0001 2165 8627Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - I. Schubert
- grid.159791.20000 0000 9127 4365GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
| | - M. Bender
- grid.159791.20000 0000 9127 4365GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany ,grid.449475.f0000 0001 0669 6924Fachbereich Ingenieurwissenschaften, Hochschule RheinMain, Kurt-Schumacher-Ring 18, 65197 Wiesbaden, Germany
| | - C. Trautmann
- grid.159791.20000 0000 9127 4365GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany ,grid.6546.10000 0001 0940 1669Fachbereich Materialwissenschaften, Technische Universität Darmstadt, Alarich-Weiss-Strasse 2, 64287 Darmstadt, Germany
| | - M. Dürr
- grid.8664.c0000 0001 2165 8627Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
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Ferner F, Lutter C, Schubert I, Schenke M, Strecker W, Dickschas J. Perioperative complications in osteotomies around the knee: a study in 858 cases. Arch Orthop Trauma Surg 2022; 142:769-775. [PMID: 33417020 DOI: 10.1007/s00402-020-03696-w] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Eight hundred and fifty-eight consecutive osteotomies around the knee joint were analyzed retrospectively to detect intra- and early postoperative complications in a period of 4 weeks postoperative. Indications for osteotomy were unilateral gonarthritis or torsional deformities resulting in femoropatellar instability or anterior knee pain. MATERIALS AND METHODS Etiology of deformity, technique and mode of correction and level of osteotomy were registered. Complications were detected and divided in minor complication (superficial wound infection, and deep-vein thrombosis) and major complication (compartment syndrome, deep infection, and vascular lesion). RESULTS Fifteen major (1.7%) and 17 minor complications (2.0%) were detected: 5 vascular lesions (0.58%), 4 compartment syndromes (0.47%) and 6 deep infections (0.70%), 14 superficial wound infections (1.6%) and 3 deep-vein thrombosis (0.35%). In posttraumatic osteotomies and continuous corrections, risk for a superficial wound infection was significantly higher and with osteoclasia risk for vascular lesion was higher compared to osteotomy with oscillating saw. No difference was found for anatomical level of osteotomy and for the other complications in terms of etiology of deformity, technique of osteotomy and mode of correction. CONCLUSION Osteotomy around the knee is a safe procedure in the treatment of unicompartmental gonarthritis in terms of intra- and postoperative complications. Major complications are rare. Pit falls for compartment syndromes (LCW and torsional corrections) have to kept in mind. There is no difference in frequency of complications between HTO and supracondylar osteotomies. Risk for superficial wound infection is higher in posttraumatic osteotomies and with continuous corrections. Osteoclasia contains a higher risk for vascular lesion compared to oscillating saw.
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Affiliation(s)
- Felix Ferner
- Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany.
| | - Christoph Lutter
- Klinik für Orthopädie, Universität Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Ilona Schubert
- Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany
| | - Maximilian Schenke
- Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany
| | - Wolf Strecker
- Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany
| | - Joerg Dickschas
- Klinik Für Orthopädie Und Unfallchirurgie Sozialstiftung Bamberg, Buger Str. 80, 96049, Bamberg, Germany
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Schubert I, Strohm PC, Maier D, Zwingmann J. Simple traumatic elbow dislocations; benefit from early functional rehabilitation: A systematic review with meta-analysis including PRISMA criteria. Medicine (Baltimore) 2021; 100:e27168. [PMID: 34871203 PMCID: PMC8568443 DOI: 10.1097/md.0000000000027168] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/16/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Elbow dislocation is the second most frequent joint dislocation after shoulder dislocation. They have a high relevance because they can result in subsequent damage and limitations in range of motion. The treatment options are controversially discussed.The purpose of this systematic review and meta-analysis was to review the literature and analyze the evidence of early functional rehabilitation. METHODS A systematic literature search was performed via Ovid Medline, whereby 1645 publications were identified and evaluated in a stepwise approach. Of these publications 29 met the inclusion criteria of the authors and described simple elbow dislocations in 5765 patients.Data from the studies and subgroups included were initially categorized descriptively in conservative and surgical primary therapies, in immobilizing (immobilization lasting 2 weeks or longer) and free-functional follow-up treatments, and those data were then extracted from each subgroup in absolutes. We then pooled these numbers into descriptive statistics to ensure their comparability. We determined the success rates from the numbers of excellent and good results of the specific used outcome scores. RESULTS The effect estimate of the conservative therapy's success rate was 84% and for surgical treatment 80% (P < .0001). The difference between the immobilizing treatment (78% success rate) and early-function therapy (83% success rate) was significant (P = .002).In a subgroup analysis the success rate of conservative and immobilizing therapy was 79%, of conservative and early-functional therapy 91%, of surgical and immobilizing groups' was 77% and of the surgical and early-functional therapies was 93%. The difference among the 4 treatment options was significant (P < .0001), as were differences between the 2 conservative groups (P < .0001) and between the 2 surgical groups (P = .044). DISCUSSION Conservative therapy is the dominant therapy. Regardless of the primary therapy chosen in simple elbow dislocations: early functional follow-up care seems to be superior to immobilizing therapy with a duration more than 2 weeks.
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Affiliation(s)
- Ilona Schubert
- Clinic for Orthopedics and Trauma Surgery, Klinikum Bamberg, Germany
| | - Peter C. Strohm
- Clinic for Orthopedics and Trauma Surgery, Klinikum Bamberg, Germany
| | - Dirk Maier
- Department of Orthopedic and Trauma Surgery, University of Freiburg Medical Center, Germany
| | - Jörn Zwingmann
- Clinic of Orthopedic and Trauma Surgery, Oberschwabenklinik Ravensburg, Germany
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Schubert I, Dickschas J, Strohm PC. [Assessment of patellar dislocations in childhood and adolescence : Accident-related or predisposition-related?]. Unfallchirurg 2021; 124:902-908. [PMID: 34387708 DOI: 10.1007/s00113-021-01059-7] [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] [Accepted: 07/01/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Numerous predisposing factors are known for patellar dislocations but the extent to which these or the trauma cause the dislocation is often unclear. AIM This study investigated whether the analysis of the accident mechanism and anatomical predisposition in juvenile patellar dislocations enables a conclusion as to the causality. MATERIAL AND METHODS Retrospective cohort study, evidence level III. In-house employers' liability insurance association (BG) cases with the diagnosis of patella dislocation in patients under 18 years were descriptively evaluated with respect to demographic and predisposing aspects as well as regarding accident information. The accident mechanisms were sorted into subgroups: direct impact, trivial trauma, fall, torsional trauma. RESULTS A total of 54 patellar dislocations were identified with a patient age of 14 years (range 9-18 years). A mild valgus configuration was found in 39% of the cases, on average normal torsion, a tibial tuberosity-trochlea groove (TTTG) distance of 17 mm (range 8-24mm), with 41% a high proportion of patella alta and a trochlear deformity in 57%. Only 20% of the children had no relevant predispositions. The trivial traumas showed the highest proportion of recurrent dislocations with 50% and in the other accident categories the proportion of first dislocations was >75%. In the fall cohort the rate of children without relevant predisposition was highest. CONCLUSION The predisposition rate in infantile patellar dislocations is high; however, falls are always significant accident events as well as medial direct impact. Torsional trauma is also a significant causative factor, unless high-grade trochlear dysplasia is present, whereas trivial traumas are not.
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Affiliation(s)
- I Schubert
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.
| | - J Dickschas
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.,Friedrich-Alexander-Universität, Erlangen, Deutschland
| | - P C Strohm
- Klinik für Orthopädie und Unfallchirurgie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Bugerstr. 80, 96049, Bamberg, Deutschland.,Albert-Ludwigs-Universität, Freiburg i. Br., Deutschland
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Abstract
Abstract
When atoms and molecules are exposed to intense low frequency laser fields, the dominant response is sequential tunnel ionization of charge states with increasing ionization potential. Sequential ionization is assumed to proceed as separate one electron processes. The theoretical analysis developed here reveals that in complex systems sequential tunnel ionization can be inhibited by Coulomb blocking. When ionization potentials of subsequent charge states are close to each other, multiple tunneling events can occur during a half cycle and in close proximity, so that a tunneled electron can block the next tunneling electron. In sub-nm clusters driven by near infrared single-cycle pulses, Coulomb blocking reduces two-electron sequential tunneling by up to 2-3 orders of magnitude.
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Schubert I, Ferner F, Dickschas J. The effect of open-wedge and closed-wedge high tibial osteotomies on the tibial posterior slope—a study of two hundred seventy-nine cases. International Orthopaedics (SICOT) 2020; 44:1077-1082. [DOI: 10.1007/s00264-020-04499-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/31/2020] [Indexed: 11/30/2022]
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Heidt V, Hermes-Moll K, Blaschke K, Lappe V, Ihle P, Schubert I, Baumann W. Anticancer therapy at the end of life of breast, prostate, and colorectal cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy295.008] [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: 11/12/2022] Open
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Petzold T, Thienel M, Konrad I, Schubert I, Regenauer R, Hoppe B, Lorenz M, Eckart A, Chandraratne S, Lennerz C, Kolb C, Braun D, Jamasbi J, Brandl R, Braun S, Siess W, Schulz C, Massberg S. Oral thrombin inhibitor aggravates platelet adhesion and aggregation during arterial thrombosis. Sci Transl Med 2016; 8:367ra168. [DOI: 10.1126/scitranslmed.aad6712] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 08/31/2016] [Indexed: 12/13/2022]
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Lappe V, Ihle P, Schubert I. Multimedikation im Alter: Versorgungsrealität und Leitlinienempfehlungen. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wang W, Haberer G, Gundlach H, Gläßer C, Nussbaumer T, Luo MC, Lomsadze A, Borodovsky M, Kerstetter RA, Shanklin J, Byrant DW, Mockler TC, Appenroth KJ, Grimwood J, Jenkins J, Chow J, Choi C, Adam C, Cao XH, Fuchs J, Schubert I, Rokhsar D, Schmutz J, Michael TP, Mayer KFX, Messing J. The Spirodela polyrhiza genome reveals insights into its neotenous reduction fast growth and aquatic lifestyle. Nat Commun 2015; 5:3311. [PMID: 24548928 PMCID: PMC3948053 DOI: 10.1038/ncomms4311] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/24/2014] [Indexed: 11/30/2022] Open
Abstract
The subfamily of the Lemnoideae belongs to a different order than other monocotyledonous species that have been sequenced and comprises aquatic plants that grow rapidly on the water surface. Here we select Spirodela polyrhiza for whole-genome sequencing. We show that Spirodela has a genome with no signs of recent retrotranspositions but signatures of two ancient whole-genome duplications, possibly 95 million years ago (mya), older than those in Arabidopsis and rice. Its genome has only 19,623 predicted protein-coding genes, which is 28% less than the dicotyledonous Arabidopsis thaliana and 50% less than monocotyledonous rice. We propose that at least in part, the neotenous reduction of these aquatic plants is based on readjusted copy numbers of promoters and repressors of the juvenile-to-adult transition. The Spirodela genome, along with its unique biology and physiology, will stimulate new insights into environmental adaptation, ecology, evolution and plant development, and will be instrumental for future bioenergy applications. Spirodela, or duckweed, is a basal monocotyledonous plant with both pharmaceutical and commercial value. Here, the authors sequence the genome of Spirodela polyrhiza, suggesting its genome has evolved by neotenous reduction and clonal propagation, and provide a platform for future comparative genomic studies in angiosperms.
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Affiliation(s)
- W Wang
- 1] Waksman Institute of Microbiology, Rutgers University, 190 Frelinghuysen Road, Piscataway, New Jersey 08854, USA [2]
| | - G Haberer
- 1] MIPS/IBIS, Institute for Bioinformatics and System Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany [2]
| | - H Gundlach
- 1] MIPS/IBIS, Institute for Bioinformatics and System Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany [2]
| | - C Gläßer
- 1] MIPS/IBIS, Institute for Bioinformatics and System Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany [2]
| | - T Nussbaumer
- MIPS/IBIS, Institute for Bioinformatics and System Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - M C Luo
- Department of Plant Sciences, University of California, 265 Hunt Hall, One Shields Avenue, Davis, California 95616, USA
| | - A Lomsadze
- Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, Georgia 30332, USA
| | - M Borodovsky
- Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, Georgia 30332, USA
| | - R A Kerstetter
- 1] Waksman Institute of Microbiology, Rutgers University, 190 Frelinghuysen Road, Piscataway, New Jersey 08854, USA [2]
| | - J Shanklin
- Brookhaven National Laboratory, 50 Bell Ave, Upton, New York 11973, USA
| | - D W Byrant
- Donald Danforth Plant Science Center, 975N Warson Road, St. Louis, Missouri 63132, USA
| | - T C Mockler
- Donald Danforth Plant Science Center, 975N Warson Road, St. Louis, Missouri 63132, USA
| | - K J Appenroth
- Department of Plant Physiology, University of Jena, Dornburger Str. 159, 07743 Jena, Germany
| | - J Grimwood
- 1] DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA [2] HudsonAlpha Institute for Biotechnology, 601 Genome Way NW, Huntsville, Alabama 35806, USA
| | - J Jenkins
- HudsonAlpha Institute for Biotechnology, 601 Genome Way NW, Huntsville, Alabama 35806, USA
| | - J Chow
- DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA
| | - C Choi
- DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA
| | - C Adam
- DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA
| | - X-H Cao
- Department of Cytogenetics and Genome Analysis, Leibniz-Institute of Plant Genetics and Crop Plant Research (IPK), OT Gatersleben Corrensstrasse 3, D-06466 Stadt Seeland, Germany
| | - J Fuchs
- Department of Cytogenetics and Genome Analysis, Leibniz-Institute of Plant Genetics and Crop Plant Research (IPK), OT Gatersleben Corrensstrasse 3, D-06466 Stadt Seeland, Germany
| | - I Schubert
- Department of Cytogenetics and Genome Analysis, Leibniz-Institute of Plant Genetics and Crop Plant Research (IPK), OT Gatersleben Corrensstrasse 3, D-06466 Stadt Seeland, Germany
| | - D Rokhsar
- DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA
| | - J Schmutz
- 1] DOE Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, California 94598, USA [2] HudsonAlpha Institute for Biotechnology, 601 Genome Way NW, Huntsville, Alabama 35806, USA
| | - T P Michael
- 1] Waksman Institute of Microbiology, Rutgers University, 190 Frelinghuysen Road, Piscataway, New Jersey 08854, USA [2]
| | - K F X Mayer
- MIPS/IBIS, Institute for Bioinformatics and System Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - J Messing
- Waksman Institute of Microbiology, Rutgers University, 190 Frelinghuysen Road, Piscataway, New Jersey 08854, USA
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Lappe V, Ihle P, Schubert I. Multimedikation bei älteren GKV-Versicherten mit Pflegeleistungen im Vergleich zu Versicherten ohne Pflege. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563220] [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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Kuhn J, Enke M, Schubert I, Köster I, Donnachie E, Wildner M, Caselmann W. Der Bayerische Diabetesbericht: Gesundheitsberichterstattung im gesundheitspolitischen Kontext. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563223] [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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Ihle P, Dippel FW, Schubert I. Statin assoziierte Myopathie: Entwicklung einer operationalen Definition zur Prävalenzabschätzung auf Basis von GKV-Routinedaten. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563222] [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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Hermann N, Schubert I. [Detection of a Disease Cluster by the Health Authorities of Stendal District due to Campylobacter jejuni in a Nursery After the Consumption of Raw Milk]. Gesundheitswesen 2015; 77:496-8. [PMID: 26227383 DOI: 10.1055/s-0035-1554679] [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: 10/23/2022]
Abstract
A notification from a laboratory concerning the detection of Campylobacter jejuni in a 6-year-old boy initiated the investigation carried out by the health authorities from Stendal district, in order to explain the morbidity rate caused by the germ. The day after the boy's pediatrician informed about a visit to a farm, which was confirmed by the head of the nursery. She told the health authorities about the consumption of raw milk during their visit at the farm.The following days more children fell sick. Within 10 days the total number of diseased children was 21. The health authorities asked for stool samples of the diseased children, nursery nurses and the head of the farm since raw milk presents a potential cause of infection. The health authorities together with the Saxony-Anhalt State Office for Consumer Protection conducted a retrospective cohort study. The aim was to explain the association between the exposure from raw milk consumption and the occurrence of the disease from C. jejuni. Based on a questionnaire data about the food and milk intake at the nursery and at home and about the trip to the farm were collected. 91% of the children's cohort and 86% of the adults' cohort were captured.The exposed group at risk showed a higher risk of falling ill than the group, which was not exposed. The risk factor raw milk explained the difference. Furthermore, the analysis of milk samples taken by the district veterinary office from 2 cows and from the farm's tank was able to detect the germs. The correlation of the illness, the consumption of raw milk, the detection of C. jejuni in the samples taken from the children and the samples taken from the cows was evident. Based on the case the health authorities recommended that heads of nurseries as well as heads of dairy farming in the district of Stendal needed to be advised on raw milk. Nurseries are still allowed to take trips to farms. However, raw animal derivates including milk must not be consumed.
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Cao HX, Vu GTH, Wang W, Messing J, Schubert I. Chromatin organisation in duckweed interphase nuclei in relation to the nuclear DNA content. Plant Biol (Stuttg) 2015; 17 Suppl 1:120-4. [PMID: 24853858 DOI: 10.1111/plb.12194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 03/13/2014] [Indexed: 05/23/2023]
Abstract
The accessibility of DNA during fundamental processes, such as transcription, replication and DNA repair, is tightly modulated through a dynamic chromatin structure. Differences in large-scale chromatin structure at the microscopic level can be observed as euchromatic and heterochromatic domains in interphase nuclei. Here, key epigenetic marks, including histone H3 methylation and 5-methylcytosine (5-mC) as a DNA modification, were studied cytologically to describe the chromatin organisation of representative species of the five duckweed genera in the context of their nuclear DNA content, which ranged from 158 to 1881 Mbp. All studied duckweeds, including Spirodela polyrhiza with a genome size and repeat proportion similar to that of Arabidopsis thaliana, showed dispersed distribution of heterochromatin signatures (5mC, H3K9me2 and H3K27me1). This immunolabelling pattern resembles that of early developmental stages of Arabidopsis nuclei, with less pronounced heterochromatin chromocenters and heterochromatic marks weakly dispersed throughout the nucleus.
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Affiliation(s)
- H X Cao
- Leibniz-Institute of Plant Genetics and Crop Plant Research (IPK), OT Gatersleben, Germany
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Kienhöfer D, Hahn J, Schubert I, Reinwald C, Ipseiz N, Lang SC, Borràs ÈB, Amann K, Sjöwall C, Barron AE, Hueber AJ, Agerberth B, Schett G, Hoffmann MH. No evidence of pathogenic involvement of cathelicidins in patient cohorts and mouse models of lupus and arthritis. PLoS One 2014; 9:e115474. [PMID: 25535966 PMCID: PMC4275226 DOI: 10.1371/journal.pone.0115474] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/24/2014] [Indexed: 11/18/2022] Open
Abstract
Apart from their role in the immune defence against pathogens evidence of a role of antimicrobial peptides (AMPs) in autoimmune diseases has accumulated in the past years. The aim of this project was to examine the functional impact of the human cathelicidin LL-37 and the mouse cathelicidin-related AMP (CRAMP) on the pathogenesis of lupus and arthritis. Serum LL-37 and anti-LL-37 levels were measured by ELISA in healthy donors and patients with Systemic Lupus Erythematosus (SLE) and Rheumatoid arthritis (RA). Pristane-induced lupus was induced in female wild type (WT) and cathelicidin-deficient (CRAMP-/-) mice. Serum levels of anti-Sm/RNP, anti-dsDNA, and anti-histone were determined via ELISA, cytokines in sera and peritoneal lavages were measured via Multiplex. Expression of Interferon I stimulated genes (ISG) was determined by real-time PCR. Collagen-induced arthritis (CIA) was induced in male WT and CRAMP-/- mice and arthritis severity was visually scored and analysed histomorphometrically by OsteoMeasure software. Serum levels of anti-LL-37 were higher in SLE-patients compared to healthy donors or patients with RA. However, no correlation to markers of disease activity or organ involvement was observed. No significant differences of autoantibody or cytokine/chemokine levels, or of expression of ISGs were observed between WT and CRAMP-/- mice after pristane-injection. Furthermore, lung and kidney pathology did not differ in the absence of CRAMP. Incidence and severity of CIA and histological parameters (inflammation, cartilage degradation, and bone erosion) were not different in WT and CRAMP-/- mice. Although cathelicidins are upregulated in mouse models of lupus and arthritis, cathelicidin-deficiency did not persistently affect the diseases. Also in patients with SLE, autoantibodies against cathelicidins did not correlate with disease manifestation. Reactivity against cathelicidins in lupus and arthritis could thus be an epiphenomenon caused by extensive overexpression in blood and affected tissues. In addition, other cationic AMPs could functionally compensate for the deficiency of cathelicidins.
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Affiliation(s)
- D. Kienhöfer
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - J. Hahn
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - I. Schubert
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C. Reinwald
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - N. Ipseiz
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - S. C. Lang
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - K. Amann
- Department of Nephropathology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C. Sjöwall
- Rheumatology/AIR, Department of Clinical and Experimental medicine, Linköping university, Linköping, Sweden
| | - A. E. Barron
- Department of Bioengineering, Stanford University, Stanford, CA, United States of America
| | - A. J. Hueber
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - B. Agerberth
- Division of Clinical Microbiology, F68, Department of Laboratory Medicine, Karolinska University, Huddinge, Stockholm, Sweden
| | - G. Schett
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
| | - M. H. Hoffmann
- Department of Internal Medicine 3, Universitätsklinikum Erlangen, Erlangen, Germany
- * E-mail:
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Köster I, Huppertz E, Hauner H, Schubert I. Costs of Diabetes Mellitus (CoDiM) in Germany, direct per-capita costs of managing hyperglycaemia and diabetes complications in 2010 compared to 2001. Exp Clin Endocrinol Diabetes 2014; 122:510-6. [PMID: 24918530 DOI: 10.1055/s-0034-1375675] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 10/25/2022]
Abstract
INTRODUCTION To identify direct health care costs of patients with diabetes in Germany in 2010, with focus on costs of treating hyperglycaemia and costs caused by diabetes complications, and to compare findings with results from the CoDiM study 2001. MATERIAL AND METHODS The cost analysis was based on administrative data (18.75% random sample of 1.5 million insured persons). Medical costs covered by statutory health insurance and costs covered by nursing care insurance were included. Incremental differences in costs of patients with diabetes (n=30 987) and age and sex-matched subjects without a diagnosis of diabetes (controls) were estimated according to the number and type of complications. Costs were standardised to the German population. RESULTS In 2010, incremental medical costs attributed to diabetes were € 2 391 (95% confidence interval: 2 257-2 524) per patient with diabetes. Of that amount, 26.5% were spent for the management of hyperglycaemia (€ 633 (622-644)) and 73.5% for the treatment of comp-lications (€ 1 758 (1 627-1 889)). Nursing care contributed incremental costs of € 289 (249-330), of which 98.8% was due to complications. From 2001 to 2010 the incremental per-capita costs for medical and nursing care decreased by 4.8% (controls: +3.9%), the per-capita costs for treating hyperglycaemia increased by 2.0% and the per-capita costs for complications decreased by 7.0%. CONCLUSION Cost for diabetes is largely caused by management of complications. It is important to prevent complications by consequent management of diabetes as well as by primary prevention of its onset.
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Affiliation(s)
- I Köster
- PMV Research Group at the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Germany
| | | | - H Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum rechts der Isar, Technical University Munich, Germany
| | - I Schubert
- PMV Research Group at the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Germany
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Huppertz E, Köster I, Hauner H, Schubert I. Ergebnisse der KoDiM-Studie 2010 – Diabetes: Häufigkeit und Kosten der Grunderkrankung, von Komplikationen und Begleiterkrankungen. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schubert I. Prävention – eine Aufgabe des ÖGD. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1371637] [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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Schubert I. Ermittlungsweg des Gesundheitsamtes des Landkreises Stendal bei einer Erkrankungshäufung durch Campylobacter jejuni in einer Kindertagesstätte nach dem Verzehr von Rohmilch. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1371646] [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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Schubert I. Sozialpsychiatrische Versorgung im ländlichen Raum. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1371673] [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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Kienhoefer D, Schubert I, Hahn J, Bosch È, Sjöwall C, Agerberth B, Schett G, Hoffmann M. A3.7 No evidence of cathelicidin being involved in the pathogenesis of lupus and arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-205124.101] [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: 11/03/2022]
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Heidemann C, Du Y, Schubert I, Rathmann W, Scheidt-Nave C. [Prevalence and temporal trend of known diabetes mellitus: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:668-77. [PMID: 23703485 DOI: 10.1007/s00103-012-1662-5] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1, 2008-2011) allows for up-to-date, representative prevalence estimates of known diabetes amongst the 18- to 79-year-old resident population of Germany. Temporal trends can be shown by comparing the survey findings with those of the "German National Health Interview and Examination Survey 1998" (GNHIES98). The definition of known diabetes was based on self-reports in physician-administered interviews that asked respondents if they had ever been diagnosed with diabetes by a doctor or were on anti-diabetic medication. Overall, diabetes had been diagnosed in 7.2 % of the adults (7.4 % of the women; 7.0 % of the men). The prevalence increased substantially with advancing age and was higher in persons of low than of high socioeconomic status. Prevalence varied depending on the type of health insurance held and was highest amongst those insured with AOK health insurance funds. In comparison with GNHIES98, there was a 38 % increase in prevalence, of which approximately one third is to be attributed to demographic ageing. In the context of other nationwide studies, the results indicate a figure of at least 4.6 million 18- to 79-year-olds having been diagnosed with diabetes at some point. Planned analyses of undiagnosed diabetes will contribute to the interpretation of the observed increase in the prevalence of known diabetes. An English full-text version of this article is available at SpringerLink as supplemental.
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Affiliation(s)
- C Heidemann
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101 Berlin, Deutschland.
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Abbas S, Ihle P, Hein R, Schubert I. [Rehabilitation in geriatric patients after ischemic stroke--a comparison of 2 organisational systems in Germany using claims data of a statutory health insurance fund]. REHABILITATION 2013; 52:375-82. [PMID: 23824567 DOI: 10.1055/s-0033-1334914] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED Due to historical aspects in some federal states in Germany rehabilitation of geriatric patients is organized in geriatric departments in hospitals (§ 109 SGB V). In other states rehabilitation of these patients is mainly realized in geriatric rehabilitation facilities outside hospital care after approval by the health insurance (§ 111 SGB V). Thus, it is of interest to compare both types of health care with respect to differences in population characteristics, resource utilization and outcome parameters (i.e., excess costs, rehospitalization, fracture risk and mortality) using a common geriatric indication, the ischemic stroke, as an example. METHODS Claims data of the AOK (Local Health Care Fund) from seven federal states in Germany were used. Insured persons with a documented hospital stay with discharge diagnosis cerebral infarction/stroke (ICD-10 I63, I64, below denoted by "ischemic stroke") in 2007 (N=39,887) were included and allocated to the respective form of rehabilitative health care via the OPS (German procedure classification for inpatient procedures) procedure 8-550 (§ 109, N=1,272) or via admission to a geriatric rehabilitation unit within 1 month after hospital discharge (§ 111, N=2,200). All direct costs were ascertained and presented with and without costs of long-term care. Excess costs were calculated as the difference of costs between the first year after insult and the costs in the previous year. Excess costs in the 2 types of care were compared using multivariate quantile regression analysis. Risk of hospitalization (due to ischemic stroke or fracture) and risk of death in a 1-year follow-up was analysed using multivariate cox regression. RESULTS Insured members treated according to health care type § 109 were somewhat older (mean: 81 vs. 80 years of age), more frequently female (72 vs. 67%), more often receiving long-term care (27 vs. 19%) and had more often documented sequelae after insult (>=4 diseases 39 vs. 28%). No significant differences in excess costs between both types of care were observed (quantile regression: 25%-percentile-comparison: p=0.49 and 0.11; median-comparison: p=0.99 and 0.13; 75%-percentile-comparison: p=0.13 and 0.30, with and without costs of long-term care, respectively). Moreover, no significant differences were observed related to the outcomes 'rehospitalization due to ischemic stroke' (hazard ratio - HR [95% confidence interval - CI])=1.12 [0.85-1.48], p=0.43) and death (HR [95% CI]=1.03 [0.88-1.20], p=0.75) in the multivariate model (reference: health care type § 111). Insured members in health care type § 109 had a significant lower risk of rehospitalization due to fracture (HR [95% CI]=0.61 [0.40-0.93], p=0.02). CONCLUSION According to health care type § 109 and § 111, geriatric patients differ in certain characteristics such as gender, statutory care and documented sequelae after insult. Except for the outcome 'fracture', no significant differences between both types of care have been observed in the selected outcomes. Primary studies with more differentiated data collection may focus on specific treatment and on aims and achievements of rehabilitation.
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Affiliation(s)
- S Abbas
- PMV forschungsgruppe an der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln
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Abstract
Total polyadenylated RNA was isolated from different organs of the field bean by oligo-dT latex particles. Complementary DNA (cDNA) was reverse transcribed from the mRNAs and used as a probe for fluorescent in situ hybridization to metaphase chromosomes. Hybridization signals covered the whole chromosome complement except for late-replicating Giemsa-banded heterochromatin regions, which are composed mainly (or exclusively) of tandemly arranged repetitive sequences.
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Abstract
A complete chromosomal fusion-fission cycle is described for the first time. In the field bean, Vicia faba, this cycle probably started with a reversible fusion of two telocentrics giving rise to the standard metacentric chromosome I. The next step was a recent fission of this chromosome into two stable telocentrics eventually followed by a new fusion reconstituting the metacentric chromosome.
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Stock C, Ihle P, Sieg A, Schubert I, Hoffmeister M, Brenner H. Krankenhausaufnahmen innerhalb von 30 Tagen nach präventiven und kurativen Koloskopien aufgrund von potentiellen Komplikationen – Eine Analyse mit Daten der Versichertenstichprobe der AOK Hessen/ KV Hessen. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323490] [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: 10/27/2022]
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Lappe V, Ihle P, Schubert I. Inanspruchnahme und Kosten von Patienten mit Alzheimer-Demenz drei Jahre vor und ein Jahr nach Diagnosedokumentation im Vergleich zu einer Kontrollgruppe – Eine Untersuchung auf Basis der Versichertenstichprobe AOK Hessen/KV Hessen. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323357] [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: 10/27/2022]
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Schubert I, Köster I, Stößel U, Siegel A. Evaluation der Integrierten Versorgung Gesundes Kinzigtal – Über-, Unter- und Fehlversorgung in der Region Kinzigtal 2004 – 2010 im Vergleich zum übrigen Baden-Württemberg. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323475] [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: 10/27/2022]
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Abbas S, Ihle P, Hein R, Schubert I. Rehabilitation geriatrischer Patienten nach Schlaganfall – Ein Vergleich zweier Versorgungssysteme in Deutschland an Hand von Routinedaten der gesetzlichen Krankenkasse. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323164] [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: 10/27/2022]
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Farré A, Cuadrado A, Lacasa-Benito I, Cistué L, Schubert I, Comadran J, Jansen J, Romagosa I. Genetic characterization of a reciprocal translocation present in a widely grown barley variety. Mol Breed 2012; 30:1109-1119. [PMID: 22924020 PMCID: PMC3410021 DOI: 10.1007/s11032-011-9698-z] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 12/27/2011] [Indexed: 05/30/2023]
Abstract
Artificially induced translocation stocks have been used to physically map the barley genome; however, natural translocations are extremely uncommon in cultivated genotypes. Albacete is a barley variety widely grown in recent decades in Spain and carrying a reciprocal translocation which obviously does not affect its agronomical fitness. This translocation has been characterized by a combination of cytological and molecular genetic approaches. Firstly, recombination frequencies between markers on chromosomes 1H and 3H were estimated to determine the boundaries of the reciprocal interchange. Secondly, 1H-3H wheat barley telosome addition lines were used to assign selected markers to chromosome arms. Thirdly, fluorescence in situ hybridization (FISH) with rDNA probes (5S and 18S-5.8S-26S) and microsatellite probes [(ACT)(5), (AAG)(5) and (CAG)(5)] was used to determine the locations of the translocation breakpoints more precisely. Fourthly, fine-mapping of the regions around the translocation breakpoints was used to increase the marker density for comparative genomics. The results obtained in this study indicate that the translocation is quite large with breakpoints located on the long arms of chromosomes 1H and 3H, between the pericentromeric (AAG)(5) bands and above the (ACT)(5) interstitial distal bands, resulting in the reciprocal translocation 1HS.1HL-3HL and 3HS.3HL-1HL. The gene content around the translocation breakpoints could be inferred from syntenic relationships observed among different species from the grass family Poaceae (rice, Sorghum and Brachypodium) and was estimated at approximately 1,100 and 710 gene models for 1H and 3H, respectively. Duplicated segments between chromosomes Os01 and Os05 in rice derived from ancestral duplications within the grass family overlap with the translocation breakpoints on chromosomes 1H and 3H in the barley variety Albacete.
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Affiliation(s)
- A. Farré
- Department of Plant Production and Forest Science, University of Lleida, Lleida, Spain
- Biometris, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - A. Cuadrado
- Department of Cell Biology and Genetics, University of Alcalá de Henares, Alcalá de Henares, Spain
| | - I. Lacasa-Benito
- Department of Plant Production and Forest Science, University of Lleida, Lleida, Spain
| | - L. Cistué
- Estación Experimental de Aula Dei, CSIC, Zaragoza, Spain
| | - I. Schubert
- Department of Cytogenetics, Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, Germany
| | - J. Comadran
- Genetics Programme, The James Hutton Institute, Dundee, Scotland, UK
| | - J. Jansen
- Biometris, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - I. Romagosa
- Department of Plant Production and Forest Science, University of Lleida, Lleida, Spain
- Centre UdL-IRTA, University of Lleida, Lleida, Spain
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Robra BP, Mansky T, Schubert I. Vorhandene Daten besser nutzen – Umsetzung der §§ 303a bis f SGB V. Dtsch Med Wochenschr 2011. [DOI: 10.1055/s-0031-1286085] [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: 10/17/2022]
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Abstract
BACKGROUND AND STUDY AIMS Colonoscopy and guaiac-based fecal occult blood tests (FOBT) are recommended and offered for colorectal cancer (CRC) screening in Germany. We aimed to explore their utilization in a large insurance-based cohort. PATIENTS AND METHODS Claims data from between 2000 and 2008 were collected for 170493 individuals who were insured by a large health insurance plan in the federal state of Hesse, Germany. The percentages of individuals who had recently utilized CRC screening-related procedures were calculated. Additionally, multiple test use and identification of CRC screening providers were ascertained. RESULTS Following the inception of the current CRC screening program in 2002, colonoscopy utilization rates varied only slightly and FOBT use decreased in individuals aged ≥50 years. At the end of 2008, the age-standardized percentages of individuals who had undergone colonoscopy within ≤10 years were 23% for men and 26% for women. The proportions of individuals who had used FOBT within ≤1 year were 14% for men and 22% for women. Patient education had been utilized by 38% of eligible persons and was increasingly followed by screening colonoscopy. For women, practices that specialized in gynecology were the main providers of FOBT (93%) and patient education (61%). CONCLUSIONS This study provides new insights into the inter-related utilization of colonoscopy, FOBT, and patient education in Germany, and may be particularly informative for the design of strategies to increase CRC screening uptake. It indicates that sex differences in CRC screening test use could result to a large extent from general visits to different types of specialist physicians involved in the CRC screening process.
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Affiliation(s)
- C Stock
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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Schubert I, Köster I. Versorgungsmonitoring mit Routinedaten am Beispiel Diabetes mellitus. Dtsch Med Wochenschr 2011. [DOI: 10.1055/s-0031-1286092] [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: 10/17/2022]
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Abstract
INTRODUCTION The prevalence of treated diabetes in Germany and direct health care costs of individuals with diabetes were analysed for the 8-year period from 2000 to 2007, based on administrative data. Special interest was given to the incremental costs attributed to diabetes. MATERIAL AND METHODS An 18.75% sample of all members of a large local German statutory health insurance provider, "AOK - Die Gesundheitskasse" in the federal state of Hesse was analysed with regard to cases of treated diabetes. To assess the incremental diabetes-related direct costs, the cost data of individuals with diabetes was compared to that of an age- and sex-matched group of persons without diabetes. Prevalence and costs were standardized according to the gender and age distribution of the German population. RESULTS Between 2000 and 2007, the administrative prevalence of treated diabetes rose continuously in Germany, from 6.5 to 8.9% (+36.8%). The number of patients treated with 'insulin' or 'insulin & oral antidiabetic agents' increased by +54.7 and +61.7%, respectively. Direct costs per patient with diabetes, calculated using the unit costs reimbursed by statutory health and nursing care insurances, rose from € 5 197 to € 5 726 (+10.2%). Incremental per-capita costs were € 2 400 in 2000 and € 2 605 in 2007 (+8.5%). However, the total direct cost burden of diabetes in Germany grew from € 27.8 billion to € 42.0 billion (+51.1%). The incremental diabetes-related cost burden increased from € 12.9 billion to € 19.1 billion (+48.6%). CONCLUSIONS There was a continuous increase in the prevalence of diabetes in Germany during the 8-year period. Although there was only a modest increase in annual diabetes-related per-capita costs, total healthcare expenditure rose substantially due to the growing number of patients being treated for diabetes.
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Affiliation(s)
- I Köster
- PMV forschungsgruppe an der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum Köln, Germany.
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Abbas S, Ihle P, Heymans L, Küpper-Nybelen J, Schubert I. [Differences in antibiotic prescribing between general practitioners and pediatricians in Hesse, Germany]. Dtsch Med Wochenschr 2010; 135:1792-7. [PMID: 20824600 DOI: 10.1055/s-0030-1263321] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND A careful consideration of antibiotic prescription is necessary due to emerging antibiotic resistance. Differences in prescription rates between physician groups have only rarely been examined. We compared the prescription of antibiotics for systemic use in children between pediatricians and general practitioners (GPs). METHOD Data source was the statutory health insurance sample AOK Hesse/KV Hesse. Overall, 47,033 insured children in 2006 between 2 and 17 years of age were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) for an antibiotic prescription were calculated by logistic regression adjusted for confounders, comparing pediatricians with GPs. Diagnosis-specific models were constructed. RESULTS GPs and pediatricians prescribed 79.3% of all antibiotics in 2006 (40.6% and 38.7%, respectively). Significantly decreased ORs for an antibiotic prescription were observed for pediatricians, with OR (95% CI) of 0.46 (0.43-0.49), 0.40 (0.30-0.54) and 0.40 (0.30-0.53) for respiratory tract infections, urinary tract infections and nonsuppurative otitis media, respectively. No significant associations were observed assessing scarlet fever, pneumonia and suppurative otitis media, respectively. CONCLUSION In this retrospective analysis, pediatricians were associated with a lower antibiotic prescription rate regarding diagnoses where antibiotic therapy is not clearly indicated. However, in diagnoses where antibiotic therapy is clearly indicated, no differences in prescription rates between pediatricians and GPs were observed. Further studies are warranted to gain insight into different treatment strategies between different groups of medical practitioners.
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Affiliation(s)
- S Abbas
- PMV forschungsgruppe, Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln, Köln, Germany.
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Egen-Lappe V, Lehmkuhl G, Schubert I. Einbindung von Spezialisten in die Verordnung von Methylphenidat/Atomoxetin zur Behandlung von ADHS. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266278] [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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Küpper-Nybelen J, Köster I, Ihle P, Schubert I. Komedikation bei Diabetes mellitus im zeitlichen Vergleich. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266600] [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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Mühlstädt M, Schulze B, Schubert I. β-Thiocyanatovinylearbonylverbindungen; Zur Umsetzung von β-Thicyanatovinylaldehyden mit Hydroxylamin. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/zfch.19810210906] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Schubert I, Ihle P, Köster I. Interne Validierung von Diagnosen in GKV-Routinedaten: Konzeption mit Beispielen und Falldefinition. Gesundheitswesen 2010; 72:316-22. [PMID: 20480460 DOI: 10.1055/s-0030-1249688] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [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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Schiffner-Rohe J, Jow S, Lilie HM, Köster I, Schubert I. [Herpes zoster in Germany. A retrospective analyse of SHL data]. MMW Fortschr Med 2010; 151 Suppl 4:193-197. [PMID: 21595148] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The incidence of herpes zoster in the elderly (50 years and older) 2004 in Germany was determined by retrospectively analysing representative treatment data of the statutory health insurance sample of AOK Hesse/KV Hesse. The overall observed incidence rate of herpes zoster was 9.4 cases per 1,000 person-years (PY). 10.1% of herpes-zoster-patients suffered at least 1 month from pain, the so called postherpetic neuralgia (PHN1), 6.9% had at least 3 months pain (PHN3). Incidence rate of herpes zoster rose markedly with age: from 6.8 per 1,000 PY in 50 to 54 year-olds to 12.4 PY in persons 80 years and older. Incidence rate in the immunocompromised was higher (11.6 per 1,000 PY) than in the immunocompetent (9.1 per 1,000 PY). According to a standardized extrapolation of the sample to the German population, about 300,000 persons 50 years and older suffered from acute herpes zoster on the year 2004 in Germany.
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Glaeske G, Augustin M, Abholz H, Banik N, Brüggenjürgen B, Hasford J, Hoffmann W, Kruse J, Lange S, Schäfer T, Schubert I, Trampisch HJ, Windeler J. Epidemiologische Methoden für die Versorgungsforschung. Gesundheitswesen 2009; 71:685-93. [DOI: 10.1055/s-0029-1239517] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schubert I, Köster I, Ihle P. GKV-Routinedaten als Basis eines auf Qualitätsindikatoren gestützten systematischen Outcome-Monitoring? Baseline-Ergebnisse einer Analyse der GKV-Routinedaten im Kinzigtal im Vergleich zu Gesamt-Baden-Württemberg. Gesundheitswesen 2009. [DOI: 10.1055/s-0029-1239118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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