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Berger K, Schiefner F, Rudolf M, Awiszus F, Junne F, Vogel M, Lohmann CH. Long-term effects of doping with anabolic steroids during adolescence on physical and mental health. Orthopadie (Heidelb) 2024:10.1007/s00132-024-04498-3. [PMID: 38653791 DOI: 10.1007/s00132-024-04498-3] [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: 03/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Systematic doping programs like in the GDR were applied in adolescent competitive athletes to induce supramaximal athletic performance. The substances had adverse somatic and psychological effects. The psychological development of the young athletes was impaired and they suffered in adulthood from long-term effects and secondary diseases even years after the doping period. METHOD The study compared three groups: competitive athletes with doping (I), competitive athletes without doping (II) and persons with no sports activities (III). Somatic and psychological diseases were analyzed to identify the adverse effects of doping in the most vulnerable phase of development in adolescence. Participants were asked to supply a patient history and completed a questionnaire with standardized psychological tests. RESULTS The doping cohort had a higher rate of somatic diseases, psychological disorders and social and professional difficulties. The differences were gender-specific with males more often having impaired liver function, depression, tumors and difficulties associated with the workplace . The doping group reported more emotional and physical neglect during childhood. They proved to be less optimistic but more pessimistic, to perceive less social support and to be more depressive. The study identified less extraversion and more neuroticism. Posttraumatic stress disorder (PTSD) occurred in a small number of participants in the doping group. Doping is associated with psychiatric variables. Predictors were the subscale identifying feelings of the Toronto alexithymia scale 20 (TAS-20), the sense of coherence and the Beck depression inventory 2 (BDI-II) and the Beck depression inventory (BDI). CONCLUSION Physical and psychosocial effects imply correlation with the application of doping substances but might not only be due to the side effects of these substances but also caused by the system, which exerts great psychological pressure and stress during adolescence, a highly vulnerable phase.
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Affiliation(s)
- K Berger
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - F Schiefner
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - M Rudolf
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Awiszus
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - F Junne
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - M Vogel
- Department for Psychosomatic and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - C H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
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Zhu J, Rao A, Berger K, Gopal M, Vrudhula A, Han D, Vouyouka A, Ting W, Finlay D, Kim SY, Tadros R, Marin M, Faries P. Determinants of Mortality and Mid-Term Outcomes After Transcarotid Artery Revascularization and Transfemoral Carotid Artery Stenting. J Endovasc Ther 2024:15266028241235791. [PMID: 38449352 DOI: 10.1177/15266028241235791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
OBJECTIVES The potential benefit of transcarotid artery revascularization (TCAR) over transfemoral carotid artery stenting (tfCAS) has been studied in the perioperative period with lower rates of stroke and death; however, data on mid-term outcomes are limited. We aimed to evaluate 3-year outcomes after TCAR and tfCAS and determine the primary predictors of 30-day and 1-year mortality following TCAR. METHODS Data from the Vascular Quality Initiative for patients undergoing TCAR or tfCAS from January 2016 to December 2022 were analyzed. 1:1 propensity score matching using the nearest-neighbor method was used to adjust baseline demographics and clinical characteristics. Kaplan-Meier survival analysis and Cox Proportional Hazard Regression were used to evaluate long-term outcomes. Iterative stepwise multiple logistic regression analysis and Cox Proportional Hazard Regression were used to identify predictors of 30-day and 1-year mortality, respectively, based upon preoperative, intraoperative, and postoperative factors. RESULTS A total of 70 237 patients were included in analysis (TCAR=58.7%, tfCAS=41.3%). Transcarotid artery revascularization patients were older and had higher rates of comorbid conditions and high-risk medical and anatomic features than tfCAS patients. Propensity score matching yielded 22 322 pairs with no major differences between groups except that TCAR patients were older (71.6 years vs 70.8 years). At 3 years, TCAR was associated with a 24% reduction in hazard of death compared with tfCAS (hazard ratio [HR]=0.76, 95% confidence interval [CI]=0.71-0.82, p<0.001), for both symptomatic and asymptomatic patients. This survival advantage was established in the first 6 months (HR=0.59, 95% CI=0.53-0.62, p<0.001), with no difference in mortality risk from 6 months to 36 months (HR=0.95, 95% CI=0.86-1.05, p=0.31). Transcarotid artery revascularization was also associated with decreased hazard for 3-year stroke (HR=0.81, 95% CI=0.66-0.99, p=0.04) and stroke or death (HR=0.81, 95% CI=0.76-0.87, p<0.001) compared with tfCAS. The top predictors for 30-day and 1-year mortality were postoperative complications. The primary independent predictor was the occurrence of postoperative stroke. CONCLUSIONS Transcarotid artery revascularization had a sustained mid-term survival advantage associated over tfCAS, with the benefit being established primarily within the first 6 months. Notably, our findings highlight the importance of postoperative stroke as the primary independent predictor for 30-day and 1-year mortal. CLINICAL IMPACT The ongoing debate over the superiority of TCAR compared to tfCAS and CEA has been limited by a lack of comparative studies examining the impact of pre-operative symptoms on outcomes. Furthermore, data are scarce on mid-term outcomes for TCAR beyond the perioperative period. As a result, it remains uncertain whether the initial benefits of stroke and death reduction observed with TCAR over tfCAS persist beyond one year. Our study addresses these gaps in the literature, offering evidence to enable clinicians to assess the efficacy of TCAR for up to three years. Additionally, our study seeks to identify risk factors for postoperative mortality following TCAR, facilitating optimal patient stratification.
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Affiliation(s)
- Jerry Zhu
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ajit Rao
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kelsey Berger
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Malika Gopal
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amey Vrudhula
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Han
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ageliki Vouyouka
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Windsor Ting
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Finlay
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sung Yup Kim
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rami Tadros
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Marin
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Faries
- Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zhu J, Rao A, Berger K, Kibrik P, Ting W, Han D, Phair J, Tadros R, Marin M, Faries P. Neck radiation is not associated with increased risk of perioperative adverse events after transcarotid artery revascularization or transfemoral carotid artery stenting. J Vasc Surg 2024; 79:71-80.e1. [PMID: 37678641 DOI: 10.1016/j.jvs.2023.08.129] [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: 05/24/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE It is unclear whether patients with prior neck radiation therapy (RT) are at high risk for carotid artery stenting (CAS). We aimed to delineate 30-day perioperative and 3-year long-term outcomes in patients treated for radiation-induced stenotic lesions by the transfemoral carotid artery stenting (TFCAS) or transcarotid artery revascularization (TCAR) approach to determine comparative risk and to ascertain the optimal intervention in this cohort. METHODS Data were extracted from the Vascular Quality Initiative CAS registry for patients with prior neck radiation who had undergone either TCAR or TFCAS. The Student t-test and the χ2 test were used to compare baseline patient characteristics. Multivariable logistic regression and Cox Hazard Proportional analysis were used to compare perioperative and long-term differences between patients with and without prior neck radiation following TCAR and TFCAS. Kaplan-Meier estimator was used to determine the incidence of 3-year adverse events. RESULTS A total of 72,656 patients (TCAR, 40,879; TFCAS, 31,777) were included in the analysis. Of these, 4151 patients had a history of neck radiation. Patients with a history of neck radiation were more likely to be younger, white, and have fewer comorbidities than patients with no neck radiation history. After adjustment for confounding factors, there was no difference in relative risk of 30-day perioperative stroke (P = .11), death (P = .36), or myocardial infarction (MI) (P = .61) between TCAR patients with or without a history of neck radiation. The odds of stroke/death (P = .10) and stroke/death/MI (P = .07) were also not statistically significant. In patients with prior neck radiation, TCAR had lower odds for in-hospital stroke/death/MI (odds ratio, 0.59; 95% confidence interval [CI], 0.35-0.99; P = .05) and access site complications than TFCAS. At year 3, patients with prior neck radiation had an increased hazard for mortality after TCAR (hazard ratio [HR], 1.24; 95% CI, 1.02-1.51; P = .04) and TFCAS (HR, 1.33; 95% CI, 1.12-1.58; P = .001). Patients with prior neck radiation also experienced an increased hazard for reintervention after TCAR (HR, 2.16; 95% CI, 1.45-3.20; P < .001) and TFCAS (HR, 1.67; 95% CI, 1.02-2.73; P<.001). CONCLUSIONS Patients with prior neck radiation had a similar relative risk of 30-day perioperative adverse events as patients with no neck radiation after adjustment for baseline demographics and disease characteristics. In these patients, TCAR was associated with reduced odds of perioperative stroke/death/MI as compared with TFCAS. However, patients with prior neck radiation were at increased risk for 3-year mortality and reintervention.
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Affiliation(s)
- Jerry Zhu
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ajit Rao
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Kelsey Berger
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Pavel Kibrik
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Windsor Ting
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Daniel Han
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - John Phair
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rami Tadros
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael Marin
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter Faries
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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4
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Jalusic KO, Ellenberger D, Stahmann A, Berger K. Adverse events in MS patients fulfilling or not inclusion criteria of the respective clinical trial - The problem of generalizability. Mult Scler Relat Disord 2023; 69:104422. [PMID: 36455503 DOI: 10.1016/j.msard.2022.104422] [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: 11/16/2021] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The aim of this study was to evaluate how many MS patients treated with an approved DMD in routine care would have fulfilled the inclusion and exclusion criteria of phase III clinical trial and would therefore be eligible for the respective drug trial. Further, adverse events and disease progression for these patients were compared. METHODS A comparison of patients fulfilling phase III clinical trial inclusion and exclusion criteria and those who do not with regard to sociodemographic and clinical characteristics, adverse events and disease progression. Database was the REGIMS register, a national, prospective, observational, clinical multicentre registry. 1248 MS Patients were included. RESULTS 27.2% patients would have been eligible for inclusion into a phase III clinical trial of their indication. Patients who did not meet the criterion age are more likely to have a serious adverse event (SAE), whereas patients who did not fulfil the criterion relapse had a significant lower occurrence of an adverse event (AE). Non-fulfilment of other inclusion criteria (EDSS Score; medication history and MS type) did not show any significant differences in drug safety variables, AE and SAE. CONCLUSION Our results suggest that a low transferability of phase III clinical trial criteria, to patients in routine care with the exception of age, does not imply a higher risk with regard to adverse and serious adverse events.
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Affiliation(s)
- K O Jalusic
- University of Muenster, Institute of Epidemiology and Social Medicine, Muenster, Germany.
| | - D Ellenberger
- MS Forschungs- und Projektentwicklungs-gGmbH, German MS Register, Hannover, Germany
| | - A Stahmann
- MS Forschungs- und Projektentwicklungs-gGmbH, German MS Register, Hannover, Germany
| | - K Berger
- University of Muenster, Institute of Epidemiology and Social Medicine, Muenster, Germany
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Dragano N, Reuter M, Peters A, Schmidt B, Bohn B, Berger K. Increase in Mental Disorders During the COVID-19 Pandemic - Role of Occupational & Financial Strains. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.028] [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: 11/14/2022] Open
Abstract
Abstract
Background
Numerous studies reported an increase in mental disorders during the COVID-19 pandemic, but the specific causes for this increase are unclear. We therefore investigate whether pandemic-related occupational and financial changes (e.g., reduced working hours, working from home, financial losses) were associated with increased symptoms of depression and anxiety compared with the situation before the pandemic.
Methods
We analyzed data from the German National Cohort Study (NAKO). Between May and November 2020, 161,849 participants answered questions on their mental state and social circumstances. Responses were compared with data from the baseline survey before the pandemic (2014-2019). Linear fixed-effects models were used to determine whether individual changes in the symptoms of depression (PHQ-9) or anxiety (GAD-7) were associated with occupational/financial changes (controlling for covariates).
Results
A pronounced increase in symptoms was observed among those who became unemployed during the pandemic (+ 1.16 points on the depression scale, 95% confidence interval [0.91; 1.41], range 0-27). Increases were also seen for reduced working hours without short-term working allowance, increased working hours, working from home, insecurity regarding employment, and financial strain. The deterioration in mental health was largely statistically explained by the occupational and financial changes investigated in the model.
Conclusions
Depressive symptoms and anxiety disorders increased in the study population during the first year of the COVID-19 pandemic and occupational and financial difficulties were an essential contributory factor. These strains should be taken into account both in the care of individual patients and in the planning of targeted prevention measures. Results suggest that welfare state benefits such as short-time allowance in times of crises may reduce mental load in affected populations.
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Affiliation(s)
- N Dragano
- Institute of Medical Sociology, University of Düsseldorf , Düsseldorf, Germany
| | - M Reuter
- Institute of Medical Sociology, University of Düsseldorf , Düsseldorf, Germany
| | - A Peters
- Institute for Epidemiology, Helmholtz Center Munich , Munich, Germany
- Medical Faculty, Ludwig-Maximilians-Universität München , Munich, Germany
| | - B Schmidt
- Medical Faculty, University Hospital of Essen , Essen, Germany
| | - B Bohn
- NAKO e.V. , Heidelberg, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Münster , Münster, Germany
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6
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Berger K, Rietschel M, Streit F. Depression Assessment in the German National Cohort (NAKO). Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.027] [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: 11/14/2022] Open
Abstract
Abstract
Background
The mental health status of populations (public mental health) and its effect on societies has gained considerable attention in recent years, especially during the current pandemic. The measurement of depressive symptoms is at core of the assessment of mental health. The detailedness of this assessment defines the range of public mental health problems that can be answered.
Methods
Between 2014 and 2019 the German National Cohort (NAKO) recruited 205,000 participants aged 20-70 years into the baseline examination in 18 study centers. Depression and depressive symptoms were assessed by different instruments including a lifetime diagnosis of depression and current treatment, the Major Depressive Disorder (MDD) section of the Mini-International-Neuropsychiatric-Interview (M.I.N.I. 5.0) and the depression scale of the Patient Health Questionnaire (PHQ-9). These instruments include different time periods and interpretations. Associations between these depression outcomes and age, gender and education are analysed in linear and logistic regression models.
Results
A lifetime physician's diagnosis of depression was reported by 14.7% of participants with considerable regional variation and almost 50% of this group received treatment within the last 12 months. Based on PHQ-9 7.9% of the participants were classified as depressive according to the dimensional assessment (score≥10) and 3% of them as having a major depression subtype. In contrast 32.8% screened positive based on the MINI and 15.4% of those receiving the full MINI had a diagnosis MDD. Associations with important socioeconomic determinants for these different depression outcomes will be reported.
Conclusions
The large NAKO sample size and the detailed assessment of depression symptoms and status enables the analysis of a broad range of public mental health questions. The analysis of depression frequencies and the distribution of depressive symptoms allow the establishment of population references.
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Affiliation(s)
- K Berger
- Institute of Epidemiology and Social Medicine, University of Münster , Münster, Germany
| | - M Rietschel
- Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - F Streit
- Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
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Koschig M, Conrad I, Berger K, Baune B, Grabe H, Gerstorf D, Pabst A, Riedel-Heller SG. Die mediierende Rolle der Persönlichkeit auf den Zusammenhang
zwischen frühkindlicher Traumatisierung und Depressivität im
jungen Erwachsenenalter. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753691] [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: 12/12/2022]
Affiliation(s)
- M Koschig
- Universität Leipzig, Medizinische Fakultät, Institut
für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig,
Deutschland
| | - I Conrad
- Universität Leipzig, Medizinische Fakultät, Institut
für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig,
Deutschland
| | - K Berger
- Universität Münster, Institut für Epidemiologie
und Sozialmedizin, Münster, Deutschland
| | - B Baune
- Universitätsklinikum Münster, Klinik für
Psychiatrie und Psychotherapie, Münster, Deutschland
| | - H Grabe
- Universitätsmedizin Greifswald, Klinik für Psychiatrie
und Psychotherapie, Greifswald, Deutschland
| | - D Gerstorf
- Humboldt-Universität zu Berlin, Institut für
Psychologie, Berlin, Deutschland
| | - A Pabst
- Universität Leipzig, Medizinische Fakultät, Institut
für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig,
Deutschland
| | - SG Riedel-Heller
- Universität Leipzig, Medizinische Fakultät, Institut
für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig,
Deutschland
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Bliss SN, Berger K, Thieme J, Maldonado Cobos M, Nyman M. Removal of 17α-ethynylestradiol and β-estradiol using bench-scale constructed wetlands. Water Sci Technol 2022; 85:3408-3418. [PMID: 35771054 DOI: 10.2166/wst.2022.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aquatic ecosystems have been devastated by the continued persistence of the synthetic estrogen compounds β-estradiol and 17α-ethynylestradiol. Common wastewater treatment methods do not reduce these compounds in effluent below problematic concentrations. An emerging cost-effective solution to this problem is the use of constructed wetlands to remove these estrogen compounds. This study analyzed the ability of duckweed (Lemna minor), water hyacinth (Eichhornia crassipes), and water cabbage (Pistia stratiotes) to remove β-estradiol and 17α-ethynylestradiol through the use of bench-scale constructed wetlands over a 15-week period. Estrogen concentration in water was collected over time along with plant nutrient content, contaminant extractions, and media extractions. Results indicated that estrogen concentration was reduced by the plants and soil media. Duckweed was the most effective at 96% removal, followed by water hyacinth at 72% removal, then water cabbage at 35% removal, and lastly sediment media at 9% removal. This study provides evidence for the ability of constructed wetlands to be used as a means to remove estrogen compounds from wastewater and demonstrates differences in plants removal efficiencies, with duckweed being the most effective of the selected plants.
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Affiliation(s)
- S N Bliss
- Civil and Environmental Engineering Department, Rensselaer Polytechnic Institute, 110 8th Street, Troy, New York 12180-3590, USA E-mail:
| | - K Berger
- Civil and Environmental Engineering Department, Rensselaer Polytechnic Institute, 110 8th Street, Troy, New York 12180-3590, USA E-mail:
| | - J Thieme
- Civil and Environmental Engineering Department, Rensselaer Polytechnic Institute, 110 8th Street, Troy, New York 12180-3590, USA E-mail:
| | - M Maldonado Cobos
- Civil and Environmental Engineering Department, Rensselaer Polytechnic Institute, 110 8th Street, Troy, New York 12180-3590, USA E-mail:
| | - M Nyman
- Civil and Environmental Engineering Department, Rensselaer Polytechnic Institute, 110 8th Street, Troy, New York 12180-3590, USA E-mail:
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Riedel-Heller S, Pabst A, Stein J, Grabe H, Rietschel M, Berger K. Mental Health in Individuals with a History of Mental Disorder during COVID-19-Pandemic - Preliminary Results of the National Cohort Study in Germany. Eur Psychiatry 2022. [PMCID: PMC9567180 DOI: 10.1192/j.eurpsy.2022.955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Research of COVID-19-Pandemic mental health impact focus on three groups: the general population, (2) so called vulnerable groups (e.g. individuals with mental disorders) and (3) individuals suffering COVID-19 including Long-COVID syndromes. Objectives We investigate whether individuals with a history of depression in the past, react to the COVID-19 pandemic with increased depressive symptoms. Methods Longitudinal Data stem from the NAKO-Baseline-Assessment (2014-2019, 18 study centers in Germany, representative sampled individuals from 20 to 74 years) and the subsequent NAKO-COVID-Assessment (5-11/2020). The sample for analysis comprises 115.519 individuals. History of psychiatric disorder was operationalized as lifetime self-report for physician-diagnosed depression. Depressive symptoms were measured with the PHQ 9. Results Mean age of the sample at baseline was 49.95 (SD 12.53). It comprised 51.70 women; 14 % of the individuals had a history of
physician-diagnosed depression. Considering a PHQ-Score with cut-off 10 as a clinical relevant depression, 3.65 % of the individuals without history of depression and 24.19 % of those with a history of depression were depressed at baseline. The NAKO-COVID-Assessment revealed 6.53 % depressed individuals without any history of depression and a similar rate of 23.29 % in those with history of depression. Conclusions In contrast to that what we expected, individuals with a history of a physician-diagnosed depression, did not react with increasing depressiveness during the first phase of the pandemic in Germany. Several reasons could be discussed. Whether there medium and long-term impact remains open. Disclosure No significant relationships.
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10
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George JM, Berger K, Watchmaker JM, McKinsey JF. Primary external iliac vein aneurysm with generalized venomegaly. J Vasc Surg Cases Innov Tech 2022; 8:33-34. [PMID: 35036671 PMCID: PMC8743186 DOI: 10.1016/j.jvscit.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Justin M. George
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kelsey Berger
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jennifer M. Watchmaker
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James F. McKinsey
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
- Correspondence: James F. McKinsey, MD, FACS, Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai W, 425 W 59th St, 7th Fl, New York, NY 10019
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11
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Faries CM, George JM, Berger K, Cooke PV, Tadros RO, Faries PL. Feasibility and Utility of Intracranial Imaging During Transcarotid Artery Revascularization. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2021.12.035] [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: 11/29/2022]
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Bousleiman J, Napolitano M, Tran S, Hamdani M, Faries C, Berger K, Harris J, Han D, Prakash V, Rao A, Tadros R, Vouyouka A, Marin M, Faries P. Multicenter Clinical Trial to Validate Efficacy of Sundt Carotid Shunt. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.07.032] [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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Korb M, Peck A, Berger K, James M, Ghoshal N, Healzer E, Henchcliffe C, Khan S, Mammen P, Patel S, Pfeffer G, Ralston S, Roy B, Seeley B, Swenson A, Mozaffar T, Weihl C, Kimonis V, Alfano L. REGISTRIES AND CARE OF NMD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.372] [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: 12/01/2022]
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Bousleiman J, Napolitano M, Tran S, Hamdani M, Faries CM, Berger K, Harris J, Prakash V, Rao A, Tadros R, Marin M, Faries P. Multicenter Clinical Trial to Validate Efficacy of Sundt Carotid Shunt. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Berger K, Hwang J, Bousleiman J, Gopal M, Kumar S, Ilonzo N, Vouyouka A, Marin M, Faries P, Ting W. Gender Differences in Vein Stenting. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.405] [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: 11/27/2022]
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Mörtl B, Beier D, Hasselmann K, Westphalen C, Berger K. 1518P Treating cancer with unknown primary (CUP) in Germany – an economic perspective. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.847] [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] Open
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Gopal M, Lau I, Harris J, Berger K, Faries P, Marin M, Tadros R. A Review of the Evolution of Abdominal Aortic Endografts and Future Directions. Surg Technol Int 2020; 37:193-201. [PMID: 32520385] [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: 06/11/2023]
Abstract
INTRODUCTION Over the years, endovascular aortic aneurysm repair (EVAR) has become the gold-standard of therapy for abdominal aortic aneurysm (AAA) repairs. This study aims to analyze the evolution of stent graft devices and discuss the future direction of technological development. MATERIALS AND METHODS In this paper, we will review prior eras of graft development (1992 to 2019) that included physician-made devices (era one), industry-made devices (era two), branch devices (era three), and fenestrated devices (era four). Additionally, future advancements that aim to overcome issues with short aneurysm necks, involvement of proximal visceral branches, and formation of endoleaks will be discussed. RESULTS Future devices of note include a more conformable version of the EXCLUDER® device (W. L. Gore & Associates, Inc., Newark, Delaware) to better steer the top of the graft and modify for angulated necks, a version of the Endurant® device to include EndoAnchors (Medtronic plc, Minneapolis, Minnesota) to prevent formation of endoleaks, a novel Nellix® EVAS II device (Endologix Inc., Irvine, California) with aneurysm sac filling to prevent endoleaks and exclude the aneurysm sac, and an expanded Zenith® fenestrated device (Cook Medical Inc., Bloomington, Indiana) to include more visceral branches. This is in the setting of more recent advancements like pivoting fenestrated branch devices for "off-shelf" use and aneurysm repair that now extends to the thoracic aorta. CONCLUSION With each iteration of devices, EVAR has evolved to overcome technical challenges and offer expanded applicability to different types of AAAs.
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Affiliation(s)
- Mallika Gopal
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
| | - Ignatius Lau
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
| | - Joshua Harris
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
| | - Kelsey Berger
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
| | - Peter Faries
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
| | - Michael Marin
- Division of Surgery, Mount Sinai Hospital, New York, New York
| | - Rami Tadros
- Division of Vascular Surgery, Mount Sinai Hospital, New York, New York
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Hwang S, Ramos J, Berger K, Veyg D, Kim S, Marin M, Faries P, Ting W. Long-term Outcomes After Iliocaval Venous Stenting. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.08.090] [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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Misselwitz B, Grau A, Berger K, Bruder I, Burmeister C, Hermanek P, Hohnhold R, Koennecke HC, Matthis C, Heuschmann PU. [Quality of care of acute ischemic stroke in Germany 2018]. Nervenarzt 2020; 91:484-492. [PMID: 32350547 DOI: 10.1007/s00115-020-00908-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In this overview the current quality of acute in-hospital care of stroke patients in Germany in 2018 is described based on standardized and evidence-based quality indicators. For this purpose the reports of the regional quality assurance projects for stroke care, which collaborated within the German-speaking Stroke Registers Study Group (ADSR) were analyzed. Overall, more than 280,000 acute admissions of stroke patients were documented in the included quality assurance projects. The results regarding the defined 16 quality indicators comprising diagnostics, acute treatment, rehabilitation and secondary prevention showed a high level of acute inpatient treatment of stroke in Germany. Only a few quality indicators, such as early transfer for thrombectomy indicated a great necessity for process optimization.
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Affiliation(s)
- B Misselwitz
- Geschäftsstelle Qualitätssicherung Hessen (GQH), Frankfurter Str. 10-14, 65760, Eschborn, Deutschland.
| | - A Grau
- Neurologische Klinik mit Klinischer Neurophysiologie, Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | - K Berger
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - I Bruder
- Qualitätssicherung im Gesundheitswesen Baden-Württemberg GmbH (QiG), Stuttgart, Deutschland
| | | | - P Hermanek
- Bayerische Arbeitsgemeinschaft für Qualitätssicherung in der stationären Versorgung (BAQ), München, Deutschland
| | - R Hohnhold
- Externe Qualitätssicherung (EQS), Hamburg, Deutschland
| | - H C Koennecke
- Klinik für Neurologie - Stroke Unit, Vivantes Klinikum im Friedrichshain, Berlin, Deutschland
| | - C Matthis
- Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - P U Heuschmann
- Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg, Deutschland
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Stogbauer J, Wirkner K, Engel C, Moebus S, Pundt N, Teismann H, Loffler M, Hummel T, Beule AG, Berger K. Prevalence and risk factors of smell dysfunction - a comparison between five German population-based studies. Rhinology 2020; 58:184-191. [PMID: 31693018 DOI: 10.4193/rhin19.181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prevalence of olfactory impairment increases with age and is known to be an early sign of different neurodegenerative diseases. Only few population-based studies examined the prevalence of olfactory impairment and comparisons across studies are scarce. Aim of this analysis was to compare the prevalence and determinants of normosmia across five population based studies in Germany. METHODOLOGY Data from five population-based, cross-sectional studies were included. They were independently conducted and used the same test system (Sniffin' Sticks Screening 12) to measure olfactory function. This system consists of 12 odor-dispensing felt-tip pens; the task is a forced-choice selection among four alternative odors per pen. Sociodemographic information and comorbidities were assessed in face-to-face interviews. Univariate, descriptive statistics and multivariable logistic regression models stratified by study, were performed to determine risks, i.e. prevalence odds ratios, associated with olfactory function. RESULTS The prevalence of normosmic participants varied considerably across studies. Olfactory function was lower in men, decreased with age, and increased with higher education. Several individual comorbidities and a comorbidity index were associated with olfactory dysfunction. Recognition performance for three of the 12 pens was especially low in all studies. CONCLUSION Four factors, well known to describe population composition, contribute to explain differences in the prevalence of olfactory function between studies when the same test system is used. Our results indicate that comorbidities and educational level should always be considered when test systems based on smell recognition are used in population-based studies.
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Affiliation(s)
- J Stogbauer
- Institute of Epidemiology and Social Medicine, University of Muenster, Germany
| | - K Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Germany
| | - C Engel
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Germany; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE),University of Leipzig, Germany
| | - S Moebus
- Centre for Urban Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, University Hospitals Essen, Germany
| | - N Pundt
- Centre for Urban Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, University Hospitals Essen, Germany
| | - H Teismann
- Institute of Epidemiology and Social Medicine, University of Muenster, Germany
| | - M Loffler
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Germany; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE),University of Leipzig, Germany
| | - T Hummel
- Clinic of Otorhinolaryngology, University Hospital Dresden, University of Dresden, Germany
| | - A G Beule
- Clinic of Otorhinolaryngology, University Hospital Muenster, University of Muenster, Germany; Department of Otorhinolaryngology, University Clinic Greifswald, University of Greifswald, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Germany
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Ramos J, Hwang S, Berger K, Rao A, Marin ML, Faries PL, Ting W. Iliocaval Venous Anomalies Encountered During Vein Stenting for Proximal Iliac Outflow Obstruction. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hwang S, Ramos J, Berger K, Rao A, Marin ML, Faries PL, Ting W. Peripheral Artery Disease Among Vein Stent Patients. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.04.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ilonzo N, Rao A, Berger K, Phair J, Vouyouka A, Ravin R, Han D, Finlay D, Tadros R, Marin M, Faries P. Acute thrombotic events as initial presentation of patients with COVID-19 infection. J Vasc Surg Cases Innov Tech 2020; 6:381-383. [PMID: 32704580 PMCID: PMC7297675 DOI: 10.1016/j.jvscit.2020.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/27/2020] [Indexed: 01/12/2023]
Abstract
We describe three patients with COVID-19 who presented with an acute vascular event rather than with typical respiratory symptoms. These patients were all subsequently found to have laboratory-confirmed COVID-19 infections as the likely cause of their thrombotic event. The primary presentation of COVID-19 infection as a thrombotic event rather than with respiratory symptoms has not been described elsewhere. Our cases and discussion highlight the thrombotic complications caused by COVID-19; we discuss management of these patients and explore the role of anticoagulation in patients diagnosed with COVID-19.
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Affiliation(s)
- Nicole Ilonzo
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Ajit Rao
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Kelsey Berger
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - John Phair
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Ageliki Vouyouka
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Reid Ravin
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Daniel Han
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - David Finlay
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Rami Tadros
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Michael Marin
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
| | - Peter Faries
- Division of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, New York, NY
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Berger K, Staudenmaier T, Cenzer I, Crispin A, Strobach D, Ostermann H. Epidemiology, patient adherence, and costs of oral mucositis in routine care in stem cell transplantation. Support Care Cancer 2019; 28:3113-3123. [DOI: 10.1007/s00520-019-05107-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 09/30/2019] [Indexed: 12/30/2022]
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25
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Cenzer I, Nkansah-Mahaney N, Wehner M, Chren MM, Berger T, Covinsky K, Berger K, Abuabara K, Linos E. A multiyear cross-sectional study of U.S. national prescribing patterns of first-generation sedating antihistamines in older adults with skin disease. Br J Dermatol 2019; 182:763-769. [PMID: 31021412 DOI: 10.1111/bjd.18042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND First-generation antihistamines (FGAs) are classified as 'potentially inappropriate' for use in older patients (patients aged ≥ 65 years). However, the prevalence of and factors associated with FGA prescription have not been studied. OBJECTIVES To examine FGA prescription rates for older patients who visited dermatology offices, and compare them to those for younger patients (patients aged 18-65 years) who visited dermatology offices and those for older patients who visited primary-care physicians (PCPs). METHODS This was a multiyear cross-sectional observational study using data from the U.S. National Ambulatory Medical Care Survey (2006-2015). Visits by patients aged 18 years or older were included in the study; the data comprised 15 243 dermatology office visits and 66 036 PCP office visits. The main outcome was FGA prescription. Other variables included physician specialty (dermatologist or PCP), patient's age, diagnosis of dermatological conditions and reason for visit. RESULTS For dermatology visits, the overall FGA prescription rate for older patients was similar to that for younger patients (1·5% vs. 1·2%; P = 0·19), even when the diagnosis was dermatitis or pruritus (3·7% vs. 4·8%; P = 0·21) or when itch was a complaint (7·6% vs. 6·7%; P = 0·64). However, the rate of FGA prescription for dermatology visits was lower than that for PCP visits, in analyses matched for patient and visit characteristics (3·9% vs. 7·4%; P = 0·02). CONCLUSIONS Our findings suggest that FGAs are overprescribed to older patients but that dermatologists are less likely to prescribe FGAs than PCPs. What's already known about this topic? First-generation antihistamines (FGAs) have been shown to pose substantial risks to older adults, including cognitive impairment, falls, confusion, dry mouth and constipation. Therefore, FGAs have been classified as 'potentially inappropriate' for use in older patients by the American Geriatrics Society. It has also been shown that dermatologists do not always take patient characteristics (e.g. age or life expectancy) into account when deciding on a treatment, instead following a 'one-size-fits-all' approach. What does this study add? FGAs are often prescribed during dermatology visits, and prescription rates do not differ between older and younger patients. There were no significant differences in prescription rates when comparing younger and older adults with the same diagnosis or symptom (e.g. dermatitis, pruritus or itch). FGAs are prescribed at higher rates in primary-care offices than in dermatology offices.
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Affiliation(s)
- I Cenzer
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A.,Department of Medicine III, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - N Nkansah-Mahaney
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, U.S.A
| | - M Wehner
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - M M Chren
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, U.S.A
| | - T Berger
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, CA, U.S.A
| | - K Covinsky
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A.,Veterans Affairs Medical Center, San Francisco, CA, U.S.A
| | - K Berger
- Division of Geriatrics, University of California, San Francisco, CA, U.S.A
| | - K Abuabara
- Program for Clinical Research, Department of Dermatology, University of California, San Francisco, CA, U.S.A
| | - E Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, U.S.A
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Berger K, Rhost S, Hughes E, Harrison H, Rafnsdottir S, Jacobsson H, Gregersson P, Magnusson Y, Fitzpatrick P, Andersson D, Ståhlberg A, Landberg G. Abstract P2-06-11: Sortilin targeted therapy in breast cancer with elevated progranulin expression. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-06-11] [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: 11/16/2022]
Abstract
Abstract
Background: A major challenge concerning breast cancer therapy is the occasional lack of effects using drugs that target cancer cells unspecifically. One possible explanation for this treatment failure is the existence of the small subpopulation of breast cancer stem cells that are believed to be more resistant towards conventional therapy and possesses the ability to drive tumor formation and disease progression. Cytokines secreted by nearby cells and other factors in the surrounding tumor microenvironment further stimulate the cancer cells, contributing to a heterogeneous and potentially more treatment resistant tumor. Thus, a more specific treatment approach targeting the breast cancer stem cell niche is crucial in preventing disease recurrences. In a cytokine screen, we identified progranulin as one of the main compounds secreted from cells exposed to hypoxia, leading to cancer stem cell propagation. Progranulin is involved in biological processes such as wound healing, inflammation and cancer progression. Progranulin and its receptor sortilin are known to be highly expressed in subgroups of breast cancer and are further associated with a clinically aggressive phenotype.
Methods/Results: By carrying out a number of in vitro and in vivo like screening assays, we demonstrate that progranulin influences the stem cell population in breast cancer and is responsible for spreading a cancer stem cell promoting signal to normoxic tumor areas. In breast cancer, progranulin induces a dedifferentiation process in the receiving cancer cells and expression of cancer stem cell markers together with an EMT-associated gene expression profile, leading to cancer stem cell expansion. By using siRNA and pharmacological inhibition of sortilin, we show that sortilin is a functional receptor of progranulin and is responsible for driving progranulin induced breast cancer stem cell propagation. Supporting the role of progranulin in cancer progression, administration of progranulin in immunocompromised mice induce lung metastasis in our breast cancer xenograft models. The use of different approaches for blocking sortilin, such as sortilin inhibitors, down-modulators or sortilin-targeted antibodies can prevent this dedifferentiation process, both in vitro and in vivo, making the tumor cells less aggressive and metastatic.
Conclusion: Targeting progranulin through its associated receptors is a potential therapeutic strategy for the treatment of patients with breast tumors having elevated progranulin or sortilin expression. By inhibiting the secretion based breast cancer progression, we could possibly block the formation of metastasis and cancer cell infiltration.
Citation Format: Berger K, Rhost S, Hughes E, Harrison H, Rafnsdottir S, Jacobsson H, Gregersson P, Magnusson Y, Fitzpatrick P, Andersson D, Ståhlberg A, Landberg G. Sortilin targeted therapy in breast cancer with elevated progranulin expression [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-06-11.
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Affiliation(s)
- K Berger
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - S Rhost
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - E Hughes
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - H Harrison
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - S Rafnsdottir
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - H Jacobsson
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - P Gregersson
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - Y Magnusson
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - P Fitzpatrick
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - D Andersson
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - A Ståhlberg
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
| | - G Landberg
- Institute of Biomedicine, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden; Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, United Kingdom; Shore Lab, Faculty of Life Sciences, University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom; Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academ, Göteborg, Sweden
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Lawrence KM, Berger K, Herkert L, Franciscovich C, O'Dea CLH, Waqar LN, Partridge E, Hanna BD, Peranteau WH, Avitabile CM, Hopper RK, Rintoul NE, Hedrick HL. Use of prostaglandin E1 to treat pulmonary hypertension in congenital diaphragmatic hernia. J Pediatr Surg 2019; 54:55-59. [PMID: 30442461 DOI: 10.1016/j.jpedsurg.2018.10.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND/PURPOSE Prostaglandin E1 (PGE) has been used to maintain ductus arteriosus patency and unload the suprasystemic right ventricle (RV) in neonates with congenital diaphragmatic hernia (CDH) and severe pulmonary hypertension (PH). Here we evaluate the PH response in neonates with CDH and severe PH treated with PGE. METHODS We performed a retrospective chart review of CDH infants treated at our center between 2011 and 2016. In a subset, PGE was initiated for echocardiographic evidence of severe PH, metabolic acidosis, or hypoxemia. To assess PH response, we evaluated laboratory data, including B-type natriuretic peptide (BNP) and echocardiograms before and after PGE treatment. Categorical and continuous data were analyzed with Fisher's exact tests and Mann-Whitney t-tests, respectively. RESULTS Fifty-seven infants were treated with PGE a mean 17 ± 2 days. BNP levels declined after 1.4 ± 0.2 days of treatment and again after 5.2 ± 0.6 days. After 6 ± 0.8 days of treatment, echocardiographic estimates of severe PH by tricuspid regurgitation jet velocity, ductus arteriosus direction, and ventricular septum position also improved significantly. Treatment was not associated with postductal hypoxemia or systemic hypoperfusion. CONCLUSIONS In patients with CDH and severe PH, PGE is well tolerated and associated with improved BNP and echocardiographic indices of PH, suggesting successful unloading of the RV. TYPE OF STUDY Treatment study. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Kendall M Lawrence
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kelsey Berger
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa Herkert
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christine Franciscovich
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carol Lynn H O'Dea
- Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Lindsay N Waqar
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Emily Partridge
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brian D Hanna
- Department of Pediatrics, Children's Hospital of Philadelphia; Perelman School of Medicine at the University of Pennsylvania
| | - William H Peranteau
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania
| | - Catherine M Avitabile
- Department of Pediatrics, Children's Hospital of Philadelphia; Perelman School of Medicine at the University of Pennsylvania
| | - Rachel K Hopper
- Department of Pediatrics, Lucille Packard Children's Hospital, Palo Alto, California
| | - Natalie E Rintoul
- Department of Pediatrics, Children's Hospital of Philadelphia; Perelman School of Medicine at the University of Pennsylvania
| | - Holly L Hedrick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania.
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Sundermann B, Pfleiderer B, Minnerup H, Berger K, Douaud G. Interaction of Developmental Venous Anomalies with Resting-State Functional MRI Measures. AJNR Am J Neuroradiol 2018; 39:2326-2331. [PMID: 30385467 DOI: 10.3174/ajnr.a5847] [Citation(s) in RCA: 4] [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] [Received: 05/10/2018] [Accepted: 08/25/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Functional MR imaging of the brain, used for both clinical and neuroscientific applications, relies on measuring fluctuations in blood oxygenation. Such measurements are susceptible to noise of vascular origin. The purpose of this study was to assess whether developmental venous anomalies, which are frequently observed normal variants, can bias fMRI measures by appearing as true neural signal. MATERIALS AND METHODS Large developmental venous anomalies (1 in each of 14 participants) were identified from a large neuroimaging cohort (n = 814). Resting-state fMRI data were decomposed using independent component analysis, a data-driven technique that creates distinct component maps representing aspects of either structured noise or true neural activity. We searched all independent components for maps that exhibited a spatial distribution of their signals following the topography of developmental venous anomalies. RESULTS Of the 14 developmental venous anomalies identified, 10 were clearly present in 17 fMRI independent components in total. While 9 (52.9%) of these 17 independent components were dominated by venous contributions and 2 (11.8%) by motion artifacts, 2 independent components (11.8%) showed partial neural signal contributions and 5 independent components (29.4%) unambiguously exhibited typical neural signal patterns. CONCLUSIONS Developmental venous anomalies can strongly resemble neural signal as measured by fMRI. They are thus a potential source of bias in fMRI analyses, especially when present in the cortex. This could impede interpretation of local activity in patients, such as in presurgical mapping. In scientific studies with large samples, developmental venous anomaly confounds could be mainly addressed using independent component analysis-based denoising.
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Affiliation(s)
- B Sundermann
- From the Nuffield Department of Clinical Neurosciences (B.S., G.D.), Oxford Centre for Functional MRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK .,Institute of Clinical Radiology (B.S., B.P.), Medical Faculty, University of Münster and University Hospital Münster, Münster, Germany
| | - B Pfleiderer
- Institute of Clinical Radiology (B.S., B.P.), Medical Faculty, University of Münster and University Hospital Münster, Münster, Germany
| | - H Minnerup
- Department of Epidemiology and Social Medicine (H.M., K.B.), University of Münster, Münster, Germany
| | - K Berger
- Department of Epidemiology and Social Medicine (H.M., K.B.), University of Münster, Münster, Germany
| | - G Douaud
- From the Nuffield Department of Clinical Neurosciences (B.S., G.D.), Oxford Centre for Functional MRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
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Weber R, Minnerup J, Nordmeyer H, Eyding J, Krogias C, Hadisurya J, Berger K. Thrombectomy in posterior circulation stroke: differences in procedures and outcome compared to anterior circulation stroke in the prospective multicentre REVASK registry. Eur J Neurol 2018; 26:299-305. [DOI: 10.1111/ene.13809] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022]
Affiliation(s)
- R. Weber
- Departments of Neurology; Alfried Krupp Krankenhaus Essen and Ruhr University Bochum; Bochum Germany
| | - J. Minnerup
- University Hospital Münster; Münster Germany
| | - H. Nordmeyer
- Department of Radiology and Neuroradiology; Alfried Krupp Krankenhaus Essen; Essen Germany
| | - J. Eyding
- University Hospital Knappschaftskrankenhaus Bochum and Klinikum Dortmund; Dortmund Germany
| | - C. Krogias
- University Hospital St Josef-Hospital Bochum; Bochum Germany
| | - J. Hadisurya
- Departments of Neurology; Alfried Krupp Krankenhaus Essen and Ruhr University Bochum; Bochum Germany
| | - K. Berger
- Institute of Epidemiology and Social Medicine; University of Münster; Münster Germany
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Schopohl D, Bidlingmaier C, Herzig D, Klamroth R, Kurnik K, Rublee D, Schramm W, Schwarzkopf L, Berger K. Prospects for research in haemophilia with real-world data-An analysis of German registry and secondary data. Haemophilia 2018; 24:584-594. [PMID: 29488669 DOI: 10.1111/hae.13443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/21/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIM Open questions in haemophilia, such as effectiveness of innovative therapies, clinical and patient-reported outcomes (PROs), epidemiology and cost, await answers. The aim was to identify data attributes required and investigate the availability, appropriateness and accessibility of real-world data (RWD) from German registries and secondary databases to answer the aforementioned questions. METHODS Systematic searches were conducted in BIOSIS, EMBASE and MEDLINE to identify non-commercial secondary healthcare databases and registries of patients with haemophilia (PWH). Inclusion of German patients, type of patients, data elements-stratified by use in epidemiology, safety, outcomes and health economics research-and accessibility were investigated by desk research. RESULTS Screening of 676 hits, identification of four registries [national PWH (DHR), national/international paediatric (GEPARD, PEDNET), international safety monitoring (EUHASS)] and seven national secondary databases. Access was limited to participants in three registries and to employees in one secondary database. One registry asks for PROs. Limitations of secondary databases originate from the ICD-coding system (missing: severity of haemophilia, presence of inhibitory antibodies), data protection laws and need to monitor reliability. CONCLUSION Rigorous observational analysis of German haemophilia RWD shows that there is potential to supplement current knowledge and begin to address selected policy goals. To improve the value of existing RWD, the following efforts are proposed: ethical, legal and methodological discussions on data linkage across different sources, formulation of transparent governance rules for data access, redefinition of the ICD-coding, standardized collection of outcome data and implementation of incentives for treatment centres to improve data collection.
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Affiliation(s)
- D Schopohl
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - C Bidlingmaier
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | | | - R Klamroth
- Department of Angiology and Haemostaseology, Vivantes Clinic, Berlin, Germany
| | - K Kurnik
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - D Rublee
- Independent Health Services Research, Munich, Germany
| | - W Schramm
- Rudolf-Marx-Foundation, LMU Munich, Munich, Germany
| | - L Schwarzkopf
- Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - K Berger
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
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Abstract
ZusammenfassungTrotz einer gut etablierten Dokumentation in der Qualitätssicherung der Akutbehandlung beim Krankheitsbild Schlaganfall sind Daten zur Lebensund Versorgungssituation betroffener Patienten im weiteren Verlauf nach Entlassung aus der Akuttherapie nur spärlich vorhanden. Im Qualitätssicherungsprojekt Schlaganfall Nordwestdeutschland wurde eine fragebogenbasierte Erhebung drei Monate nach Entlassung aus dem akut behandelnden Krankenhaus durchgeführt. Ziel der Studie war die Erhebung der Lebensund Versorgungssituation einschließlich der Re-Insulthäufigkeit, der Mortalität und der funktionellen Leistungsfähigkeit. 3 632 Patienten nahmen an der Follow-up-Untersuchung teil, davon hatten etwa zwei Drittel die Diagnose eines ischämischen Insultes und etwa 20% eine TIA. Die Mortalität im Zeitraum zwischen Entlassung und Follow-up lag bei 5,0% und die Re-Insulthäufigkeit bei 3,5%. Standardisierte Nachbefragung von Schlaganfallpatienten liefern wichtige Informationen zum weiteren Krankheitsverlauf, die auch für die akut behandelnde Klinik wertvolle Hinweise enthalten.
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Abstract
ZusammenfassungHintergrund: Epidemiologischen Studien zufolge erfüllen 7 bis 10% der deutschen Bevölkerung die Kriterien des Restless Legs Syndroms (RLS). Um die bisher für Deutschland berichteten Befunde auf eine sichere Datenbasis zu stellen, wurden im Rahmen einer bundesweiten Untersuchung alle in 311 Praxen der Primärversorgung an einem Stichtag vorstelligen Patienten gebeten, einen Fragebogen auszufüllen, der die essenziellen Kriterien für die Diagnose RLS sowie die Häufigkeit der Beschwerden, Angaben zu Schlafstörungen und demografische Daten erfragt. Ergebnisse: Von den 19 593 Patienten mit auswertbarem Fragebogen (90,5%) erfüllten 14,9% die vier Minimalkriterien des RLS. Die Prävalenz stieg mit dem Alter an und Frauen waren häufiger betroffen als Männer. Bei 55% der RLS-Patienten war die Schlafqualität erheblich reduziert. 31% der Betroffenen wollten die Beschwerden beim Arztbesuch von sich aus ansprechen, bei 11,6% war die RLSSymptomatik der Hauptgrund für den Arztbesuch. Schlussfolgerungen: RLS ist bei Patienten in Praxen der Primärversorgung häufig und die RLS-Prävalenz höher als in der Allgemeinbevölkerung. Insbesondere bei Patienten, die im Praxisgespräch über Schlafstörungen berichten, sollten daher gezielt die essenziellen Diagnosekriterien des RLS abgefragt werden.
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Nashef A, Qabaja R, Salaymeh Y, Botzman M, Munz M, Dommisch H, Krone B, Hoffmann P, Wellmann J, Laudes M, Berger K, Kocher T, Loos B, van der Velde N, Uitterlinden AG, de Groot LCPGM, Franke A, Offenbacher S, Lieb W, Divaris K, Mott R, Gat-Viks I, Wiess E, Schaefer A, Iraqi FA, Haddad YH. Integration of Murine and Human Studies for Mapping Periodontitis Susceptibility. J Dent Res 2018; 97:537-546. [PMID: 29294296 DOI: 10.1177/0022034517744189] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Periodontitis is one of the most common inflammatory human diseases with a strong genetic component. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWASs) of chronic periodontitis (CP) have largely been unsuccessful in identifying common susceptibility factors. A combination of quantitative trait loci (QTL) mapping in mice with association studies in humans has the potential to discover novel risk loci. To this end, we assessed alveolar bone loss in response to experimental periodontal infection in 25 lines (286 mice) from the Collaborative Cross (CC) mouse population using micro-computed tomography (µCT) analysis. The orthologous human chromosomal regions of the significant QTL were analyzed for association using imputed genotype data (OmniExpress BeadChip arrays) derived from case-control samples of aggressive periodontitis (AgP; 896 cases, 7,104 controls) and chronic periodontitis (CP; 2,746 cases, 1,864 controls) of northwest European and European American descent, respectively. In the mouse genome, QTL mapping revealed 2 significant loci (-log P = 5.3; false discovery rate = 0.06) on chromosomes 1 ( Perio3) and 14 ( Perio4). The mapping resolution ranged from ~1.5 to 3 Mb. Perio3 overlaps with a previously reported QTL associated with residual bone volume in F2 cross and includes the murine gene Ccdc121. Its human orthologue showed previously a nominal significant association with CP in humans. Use of variation data from the genomes of the CC founder strains further refined the QTL and suggested 7 candidate genes ( CAPN8, DUSP23, PCDH17, SNORA17, PCDH9, LECT1, and LECT2). We found no evidence of association of these candidates with the human orthologues. In conclusion, the CC populations enabled mapping of confined QTL that confer susceptibility to alveolar bone loss in mice and larger human phenotype-genotype samples and additional expression data from gingival tissues are likely required to identify true positive signals.
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Affiliation(s)
- A Nashef
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - R Qabaja
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - Y Salaymeh
- 2 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Botzman
- 3 Department of Cell Research and Immunology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - M Munz
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
- 5 Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein-Campus, Lübeck, Germany
| | - H Dommisch
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - B Krone
- 6 Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen, Germany
| | - P Hoffmann
- 7 Institute of Human Genetics, University of Bonn, Bonn, Germany
- 8 Germany und Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - J Wellmann
- 9 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - M Laudes
- 10 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - K Berger
- 9 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T Kocher
- 11 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - B Loos
- 12 Department of Periodontology and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - N van der Velde
- 13 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
- 14 Department of Internal Medicine Section of Geriatrics, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - A G Uitterlinden
- 13 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - L C P G M de Groot
- 15 Department of Epidemiology and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - A Franke
- 16 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - S Offenbacher
- 17 School of Dentistry, Department of Periodontology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - W Lieb
- 18 Institute of Epidemiology, Biobank popgen, Christian-Albrechts-University, Kiel, Germany
| | - K Divaris
- 19 Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
- 20 School of Dentistry, Department of Pediatric Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - R Mott
- 21 Genetics Institute, University Collage of London, London, UK
| | - I Gat-Viks
- 3 Department of Cell Research and Immunology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - E Wiess
- 22 Maurice and Gabriella Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Schaefer
- 4 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - F A Iraqi
- 2 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y H Haddad
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
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Eheberg D, Oldenburg J, Tiede A, Schramm W, Berger K, Schopohl D. Prophylaktische Faktorsubstitution bei schwerer Hämophilie A. Hamostaseologie 2017; 34:291-300. [DOI: 10.5482/hamo-14-03-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 08/12/2014] [Indexed: 11/05/2022] Open
Abstract
ZusammenfassungProphylaxe kann bei Erwachsenen mit schwerer Hämophilie A klinisch notwendig sein. Ziel war es, die prophylaktische Faktor-VIII-Substitution bei erwachsenen Patienten mit Hämophilie in Deutschland ökonomisch zu bewerten. Patienten, Methoden: Für die Analysen wurde ein Entscheidungsmodell erstellt: Zeithorizont ein Jahr; Perspektive gesetzliche Krankenkassen; Referenzpatient (RP) und zwei Patientenprofile. Die Berech-nungen basieren auf Daten aus einer struktu-rierten Literatursuche, -analyse und einer Pharmakovigilanzstudie mit Patienten zu Therapiewechsel On-demand/Prophylaxe (OD/Proph). Ergebnisse: RP: 45 Jahre, 20 Blutungen p.a. OD, 16 vermiedene Blutungen mit 8,5 I.U./kg/d Proph, Zusatzkosten 141 113 Euro p.a.; Profil 1: 50 Jahre, 55 Blutungen p.a. OD, Faktorverbrauch pro Blutung 20 I.U./kg höher als bei R P, 39 vermiedene Blutungen mit 8,5 I.U./kg/d Proph, Zusatzkosten 19 134 Euro p.a.; Profil 2: 60 Jahre, 35 Blutungen p.a. OD, Faktorverbrauch pro Blutung 40–80 I.U./kg höher als bei R P, 34 vermiedene Blutungen mit 11 I.U./kg/d Proph, Einsparung 660 Euro p.a. Schlussfolgerung: In der indivi-duellen Situation kann eine prophylaktische Faktorsubstitution bei erwachsenen Patienten auch ökonomisch sinnvoll sein. Um künftig diesen Effekt umfassend zu bewerten, werden longitudinale Daten aus dem Versorgungsalltag inklusive klinischer Outcomes, Lebensqua-lität und Adhärenz benötigt.
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Szentkirályi A, Stefani A, Hackner H, Czira M, Stubbe B, Völzke H, Ewert R, Gläser S, Penzel T, Fietze I, Young P, Högl B, Berger K. Prevalence and correlates of periodic limb movement in sleep in two German population-based studies. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rahe C, Nauck M, Berger K. Zusammenhang zwischen Depression und Diabetes mellitus Typ 2 unter Berücksichtigung des Erkrankungsschweregrads der Depression. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605828] [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: 10/18/2022]
Affiliation(s)
- C Rahe
- Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg
| | - M Nauck
- Universitätsmedizin Greifswald, Institut für Klinische Chemie und Laboratoriumsmedizin, Greifswald
| | - K Berger
- Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg
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Cole JCM, Olkkola M, Zarrin HE, Berger K, Moldenhauer JS. Universal Postpartum Mental Health Screening for Parents of Newborns With Prenatally Diagnosed Birth Defects. J Obstet Gynecol Neonatal Nurs 2017. [PMID: 28646642 DOI: 10.1016/j.jogn.2017.04.131] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe the implementation of a nurse-led project to screen parents for depression and traumatic stress in the postpartum period after visiting their newborns in the NICU. DESIGN A standardized universal mental health postpartum screening and referral protocol was developed for parents of high-risk neonates. SETTING/LOCAL PROBLEM The project occurred at the Garbose Family Special Delivery Unit, the world's first obstetrics unit housed within a pediatric hospital serving healthy women who give birth to newborns with prenatally diagnosed fetal anomalies. Parents of neonates admitted to the NICU are at greater risk to develop postpartum psychological distress; therefore, early identification is critical. PATIENTS A total of 1,327 participants were screened, including 725 women who gave birth to live newborns at the Garbose Family Special Delivery Unit and 602 fathers. INTERVENTION/MEASUREMENTS Obstetric nurses asked parents to complete a screening tool that assessed their psychological risk in the postpartum period. A system for mental health triage and referral was available for parents with elevated scores. RESULTS Overall monthly screening procedure compliance rates were high (96.5% mothers and 79.6% fathers). Women (5.5%, n = 40) and men (5.5%, n = 33) showed high risk for traumatic stress, and 35.9% (n = 260) of women and 9.5% (n = 57) of men showed elevated risk for major depression in the imediate postpartum period. CONCLUSION Incorporating the screening process into routine nursing practice with immediate mental health triage and referral made the program feasible. The risk factors identified add to the growing knowledge about parents of newborns in the NICU.
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Szentkirályi A, Völzke H, Hoffmann W, Dörr M, Hense HW, Berger K. Ankle-brachial index and peripheral artery disease are not related to restless legs syndrome. Sleep Med 2017; 35:74-79. [PMID: 28619186 DOI: 10.1016/j.sleep.2017.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Our aim was to investigate the relationship between impaired peripheral arterial circulation as measured by ankle-brachial index (ABI) and restless legs syndrome (RLS) in the general population. METHODS Data are derived from three independent, German population-based, prospective studies: the control sample of BiDirect (N = 966), the second follow-up of SHIP (N = 2333), and a subsample of SHIP-Trend (N = 1269). RLS was assessed with questions based on the RLS minimal criteria. ABI was measured with an automated method in BiDirect and with Doppler ultrasound in both SHIP studies. An ABI score below 0.9 was indicative of peripheral arterial disease (PAD). Co-morbidities, medications and behavioural factors were self-reported. Additional measurements included body mass index and haemoglobin from blood serum. For BiDirect, a follow-up with identical methodology was performed after a median of 2.5 years. RESULTS In cross-sectional analyses, decreased ABI was not significantly associated with RLS as outcome in multivariable logistic regression models adjusted for several potential confounders (BiDirect: odds ratio (OR) = 1.07 for a -0.1 change in ABI, 95% confidence interval (CI): 0.81-1.42, p = 0.62; SHIP-2: OR = 0.99, CI: 0.85-1.16, p = 0.94; SHIP-Trend: OR = 0.99, CI: 0.87-1.13, p = 0.88). Similar non-significant results were achieved using PAD (instead of ABI) as an independent variable. In BiDirect, baseline ABI was not a significant predictor of incident RLS in longitudinal analysis (OR = 0.77, CI: 0.53-1.12, p = 0.17). CONCLUSION Results from three independent studies suggest that reduced ABI is not a risk factor for RLS in the general population.
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Affiliation(s)
- A Szentkirályi
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Germany.
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Germany
| | - W Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Germany; German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - M Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Germany
| | - H W Hense
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster, Germany; German Centre for Diabetes Research, Partner Site Münster, Germany
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Shusterman A, Munz M, Richter G, Jepsen S, Lieb W, Krone B, Hoffman P, Laudes M, Wellmann J, Berger K, Kocher T, Offenbacher S, Divaris K, Franke A, Schreiber S, Dommisch H, Weiss E, Schaefer AS, Houri-Haddad Y, Iraqi FA. The PF4/PPBP/CXCL5 Gene Cluster Is Associated with Periodontitis. J Dent Res 2017; 96:945-952. [PMID: 28467728 DOI: 10.1177/0022034517706311] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Periodontitis is a common dysbiotic inflammatory disease with an estimated heritability of 50%. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWAS) of chronic periodontitis (CP) have been unsuccessful in discovering susceptibility factors. A strategy that combines agnostic GWAS with a well-powered candidate-gene approach has the potential to discover novel loci. We combined RNA-seq data from gingival tissues with quantitative trait loci (QTLs) that were identified in a F2-cross of mice resistant and susceptible to infection with oral bacterial pathogens. Four genes, which were located within the mapped QTLs, showed differential expression. The chromosomal regions across the human orthologous were interrogated for putative periodontitis-associated variants using existing GWAS data from a German case-control sample of aggressive periodontitis (AgP; 651 cases, 4,001 controls), the most severe and early onset form of periodontitis. Two haplotype blocks, one upstream to the coding region of UGT2A1 (rs146712414, P = 9.1 × 10-5; odds ratio [OR], 1.34; 95% confidence interval [CI], 1.16-1.56) and one downstream of the genes PF4/PPBP/CXCL5 (rs1595009, P = 1.3 × 10-4; OR, 1.32; 95% CI, 1.15-1.52), were associated with AgP. The association of rs1595009 was validated in an independent cohort of CP of European Americans (1,961 cases and 1,864 controls; P = 0.03; OR, 1.45; 95% CI, 1.01-1.29). This association was further replicated in another sample of 399 German CP cases (disease onset <60 y of age) and 1,633 controls ( P = 0.03; OR, 1.75; 95% CI, 1.06-2.90). The combined estimates of association from all samples were P = 2.9 × 10-5 (OR, 1.2; 95% CI, 1.1-1.3). This study shows the strength of combining QTL mapping and RNA-Seq data from a mouse model with association studies in human case-control samples to identify genetic risk variants of periodontitis.
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Affiliation(s)
- A Shusterman
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - M Munz
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
- 3 Institute for Integrative and Experimental Genomics, University Medical Center Schleswig-Holstein-Campus Lübeck, Lübeck, Germany
| | - G Richter
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - S Jepsen
- 4 Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - W Lieb
- 5 Institute of Epidemiology, Biobank popgen, Christian-Albrechts-University, Kiel, Germany
| | - B Krone
- 6 Institute of Medical Informatics, Biometry and Epidemiology, University Clinic Essen, Essen, Germany
| | - P Hoffman
- 7 Institute of Human Genetics, University of Bonn, Bonn, Germany
- 8 Germany und Human Genomics Research Group, Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - M Laudes
- 9 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
| | - J Wellmann
- 10 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - K Berger
- 10 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T Kocher
- 11 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - S Offenbacher
- 12 University of North Carolina-Chapel Hill, School of Dentistry, Department of Periodontology, Chapel Hill, NC, USA
| | - K Divaris
- 13 University of North Carolina-Chapel Hill, School of Dentistry, Department of Pediatric Dentistry, Chapel Hill, NC, USA
- 14 University of North Carolina-Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - A Franke
- 15 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - S Schreiber
- 9 Clinic of Internal Medicine, University Clinic Schleswig-Holstein, Kiel, Germany
- 15 Institute of Clinical Molecular Biology, Christian-Albrechts-University, Kiel, Germany
| | - H Dommisch
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - E Weiss
- 16 Maurice and Gabriella Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A S Schaefer
- 2 Department of Periodontology and Synoptic Medicine, Institute for Dental and Craniofacial Sciences, Charité-University Medicine Berlin, Berlin, Germany
| | - Y Houri-Haddad
- 1 Department of Prosthodontics, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel
| | - F A Iraqi
- 17 Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Opel N, Redlich R, Kaehler C, Grotegerd D, Dohm K, Heindel W, Kugel H, Thalamuthu A, Koutsouleris N, Arolt V, Teuber A, Wersching H, Baune BT, Berger K, Dannlowski U. Prefrontal gray matter volume mediates genetic risks for obesity. Mol Psychiatry 2017; 22:703-710. [PMID: 28348383 DOI: 10.1038/mp.2017.51] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [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: 10/19/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 12/18/2022]
Abstract
Genetic and neuroimaging research has identified neurobiological correlates of obesity. However, evidence for an integrated model of genetic risk and brain structural alterations in the pathophysiology of obesity is still absent. Here we investigated the relationship between polygenic risk for obesity, gray matter structure and body mass index (BMI) by the use of univariate and multivariate analyses in two large, independent cohorts (n=330 and n=347). Higher BMI and higher polygenic risk for obesity were significantly associated with medial prefrontal gray matter decrease, and prefrontal gray matter was further shown to significantly mediate the effect of polygenic risk for obesity on BMI in both samples. Building on this, the successful individualized prediction of BMI by means of multivariate pattern classification algorithms trained on whole-brain imaging data and external validations in the second cohort points to potential clinical applications of this imaging trait marker.
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Affiliation(s)
- N Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - C Kaehler
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - K Dohm
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - A Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - N Koutsouleris
- Department of Psychiatry, University of Munich, Munich, Germany
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - A Teuber
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - H Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - B T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
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Berger K, Schopohl D, Lowe G, Holme PA, Tait RC, Combescure C, Rauchensteiner S, Klamroth R. How to compare cardiovascular disease and risk factors in elderly patients with haemophilia with the general population. Haemophilia 2016; 22:e406-16. [DOI: 10.1111/hae.13069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 12/13/2022]
Affiliation(s)
- K. Berger
- Department of Haematology/Oncology; University Hospital of Munich; Munich Germany
| | - D. Schopohl
- Department of Haematology/Oncology; University Hospital of Munich; Munich Germany
| | - G. Lowe
- Haemophilia Centre; Glasgow UK
- Royal Infirmary; Glasgow UK
| | - P. A. Holme
- Department of Haematology; Oslo University Hospital and Institute of Clinical Medicine University of Oslo; Oslo Norway
| | - R. C. Tait
- Haemophilia Centre; Glasgow UK
- Royal Infirmary; Glasgow UK
| | - C. Combescure
- University Hospital and Faculty of Medicine of Geneva; Geneva Switzerland
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Fischer K, Poonnoose P, Dunn AL, Babyn P, Manco-Johnson MJ, David JA, van der Net J, Feldman B, Berger K, Carcao M, de Kleijn P, Silva M, Hilliard P, Doria A, Srivastava A, Blanchette V. Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective. Haemophilia 2016; 23:11-24. [DOI: 10.1111/hae.13088] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 01/23/2023]
Affiliation(s)
- K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - P. Poonnoose
- Department of Orthopaedics; Christian Medical College; Vellore Tamil Nadu India
| | - A. L. Dunn
- Division of Hematology and Oncology; Nationwide Children's Hospital and The Ohio State University; Columbus OH USA
| | - P. Babyn
- Department of Medical Imaging; University of Saskatchewan and Saskatoon Health Region Royal University Hospital; Saskatoon SK Canada
| | - M. J. Manco-Johnson
- Section of Hematology/Oncology/Bone Marrow Transplantation; Department of Pediatrics; University of Colorado Anschutz Medical Campus and Children's Hospital; Aurora CO USA
| | - J. A. David
- Department of PMR; Christian Medical College; Vellore Tamil Nadu India
| | - J. van der Net
- Child Health Services; Child Development and Exercise Center; University Medical Center and Children's Hospital; Utrecht The Netherlands
| | - B. Feldman
- Division of Rheumatology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - K. Berger
- Division of Haematology/Oncology; University Hospital of Munich; Munich Germany
| | - M. Carcao
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - P. de Kleijn
- Department of Rehabilitation, Nursing Science and Sports, and Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - M. Silva
- Department of Orthopaedic Surgery; Orthopaedic Institute for Children; David Geffen School of Medicine at UCLA; Los Angeles CA USA
| | - P. Hilliard
- Department of Rehabilitation; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Doria
- Department of Diagnostic Imaging; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - V. Blanchette
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
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Abstract
This population-based cross-sectional study examined the 3-month prevalence of headache, migraine and tension-type headache (TTH) among adolescents aged 12-15 years in Germany Students ( n = 3324) from 20 schools completed a questionnaire on general and headache-specific pain which included a sociodemographic module. The headache-specific questionnaire complied with the respective revised criteria of the International Headache Society (IHS). 'Modified criteria' changed the item 'duration' in migraine (>30 min instead of >4 h). The overall 3-month prevalence of headache was 69.4% (boys 59.5%, girls 78.9%), with 4.4% of the adolescents suffering from frequent (≥ 14 days/3 months) and severe (grade 8-10 on a 10-point visual analogue scale) headache and 1.4% (boys 0.9%, girls 1.9%) from headache ≥15 days/month. The 3-month prevalence of migraine was 2.6% (boys 1.6%, girls 3.5%) applying strict IHS criteria and 6.9% (boys 4.4%, girls 9.3%) with modified criteria; 12.6% (boys 8.3%, girls 16.7%) suffered from probable migraine, 0.07% fulfilled the criteria for chronic migraine, 4.5% (boys 4.6%, girls 4.3%) suffered from TTH, 0.2% from chronic TTH and 15.7% (boys 14.5%, girls 16.9%) from probable TTH. Headache and migraine were more common in girls than in boys and in teenagers, especially in girls, aiming at higher education. Recurrent headache and primary headache disorders are common complaints among German adolescents, especially among girls.
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Affiliation(s)
- K Fendrich
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University of Greifswald, Greifswald, Germany
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Demirkan A, Lahti J, Direk N, Viktorin A, Lunetta KL, Terracciano A, Nalls MA, Tanaka T, Hek K, Fornage M, Wellmann J, Cornelis MC, Ollila HM, Yu L, Smith JA, Pilling LC, Isaacs A, Palotie A, Zhuang WV, Zonderman A, Faul JD, Sutin A, Meirelles O, Mulas A, Hofman A, Uitterlinden A, Rivadeneira F, Perola M, Zhao W, Salomaa V, Yaffe K, Luik AI, Liu Y, Ding J, Lichtenstein P, Landén M, Widen E, Weir DR, Llewellyn DJ, Murray A, Kardia SLR, Eriksson JG, Koenen K, Magnusson PKE, Ferrucci L, Mosley TH, Cucca F, Oostra BA, Bennett DA, Paunio T, Berger K, Harris TB, Pedersen NL, Murabito JM, Tiemeier H, van Duijn CM, Räikkönen K. Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: a meta-analysis of genome-wide association studies. Psychol Med 2016; 46:1613-1623. [PMID: 26997408 PMCID: PMC5812462 DOI: 10.1017/s0033291715002081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains. METHOD We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons). RESULTS One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (p discovery = 3.82 × 10-8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (p discovery+replication = 1.10 × 10-6) with evidence of heterogeneity. CONCLUSIONS Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.
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Affiliation(s)
- A. Demirkan
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - J. Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - N. Direk
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - A. Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - K. L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - A. Terracciano
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
- College of Medicine, Florida State University, Tallahassee, FL, USA
| | - M. A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - T. Tanaka
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - K. Hek
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC, Rotterdam, The Netherlands
| | - M. Fornage
- Houston Institute of Molecular Medicine, University of Texas, Houston, TX, USA
| | - J. Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - M. C. Cornelis
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - H. M. Ollila
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - L. Yu
- Department of Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - J. A. Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | | | - A. Isaacs
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - A. Palotie
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, UK
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - W. V. Zhuang
- Department of Preventive Medicine and Public Health, School of Medicine, Creighton University, Omaha, NE, USA
| | - A. Zonderman
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - J. D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - A. Sutin
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - O. Meirelles
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - A. Mulas
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Cagliari, Italy
| | - A. Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - A. Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - F. Rivadeneira
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - M. Perola
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - W. Zhao
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - V. Salomaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - K. Yaffe
- Departments of Psychiatry, University of California, San Francisco, CA, USA
| | - A. I. Luik
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - NABEC
- North American Brain Expression Consortium, USA
| | - UKBEC
- UK Brain Expression Consortium, UK
| | - Y. Liu
- Center for Human Genomics, Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - J. Ding
- Geriatrics & Gerontology, Sticht Center on Aging, Wake Forest University, Primate Center, Epidemiology & Prevention, Winston-Salem, NC, USA
| | - P. Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - M. Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - E. Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - D. R. Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - A. Murray
- University of Exeter Medical School, Exeter, UK
| | - S. L. R. Kardia
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - J. G. Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - K. Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - P. K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - L. Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - T. H. Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - F. Cucca
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, Cagliari, Italy
| | - B. A. Oostra
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - D. A. Bennett
- Department of Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - T. Paunio
- Public Health Genomics Unit and Institute for Molecular Medicine Finland (FIMM), National Institute for Health and Welfare, Helsinki, Finland
| | - K. Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - T. B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Ageing, National Institutes of Health, Bethesda, MD, USA
| | - N. L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - J. M. Murabito
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - H. Tiemeier
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - C. M. van Duijn
- Genetic Epidemiology Unit, Departments of Epidemiology and Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Member of Netherlands Consortium for Healthy Aging sponsored by Netherlands Genomics Initiative, Leiden, The Netherlands
| | - K. Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
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Cole JCM, Moldenhauer JS, Berger K, Cary MS, Smith H, Martino V, Rendon N, Howell LJ. Identifying expectant parents at risk for psychological distress in response to a confirmed fetal abnormality. Arch Womens Ment Health 2016; 19:443-53. [PMID: 26392365 DOI: 10.1007/s00737-015-0580-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 09/14/2015] [Indexed: 11/25/2022]
Abstract
The aim of the study was to determine the incidence of psychological distress among expectant women carrying fetuses with prenatal diagnosed abnormalities and their partners. A 2-year retrospective medical chart review was completed of 1032 expectant mothers carrying fetuses with a confirmed anomaly, and 788 expectant fathers, who completed the CFDT Mental Health Screening Tool. Furthermore, 19.3 % of women and 13.1 % of men reported significant post-traumatic stress symptoms, and 14 % of men and 23 % of women scored positive for a major depressive disorder. Higher risk was noted among expectant parents of younger age and minority racial/ethnic status, and women with post-college level education and current or prior use of antidepressant medications. Heightened distress was noted within fetal diagnostic subgroups including neck masses, sacrococcygeal teratomas, neurological defects, and miscellaneous diagnoses. Incorporating screening tools into prenatal practice can help clinicians better identify the potential risk for psychological distress among expectant parents within high-risk fetal settings.
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Affiliation(s)
- Joanna C M Cole
- Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Julie S Moldenhauer
- Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Kelsey Berger
- Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA, 19129, USA
| | - Mark S Cary
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 518 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Haley Smith
- Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Victoria Martino
- Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA, 19129, USA
| | - Norma Rendon
- Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Lori J Howell
- Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Philadelphia, PA, 19104, USA
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Müller G, Wellmann J, Hartwig S, Greiser KH, Moebus S, Jöckel KH, Schipf S, Völzke H, Maier W, Meisinger C, Tamayo T, Rathmann W, Berger K. Association of neighbourhood unemployment rate with incident Type 2 diabetes mellitus in five German regions. Diabet Med 2015; 32:1017-22. [PMID: 25440771 DOI: 10.1111/dme.12652] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 01/28/2023]
Abstract
AIM To analyse the association of neighbourhood unemployment with incident self-reported physician-diagnosed Type 2 diabetes in a population aged 45-74 years from five German regions. METHODS Study participants were linked via their addresses at baseline to particular neighbourhoods. Individual-level data from five population-based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self-reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval-censoring and clustering. RESULTS We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person-years (95% CI 11.4-13.8). The risk of Type 2 diabetes mellitus was higher in men [hazard ratio 1.79 (95% CI 1.47-2.18)] than in women and higher in people with a low education level [hazard ratio 1.55 (95% CI 1.18-2.02)] than in those with a high education level. Independently of individual-level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment [quintile 5; hazard ratio 1.72 (95% CI 1.23-2.42)] than in neighbourhoods with low unemployment (quintile 1). CONCLUSIONS Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high-risk populations.
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Affiliation(s)
- G Müller
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - J Wellmann
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - S Hartwig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - K H Greiser
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - S Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - K-H Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - S Schipf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre of Cardiovascular Research, Site Greifswald, Germany
| | - W Maier
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - C Meisinger
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - T Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - W Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
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Cole JC, Olkkola M, Lynch KS, Berger K, Moldenhauer J, Howell L. Implementation of Universal Postpartum Screening on a High‐Risk L&D Unit Specializing in Delivering Babies with Birth Defects. J Obstet Gynecol Neonatal Nurs 2015. [DOI: 10.1111/1552-6909.12638] [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: 11/29/2022] Open
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Berger K, Francony G, Bouzat P, Halle C, Genty C, Oddoux M, Gay E, Albaladejo P, Payen JF. Prone position affects stroke volume variation performance in predicting fluid responsiveness in neurosurgical patients. Minerva Anestesiol 2015; 81:628-635. [PMID: 25263024] [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: 06/03/2023]
Abstract
BACKGROUND Stroke volume variation (SVV) during mechanical ventilation predicts preload responsiveness. We hypothesized that the prone position would alter the performance of this dynamic indicator. METHODS Two parallel groups of ventilated neurosurgical patients with low tidal volume (6-8 ml.kg-1) were studied before surgical incision. SVV was measured at T0, T15 and T30 min during a fluid volume expansion (250 mL hetastarch 6% over 30 min) with patients in either the supine (N.=29; Supine group) or prone position (N.=23; Prone group). Fluid responsiveness was defined as an increase in the stroke volume index (SVI) of ≥20% at T30. Receiver-operating characteristics (ROC) curves were generated for SVV. RESULTS Prone positioning significantly increased SVV. Volume expansion in the Prone group increased SVI but led to a decline in SVV from 16% (12-22; median, 25-75th percentile) at T0 to 9% (8-13%) at T30. These effects on SVI and SVV were more pronounced compared to those obtained in the Supine group (P ≤0.05). Fluid responsiveness was predicted by SVV >12% at T0 (sensitivity 88%, specificity 62%) in the Supine group. In the Prone group, the area under the ROC curve of SVV (0.53; 95% confidence interval 0.27-0.79) did not allow the determination of a threshold SVV value. CONCLUSION In ventilated patients with low tidal volume, a prone position may have a direct effect on the heart that alters the performance of SVV in predicting fluid responsiveness. External factor such as prone position renders difficult the interpretation of SVV as a dynamic indicator of cardiac preload.
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Affiliation(s)
- K Berger
- Department of Anesthesia and Critical Care, Michallon Hospital, and Joseph Fourier University, Grenoble, France -
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Heyman‐Lindén L, Kotowska D, Sand E, Holm C, Fåk F, Berger K. Lingonberries have Anti‐obesity Effects and Modulate the Gut Microbiota in High‐fat Fed C57BL/6J Mice. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.385.6] [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: 11/11/2022]
Affiliation(s)
| | - D Kotowska
- Experimental Medical Science Lund University LundSweden
| | - E Sand
- Experimental Medical Science Lund University LundSweden
| | - C Holm
- Experimental Medical Science Lund University LundSweden
| | - F Fåk
- Food Technology Lund University LundSweden
| | - K Berger
- Experimental Medical Science Lund University LundSweden
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Schunk M, Reitmeir P, Schipf S, Völzke H, Meisinger C, Ladwig KH, Kluttig A, Greiser KH, Berger K, Müller G, Ellert U, Neuhauser H, Tamayo T, Rathmann W, Holle R. Health-related quality of life in women and men with type 2 diabetes: a comparison across treatment groups. J Diabetes Complications 2015; 29:203-11. [PMID: 25499244 DOI: 10.1016/j.jdiacomp.2014.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/11/2014] [Accepted: 11/17/2014] [Indexed: 01/14/2023]
Abstract
AIM This study compares health-related quality of life (HRQL) in patients with type 2 diabetes (T2DM) across treatment groups and explores gender differences. METHODS Four regional surveys (KORA, CARLA, SHIP, DHS) and a national survey (GNHIES98) were pooled at individual level. HRQL was assessed with the SF-12/-36v1. Linear regression models were used to assess the effect of T2DM by treatment type (no medication; oral; oral/insulin combination; insulin) on the physical (PCS-12) and mental summary score (MCS-12) and the SF-6D, controlling for age, sex, study and covariates. We also performed an explanatory analysis of single items. RESULTS PCS-12 scores and treatment type were associated (P-value 0.006), with lowest values for insulin treatment (-4.44 vs. oral; -4.41 vs. combination). MCS-12 scores were associated with treatment type and gender (P-value <0.012), with lower scores for women undergoing oral (-4.25 vs. men) and combination treatment (-6.99 vs. men). Similar results were observed for SF-6D utilities and single items, related to mental health, social functioning, vitality and role limitation (emotional). Comorbidities were predictors of lower PCS-12 and SF-6D scores. CONCLUSIONS T2DM treatment impacts differently on physical and mental HRQL and on women and men. Further studies of gender-specific perceptions of T2DM treatment regimens are needed.
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Affiliation(s)
- M Schunk
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - P Reitmeir
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - S Schipf
- Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany
| | - C Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - K-H Ladwig
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - A Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - K H Greiser
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany; German Cancer Research Centre, Division of Cancer Epidemiology, Heidelberg, Germany
| | - K Berger
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - G Müller
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - U Ellert
- Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Germany
| | - H Neuhauser
- Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Germany
| | - T Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - W Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - R Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
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