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Xie Y, Reid CM, Granados AA, Garcia MT, Dale-Huang F, Hanson SM, Mancia W, Liu J, Adam M, Mosto O, Pisco AO, Alvarez-Buylla A, Harwell CC. Developmental origin and local signals cooperate to determine septal astrocyte identity. bioRxiv 2023:2023.10.08.561428. [PMID: 37873089 PMCID: PMC10592657 DOI: 10.1101/2023.10.08.561428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Astrocyte specification during development is influenced by both intrinsic and extrinsic factors, but the precise contribution of each remains poorly understood. Here we show that septal astrocytes from Nkx2.1 and Zic4 expressing progenitor zones are allocated into non-overlapping domains of the medial (MS) and lateral septal nuclei (LS) respectively. Astrocytes in these areas exhibit distinctive molecular and morphological features tailored to the unique cellular and synaptic circuit environment of each nucleus. Using single-nucleus (sn) RNA sequencing, we trace the developmental trajectories of cells in the septum and find that neurons and astrocytes undergo region and developmental stage-specific local cell-cell interactions. We show that expression of the classic morphogens Sonic hedgehog (Shh) and Fibroblast growth factors (Fgfs) by MS and LS neurons respectively, functions to promote the molecular specification of local astrocytes in each region. Finally, using heterotopic cell transplantation, we show that both morphological and molecular specifications of septal astrocytes are highly dependent on the local microenvironment, regardless of developmental origins. Our data highlights the complex interplay between intrinsic and extrinsic factors shaping astrocyte identities and illustrates the importance of the local environment in determining astrocyte functional specialization.
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Affiliation(s)
- Yajun Xie
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
| | - Christopher M. Reid
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
- Department of Neurobiology, Harvard Medical School, Boston, MA
- Ph.D. Program in Neuroscience, Harvard University, Boston, MA
| | | | - Miguel Turrero Garcia
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
| | - Fiona Dale-Huang
- Department of Neurology, University of California, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, CA
| | - Sarah M. Hanson
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
| | - Walter Mancia
- Department of Neurology, University of California, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, CA
| | - Jonathan Liu
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
| | - Manal Adam
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
| | - Olivia Mosto
- Department of Neurobiology, Harvard Medical School, Boston, MA
| | | | - Arturo Alvarez-Buylla
- Department of Neurology, University of California, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, CA
| | - Corey C. Harwell
- Department of Neurology, University of California, San Francisco, CA
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, San Francisco, CA
- Chan Zuckerberg Biohub San Francisco, San Francisco, CA
- Lead contact
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2
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Supady A, Nguyen K, Aziz MAE, Überreiter C, Bärnighausen T, Adam M. A short, animated storytelling video about sodium intake as a major cardiovascular risk factor and recommendations for a healthy diet: an online, randomized, controlled trial. Trials 2023; 24:390. [PMID: 37296468 DOI: 10.1186/s13063-023-07418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Increased uptake of sodium is a major cause for cardiovascular disease and mortality. Reduction of daily salt intake below a reference level of 2 g per day (the equivalent to 5 g salt/day) is known to effectively reduce cardiovascular mortality. The widespread use of social media, with a constant increase in video consumption, is opening new avenues for the dissemination of innovative and scalable approaches to health-related information and recommendations for a healthy diet, such as via video interventions with short animated stories (SAS). OBJECTIVE This study will evaluate the effect of a sodium intake-SAS video intervention on immediate and medium-term knowledge about dietary sodium. Beyond that, immediate and medium-term effects on behavioral expectation to reduce sodium intake as well as voluntary post-trial engagement with the video content will be examined. METHODS In this 4-armed, parallel, randomized controlled trial, 10,000 adult, US participants will be randomly assigned to (1) a short, animated storytelling intervention video on sodium as a cardiovascular disease risk factor followed by surveys assessing the facts on sodium and cardiovascular disease conveyed in the video (2) the surveys only, (3) an attention placebo control video followed by the before mentioned surveys, and (4) an arm that is exposed to neither the video nor the surveys. Two weeks later, participants in all four arms will complete all of the surveys. RESULTS Primary outcomes are the immediate and medium-term effects of the short, animated storytelling intervention video on knowledge about dietary sodium. Secondary outcomes are immediate and medium-term effects of the short, animated storytelling intervention on behavioral expectation to reduce sodium intake as well as voluntary post-trial engagement with the video content. CONCLUSION This study will extend the knowledge on the effects of short, animated storytelling for the containment of the global cardiovascular disease burden. Knowledge on the groups that may be more likely to voluntarily engage with SAS video content will help to improve targeting of future interventions towards audiences at risk. TRIAL REGISTRATION {2A}: ClinicalTrials.gov NCT05735457. Registered on February 21, 2023.
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Affiliation(s)
- A Supady
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
| | - K Nguyen
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - M Abd El Aziz
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Division of Infectious Diseases and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - C Überreiter
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - T Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Department of Global Health and Population, Harvard T. H Chan School of Public Health, Boston, USA
- Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa
| | - M Adam
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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3
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Goldschmidt T, Kippe Y, Finck A, Adam M, Hamadoun H, Winkler JG, Bermpohl F, Schouler-Ocak M, Gutwinski S. Psychiatric presentations and admissions during the first wave of Covid-19 compared to 2019 in a psychiatric emergency department in Berlin, Germany: a retrospective chart review. BMC Psychiatry 2023; 23:38. [PMID: 36639626 PMCID: PMC9839445 DOI: 10.1186/s12888-023-04537-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Most studies agree that the Covid-19 pandemic and the subsequent lockdown had a negative impact on mental health. On the other hand, international studies have shown that psychiatric emergency departments (pED) experienced a decrease in presentations and admissions. METHODS Retrospective chart review of all pED presentations and admissions during the first wave of Covid-19 pandemic in Germany (Covid-19 period: 3/2/20 to 05/24/20) in a psychiatric hospital in Berlin compared to 1 year earlier (pre-Covid-19 period). Descriptive statistics and logistic regression were performed. RESULTS We observed no statistical significant changes in overall pED presentations and overall hospital admissions during the Covid-19 period compared to the pre-Covid-19 period (813 vs. 894, - 9.1%, p = 0.064 and (363 vs. 437, - 16.9%, p = 0.080 respectively). In the subgroup analysis, less patients with depressive disorders (p = 0.035) and with personality disorders (p = 0.002) presented to the pED, a larger number of presentations with schizophrenia was observed (p = 0.020). In the Covid-19 period, less patients with substance use disorder and paranoid schizophrenia were admitted to the hospital via the pED than in the pre-Covid-19 period (p = 0.035 and p = 0.006, respectively). Bed capacity was reduced in the Covid-19 period by - 32.8% (p < 0.001). Presentations in police custody were 13.7% (p = 0.029) higher during the Covid-19 compared to pre-Covid-19 period, with higher rates in female presentations (p = 0.008) and suicide attempts (p = 0.012) and less hospital admissions (p = 0.048). Logistic regression analyses revealed that positive predictors for pED presentation during Covid-19 period were police custody (p < 0.001), being redirected from another hospital (p < 0.001), suicide attempt (p = 0.038), suicidal thoughts (p = 0.004), presentation with paranoid schizophrenia (p = 0.001) and bipolar and manic disorders (p = 0.004), negative predictors were hospital admission (p < 0.001), depressive disorders (p = 0.021) and personality disorders (p < 0.001). CONCLUSIONS A larger number of presentations in police custody during the Covid-19 period may represent untreated medical needs. This was seen predominantly in female patients, suggesting this subgroup might have suffered particularly under lockdown measures. Patients with paranoid schizophrenia were the only subgroup, which increased in absolute numbers, also suggesting a particular lockdown effect. Reduced bed capacity due to infection curbing measures is suggestive to have played an important role in augmenting the threshold for hospital admissions.
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Affiliation(s)
- T Goldschmidt
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany.
| | - Y Kippe
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - A Finck
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - M Adam
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - H Hamadoun
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - J G Winkler
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - F Bermpohl
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - M Schouler-Ocak
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
| | - S Gutwinski
- Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, 10115, Berlin, Germany
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Eyraud C, Biermé P, Adam M, Braun C. Drug-induced enterocolitis syndrome: A rare, severe, non-IgE-mediated immediate drug allergy. Case report and literature review. Arch Pediatr 2023; 30:67-70. [PMID: 36462992 DOI: 10.1016/j.arcped.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/29/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022]
Abstract
We report the case of a 4-year-old child who presented with vomiting, abdominal pain, and intense pallor 2 h after amoxicillin ingestion. An IgE-mediated reaction was suspected at first, which was finally diagnosed as a drug-induced enterocolitis syndrome. In this rare and poorly described non-IgE-mediated drug allergy, adrenaline is not effective. This diagnostic challenge must be known in order to administer adequate treatment, i.e., antiemetic drugs (ondansetron) and fluid challenge.
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Affiliation(s)
- C Eyraud
- Service de Pédiatrie, Pneumologie, Allergologie et Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - P Biermé
- Service de Pédiatrie, Pneumologie, Allergologie et Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - M Adam
- Service de Pédiatrie, Pneumologie, Allergologie et Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - C Braun
- Service de Pédiatrie, Pneumologie, Allergologie et Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, UCBL1, ENS de Lyon, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France.
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5
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Woolley SD, Dermont M, Adam M, Pallet SJC, Reece N, Hoysal N, Holden G, Attridge KK, Fletcher TE, O'Shea MK, Hutley EJ, Nicol ED, Lamb LE. The 2022 monkeypox outbreak: A UK military perspective. Travel Med Infect Dis 2022; 52:102540. [PMID: 36587754 PMCID: PMC9800014 DOI: 10.1016/j.tmaid.2022.102540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
With the emergence of SARS-CoV-2 and now monkeypox, the UK Defence Medical Services have been required to provide rapid advice in the management of patients with airborne high consequence infectious diseases (A-HCID). The Defence Public Health Network (DPHN) cadre, consisting of closely aligned uniformed and civilian public health specialists have worked at pace to provide evidence-based recommendations on the clinical management, public health response and policy for monkeypox, with military medicine and pathology clinicians (primarily infectious disease physicians and medical microbiologists). Military environments can be complicated and nuanced requiring specialist input and advice to non-specialists as well as unit commanders both in the UK and overseas. DPHN and military infection clinicians have close links with the UK National Health Service (NHS) and the UK Health Security Agency (UKHSA), allowing for a dynamic two-way relationship that encompasses patient management, public health response, research and development of both UK military and national guidelines. This is further demonstrated with the Royal Air Force (RAF) Air Transport Isolator (ATI) capability, provided by Defence to support the UK Government and UKHSA. Military infectious disease clinicians are also embedded within NHS A-HCID units. In this manuscript we provide examples of the close interdisciplinary working of the DPHN and Defence clinicians in managing military monkeypox patients, co-ordinating the public health response, advising the Command and developing monkeypox policy for Defence through cross-government partnership. We also highlight the co-operation between civilian and military medical authorities in managing the current outbreak.
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Affiliation(s)
- S D Woolley
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Tropical and Infectious Disease Unit, Royal Liverpool Hospital, Liverpool, UK.
| | - M Dermont
- Defence Public Health Unit, DMS Whittington, Lichfield, UK
| | - M Adam
- Regional Infectious Diseases Unit, Western General Hospital, NHS Lothian, Edinburgh, UK; Tactical Medical Wing, RAF Brize Norton, Carterton, UK
| | - S J C Pallet
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Infection and Immunity Clinical Academic Group, St George's Hospital, London, UK
| | - N Reece
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Department of Microbiology, Queen Alexandra Hospital, Portsmouth, UK
| | - N Hoysal
- Defence Public Health Unit, DMS Whittington, Lichfield, UK
| | - G Holden
- Defence Public Health Unit, DMS Whittington, Lichfield, UK
| | - K K Attridge
- RAF Health Directorate, RAF High Wycombe, Buckinghamshire, UK
| | - T E Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Tropical and Infectious Disease Unit, Royal Liverpool Hospital, Liverpool, UK; Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - M K O'Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK; Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - E J Hutley
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Department of Microbiology, Frimley Park Hospital, Camberley, UK
| | - E D Nicol
- RAF Health Directorate, RAF High Wycombe, Buckinghamshire, UK; Department of Cardiology, Royal Brompton Hospital, London, UK
| | - L E Lamb
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK; Department of Infectious Diseases, Royal Free Hospital, London, UK
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Vantler M, Schorscher M, Moore JB, Berhausen EM, Zierden M, Mollenhauer M, Adam M, Mehrkens D, Baldus S, Rosenkranz S. Lack of PI 3-kinase isoform p110alpha impairs SMC differentiation and proliferation and promotes aortic aneurysm formation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Proliferation and phenotypic modulation of vascular smooth muscle cells (SMCs) significantly contribute to the functionality of the aortic wall. Dysregulation of underlying signal transduction pathways impairs the vessel wall structure and promote the development and progression of abdominal aortic aneurysms (AAA). The PI 3-kinase (PI3K) isoform p110α is activated downstream of receptor tyrosine kinases (RTKs) and represents the most relevant PI3K isoform in SMCs.
Aim
This project follows the hypothesis that p110α deficiency impairs proliferation and phenotypic modulation of SMCs as well as the structure of the extracellular matrix (ECM) and therefore promotes the development and progression of AAA. It was investigated how p110α deficiency affects the plasticity of SMCs, the production and structure of ECM components, and the formation of AAA.
Methods and results
Western blot analyses showed that SMCs isolated from smooth muscle specific p110α−/− (sm-p110α−/−) mice were characterized by decreased expression of the differentiation markers sm-α-actin, calponin and sm-MHC. Mechanistically, phosphorylation of key modulators of the SMC phenotype – AKT1, AKT2, FOXO1, -3 and -4 as well as GSK3β – was impaired in p110α−/− SMCs after RTK stimulation. These findings indicate that phenotypic modulation of p110α−/− SMCs is restricted. In addition, protein expression of elastin and fibrillin was reduced in p110α−/− SMCs. In silico analysis (MatLab macro CT-FIRE and Curvalign) of the ECM produced by SMCs in vitro revealed a significantly reduced elastin fiber length and width in p110α−/− SMCs compared to fibers produced by WT SMCs (p<0.05). Consistently, aortas from sm-p110α−/− mice showed a significantly higher number of elastic fiber breaks specifically in the thoracic section than WT controls (289±31 mmm–2 versus 190±9 mmm–2, n=5, p=0.015). Aortic aneurysms in sm-p110α−/− mice and wild-type littermates were analyzed using the established porcine pancreatic elastase (PPE) model. PPE was perfused into the infrarenal aorta to induce AAA formation. Ultrasound examination of the aorta revealed an enlarged aortic diameter in all PPE-treated mice. However, the increase in aortic diameter in sm-p110α−/− mice (70.16±10.82% mm, n=9) was significant more pronounced compared to wild-type animals (42.44±5.99%, n=10) (p<0.05). Three days after PPE perfusion, the number of elastic fiber breaks was significantly increased, and amount of proliferating SMCs were decreased in the infrarenal aorta of sm-p110α−/− mice compared to WT controls.
Conclusion
p110α deficiency in SMCs impairs aortic wall structure and promotes the development and progression of aortic aneurysms. Mechanistically, p110α activity maintains a differentiated SMC phenotype as well as the expression and assembly of ECM components. These data identify p110α signaling as a modifiable target for preventive and therapeutic strategies for aortic aneurysms.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft
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Affiliation(s)
- M Vantler
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - M Schorscher
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - J B Moore
- University of Louisville School of Medicine, Department of Medicine , Louisville , United States of America
| | - E M Berhausen
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - M Zierden
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - M Mollenhauer
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - D Mehrkens
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
| | - S Rosenkranz
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine , Cologne , Germany
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7
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Al-Kassou B, Veulemans V, Shamekhi J, Maier O, Aksoy A, Zietzer A, Meertens M, Weber M, Sinning JM, Adam M, Zimmer S, Baldus S, Kelm M, Nickenig G, Sedaghat A. Optimal protamine-to-heparin dosing ratio for the prevention of bleeding complications in patients undergoing TAVR – a multicentre experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Despite major advances, transcatheter aortic valve replacement (TAVR) is associated with procedure-related vascular and bleeding complications, that have a significant impact on mortality. A recently published study has shown that heparin antagonization using protamine resulted in significantly lower rates of serious bleeding events in patients undergoing TAVR as compared to those without heparin reversal. However, the optimal protamine-to-heparin dosing ratio to prevent bleeding complications without increasing ischemic complications in patients undergoing TAVR is unknown. Accordingly, daily clinical practice varies between selective to routine administration of protamine in different dosing ratios.
Purpose
The aim of this observational multicentre study was to compare the safety and efficacy of two different protamine-to-heparin dosing ratios for the prevention of bleeding complications after TAVR.
Methods
The study included 1446 patients undergoing TAVR, of whom 623 (43.1%) received partial and 823 (56.9%) full heparin antagonization (0.4–0.6 mg versus 0.9–1.0 mg protamine/100 units of heparin). The indication for partial or full heparin antagonization was left to the discretion of the operator, who made the decision according to the patient's individual thrombotic and bleeding risk. The primary endpoint was a composite of 30-day mortality, life-threatening and major bleeding. Safety endpoints included stroke and myocardial infarction at 30 days.
Results
The overall study population had a mean age of 81.1±6.0 years; 47.9% were of female gender.
The baseline characteristics were well balanced between the two groups. Full antagonization of heparin resulted in significantly lower rates of the primary endpoint as compared to partial heparin reversal (5.6 vs. 10.4%, p<0.01), mainly driven by lower rates of life-threatening (0.5 vs 1.6%, p=0.05) and major bleeding (3.2 vs 7.5%, p<0.01). The incidence of major vascular complications was significantly lower in patients with full heparin reversal (3.5 vs 7.5%, p<0.01), as presented in Figure 1. Accordingly, the post-interventional drop in hemoglobin level and the need for red-blood-cell transfusion was lower in patients receiving full as compared to partial heparin reversal (1.5±1.2 vs 1.7±1.2 g/dl, p<0.01; 10.4 vs 15.9%, p<0.01, respectively). Regarding safety endpoints, no differences were observed in the incidence of stroke and myocardial infarction between the groups (2.2 vs 2.6%, p=0.73 and 0.2 vs 0.4%, p=0.64, respectively). Multivariate regression analyses revealed that full antagonization of heparin (OR: 0.43 [95% CI: 0.24–0.81], p<0.01) was independently associated with the primary end point
Conclusion
Full heparin antagonization resulted in significantly lower rates of life-threatening and major bleeding after TAVR as compared to partial heparin reversal. The occurrence of stroke and myocardial infarction was low and comparable between both groups.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation).
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Affiliation(s)
- B Al-Kassou
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - V Veulemans
- University Hospital Duesseldorf, Division of Cardiology , Duesseldorf , Germany
| | - J Shamekhi
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - O Maier
- University Hospital Duesseldorf, Division of Cardiology , Duesseldorf , Germany
| | - A Aksoy
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - A Zietzer
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - M Meertens
- University hospital Koln, Department of Cardiology, Heart Center , Cologne , Germany
| | - M Weber
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - J M Sinning
- St Vinzenz-Hospital, Department of Cardiology , Cologne , Germany
| | - M Adam
- University hospital Koln, Department of Cardiology, Heart Center , Cologne , Germany
| | - S Zimmer
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - S Baldus
- University hospital Koln, Department of Cardiology, Heart Center , Cologne , Germany
| | - M Kelm
- University Hospital Duesseldorf, Division of Cardiology , Duesseldorf , Germany
| | - G Nickenig
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
| | - A Sedaghat
- University Hospital Bonn, Department of Cardiology, Angiology and Pneumology , Bonn , Germany
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8
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Adam M, Smith V. Getting it right from the start – collecting best data with the D8 VENTURE platform. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322093895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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9
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Richert C, Berking T, Frey W, Stuerzer T, Adam M. Chaperone compounds for co-crystallization of small molecules. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322094876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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10
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Langenbach CM, Breidert I, Klein K, Maintz D, Adam M, Wienemann H. Vergleich zwischen Resting Full-Cycle Ratio und CT-basierter fraktioneller Flussreserve bei Patienten mit schwerer Aortenklappenstenose: Vorläufige Ergebnisse. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749811] [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: 11/05/2022]
Affiliation(s)
- C M Langenbach
- Universitätsklinikum Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | | | - K Klein
- Radiologie, Uniklinik Köln, Köln
| | - D Maintz
- , Universitätsklinikum Köln, Köln
| | - M Adam
- Kardiologie, Universitätsklinikum Köln, Köln
| | - H Wienemann
- Kardiologie, Universitätsklinikum Köln, Köln
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11
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Xie Y, Kuan AT, Wang W, Herbert ZT, Mosto O, Olukoya O, Adam M, Vu S, Kim M, Tran D, Gómez N, Charpentier C, Sorour I, Lacey TE, Tolstorukov MY, Sabatini BL, Lee WCA, Harwell CC. Astrocyte-neuron crosstalk through Hedgehog signaling mediates cortical synapse development. Cell Rep 2022; 38:110416. [PMID: 35196485 PMCID: PMC8962654 DOI: 10.1016/j.celrep.2022.110416] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/04/2021] [Accepted: 01/28/2022] [Indexed: 12/12/2022] Open
Abstract
Neuron-glia interactions play a critical role in the regulation of synapse formation and circuit assembly. Here we demonstrate that canonical Sonic hedgehog (Shh) pathway signaling in cortical astrocytes acts to coordinate layer-specific synaptic connectivity. We show that the Shh receptor Ptch1 is expressed by cortical astrocytes during development and that Shh signaling is necessary and sufficient to promote the expression of genes involved in regulating synaptic development and layer-enriched astrocyte molecular identity. Loss of Shh in layer V neurons reduces astrocyte complexity and coverage by astrocytic processes in tripartite synapses; conversely, cell-autonomous activation of Shh signaling in astrocytes promotes cortical excitatory synapse formation. Furthermore, Shh-dependent genes Lrig1 and Sparc distinctively contribute to astrocyte morphology and synapse formation. Together, these results suggest that Shh secreted from deep-layer cortical neurons acts to specialize the molecular and functional features of astrocytes during development to shape circuit assembly and function. Xie et al. show that Sonic hedgehog expressed by cortical layer V neurons signals to Ptch1-expressing astrocytes where it is necessary to promote the expression of layer-enriched astrocyte gene networks that control synapse formation and astrocyte morphological complexity.
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Affiliation(s)
- Yajun Xie
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Aaron T Kuan
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Wengang Wang
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Zachary T Herbert
- Molecular Biology Core Facilities, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Olivia Mosto
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Olubusola Olukoya
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Manal Adam
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Steve Vu
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Minsu Kim
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Diana Tran
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Nicolás Gómez
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Claire Charpentier
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Ingie Sorour
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Tiara E Lacey
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Michael Y Tolstorukov
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Bernardo L Sabatini
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Wei-Chung Allen Lee
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Corey C Harwell
- Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA.
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12
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Kuhn E, Eghbalzadeh K, Krasivskyi I, Djordjevic I, Adam M, Körber MI, Baldus S, Wahlers T. Early Clinical Results with the Tendyne Transcatheter Mitral Valve. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742890] [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: 10/19/2022]
Affiliation(s)
- E. Kuhn
- University Hospital of Cologne, Köln, Deutschland
| | | | - I. Krasivskyi
- Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland, Köln, Deutschland
| | - I. Djordjevic
- University Hospital of Cologne, Cologne, Deutschland
| | - M. Adam
- Department of Internal Medicine III, Heart Center Cologne, Köln, Deutschland
| | - M. I. Körber
- Department of Internal Medicine III, Heart Center Cologne, Cologne, Deutschland
| | - S. Baldus
- Department of Internal Medicine III, Heart Center Cologne, Köln, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Köln, Deutschland
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13
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Elderia A, Gerfer S, Zeschky C, Eghbalzadeh K, Rustenbach C, Adam M, Rahmanian P, Mader N, Baldus S, Wahlers T, Kuhn E. Surgical Versus Interventional Treatment of Concomitant Aortic Valve Stenosis and Coronary Artery Disease. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742879] [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: 10/19/2022]
Affiliation(s)
- A. Elderia
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - S. Gerfer
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - C. Zeschky
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - K. Eghbalzadeh
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - C. Rustenbach
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - M. Adam
- Department of Internal Medicine, Heart Center Cologne, Köln, Deutschland
| | - P. Rahmanian
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - N. Mader
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
| | - S. Baldus
- Department of Internal Medicine, Heart Center Cologne, Köln, Deutschland
| | - T. Wahlers
- University Hospital of Cologne, Köln, Deutschland
| | - E. Kuhn
- Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
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14
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Vantler M, Schorscher M, Berghausen E, Zierden M, Wissmueller M, Mollenhauer M, Mehrkens D, Adam M, Baldus S, Rosenkranz S. PI 3-kinase isoform PI3Kalpha controls smooth muscle cell functionality and protects against aortic aneurysm formation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Class I PI 3-kinase isoform PI3Kα is a lipid kinase and signals downstream of receptor tyrosine kinases. Smooth muscle cells (SMCs) lacking PI3Kα are characterized by impaired proliferation, migration and survival. Mice, harbouring a smooth muscle specific PI3Kα deficiency (SM-PI3Kα−/−), display reduced vascular wall thickness and impaired vascular remodeling in response to vessel injury. We hypothesize that SM-PI3Kα−/− mice are prone to aortic aneurysm (AA) formation due to impaired SMC functions. Herein, we investigated, how PI3Kα-dependent signaling in SMCs affect aortic aneurysm (AA) formation, aortic wall structure, and expression of extracellular matrix (ECM) components.
Methods and results
AA formation in SM-PI3Kα−/− mice and wild-type littermates was examined by means of the “porcine pancreatic elastase” (PPE) AA model. PPE was infused into the infrarenal aorta to induce AA formation. Ultrasound examination revealed a significantly increased aortic diameter in SM-PI3Kα−/− mice (1.22±0.12 mm) compared to wild-type animals (0.96±0.02 mm, p=0.014). These data indicate a protective function of SM-PI3Kα in AA formation. In addition, the media thickness in the abdominal aorta was significantly reduced in SM-PI3Kα−/− mice (29.0±3.1 vs. 42.5±4.1 μm). Ultrastructural analysis of aortic wall morphology in SM-PI3Kα−/−mice using transmission electron microscopy (TEM) showed a deranged tunica media with detached SMCs and increased apoptotic cell death. Consequently, SM-PI3Kα deficiency significantly diminished responsiveness of aortic rings to vasodilator acetylcholine and NO-donor nitroglycerin, further indicating impaired aortic wall structure. Western blots demonstrated a reduced elastin and fibrillin expression in SMCs from SM-PI3Kα−/− mice. Furthermore, immunofluorescence stainings of PI3Kα−/− and wild-type SMCs, cultured for seven days under 10% fetal calf serum containing DMEM medium, showed significantly disturbed structures of elastin-, fibrillin-1- and collagen-1-fibers. These data indicate that PI3Kα signaling contributes to elastic fiber homeostasis thus affecting SMC phenotypic modulation. Immunoblots demonstrated that PDGF and insulin induced phosphorylation and inactivation of key regulators of SMC differentiation and dedifferentiation including FoxO1, FoxO3a, Foxo4, and GSK3b, respectively, were reduced or even abrogated in PI3Kα−/− SMCs.
Conclusion
These data show that deficiency of PI3Kα in SMCs promotes the formation and progression of AA. Causative is a deranged aortic structure of SM-PI3Kα−/− aortae which can likely be attributed to an impaired production of elastic fiber components by PI3Kα−/− SMCs.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft
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Affiliation(s)
- M Vantler
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Schorscher
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - E Berghausen
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Zierden
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Wissmueller
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Mollenhauer
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - D Mehrkens
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - S Rosenkranz
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
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15
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Ludwig S, Gruhl L, Gossling A, Seiffert M, Westermann D, Sinning JM, Sugiura A, Adam M, Mauri V, Frank D, Seoudy H, Rudolph TK, Potratz M, Conradi L, Schofer N. Risk prediction in patients with classical Low-flow, low-gradient aortic stenosis undergoing TAVI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with classical low-flow, low-gradient aortic stenosis (LFLG AS) undergoing transcatheter aortic valve implantation (TAVI) are known to suffer from poor prognosis. Risk prediction is difficult and predictors of outcome are scarce in this complex patient subset.
Purpose
This study aimed to develop a simple score system for risk prediction in patients with classical LFLG AS scheduled for TAVI including baseline clinical, echocardiographic and computed tomography (CT) parameters.
Methods
Among 9,150 patients undergoing TAVI (2008–2019) at five German centers, patients with classical LFLG AS were screened for availability of sufficient CT data for aortic valve calcification (AVC) quantification. Score variables were defined as all variables included into the best performing multivariable regression model. Score performance was assessed by Kaplan-Meier analysis for the endpoint of 1-year all-cause as well as c-index calculation.
Results
A total of 718 patients were included into the study. Predictors of all-cause mortality were male sex (HR 1.27 [0.98, 1.65], p=0.068), chronic obstructive pulmonary disease (HR 1.59 [1.21,2.08], p<0.001), atrial fibrillation (HR 1.33 [1.03,1.70], p=0.026), stroke volume index (HR 0.96 [0.94, 0.98], p<0.001), non-transfemoral access (HR 1.44 [1.09,1.91], p=0.011), pulmonary hypertension (HR 1.58 [1.20,2.08], p=0.0012) and low AVC density (HR 1.49 [1.16,1.90], p=0.0016). A score system was developed ranging from 0 points to 11 points. Kaplan-Meier analysis for low (0–2 points), moderate (3–6 points) and high score (>6 points) demonstrated 1-year mortality rates of 20.9%, 28.9% and 64.3% (p<0.001), respectively. C-index for prediction of 1-year mortality was 0.69 (95%-CI 0.65–0.84). The RELiEF TAVI score outperformed classical risk prediction models like the logistic euroSCORE (c-index 0.60 [95%-CI 0.51–0.72], p=0.013), the EuroSCORE II (c-index 0.57 [95%-CI 0.45–0.70], p=0.039) and the STS PROM (c-index 0.60 [0.48–0.70], p=0.035).
Conclusions
The RELiEF TAVI score is based on simple clinical, echocardiographic and CT parameters and might serve as a helpful tool for risk prediction in the vulnerable subset of patients with classical LFLG AS scheduled for TAVI.
Funding Acknowledgement
Type of funding sources: None. RELiEF TAVI Score
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Affiliation(s)
- S Ludwig
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - L Gruhl
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - A Gossling
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - M Seiffert
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - D Westermann
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - J M Sinning
- Heartcenter Bonn, University Hospital Bonn, Bonn, Germany
| | - A Sugiura
- Heartcenter Bonn, University Hospital Bonn, Bonn, Germany
| | - M Adam
- Heart Center at the University of Cologne, Cologne, Germany
| | - V Mauri
- Heart Center at the University of Cologne, Cologne, Germany
| | - D Frank
- University Medical Center of Schleswig-Holstein - Campus Kiel, Kiel, Germany
| | - H Seoudy
- University Medical Center of Schleswig-Holstein - Campus Kiel, Kiel, Germany
| | - T K Rudolph
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - M Potratz
- Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - L Conradi
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, Hamburg, Germany
| | - N Schofer
- University Heart & Vascular Center Hamburg, Hamburg, Germany
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16
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Abu-Shahba AG, Wilkman T, Kornilov R, Adam M, Salla KM, Lindén J, Lappalainen AK, Björkstrand R, Seppänen-Kaijansinkko R, Mannerström B. Periosteal Flaps Enhance Prefabricated Engineered Bone Reparative Potential. J Dent Res 2021; 101:166-176. [PMID: 34514892 PMCID: PMC8808084 DOI: 10.1177/00220345211037247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The clinical translation of bone tissue engineering for reconstructing large bone defects has not advanced without hurdles. The in vivo bioreactor (IVB) concept may therefore bridge between bone tissue engineering and reconstructive surgery by employing the patient body for prefabricating new prevascularized tissues. Ideally, IVB should minimize the need for exogenous growth factors/cells. Periosteal tissues are promising for IVB approaches to prefabricate tissue-engineered bone (TEB) flaps. However, the significance of preserving the periosteal vascular supply has not been adequately investigated. This study assessed muscle IVB with and without periosteal/pericranial grafts and flaps for prefabricating TEB flaps to reconstruct mandibular defects in sheep. The sheep (n = 14) were allocated into 4 groups: muscle IVB (M group; nM = 3), muscle + periosteal graft (MP group; nMP = 4), muscle + periosteal flap (MVP group; nMVP = 4), and control group (nControl = 3). In the first surgery, alloplastic bone blocks were implanted in the brachiocephalic muscle (M) with a periosteal graft (MP) or with a vascularized periosteal flap (MVP). After 9 wk, the prefabricated TEB flaps were transplanted to reconstruct a mandibular angle defect. In the control group, the defects were reconstructed by non-prevascularized bone blocks. Computed tomography (CT) scans were performed after 13 wk and after 23 wk at termination, followed by micro-CT (µCT) and histological analyses. Both CT and µCT analysis revealed enhanced new bone formation and decreased residual biomaterial volume in the MVP group compared with control and MP groups, while the M group showed less new bone formation and more residual biomaterial. The histological analysis showed that most of the newly formed bone emerged from defect edges, but larger areas of new bone islands were found in MP and MVP groups. The MVP group showed enhanced vascularization and higher biomaterial remodeling rates. The periosteal flaps boosted the reconstructive potential of the prefabricated TEB flaps. The regenerative potential of the periosteum was manifested after the transplantation into the mechanically stimulated bony defect microenvironment.
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Affiliation(s)
- A G Abu-Shahba
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - T Wilkman
- Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, Helsinki, Finland
| | - R Kornilov
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Adam
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - K M Salla
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - J Lindén
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.,Finnish Centre for Laboratory Animal Pathology (FCLAP), HiLIFE, University of Helsinki, Helsinki, Finland
| | - A K Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - R Björkstrand
- Department of Mechanical Engineering, Aalto University, Espoo, Finland
| | - R Seppänen-Kaijansinkko
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral and Maxillofacial Surgery, Helsinki University Hospital, Helsinki, Finland
| | - B Mannerström
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Assimakis N, Adam M, Ktena A, Manasis C. Steady state Kalman filter design for cases and deaths prediction of Covid-19 in Greece. Results Phys 2021; 26:104391. [PMID: 34104629 PMCID: PMC8175047 DOI: 10.1016/j.rinp.2021.104391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 06/12/2023]
Abstract
In this work we study the applicability of the steady state Kalman filter in order to predict new cases and deaths of Covid-19. We use the actual observations of new cases and deaths. First, we deal with short term prediction, namely daily prediction. We propose the use of the golden steady state Kalman Filter, which is designed to have parameters related to the golden section. It was found that the proposed golden steady state Kalman Filter has a satisfactory behavior compared with the classical mean or average filter. Secondly, we deal with long term prediction, for example average prediction per quarantine period (14 days). We propose to process blocks of measurements of time window corresponding for example to the quarantine period in order to predict the average of cases and deaths using steady state Kalman Filter. It was found that the proposed golden steady state Kalman Filter produces more reliable predictions than the classical mean or average filter does. The use of steady state Kalman Filter for cases and deaths prediction of Covid-19 can be effective for resources and prevention measures planning.
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Affiliation(s)
- N Assimakis
- Energy Systems Laboratory, National and Kapodistrian University of Athens, Greece
| | - M Adam
- Dept. of Computer Science & Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - A Ktena
- Energy Systems Laboratory, National and Kapodistrian University of Athens, Greece
| | - C Manasis
- Energy Systems Laboratory, National and Kapodistrian University of Athens, Greece
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18
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Freischlag K, Olivere L, Turner M, Adam M, Mantyh C, Migaly J. Does Fragmentation of Care in Locally Advanced Rectal Cancer Increase Patient Mortality? J Gastrointest Surg 2021; 25:1287-1296. [PMID: 32754789 DOI: 10.1007/s11605-020-04760-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/19/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate health care fragmentation in patients with stage II and III rectal cancers. BACKGROUND Fragmentation of care among multiple hospitals may worsen outcomes for cancer patients. METHODS National Cancer Database was queried for adult patients who underwent radiation and surgery for locally advanced (stage II-III) rectal adenocarcinoma from 2006 to 2015. Fragmented care was defined as receiving radiation at a different hospital from surgery. Descriptive statistics characterized patients, and survival probability was plotted using the Kaplan-Meier method and a Cox proportional hazards model. RESULTS A total of 37,081 patients underwent surgery and radiation for stage II-III rectal cancer from 2006 to 2015 (24,102 integrated care vs. 12,979 fragmented care). Patients who received fragmented care (hazard ratio [HR] 1.105; 95% CI 1.045-1.169) had a higher risk of mortality. Patients who received at least surgery (HR 0.84; 95% CI 0.77-0.92) at academic hospitals had a lower risk of mortality. Academic hospitals had a higher proportion of patients with fragmented care (38.0 vs. comprehensive community 32.8% vs. community 33.8%, p < 0.001). Within academic hospitals, fragmented care portended worse survival (integrated academic 80.0% vs. fragmented academic 76.7%, p = 0.0002). Fragmented care at academic hospitals had increased survival over integrated care at community hospitals (fragmented academic 76.7 vs. integrated community 72.2%, p = 0.00039). CONCLUSIONS In patients with stage II-III rectal cancer, patients who have integrated care at academic hospitals or at least surgery at academic centers had better survival. All efforts should be made to reduce care fragmentation and surgery at academic centers should be prioritized.
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Affiliation(s)
- Kyle Freischlag
- Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - L Olivere
- Duke University School of Medicine, Durham, NC, USA
| | - M Turner
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - M Adam
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - C Mantyh
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - J Migaly
- Duke University Medical Center, Surgery, Durham, NC, USA
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19
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Vantler M, Berghausen E, Zierden M, Mollenhauer M, Mehrkens D, Adam M, Baldus S, Rosenkranz S. Lack of PI 3-kinase isoform p110alpha in smooth muscle cells impairs aortic wall homoeostasis and thus promotes aortic aneurysm formation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In smooth muscle cells (SMCs), the PI 3-kinase isoform p110α mediates receptor tyrosine kinase dependent proliferation, chemotaxis and cell survival. Since mice, harbouring a smooth muscle specific p110α deficiency (SM-p110α−/−), display reduced vascular wall thickness, we hypothesized that SM-p110α−/− mice might be prone to aortic aneurysm (AA) formation. The pathogenesis of AA is characterized by increased dedifferentiation of SMCs, extracellular matrix (ECM) degeneration and inflammation in the aortic wall. Herein, we investigated how p110α-dependent signal transduction in SMCs affects these processes.
Methods and results
We examined AA formation in SM-p110α−/− mice and wild-type littermates using the “porcine pancreatic elastase” (PPE) AA model. PPE was infused into the infrarenal aorta to induce AA formation. Ultrasound examination of the aorta revealed an enlarged aortic diameter in all PPE-treated mice. The aortic diameter in SM-p110α−/− mice (0.46±0.12 mm) was significantly increased compared to wild-type animals (0.18±0.03 mm, p<0.01). These data indicate a protective function of p110α in AA formation. Immunocytochemical examination of the tunica media of PPE-perfused SM-p110α−/− mice revealed significantly increased infiltration of CD45+ leukocytes. In particular, the number of MOMA-2+ monocytes / macrophages in the vessel wall was significantly increased indicating elevated inflammation of the aortic wall during AA progression in comparison to wild-type control mice. Ultrastructural analysis of aortic wall morphology in SM-p110α−/− mice using transmission electron microscopy (TEM) showed a deranged tunica media and increased apoptotic cell death. In addition, the media thickness in the abdominal aorta was significantly reduced in SM-p110α−/− mice (29.0±3.1 μm vs. 42.5±4.1 μm). Western blots demonstrated a reduced elastin and fibrillin expression in SMCs from SM-p110α−/− mice. p110α−/− SMCs showed significantly reduced expression of differentiation markers SM-α-actin and SM-MHC. In addition, aortic p110α-deficient SMCs were significantly impaired in their ability to proliferate and migrate. These findings indicate that p110α−/− SMCs are neither differentiated nor dedifferentiated and have therefore largely lost their plasticity. Consequently, p110α deficiency significantly diminished responsiveness of aortic rings to vasodilator acetylcholine and NO-donor nitroglycerin, further indicating impaired contractility of SMCs. Mechanistically, we demonstrated that PDGF and insulin induced phosphorylation and inactivation of key regulators of SMC differentiation and dedifferentiation, Foxo4 and GSK3b, respectively, were abrogated in p110α−/− SMCs.
Conclusion
These data show that deficiency of p110α in SMCs promotes the formation and progression of AA. Causative are impaired SMC plasticity and ECM homeostasis as well as inflammatory processes in the vascular wall.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Deutsche Forschungsgemeinschaft (DFG)
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Affiliation(s)
- M Vantler
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - E Berghausen
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Zierden
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Mollenhauer
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - D Mehrkens
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
| | - S Rosenkranz
- Cologne University Hospital - Heart Center, Department III, Cologne, Germany
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Macherey S, Meertens M, Eichel S, Schipper J, Mauri V, Frerker C, Adam M, Kuhn E, Wahlers T, Lee S, Baldus S, Schmidt T. Stroke and mortality rates after valve-in-valve TAVR and comparison with data from redo SAVR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and purpose
Early registry data described a potentially increased risk for cerebrovascular events and mortality in patients undergoing transcatheter aortic valve replacement (TAVR) as valve-in-valve (viv) procedures. Further data of small patient cohorts described divergent results for cerebrovascular events and mortality in patients undergoing TAVR as viv procedures for failed surgical bioprotheses in comparison with patients on redo surgical aortic valve replacement (SAVR). We performed a meta-analysis of stroke rates and mortality for viv TAVR procedures basing on the current literature.
Methods
We included all case series (≥10 patients), case-control studies and randomized controlled trials comparing viv TAVR and redo SAVR procedures with respect to cerebrovascular events and mortality rates. Additionally, we included all case series and registries with patients undergoing viv TAVR. After a structured literature research, 17 studies were eligible. For statistical analysis risk ratios and confidence intervals using Mantel-Haenszel test and the I-statistic to quantify possible heterogeneity were calculated. A P-value <0.05 was defined as statistical significant difference.
Results
Eleven case series and registries reporting on stroke and mortality in 8,509 patients undergoing viv TAVR were eligible for analysis. The quantitative analysis of non-comparative studies showed a calculated 30-day stroke rate of 2.2% and 30-day mortality rate of 4.2% after viv TAVR. Data on the 1-year rates were sporadically reported, therefore meta analysis was not appropriately feasible.
Six studies reporting on 498 participants undergoing viv TAVR (N=254) and redo SAVR (N=244) were eligible. The median age ranged from 72.3 to 80.2 years for viv TAVR and from 66.2 to 78.8 years for redo SAVR patients. The STS score was 7.2–7.4% (viv TAVR) and 5.8–7.7% (redo SAVR), respectively. A total of 3/226 participants treated with viv TAVR and 4/214 patients undergoing redo SAVR experienced a stroke during the first 30 postoperative days (N=4 trials, RR 0.86, 95% CI 0.20 to 3.59, p=0.83, I2 = 0%). None of the studies reported sufficient data on the 1-year stroke incidence. The 30-day mortality was 4.3% for viv TAVR and 4.5% for redo SAVR patients. This difference was not significantly different (N=6 trials, RR 0.90, 95% CI 0.40 to 2.05, p=0.80, I2 = 0%). The 1-year mortality rates were 13.3% and 13.6%, respectively (N=2 trials, RR 0.98, 95% CI 0.49 to 1.94, p=0.94, I2 = 0%).
Conclusion
In the current literature favorable stroke and mortality rates at 30 days for patients undergoing viv TAVR are documented. Similar stroke and mortality rates comparing viv TAVR and redo SAVR patients at 30 days were found as well as similar 1-year mortality. A selection bias for the viv TAVR and redo SAVR patients may exist, but cannot be dissolved with this registry analysis, only showing a trend of younger and lower risk patients receiving a redo SAVR procedure.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Macherey
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M Meertens
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - S Eichel
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - J Schipper
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - V Mauri
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - C Frerker
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - E Kuhn
- Cologne University Hospital - Heart Center, Department of Cardiothoracic Surgery, Cologne, Germany
| | - T Wahlers
- Cologne University Hospital - Heart Center, Department of Cardiothoracic Surgery, Cologne, Germany
| | - S Lee
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - T Schmidt
- Cologne University Hospital - Heart Center, Cologne, Germany
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Elderia A, Eghbalzadeh K, Zeschky C, Zeriouh M, Adam M, Baldus S, Mader N, Kuhn E, Wahlers T. Transcatheter Aortic Valve Implantation: Cardiologists versus Cardiac Surgeons. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705304] [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: 10/24/2022]
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Tichelbäcker T, Dumitrescu D, Gerhardt F, Stern D, Wissmüller M, Adam M, Schmidt T, Frerker C, Pfister R, Halbach M, Baldus S, Rosenkranz S. Pulmonary hypertension and valvular heart disease. Herz 2019; 44:491-501. [PMID: 31312873 DOI: 10.1007/s00059-019-4823-6] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Pulmonary hypertension (PH) is an important contributor to morbidity and mortality in patients with left-sided heart disease, including valvular heart disease. In this context, elevated left atrial pressure primarily leads to the development of post-capillary PH. Despite the fact that repair of left-sided valvular heart disease by surgical or interventional approaches will improve PH, recent studies have highlighted that PH (pre- or post-interventional) remains an important predictor of long-term outcome. Here, we review the current knowledge on PH in valvular heart disease taking into account new hemodynamic PH definitions, and the distinction between post- and pre-capillary components of PH. A specific focus is on the precise characterization of hemodynamics and cardiopulmonary interaction, and on potential strategies for the management of residual PH after mitral or aortic valve interventions. In addition, we highlight the clinical significance of tricuspid regurgitation, which may occur as a primary condition or as a consequence of PH and right heart dilatation (functional). In this context, proper patient selection for potential tricuspid valve interventions is crucial. Finally, the article highlights gaps in evidence, and points toward future perspectives.
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Affiliation(s)
- T Tichelbäcker
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - D Dumitrescu
- Klinik für Allgemeine und Interventionelle Kardiologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - F Gerhardt
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - D Stern
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - M Wissmüller
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - M Adam
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - T Schmidt
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - C Frerker
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - R Pfister
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - M Halbach
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Baldus
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Rosenkranz
- Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum, Universitätsklinik Köln, Kerpener Str. 62, 50937, Cologne, Germany.
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Niepmann ST, Steffen E, Zietzer A, Adam M, Nordsiek J, Gyamfi-Poku I, Piayda K, Sinning JM, Baldus S, Nickenig G, Zimmer S, Quast C. P5987Novel model of intensity graded murine wire-induced aortic valve stenosis mimics distinct stages of human aortic valve pathology. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Aortic valve stenosis (AS) is the most common valve disease requiring therapeutic intervention. Even though the incidence of AS has been continuously rising and AS is associated with significant morbidity and mortality, to date, no medical treatments have been identified that can modify disease progression. In fact, only invasive interventional or surgical replacement of severely diseased valves is recommended. This unmet medical need is likely attributed to the lack of a clear understanding of the molecular mechanism driving disease development. To investigate the pathophysiology leading to AS, reliable and reproducible animal models that mimic human pathophysiology are needed.
Hypothesis
Induction of a graded wire-induced aortic valve stenosis model in mice is feasible to reflect and study pathophysiological mechanisms underlying the progression of aortic valve stenosis.
Methods
We have tested and expanded the protocols of a novel wire-injury induced aortic valve stenosis mouse model. A spring coronary guide wire or a bare metal wire was used to apply shear stress to the aortic valve cusps with increasing intensity with ultrasound-guided monitoring in male 10 to 12-week-old C57Bl/6j mice. These protocols allowed the induction of distinct models with soft, moderate and intense wire injury. Functional analysis including maximum flow velocity (Vmax), ejection fraction, fractional shortening, left ventricular volumes, diameters and wall thickness were assessed by echocardiography before, one and four weeks after induction of aortic valve stenosis. Immunohistological analysis were performed after eight weeks (hematoxylin and eosin, von-Kossa staining, anti-CD68-staining).
Results
Upon moderate or severe injury, AS developed with a significant increase in aortic valve peak blood flow velocity. While moderate injury promoted solitary AS, severe-injury induced mixed aortic valve disease with concomitant mild to moderate aortic regurgitation. Only 5% of the mice who received a moderate injury displayed a mild aortic regurgitation. In the group of mice with intense injury 50% of the mice had a mild and 18,75% had a moderate aortic insufficiency. The changes in aortic valve function were reflected by dilation and hypertrophy of the left ventricle, as well as a decreased left ventricular ejection fraction after intense injury, while moderate injury did not show significant dilation of the left ventricle. Histological analysis revealed the three classic hallmarks of human disease with aortic valve thickening, increased macrophage infiltration and calcification eight weeks after injury.
Conclusion
Hereby, we demonstrate that the induction of a graded wire induced aortic valve stenosis model in mice mimicking relevant pathophysiological mechanisms is feasible to study disease progression. We extended existing protocols to induce moderate stenosis allowing to solely study aortic valve stenosis without relevant aortic valve regurgitation.
Acknowledgement/Funding
S.N. was funded by Else-Kröner-Fresenius-Foundation of the Medical Faculty of the University of Bonn
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Affiliation(s)
- S T Niepmann
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - E Steffen
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - A Zietzer
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - J Nordsiek
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - I Gyamfi-Poku
- University Hospital Dusseldorf, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Dusseldorf, Germany
| | - K Piayda
- University Hospital Dusseldorf, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Dusseldorf, Germany
| | - J M Sinning
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Cologne, Germany
| | - G Nickenig
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - S Zimmer
- University Hospital Bonn, Heart Centre, Bonn, Germany
| | - C Quast
- University Hospital Dusseldorf, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Dusseldorf, Germany
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Adam M, Singh KK, Connelly KA. P5434P300-mediated inactivation of p53 protects against doxorubicin-induced cardiotoxicity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Doxorubicin is amongst the most widely prescribed chemotherapy drugs due to its effectiveness in cancer treatment. However, progressive treatment using doxorubicin severely increases the risk of congestive heart failure. Mechanistically, researchers have shown that doxorubicin (i) intercalates into DNA and disrupts topoisomerase-II-mediated DNA repair and (ii) generates free radicals which then causes damage to cellular membranes, DNA, and proteins. Ultimately these cellular insults induce cardiomyocyte (CM) death mediated by the tumour suppressor, p53. Currently, there are no clinically applicable preventative treatments for doxorubicin-induced cardiotoxicity and so, extensive research is being done in discovering a potential therapy. One such candidate is curcumin – a natural polyphenol compound non-toxic to humans. We have previously demonstrated that curcumin inhibits lysine acetyltransferase activity of p300, therefore reducing both histone and non-histone protein acetylation. To induce CM death, p53 requires acetylation by p300. Therefore, we hypothesize that curcumin protects against doxorubicin-induced CM death and cardiotoxicity via p300-mediated inactivation of p53.
Methods
Rat H9c2 cardiomyoblast cells were cultured and treated with a 2.5 μM dose of doxorubicin for 16 hours. One group of cells were pre-treated with curcumin (15μM) 4 hours prior to doxorubicin treatment, and controls were cultured with only diluent added. Following treatment, the cells were harvested for total protein. At end point, we performed immunoblotting to measure protein expression of key proteins involved in DNA damage (y-H2A.X, p53), and apoptosis (cleaved-Caspase 3).
Results
Our findings show that following doxorubicin treatment, p53 expression was significantly increased (p<0.001), confirming its role in doxorubicin-associated cardiotoxicity. Furthermore, doxorubicin was associated with increased DNA-damage as evidenced by increased expression and activation of DNA double-stranded breaks (DSBs) marker, y-H2A.X (p<0.001). Elevated levels of DNA-damage were further associated with significantly increased doxorubicin-induced apoptosis as measured by immunoblotting for cleaved-Caspase 3 (p<0.001). However, DNA-damage and apoptosis were attenuated by pre-treatment of cells with curcumin. Curcumin treatment led to a significant decrease in both y-H2A.X (p<0.01) and cleaved-Caspase 3 (p<0.01) expression compared to cells treated with only doxorubicin.
Conclusions
Our data provides the first evidence that curcumin protects against doxorubicin-induced apoptosis in rat cardiomyoblast cells in vitro. Further studies are warranted in vivo to confirm the potential of curcumin as a cardio-protective drug. Curcumin is a natural compound with little to no side-effects in humans, therefore our finding may provide a novel therapeutic target and treatment approach for doxorubicin-associated cardiotoxicity.
Acknowledgement/Funding
Heart & Stroke Foundation of Canada
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Affiliation(s)
- M Adam
- St. Michael's Hospital, Toronto, Canada
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Quast C, Zimmer S, Boenner F, Jacoby C, Gyamfi-Poku I, Piayda K, Erkens R, Niepmann ST, Adam M, Baldus S, Nickenig G, Kelm M, Floegel U. P5993Comprehensive characterization of experimental aortic valve stenosis by multiparametric MRI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, we established an experimental model of moderate aortic valve stenosis (AS) aiming to mimic human disease progression closely. Functional and structural MRI of a mouse model in experimental aortic valve stenosis has not been accomplished so far.
Purpose
Here, we aimed at developing comprehensive MRI approach for simultaneous assessment of changes in valvular, left ventricular and aortic morphology and function.
Methods
Male 12-week-old wildtype mice (C57Bl/6) were subjected to wire injury of the aortic valve to induce aortic valve stenosis. High resolution MRI at 9.4T was used to monitor subsequent functional and structural changes in the aortic valve, the ascending aorta, the left ventricle and aortic flow patterns.
Results
MRI permits accurate planimetry of the orifice and the thickness of the aortic valve, allows a reliable three-dimensional mapping of transvalvular aortic flow, simultaneously depicts aortic regurgitation in 3D fashion and permits assessment of left ventricular changes due to AS. In our model we observed a reduced valve orifice and an increase in valve thickness. Homogenous flow pattern under control converted to heterogenous and turbulent flow with progression of AS associated with increased aortic strain, aortic wall and left ventricular wall thickness.
Conclusions
In a murine model of aortic valve stenosis MRI is capable to reliably display a three-dimensional transvalvular aortic flow profile with concomitant quantification of structural and functional changes in aortic valve, left ventricle, and ascending aorta. This comprehensive functional imaging at high resolution and distinct reproducibility offers for the first time serial assessment of disease progression in an experimental model of aortic valve stenosis.
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Affiliation(s)
- C Quast
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - S Zimmer
- University Hospital Bonn, Heart Center Bonn, Clinic for Internal Medicine II, Bonn, Germany
| | - F Boenner
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - C Jacoby
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - I Gyamfi-Poku
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - K Piayda
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - R Erkens
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - S T Niepmann
- University Hospital Bonn, Heart Center Bonn, Clinic for Internal Medicine II, Bonn, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Clinic for Cardiology, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Clinic for Cardiology, Cologne, Germany
| | - G Nickenig
- University Hospital Bonn, Heart Center Bonn, Clinic for Internal Medicine II, Bonn, Germany
| | - M Kelm
- Heinrich-Heine-University, Medical Faculty, Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
| | - U Floegel
- Heinrich-Heine-University, Department of Molecular Cardiology, Düsseldorf, Germany
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Vantler M, Berghausen EM, Zierden M, Mollenhauer M, Mehrkens D, Adam M, Baldus S, Rosenkranz S. P1937Deficiency of PI 3-kinase isoform p110alpha in smooth muscle cells impairs vascular integrity and promotes aortic aneurysm formation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The pathobiology of aortic aneurysms is characterized by vascular inflammation, extracellular matrix degeneration, and particularly by loss and dedifferentiation of vascular smooth muscle cells (SMCs). In SMCs, the PI 3-kinase isoform p110α mediates receptor tyrosine kinase dependent proliferation, chemotaxis, and survival. Smooth muscle specific p110α deficient mice (SM-p110α−/− mice) display reduced medial wall thickness, substantially reduced neointima formation and media hypertrophy after balloon injury of the carotid artery.
Objective
We hypothesized that loss of p110α signaling impairs vascular integrity and promotes development and progression of abdominal aortic aneurysms (AAA). We aimed to elucidate the impact of p110α deficiency on vascular integrity, SMC phenotypic modulation, vascular inflammation, and AAA formation.
Methods and results
Ultra-structural characterization of aortic wall morphology in abdominal aortas from SM-p110α−/− mice by transmission electron microscopy (TEM) revealed disarranged structure of tunica media as indicated by disorganized elastic fibers, detached SMCs, and elastic fiber breaks. Western blots showed reduced elastin and fibrillin expression in SMCs from p110α−/− mice. Media thickness was significantly reduced in abdominal aortas from SM-p110α−/− mice compared to wild type (WT) controls (29.0±3.1 vs. 42.5±4.1 μm). Lack of p110α decreased expression of differentiation markers SM-α-actin and SM-MHC. p110α deficiency significantly diminished responsiveness of aortic rings to vasodilator acetylcholine. These data indicate loss of differentiation and impaired contractility of p110α−/− SMCs. We subjected SM-p110α−/− mice and WT littermate controls to the porcine pancreatic elastase (PPE) model of AAA. PPE was infused into the infrarenal aorta, respectively, to induce AAA formation. Ultrasonic examination of abdominal aortas demonstrated an enlarged aortic diameter in PPE challenged mice. AAA formation was significantly (p<0.01) enhanced in SM-p110α−/− (0.46±0.12 mm, n=8) compared to SM-p110α+/+ mice (0.18±0.03 mm, n=4). These data indicate a protective function of p110α in AAA formation. Immunocytochemistry of the aortic medial compartment from PPE-perfused SM-p110α−/− mice revealed significantly increased MOMA-2+ monocyte/macrophage content indicating augmented aortic inflammation during AAA formation compared to WT controls. Furthermore, SMCs from SM-p110α−/− mice expressed reduced amounts of anti-inflammatory angiopoietin1 compared to p110α+/+ SMCs. Moreover, frequent apoptotic/necrotic SMCs were found in the aortic media of SM-p110α−/− mice by TEM, potentially contributing to vascular inflammation in a critical fashion.
Conclusion
These data indicate that p110α signaling critically contributes to vascular integrity via maintaining SMC plasticity, elastic fiber homeostasis, and anti-inflammatory processes. Consequently, lack of proper p110α signaling promotes progression of AAA formation.
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Affiliation(s)
- M Vantler
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - E M Berghausen
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - M Zierden
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - M Mollenhauer
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - D Mehrkens
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
| | - S Rosenkranz
- Cologne University Hospital - Heart Center, Clinic III for Internal Medicine, Cologne, Germany
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Faliza N, Adam M, Basri H, Shabri Abd. Madjid M. Corporate Social Responsibility in Islamic and Conventional View: A Theoretical Approach. KSS 2019; 3:440. [DOI: 10.18502/kss.v3i14.4329] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Freischlag K, Adam M, Turner M, Watson J, Ezekian B, Schroder PM, Mantyh C, Migaly J. With widespread adoption of MIS colectomy for colon cancer, does hospital type matter? Surg Endosc 2019; 33:159-168. [PMID: 29946919 DOI: 10.1007/s00464-018-6289-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/19/2018] [Accepted: 06/18/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Recent studies have shown that hospital type impacts patient outcomes, but no studies have examined hospital differences in outcomes for patients undergoing minimally invasive surgery (MIS) for segmental colectomies. METHODS The 2010-2014 National Cancer Data Base was queried for patients undergoing segmental colectomy for non-metastatic colon adenocarcinoma. Descriptive statistics characterized MIS utilization by hospital type. Multivariable models were used to examine the effect of hospital type on outcomes after MIS. Survival probability was plotted using the Kaplan-Meier method. RESULTS 80,922 patients underwent MIS segmental colectomy for colon cancer from 2010 to 2014. From 2010 to 2014, the number of MIS segmental colectomies increased by 157% at academic hospitals, 151% at comprehensive hospitals, and 153% at community hospitals. Compared to academic hospitals, community and comprehensive hospitals had greater adjusted odds of positive margins (Community OR 1.525, 95% Confidence Interval 1.233-1.885; Comprehensive OR 1.216, 95% CI 1.041-1.42), incomplete number of lymph nodes analyzed (< 12 LNs) from surgery (Community OR 2.15, 95% CI 1.98-2.32; Comprehensive OR 1.42, 95% CI 1.34-1.51), and greater 30-day mortality (Community OR 1.43, 95% CI 1.14-1.78; Comprehensive OR 1.36, 95% CI 1.17-1.59). Patient survival probability was higher at academic hospitals at 5 years (Academic 69% vs. Comprehensive 66% vs. Community 63%, p < 0.001). Community hospitals and comprehensive hospitals had significantly higher risk of adjusted long-term mortality (Community HR 1.28; 95% CI 1.19-1.37; p < 0.001; Comprehensive HR 1.14; 95% CI 1.09-1.20; p < 0.001). CONCLUSIONS Despite widespread use of laparoscopic oncologic surgery, short- and long-term outcomes from MIS for segmental colectomy are superior at academic hospitals. This difference may be due to superior perioperative oncologic technique and surgical outcomes at academic hospitals. Our data provide important information for patients, referring physicians, and surgeons about the significance of hospital type in management of colon cancer.
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Affiliation(s)
- K Freischlag
- Duke University School of Medicine, Durham, NC, USA.
| | - M Adam
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - M Turner
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - J Watson
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - B Ezekian
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - P M Schroder
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - C Mantyh
- Duke University Medical Center, Surgery, Durham, NC, USA
| | - J Migaly
- Duke University Medical Center, Surgery, Durham, NC, USA
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Stempinski-Metoyer K, Madrigal J, Adam M, Patel A. Utility of the Comfort, Assurance, Language Model (CALM) as a nonpharmacological intervention for pain relief during IUD insertion. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.079] [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: 10/28/2022]
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Jackson H, Bhattacharya S, Bojczuk P, Kilian D, Seestaller Wehr L, Hahn A, Shi H, Bi M, Adam M, Jing J, Morley P, Hopson C, Paul E, Hoos A, Smothers J, Srinivasan R, Yanamandra N. Evaluation of OX40 receptor density, influence of IgG Isotype and dosing paradigm in anti-OX40-mediated efficacy and biomarker responses with PD-1 blockade. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.065] [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: 11/13/2022] Open
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Vanherle K, Werkman AM, Baete E, Barkmeijer A, Kolm A, Gast C, Ramminger S, Höld E, Kohlenberg-Müller K, Ohlrich-Hahn S, Walters ME, Wewerka-Kreimel D, Adam M, Valentini L. Proposed standard model and consistent terminology for monitoring and outcome evaluation in different dietetic care settings: Results from the EU-sponsored IMPECD project. Clin Nutr 2018; 37:2206-2216. [PMID: 30274899 DOI: 10.1016/j.clnu.2018.08.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 08/10/2018] [Accepted: 08/31/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND & AIMS Dietetic interventions contribute to certain health objectives and other outcomes, but are mostly part of a multimodal and multidisciplinary approach what makes evaluating the actual effects of dietitians' involvement rather complex. Although monitoring and outcome evaluation (M&OE) can provide routine data to prove the effectiveness of dietetic interventions, this has not been established yet in different dietetic settings. METHODS A comprehensive framework for M&OE in dietetics was developed by dietetic experts from five European higher education institutes for dietetics in the course of the EU sponsored project "Improvement of Education and Competences in Dietetics (IMPECD)". RESULTS Firstly, clear definitions on M&OE are proposed to facilitate the use of consistent terminology, with a specific emphasis on the term "impact" covering macro-level outcomes such as cost-effectiveness. Secondly, the Dietetic Care Process (DCP) was merged into a logic model to demonstrate the position of M&OE in relation to intervention planning and implementation, in both group and individual settings. Thirdly, selecting the appropriate indicators is indispensable to monitor and evaluate outcomes, and requires a high level of dietitians' critical reasoning. A categorized overview of indicators is provided to support this process. Lastly, the consortium developed a checklist to give dietitians a handle on what elements could be included in their M&OE plan and trigger them to perform M&OE in practice. CONCLUSIONS Innovative M&OE models may help dietitians to demonstrate their effectiveness in improving clinical outcomes and justify their role in health care.
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Affiliation(s)
- K Vanherle
- Artesis Plantijn University College Antwerp, Department of Science and Technology, Nutrition and Dietetics Programme, Kronenburgstraat 47, 2000, Antwerp, Belgium.
| | - A M Werkman
- Hanzehogeschool Groningen, School of Health Care Studies, Nutrition and Dietetics Programme, Petrus Driessenstraat 3, NL 9714 CA, Groningen, the Netherlands
| | - E Baete
- Artesis Plantijn University College Antwerp, Department of Science and Technology, Nutrition and Dietetics Programme, Kronenburgstraat 47, 2000, Antwerp, Belgium
| | - A Barkmeijer
- Hanzehogeschool Groningen, School of Health Care Studies, Nutrition and Dietetics Programme, Petrus Driessenstraat 3, NL 9714 CA, Groningen, the Netherlands
| | - A Kolm
- University of Applied Sciences St. Pölten, Department of Health Sciences, Dietetics Programme, Matthias Corvinus-Straße 15, 3100, St. Pölten, Austria
| | - C Gast
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Leipziger Straße 123, 36037, Fulda, Germany
| | - S Ramminger
- University of Applied Sciences Neubrandenburg, Section of Dietetics, Dept. of Agriculture and Food Sciences, Brodaer Str 2, 17033, Neubrandenburg, Germany
| | - E Höld
- University of Applied Sciences St. Pölten, Department of Health Sciences, Dietetics Programme, Matthias Corvinus-Straße 15, 3100, St. Pölten, Austria
| | - K Kohlenberg-Müller
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Leipziger Straße 123, 36037, Fulda, Germany
| | - S Ohlrich-Hahn
- University of Applied Sciences Neubrandenburg, Section of Dietetics, Dept. of Agriculture and Food Sciences, Brodaer Str 2, 17033, Neubrandenburg, Germany
| | - M E Walters
- Hanzehogeschool Groningen, School of Health Care Studies, Nutrition and Dietetics Programme, Petrus Driessenstraat 3, NL 9714 CA, Groningen, the Netherlands
| | - D Wewerka-Kreimel
- University of Applied Sciences St. Pölten, Department of Health Sciences, Dietetics Programme, Matthias Corvinus-Straße 15, 3100, St. Pölten, Austria
| | - M Adam
- Artesis Plantijn University College Antwerp, Department of Science and Technology, Nutrition and Dietetics Programme, Kronenburgstraat 47, 2000, Antwerp, Belgium
| | - L Valentini
- University of Applied Sciences Neubrandenburg, Section of Dietetics, Dept. of Agriculture and Food Sciences, Brodaer Str 2, 17033, Neubrandenburg, Germany
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Mehrkens D, Dohr JK, Mollenhauer M, Kochen M, Silva A, Sengle G, Rudolph V, Klinke A, Adam M, Baldus S. P4551Myeloperoxidase activity aggravates aortic wall remodeling and participates in aneurysm development in Marfan Syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Mehrkens
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - J K Dohr
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - M Mollenhauer
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - M Kochen
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - A Silva
- Institute of Biochemistry, Cologne, Germany
| | - G Sengle
- Institute of Biochemistry, Cologne, Germany
| | - V Rudolph
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - A Klinke
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - M Adam
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
| | - S Baldus
- Cologne University Hospital - Heart Center, Department of Cardiology, Cologne, Germany
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Adam M, Huuskonen V, Raekallio MR, Casoni D, Mykkänen AK, Lappalainen AK, Kajula M, Kallio-Kujala IJ, Vainio OM. Cardiopulmonary effects of vatinoxan in sevoflurane-anaesthetised sheep receiving dexmedetomidine. Vet J 2018; 238:63-69. [PMID: 30103917 DOI: 10.1016/j.tvjl.2018.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/25/2018] [Accepted: 07/16/2018] [Indexed: 11/17/2022]
Abstract
The effects of pre-treatment with vatinoxan (MK-467) on dexmedetomidine-induced cardiopulmonary alterations were investigated in sheep. In a crossover study design with a 20-day washout, seven sheep were anaesthetised with sevoflurane in oxygen and air. The sheep were ventilated with the pressure-limited volume-controlled mode and a positive end-expiratory pressure of 5cmH2O. Peak inspiratory pressure (PIP) was set at 25cmH2O. The sheep received either 150μg/kg vatinoxan HCl (VAT+DEX) or saline intravenously (IV) 10min before IV dexmedetomidine HCl (3μg/kg, DEX). Cardiopulmonary variables were measured before treatments (baseline), 3min after vatinoxan or saline, and 5, 15 and 25min after dexmedetomidine. Computed tomography (CT) of lung parenchyma was performed at baseline, 2min before dexmedetomidine, and 10, 20 and 30min after DEX. Bronchoalveolar lavage (BAL) was performed after the last CT scan and shortly before sheep recovered from anaesthesia. After VAT, cardiac output significantly increased from baseline. DEX alone significantly decreased partial arterial oxygen tension, total dynamic compliance and tidal volume, whereas PIP was significantly increased. With VAT+DEX, these changes were minimal. No significant changes were detected in haemodynamics from baseline after DEX. With VAT+DEX, mean arterial pressure and systemic vascular resistance were significantly decreased from baseline, although hypotension was not detected. On CT, lung density was significantly increased with DEX as compared to baseline. No visual abnormalities were detected in bronchoscopy and no differences were detected in the BAL fluid after either treatment. The pre-administration of vatinoxan alleviates dexmedetomidine-induced bronchoconstriction, oedema and hypoxaemia in sevoflurane-anaesthetised sheep.
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Affiliation(s)
- M Adam
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland; Pharmacology Department, Faculty of Veterinary Medicine, Beni-Suef University, 62511 Beni-Suef, Egypt.
| | - V Huuskonen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland; University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland
| | - M R Raekallio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - D Casoni
- Department for BioMedical Research, Faculty of Medicine, University of Bern, Murtenstrasse 35, 3008 Bern, Switzerland
| | - A K Mykkänen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - A K Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - M Kajula
- Admescope, Typpitie 1, 90620 Oulu, Finland
| | - I J Kallio-Kujala
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - O M Vainio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
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Mayer C, Adam M, Walenta L, Schmid N, Heikelä H, Schubert K, Flenkenthaler F, Dietrich KG, Gruschka S, Arnold GJ, Fröhlich T, Schwarzer JU, Köhn FM, Strauss L, Welter H, Poutanen M, Mayerhofer A. Insights into the role of androgen receptor in human testicular peritubular cells. Andrology 2018; 6:756-765. [PMID: 29869453 DOI: 10.1111/andr.12509] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 01/07/2023]
Abstract
Contractile smooth muscle-like peritubular cells build the wall of seminiferous tubules in men. They are crucial for sperm transport and complement the functions of Sertoli cells by secreting factors, including glial cell line-derived neurotrophic factor. Previous studies revealed that they also secrete the chemokine C-X-C motif chemokine ligand 12 (CXCL12), which has known roles in spermatogenesis. Peritubular cells express the androgen receptor (AR), which is retained in isolated human testicular peritubular cells. We aimed to explore AR-regulated functions in human testicular peritubular cells. Bearing in mind that infertile men often have high aromatase activity, which may lower intratesticular androgen concentrations, an animal model for male infertility was studied. These mice display an age-dependent loss in spermatogenesis due to high aromatase activity. Human testicular peritubular cells were exposed to dihydrotestosterone or the antiandrogen flutamide. We studied AR, smooth muscle cell markers, glial cell line-derived neurotrophic factor and 15 secreted factors previously identified, including CXCL12. We used qPCR, Western blotting, ELISA or selected reaction monitoring (SRM). In the animal model for male infertility, we employed qPCR and immunohistochemistry. Dihydrotestosterone increased AR and flutamide prevented these actions. The smooth muscle cell markers calponin and smooth muscle actin were likewise increased, while cell size or cellular proliferation was not changed. Dihydrotestosterone did not increase glial cell line-derived neurotrophic factor or CXCL12 secretion but increased levels of serine proteinase inhibitor (SERPIN) E1. The animal model for male infertility with high aromatase activity showed reduced numbers of AR-immunoreactive testicular peritubular cells, suggesting that altered androgen and/or oestrogen levels could influence AR-mediated responses in peritubular cells. Androgens act on human testicular peritubular cells to enhance AR levels, their contractile phenotype and to modulate the secretion of some secreted factors. This study suggests that some aspects of human peritubular cell functions are regulated by androgens.
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Affiliation(s)
- C Mayer
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - M Adam
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany.,Turku Center for Disease Modeling and Institute of Biomedicine, University of Turku, Turku, Finland
| | - L Walenta
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - N Schmid
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - H Heikelä
- Turku Center for Disease Modeling and Institute of Biomedicine, University of Turku, Turku, Finland
| | - K Schubert
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - F Flenkenthaler
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU, Munich, Germany
| | - K-G Dietrich
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - S Gruschka
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - G J Arnold
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU, Munich, Germany
| | - T Fröhlich
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU, Munich, Germany
| | | | | | - L Strauss
- Turku Center for Disease Modeling and Institute of Biomedicine, University of Turku, Turku, Finland
| | - H Welter
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
| | - M Poutanen
- Turku Center for Disease Modeling and Institute of Biomedicine, University of Turku, Turku, Finland
| | - A Mayerhofer
- Cell Biology, Anatomy III, BMC Munich, Ludwig-Maximilians-Universität (LMU), Munich, Germany
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Dickson SJ, Clay KA, Adam M, Ardley C, Bailey MS, Burns DS, Cox AT, Craig DG, Espina M, Ewington I, Fitchett G, Grindrod J, Hinsley DE, Horne S, Hutley E, Johnston AM, Kao RLC, Lamb LE, Lewis S, Marion D, Moore AJ, Nicholson-Roberts TC, Phillips A, Praught J, Rees PS, Schoonbaert I, Trinick T, Wilson DR, Simpson AJ, Wang D, O'Shea MK, Fletcher TE. Enhanced case management can be delivered for patients with EVD in Africa: Experience from a UK military Ebola treatment centre in Sierra Leone. J Infect 2018; 76:383-392. [PMID: 29248587 PMCID: PMC5903873 DOI: 10.1016/j.jinf.2017.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/28/2017] [Accepted: 12/10/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with Ebola virus disease (EVD) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. METHODS Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015. RESULTS A total of 44 EVD patients were admitted (median age 37 years (range 17-63), 32/44 healthcare workers), and excluding those evacuated, the case fatality rate was 49% (95% CI 33%-65%). No pregnant women were admitted. At admission 9/44 had stage 1 disease (fever and constitutional symptoms only), 12/44 had stage 2 disease (presence of diarrhoea and/or vomiting) and 23/44 had stage 3 disease (presence of diarrhoea and/or vomiting with organ failure), with case fatality rates of 11% (95% CI 1%-58%), 27% (95% CI 6%-61%), and 70% (95% CI 47%-87%) respectively (p = 0.009). Haemorrhage occurred in 17/41 (41%) patients. The majority (21/40) of patients had hypokalaemia with hyperkalaemia occurring in 12/40 patients. Acute kidney injury (AKI) occurred in 20/40 patients, with 14/20 (70%, 95% CI 46%-88%) dying, compared to 5/20 (25%, 95% CI 9%-49%) dying who did not have AKI (p = 0.01). Ebola virus (EBOV) PCR cycle threshold value at baseline was mean 20.3 (SD 4.3) in fatal cases and 24.8 (SD 5.5) in survivors (p = 0.007). Mean national early warning score (NEWS) at admission was 5.5 (SD 4.4) in fatal cases and 3.0 (SD 1.9) in survivors (p = 0.02). Central venous catheters were placed in 37/41 patients and intravenous fluid administered to 40/41 patients (median duration of 5 days). Faecal management systems were inserted in 21/41 patients, urinary catheters placed in 27/41 and blood component therapy administered to 20/41 patients. CONCLUSIONS EVD is commonly associated life-threatening electrolyte imbalance and organ dysfunction. We believe that the enhanced levels of protocolized care, scale and range of medical interventions we report, offer a blueprint for the future management of EVD in resource-limited settings.
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Affiliation(s)
- S J Dickson
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - K A Clay
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - M Adam
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - C Ardley
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - M S Bailey
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - D S Burns
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - A T Cox
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - D G Craig
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - M Espina
- Royal Canadian Medical Services, Ottawa, Canada
| | - I Ewington
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - G Fitchett
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - J Grindrod
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - D E Hinsley
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - S Horne
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - E Hutley
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - A M Johnston
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - R L C Kao
- Royal Canadian Medical Services, Ottawa, Canada
| | - L E Lamb
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - S Lewis
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - D Marion
- Royal Canadian Medical Services, Ottawa, Canada
| | - A J Moore
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - T C Nicholson-Roberts
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - A Phillips
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - J Praught
- Royal Canadian Medical Services, Ottawa, Canada
| | - P S Rees
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | | | - T Trinick
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - D R Wilson
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - A J Simpson
- Rare and Imported Pathogens Laboratory, Public Health England, Porton, United Kingdom
| | - D Wang
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - M K O'Shea
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - T E Fletcher
- U.K. Defence Medical Services EVD Group, Royal Centre for Defence Medicine, Birmingham, United Kingdom; Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom.
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Silveira A, Carlo A, Adam M, McLeod O, Lundman P, Boquist S, Woodhams BJ, Hamsten A. VIIaAT complexes, procoagulant phospholipids, and thrombin generation during postprandial lipemia. Int J Lab Hematol 2018; 40:251-257. [PMID: 29356352 DOI: 10.1111/ijlh.12773] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Factor VII activation occurs postprandially. A proportion of activated factor VII (VIIa) circulates in complex with antithrombin (VIIaAT). Our primary objective was to assess the effects of postprandial lipemia on circulating VIIaAT, procoagulant phospholipid (PPL) activity, and thrombin generation. METHODS Plasma samples from postmyocardial infarction patients (n = 40) and controls (n = 39) were taken before and at 3 and 6 hours during a standardized oral fat tolerance test (OFTT). Fasting PPL activity measurements were also made in a second cohort of 108 postinfarction patients and 109 controls. VIIaAT was analyzed with the Asserachrom VIIaAT ELISA, PPL activity with the STA-Procoag-PPL kit, and thrombin generation with calibrated automated thrombogram with PRP-Reagent as trigger (all Diagnostica Stago products). RESULTS Postprandially, VIIaAT increased in all samples without significant case-control differences in the overall response during the OFTT. Thrombin generation measures peak height and velocity, and PPL activity, were marginally affected by the test meal in the controls. Levels of all patient baseline measures were significantly different from controls, indicating a more hypercoagulable state, and these differences were maintained throughout the OFTT. Fasting samples from cases showed higher PPL activity than control samples. CONCLUSION Viewing VIIaAT quantitation as a surrogate for TF activity measurement, postprandial increase in VIIaAT may reflect a mechanism that adds to the cardiovascular risk associated with postprandial lipemia. On the other hand, the impact of postprandial lipemia on PPL activity and thrombin generation seems to be minor.
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Affiliation(s)
- A Silveira
- Cardiovascular Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A Carlo
- Diagnostica Stago, Gennevilliers, France
| | - M Adam
- Diagnostica Stago, Gennevilliers, France
| | - O McLeod
- Cardiovascular Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Lundman
- Department of Clinical Sciences, Division of Cardiovascular Medicine, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - S Boquist
- Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
| | | | - A Hamsten
- Cardiovascular Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
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Adam M, Raekallio MR, Keskitalo T, Honkavaara JM, Scheinin M, Kajula M, Mölsä S, Vainio OM. The impact of MK-467 on plasma drug concentrations, sedation and cardiopulmonary changes in sheep treated with intramuscular medetomidine and atipamezole for reversal. J Vet Pharmacol Ther 2018; 41:447-456. [DOI: 10.1111/jvp.12486] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/21/2017] [Indexed: 11/28/2022]
Affiliation(s)
- M. Adam
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
- Pharmacology Department; Faculty of Veterinary Medicine; Beni-Suef University; Beni-Suef Egypt
| | - M. R. Raekallio
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
| | - T. Keskitalo
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
| | - J. M. Honkavaara
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
| | - M. Scheinin
- Department of Pharmacology; Drug Development and Therapeutics; University of Turku; Turku Finland
- Unit of Clinical Pharmacology; Turku University Hospital; Turku Finland
| | | | - S. Mölsä
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
| | - O. M. Vainio
- Department of Equine and Small Animal Medicine; Faculty of Veterinary Medicine; University of Helsinki; Helsinki Finland
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Antonescu F, Adam M, Popa C, Tuţă S. A review of cervical spine MRI in ALS patients. J Med Life 2018; 11:123-127. [PMID: 30140318 PMCID: PMC6101680] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Rationale. In recent years, significant advances have been made on the subject of MRI examination techniques, which have opened new avenues of research regarding the spinal involvement in amyotrophic lateral sclerosis (ALS). Objective. Our objective was to compile and analyze the available literature data, concerning the MRI of the cervical spine in ALS, detailing the metrics and their significance in diagnosis and follow-up. Methods and results. We have conducted an extensive search on the subject using literature data published over the last fifteen years, correlating it with our own experience. In ALS, there is a permanent interest in developing new biomarkers that might be sensitive to spatial and temporal patterns of neurodegeneration, which will permit early diagnosis and hopefully lead to new therapeutic approaches. Both diffusion tensor imaging (DTI) and spinal cord morphometry (especially spinal atrophy) reflect different aspects of the disease and correlate with clinical deterioration. Newer approaches like inhomogeneous magnetization transfer (ihMTR) and multiparametric analysis seem to have better sensitivity, are more appropriate for follow-up, and lend themselves to prognostic conclusions. Discussion. We conclude that MRI is a constantly expanding field, a unique non-invasive tool with immense potential in evaluating the in vivo evolution of the neurodegenerative ALS process, both structurally and functionally, with high hopes for the future. Abbreviations: ALS - amyotrophic lateral sclerosis, UMN - upper motor neuron, LMN - lower motor neuron, EMG - electromyography, CST - cortico-spinal tract, FLAIR - fluid-attenuated inversion recovery, MND - motor neuron disease, DTI - Diffusion tensor imaging, FA - fractional anisotropy, MD - mean diffusivity, ihMTR - inhomogeneous magnetization transfer, fMRI - functional MRI.
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Affiliation(s)
- F Antonescu
- National Institute of Neurology and Neurovascular Diseases, Bucharest,“Carol Davila” University of Medicine and Pharmacy, Bucharest
| | - M Adam
- MEDINST Diagnostic Center, Bucharest
| | - C Popa
- National Institute of Neurology and Neurovascular Diseases, Bucharest,“Carol Davila” University of Medicine and Pharmacy, Bucharest
| | - S Tuţă
- National Institute of Neurology and Neurovascular Diseases, Bucharest,“Carol Davila” University of Medicine and Pharmacy, Bucharest
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Lacroix-Poisson F, Benard F, Wilson D, Adam M, Yapp D, Ho C, Laskin J. P1.03-020 Detection of Hypoxia Using EF5 PET/CT in 10 Patients with Advanced NSCLC Receiving Chemotherapy with and without Bevacizumab. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.824] [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: 10/18/2022]
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Franke ML, Heinrich M, Adam M, Sünkel U, Diefenbacher A, Sappok T. [Body weight and mental disorders : Results from a clinical psychiatric cross-sectional study of people with intellectual disabilities]. Nervenarzt 2017; 89:552-558. [PMID: 28849297 DOI: 10.1007/s00115-017-0411-2] [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] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have a shorter life expectancy and higher mortality rate and more often suffer from various physical and mental disorders (WHO: 3-4 times more often than the general population). Obesity is an important risk factor for various disorders. This cross-sectional study examined the body weight and its risk factors in a clinical population of adults with ID. METHODS The prevalence of underweight, normal weight, and overweight was determined using the body mass index (BMI) for 633 patients of an outpatient clinic for people with ID and mental disorders. A multiple logistic regression analysis was used to assess factors for alterations in body weight. RESULTS Approximately one out of two men and two out of three women with ID and mental disorders were overweight. Adults with mild and moderate ID, female gender, increasing age, Down's syndrome, behavioral disorders, and a less supported living situation were associated with a higher rate of obesity. People with dementia and autism spectrum disorders showed a lower rate of obesity. CONCLUSION Young women with ID and mental disorders were particularly at risk for obesity. The respective factors may support the development of specific prevention programs to reduce the risk of overweight and thereby lead to better mental and physical health in people with ID.
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Affiliation(s)
- M L Franke
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland.
| | - M Heinrich
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland.,Fachbereich Erziehungswissenschaften und Psychologie, Freie Universität Berlin, Berlin, Deutschland
| | - M Adam
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
| | - U Sünkel
- Hertie-Institut für klinische Hirnforschung, Tübingen, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen, Deutschland
| | - A Diefenbacher
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
| | - T Sappok
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
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Geissen S, Mehrkens D, Schaetzle A, Mollenhauer M, Adam M, Klinke A, Baldus S, Rudolph V. P2310Cardiac hypertrophy, fibrosis and diastolic dysfunction are attenuated upon administration of nitro oleic acid in a murine model of hypertensive heart disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Adam M, Kirch A. EHEC-Untersuchungen am Landesgesundheitsamt Baden-Württemberg. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602095] [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: 10/19/2022]
Affiliation(s)
- M Adam
- Regierungspräsidium Stuttgart, Landesgesundheitsamt Baden-Württemberg, Stuttgart
| | - A Kirch
- Regierungspräsidium Stuttgart, Landesgesundheitsamt Baden-Württemberg, Stuttgart
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Guenther S, Adam M, Hu X, Tediashvili G, Wang D, Velden J, Renne T, Deuse T, Reichenspurner H, Tsao P, Schrepfer S. Tacrolimus Regulates MicroRNAs in Recipient Immune Cells after Experimental Cardiac Transplantation. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598895] [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: 10/20/2022]
Affiliation(s)
- S.P.W. Guenther
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
| | - M. Adam
- Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany
| | - X. Hu
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
| | - G. Tediashvili
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
| | - D. Wang
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
| | - J. Velden
- Department of Pathology, Marienkrankenhaus Hamburg, Hamburg, Germany
| | - T. Renne
- Department of Clinical Chemistry, University Medical Center Hamburg, Hamburg, Germany
| | - T. Deuse
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - P.S. Tsao
- Division of Cardiovascular Medicine, Stanford University, Stanford, United States
| | - S. Schrepfer
- Transplant and Stem Cell Immunobiology (TSI) Laboratory, Department of Surgery, University of California San Francisco, San Francisco, United States
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Adam M, Tohamy MA, El-Sadek S, M. Radi A. Pharmacokinetic interaction of tulathromycin with Flunixin meglumine after intravenous injection in goats. Journal of Veterinary Medical Research 2016. [DOI: 10.21608/jvmr.2016.43241] [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: 10/26/2022] Open
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Adam M, Tohamy MA, El-Sadek S, M. Radi A. Subcutaneous pharmacokinetic interaction of tulathromycin With flunixin meglumine in goats. Journal of Veterinary Medical Research 2016. [DOI: 10.21608/jvmr.2016.43242] [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: 10/26/2022] Open
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Mayer C, Adam M, Glashauser L, Dietrich K, Schwarzer JU, Köhn FM, Strauss L, Welter H, Poutanen M, Mayerhofer A. Sterile inflammation as a factor in human male infertility: Involvement of Toll like receptor 2, biglycan and peritubular cells. Sci Rep 2016; 6:37128. [PMID: 27849015 PMCID: PMC5111051 DOI: 10.1038/srep37128] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 10/25/2016] [Indexed: 12/16/2022] Open
Abstract
Changes in the wall of seminiferous tubules in men with impaired spermatogenesis imply sterile inflammation of the testis. We tested the hypothesis that the cells forming the wall of seminiferous tubules, human testicular peritubular cells (HTPCs), orchestrate inflammatory events and that Toll like receptors (TLRs) and danger signals from the extracellular matrix (ECM) of this wall are involved. In cultured HTPCs we detected TLRs, including TLR2. A TLR-2 ligand (PAM) augmented interleukin 6 (IL-6), monocyte chemo-attractant protein-1 (MCP-1) and pentraxin 3 (PTX3) in HTPCs. The ECM-derived proteoglycan biglycan (BGN) is secreted by HTPCs and may be a TLR2-ligand at HTPCs. In support, recombinant human BGN increased PTX3, MCP-1 and IL-6 in HTPCs. Variable endogenous BGN levels in HTPCs derived from different men and differences in BGN levels in the tubular wall in infertile men were observed. In testes of a systemic mouse model for male infertility, testicular sterile inflammation and elevated estradiol (E2) levels, BGN was also elevated. Hence we studied the role of E2 in HTPCs and observed that E2 elevated the levels of BGN. The anti-estrogen ICI 182,780 blocked this action. We conclude that TLR2 and BGN contribute to sterile inflammation and infertility in man.
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Affiliation(s)
- C Mayer
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany
| | - M Adam
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany.,Turku Center for Disease Modeling and Department of Physiology, Institute of Biomedicine, University of Turku, FL-20520 Turku, Finland
| | - L Glashauser
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany
| | - K Dietrich
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany
| | | | - F-M Köhn
- Andrologicum, D-80331 Munich, Germany
| | - L Strauss
- Turku Center for Disease Modeling and Department of Physiology, Institute of Biomedicine, University of Turku, FL-20520 Turku, Finland
| | - H Welter
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany
| | - M Poutanen
- Turku Center for Disease Modeling and Department of Physiology, Institute of Biomedicine, University of Turku, FL-20520 Turku, Finland
| | - A Mayerhofer
- Biomedical Center (BMC), Cell Biology, Anatomy III, Ludwig-Maximilians-Universität (LMU), D-82152 Planegg, Germany
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Steinhilber B, Hoffmann S, Seibt R, Rieger MA, Karlovic K, Maier T, Heidingsfeld M, Sawodny O, Adam M, Rothmund R. Ein Arm-Stütz-System für laparoskopische Eingriffe: Entwicklung und Evaluation. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592750] [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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Cortier D, Van Dreden P, Adam M, Bironien R, François D, Vasse M. Transient Factor V deficiency associated with Factor V-immunoglobulin complexes but without evidence of a classical inhibitor. Thromb Res 2016; 147:10-12. [PMID: 27664390 DOI: 10.1016/j.thromres.2016.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 02/08/2023]
Affiliation(s)
- D Cortier
- Intensive Care Unit, Hôpital Foch, Suresnes, France
| | | | - M Adam
- Diagnostica Stago, Gennevilliers, France
| | - R Bironien
- Biology Department, Hôpital Foch, Suresnes, France & NSERM UMR_1176, Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - D François
- Biology Department, Hôpital Foch, Suresnes, France & NSERM UMR_1176, Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - M Vasse
- Biology Department, Hôpital Foch, Suresnes, France & NSERM UMR_1176, Université Paris-Sud, Le Kremlin-Bicêtre, France.
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McAlhaney M, Ndungu J, Mbugua S, Waithera C, Jowi B, Adam M. Effects of a short training course and professional background on the job
performance of community health extension workers in Kenya. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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