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Durst M, Graf TR, Graf R, Kron M, Arras M, Zechner D, Palme R, Talbot SR, Jirkof P. Analysis of Pain and Analgesia Protocols in Acute Cerulein-Induced Pancreatitis in Male C57BL/6 Mice. Front Physiol 2021; 12:744638. [PMID: 34880773 PMCID: PMC8645955 DOI: 10.3389/fphys.2021.744638] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Pancreatitis is known to be painful in humans and companion animals. However, the extent of pain in experimental mouse models of acute pancreatitis is unknown. Consequently, the severity classification of acute pancreatitis in mice is controversially discussed and standardized pain management is missing. In this study, we investigated acute Cerulein-induced pancreatitis with pain-specific and well-being orientated parameters to detect its impact on mice. Male C57BL/6J male mice were injected with Cerulein; animals that received saline injections served as control group. The animals were observed for weight change and water intake. To assess pain, behaviors like stretch-and-press and reduced rearing, the Mouse Grimace Scale, and von Frey hypersensitivity were assessed. Fecal corticosterone metabolites and burrowing behavior were assessed to detect changes in the animal’s well-being. Pancreatitis severity was evaluated with amylase and lipase in the blood and pancreas histology. To investigate whether different analgesics can alleviate signs of pain, and if they influence pancreas inflammation, animals received Buprenorphine, Paracetamol in combination with Tramadol, or Metamizole in the drinking water. The calculated intake of these analgesics via drinking reached values stated to be efficient for pain alleviation. While pancreatitis did not seem to be painful, we detected acute pain from Cerulein injections that could not be alleviated by analgesics. The number of inflammatory cells in the pancreas did not differ with the analgesic administered. In conclusion: (1) Cerulein injections appear to be acutely painful but pain could not be alleviated by the tested analgesics, (2) acute pancreatitis induced by our protocol did not induce obvious signs of pain, (3) analgesic substances had no detectable influence on inflammation. Nevertheless, protocols inducing more severe or even chronic pancreatitis might evoke more pain and analgesic treatment might become imperative. Considering our results, we recommend the use of Buprenorphine via drinking water in these protocols. Further studies to search for efficient analgesics that can alleviate the acute pain induced by Cerulein injections are needed.
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Affiliation(s)
- Mattea Durst
- Centre for Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Theresia Reding Graf
- Pancreas Research Laboratory, Department of Visceral Surgery & Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Rolf Graf
- Pancreas Research Laboratory, Department of Visceral Surgery & Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Mareike Kron
- Centre for Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Margarete Arras
- Centre for Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dietmar Zechner
- Rudolf-Zenker-Institute of Experimental Surgery, University Medical Center, Rostock, Germany
| | - Rupert Palme
- Unit of Physiology, Pathophysiology and Experimental Endocrinology, Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Steven R Talbot
- Institute for Laboratory Animal Science, Hannover Medical School, Hanover, Germany
| | - Paulin Jirkof
- Centre for Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Office for Animal Welfare & 3R, University of Zurich, Zurich, Switzerland
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Schmid Daners M, Hall S, Sündermann S, Cesarovic N, Kron M, Falk V, Starck C, Meboldt M, Dual SA. Real-Time Ventricular Volume Measured Using the Intracardiac Electromyogram. ASAIO J 2021; 67:1312-1320. [PMID: 33899813 PMCID: PMC8614557 DOI: 10.1097/mat.0000000000001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Left ventricular end-diastolic volume (EDV) is an important parameter for monitoring patients with left ventricular assist devices (LVADs) and might be useful for automatic LVAD work adaptation. However, continuous information on the EDV is unavailable to date. The depolarization amplitude (DA) of the noncontact intracardiac electromyogram (iEMG) is physically related to the EDV. Here, we show how a left ventricular (LV) volume sensor based on the iEMG might provide beat-wise EDV estimates. The study was performed in six pigs while undergoing a series of controlled changes in hemodynamic states. The LV volume sensor consisted of four conventional pacemaker electrodes measuring the far-field iEMG inside the LV blood pool, using a novel unipolar amplifier. Simultaneously, noninvasive measurements of EDV and hematocrit were recorded. The proposed EDV predictor was tested for statistical significance using a mixed-effect model and associated confidence intervals. A statistically significant (p = 3e-07) negative correlation was confirmed between the DA of the iEMG and the EDV as measured by electric impedance at a slope of -0.069 (-0.089, -0.049) mV/mL. The DA was slightly decreased by increased hematocrit (p = 0.039) and moderately decreased with the opening of the thorax (p = 0.003). The DA of the iEMG proved to be a significant, independent predictor of EDV. The proposed LV volume sensor is simple to integrate into the inflow cannula of an LVAD and thus has the potential to inform the clinician about the state of LV volume in real time and to automatically control the LVAD.
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Affiliation(s)
| | - Sophie Hall
- From the Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
| | - Simon Sündermann
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiovascular Surgery, Berlin, Germany
- German Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - Nikola Cesarovic
- German Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
- Division for Surgical Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Mareike Kron
- Division for Surgical Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Volkmar Falk
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiovascular Surgery, Berlin, Germany
- German Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Christoph Starck
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Steinbeis University Berlin, Institute (STI) of Cardiovascular Perfusion, Berlin, Germany
| | - Mirko Meboldt
- From the Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
| | - Seraina A. Dual
- From the Product Development Group Zurich, ETH Zurich, Zurich, Switzerland
- Radiology, Stanford University, Stanford, California
- Cardiovascular Institute, Stanford University, Stanford, California
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Stoeck CT, von Deuster C, Fuetterer M, Polacin M, Waschkies CF, van Gorkum RJH, Kron M, Fleischmann T, Cesarovic N, Weisskopf M, Kozerke S. Cardiovascular magnetic resonance imaging of functional and microstructural changes of the heart in a longitudinal pig model of acute to chronic myocardial infarction. J Cardiovasc Magn Reson 2021; 23:103. [PMID: 34538266 PMCID: PMC8451129 DOI: 10.1186/s12968-021-00794-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 01/06/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We examined the dynamic response of the myocardium to infarction in a longitudinal porcine study using relaxometry, functional as well as diffusion cardiovascular magnetic resonance (CMR). We sought to compare non contrast CMR methods like relaxometry and in-vivo diffusion to contrast enhanced imaging and investigate the link of microstructural and functional changes in the acute and chronically infarcted heart. METHODS CMR was performed on five myocardial infarction pigs and four healthy controls. In the infarction group, measurements were obtained 2 weeks before 90 min occlusion of the left circumflex artery, 6 days after ischemia and at 5 as well as 9 weeks as chronic follow-up. The timing of measurements was replicated in the control cohort. Imaging consisted of functional cine imaging, 3D tagging, T2 mapping, native as well as gadolinium enhanced T1 mapping, cardiac diffusion tensor imaging, and late gadolinium enhancement imaging. RESULTS Native T1, extracellular volume (ECV) and mean diffusivity (MD) were significantly elevated in the infarcted region while fractional anisotropy (FA) was significantly reduced. During the transition from acute to chronic stages, native T1 presented minor changes (< 3%). ECV as well as MD increased from acute to the chronic stages compared to baseline: ECV: 125 ± 24% (day 6) 157 ± 24% (week 5) 146 ± 60% (week 9), MD: 17 ± 7% (day 6) 33 ± 14% (week 5) 29 ± 15% (week 9) and FA was further reduced: - 31 ± 10% (day 6) - 38 ± 8% (week 5) - 36 ± 14% (week 9). T2 as marker for myocardial edema was significantly increased in the ischemic area only during the acute stage (83 ± 3 ms infarction vs. 58 ± 2 ms control p < 0.001 and 61 ± 2 ms in the remote area p < 0.001). The analysis of functional imaging revealed reduced left ventricular ejection fraction, global longitudinal strain and torsion in the infarct group. At the same time the transmural helix angle (HA) gradient was steeper in the chronic follow-up and a correlation between longitudinal strain and transmural HA gradient was detected (r = 0.59 with p < 0.05). Comparing non-gadolinium enhanced data T2 mapping showed the largest relative change between infarct and remote during the acute stage (+ 33 ± 4% day 6, with p = 0.013 T2 vs. MD, p = 0.009 T2 vs. FA and p = 0.01 T2 vs. T1) while FA exhibited the largest relative change between infarct and remote during the chronic follow-up (+ 31 ± 2% week 5, with p = N.S. FA vs. MD, p = 0.03 FA vs. T2 and p = 0.003 FA vs. T1). Overall, diffusion parameters provided a higher contrast (> 23% for MD and > 27% for FA) during follow-up compared to relaxometry (T1 17-18%/T2 10-20%). CONCLUSION During chronic follow-up after myocardial infarction, cardiac diffusion tensor imaging provides a higher sensitivity for mapping microstructural alterations when compared to non-contrast enhanced relaxometry with the added benefit of providing directional tensor information to assess remodelling of myocyte aggregate orientations, which cannot be otherwise assessed.
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Affiliation(s)
- Christian T. Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Constantin von Deuster
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Maximilian Fuetterer
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Malgorzata Polacin
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Conny F. Waschkies
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Robbert J. H. van Gorkum
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
| | - Mareike Kron
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Thea Fleischmann
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
- Institute of Translational Cardiovascular Technologies, ETH Zurich, Zurich, Switzerland
| | - Miriam Weisskopf
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland
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Cesarovic N, Weisskopf M, Kron M, Glaus L, Peper ES, Buoso S, Suendermann S, Canic M, Falk V, Kozerke S, Emmert MY, Stoeck CT. Septaly Oriented Mild Aortic Regurgitant Jets Negatively Influence Left Ventricular Blood Flow-Insights From 4D Flow MRI Animal Study. Front Cardiovasc Med 2021; 8:711099. [PMID: 34434980 PMCID: PMC8380779 DOI: 10.3389/fcvm.2021.711099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: Paravalvular leakage (PVL) and eccentric aortic regurgitation remain a major clinical concern in patients receiving transcatheter aortic valve replacement (TAVR), and regurgitant volume remains the main readout parameter in clinical assessment. In this work we investigate the effect of jet origin and trajectory of mild aortic regurgitation on left ventricular hemodynamics in a porcine model. Methods: A pig model of mild aortic regurgitation/PVL was established by transcatheter piercing and dilating the non-coronary (NCC) or right coronary cusp (RCC) of the aortic valve close to the valve annulus. The interaction between regurgitant blood and LV hemodynamics was assessed by 4D flow cardiovascular MRI. Results: Six RCC, six NCC, and two control animals were included in the study and with one dropout in the NCC group, the success rate of model creation was 93%. Regurgitant jets originating from NCC were directed along the ventricular side of the anterior mitral leaflet and integrated well into the diastolic vortex forming in the left ventricular outflow tract. However, jets from the RCC were orientated along the septum colliding with flow within the vortex, and progressing down to the apex. As a consequence, the presence as well as the area of the vortex was reduced at the site of impact compared to the NCC group. Impairment of vortex formation was localized to the area of impact and not the entire vortex ring. Blood from the NCC jet was largely ejected during the following systole, whereas ejection of large portion of RCC blood was protracted. Conclusions: Even for mild regurgitation, origin and trajectory of the regurgitant jet does cause a different effect on LV hemodynamics. Septaly oriented jets originating from RCC collide with the diastolic vortex, reduce its size, and reach the apical region of the left ventricle where blood resides extendedly. Hence, RCC jets display hemodynamic features which may have a potential negative impact on the long-term burden to the heart.
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Affiliation(s)
- Nikola Cesarovic
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Miriam Weisskopf
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mareike Kron
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lukas Glaus
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Eva S Peper
- Institute for Biomedical Engineering, University and ETH Zürich, Zurich, Switzerland
| | - Stefano Buoso
- Institute for Biomedical Engineering, University and ETH Zürich, Zurich, Switzerland
| | - Simon Suendermann
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marko Canic
- Division of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Volkmar Falk
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zürich, Zurich, Switzerland
| | - Maximilian Y Emmert
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Christian T Stoeck
- Institute for Biomedical Engineering, University and ETH Zürich, Zurich, Switzerland
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Weisskopf M, Kron M, Giering T, Walker T, Cesarovic N. The sheep as a pre-clinical model for testing intra-aortic percutaneous mechanical circulatory support devices. Int J Artif Organs 2021; 44:703-710. [PMID: 34405723 PMCID: PMC8450982 DOI: 10.1177/03913988211025537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The save deployment of intra-aortic percutaneous mechanical circulatory support devices is highly dependent on the inner aortic diameter. Finding the anatomically and ethically most suitable animal model for performance testing of new pMCS devices remains challenging. For this study, an ovine model using adult ewes of a large framed breed (Swiss White Alpine Sheep) was developed to test safety, reliability, and biocompatibility of catheter-mounted mechanical support devices placed in the descending thoracic aorta. Following the drawback of fluctuating aortic diameter and device malfunction in the first four animals, the model was improved by stenting the following animals with an aortic stent. Stenting the animals with an intra-aortic over the balloon stent was found to standardize the experimental set-up and to avoid early termination of the experiment due to non-device related issues.
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Affiliation(s)
- Miriam Weisskopf
- Center of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mareike Kron
- Center of Surgical Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Nikola Cesarovic
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
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Dual SA, Llerena Zambrano B, Sündermann S, Cesarovic N, Kron M, Magkoutas K, Hengsteler J, Falk V, Starck C, Meboldt M, Vörös J, Schmid Daners M. Continuous Heart Volume Monitoring by Fully Implantable Soft Strain Sensor. Adv Healthc Mater 2020; 9:e2000855. [PMID: 32893478 DOI: 10.1002/adhm.202000855] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/20/2020] [Revised: 08/12/2020] [Indexed: 12/11/2022]
Abstract
Cardiothoracic open-heart surgery has revolutionized the treatment of cardiovascular disease, the leading cause of death worldwide. After the surgery, hemodynamic and volume management can be complicated, for example in case of vasoplegia after endocarditis. Timely treatment is crucial for outcomes. Currently, treatment decisions are made based on heart volume, which needs to be measured manually by the clinician each time using ultrasound. Alternatively, implantable sensors offer a real-time window into the dynamic function of our body. Here it is shown that a soft flexible sensor, made with biocompatible materials, implanted on the surface of the heart, can provide continuous information of the heart volume after surgery. The sensor works robustly for a period of two days on a tensile machine. The accuracy of measuring heart volume is improved compared to the clinical gold standard in vivo, with an error of 7.1 mL for the strain sensor versus impedance and 14.0 mL versus ultrasound. Implanting such a sensor would provide essential, continuous information on heart volume in the critical time following the surgery, allowing early identification of complications, facilitating treatment, and hence potentially improving patient outcome.
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Affiliation(s)
- Seraina A. Dual
- Product Development Group Zurich ETH Zurich Tannenstrasse 3 Zurich 8092 Switzerland
- Cardiothoracic Surgery Stanford University Stanford CA 94305‐5101 USA
| | - Byron Llerena Zambrano
- Laboratory of Biosensors and Bioelectronics ETH Zurich Gloriastrasse 35 Zurich 8092 Switzerland
| | - Simon Sündermann
- DZHK (German Center for Cardiovascular Research) Partner Site Berlin 10785 Berlin Germany
- Department of Cardiovascular Surgery Charité—Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
- Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Augustenburger Pl. 1 13353 Berlin Germany
| | - Nikola Cesarovic
- Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Augustenburger Pl. 1 13353 Berlin Germany
- Department of Health Sciences and Technology Tannenstrasse 3 Zürich 8092 Switzerland
- Division for Surgical Research University Hospital Zurich and University of Zurich Rämistrasse 100 Zürich 8091 Switzerland
| | - Mareike Kron
- Division for Surgical Research University Hospital Zurich and University of Zurich Rämistrasse 100 Zürich 8091 Switzerland
| | | | - Julian Hengsteler
- Laboratory of Biosensors and Bioelectronics ETH Zurich Gloriastrasse 35 Zurich 8092 Switzerland
| | - Volkmar Falk
- DZHK (German Center for Cardiovascular Research) Partner Site Berlin 10785 Berlin Germany
- Department of Cardiovascular Surgery Charité—Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany
- Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Augustenburger Pl. 1 13353 Berlin Germany
- Department of Health Sciences and Technology Tannenstrasse 3 Zürich 8092 Switzerland
| | - Christoph Starck
- DZHK (German Center for Cardiovascular Research) Partner Site Berlin 10785 Berlin Germany
| | - Mirko Meboldt
- Product Development Group Zurich ETH Zurich Tannenstrasse 3 Zurich 8092 Switzerland
| | - János Vörös
- Laboratory of Biosensors and Bioelectronics ETH Zurich Gloriastrasse 35 Zurich 8092 Switzerland
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Meissner V, Strüh J, Kron M, Liesenfeld L, Kranz S, Gschwend J, Jahnen M, Herkommer K. The role of fatal family history and mode of inheritance in prostate cancer for long-term outcomes following radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32724-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Meissner V, Hollerer M, Kron M, Schiele S, Albers P, Arsov C, Kuczyk M, Imkamp F, Hohenfellner M, Schütz V, Gschwend J, Herkommer K. Effect of sexual behavior on prostate-specific antigen levels in middle-aged men screened for prostate cancer: Results from the PROBASE trial. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32651-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Schulman H, Niward K, Abate E, Idh J, Axenram P, Bornefall A, Forsgren S, Jakobsson J, Öhrling C, Kron M, Brudin L, Diro E, Getachew Kebede A, Paues J, Bruchfeld J, Wejse C, Stendahl O, Schön T. Sedimentation rate and suPAR in relation to disease activity and mortality in patients with tuberculosis. Int J Tuberc Lung Dis 2020; 23:1155-1161. [PMID: 31718751 DOI: 10.5588/ijtld.18.0634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To investigate how levels of the soluble urokinase plasminogen activator receptor (suPAR) and erythrocyte sedimentation rate (ESR) correlate with disease activity and prognosis in pulmonary tuberculosis (PTB).DESIGN: This was a retrospective analysis of patients with active PTB (n = 500) in Gondar, Ethiopia, for whom the suPAR (n = 301) and ESR (n = 330) were analysed at the start of treatment. Both biomarkers were available for 176 patients. Human immunodeficiency virus (HIV) status, chest X-ray (CXR) findings, classification according to the clinical TBscore and treatment outcome were all recorded.RESULTS: In a multivariable logistic regression analysis adjusted for age, sex and HIV status, surrogate markers of disease activity such as advanced CXR patterns correlated with increased levels of suPAR (adjusted OR [aOR] 8.24, P < 0.001) and of ESR (aOR 1.63, P = 0.030), whereas ESR only correlated significantly with a TBscore >6 points. Increased levels of both suPAR and ESR were associated with unsuccessful treatment outcomes (aOR 2.93, P = 0.013; aOR 2.52, P = 0.025). The highest quartile of suPAR (aOR 13.3, P = 0.029) but not ESR levels correlated independently with increased mortality.CONCLUSION: SuPAR and ESR levels correlate with disease activity in PTB; however, the clinical role of these potentially prognostic biomarkers needs to be verified in prospective studies.
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Affiliation(s)
- H Schulman
- Department of Infectious Diseases, Linköping University Hospital, Linköping
| | - K Niward
- Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - E Abate
- Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - J Idh
- Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University
| | - P Axenram
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - A Bornefall
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - S Forsgren
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Jakobsson
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - C Öhrling
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M Kron
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - L Brudin
- Department of Clinical Physiology, Kalmar County Hospital, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - E Diro
- Department of Internal Medicine, University of Gondar, Gondar
| | - A Getachew Kebede
- Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - J Paues
- Department of Infectious Diseases, Linköping University Hospital, Linköping, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Bruchfeld
- Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C Wejse
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, GloHAU, Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - O Stendahl
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University
| | - T Schön
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation, Linköping University, Department of Infectious Diseases and Clinical Microbiology, Kalmar County Hospital, Linköping University, Linköping, Sweden
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Meissner V, Dumler S, Kron M, Schiele S, Bannowsky A, Gschwend J, Herkommer K. HP-04-004 Does masturbation have a positive influence on functional outcome in the postoperative course after radical prostatectomy? J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.133] [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]
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Schineis J, Kron M, Schiele S, Dinkel A, Arsov C, Hadaschik B, Imkamp F, Gschwend J, Herkommer K. PO-01-073 More negative sexual self-concept in men with erectile dysfunction, premature ejaculation or low sexual desire. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.216] [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]
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Herkommer K, Hollerer M, Meissner V, Schiele S, Kron M, Albers P, Arsov C, Imkamp F, Hohenfellner M, Hadaschik B, Gschwend J. HP-04-006 Association of sexual identity and activity with prostate-specific antigen (PSA) in a prostate cancer screening population. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Schneider-Wirth S, Kron M, Schulwitz H, Dinkel A, Arsov C, Hadaschik B, Imkamp F, Gschwend J, Herkommer K. 050 Associations between HIV-status and sexual dysfunction in homosexual men – findings from the German male sex-study. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.054] [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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Peterová V, Peterová K, Kron M, Baxová N. How cognitive disorders and depression in neuropsychiatric lupus patients with and without epilepsy correlate with antibodies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Herkommer K, Hallanzy J, Kron M, Köhn FM, Albers P, Arsov C, Kuczyk M, Imkamp F, Hadaschik B, Hohenfellner M, Gschwend J. PS-07-001 Prevalence of erectile dysfunction in 45-year old German men in association with risk factors and comorbidities-results of the German male sex-study. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Landewe R, van der Horst-Bruinsma I, Tari S, Florentinus S, Song A, Kron M, Pathai S, Rosenbaum J. THU0583 Quiescence in Active and Inactive Non-Infectious, Intermediate, Posterior, or Panuveitis in Patients Treated with Adalimumab: Visual I and Visual II Trials. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brézin A, Dick A, Jaffe G, Ohno S, Namba K, Goto H, Inomata N, Song A, Kron M, Camez A, Tari S, Nguyen Q. THU0561 Adalimumab in Patients with Active and Inactive, Non-Infectious Uveitis: Visual I and Visual II Trials. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Peterova V, Peterova K, Svobodova R, Podrazilova L, Kron M, Ecerova V, Jancová E. Correlations of brain volumes with clinical data in neuropsychiatric lupus patients. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jaffe G, Thorne J, Scales D, Franco P, Tari S, Camez A, Song A, Kron M, Barisani-Asenbauer T, Dick A. SAT0523 Adalimumab in Patients with Active, Non-Infectious Uveitis Requiring High-Dose Corticosteroids: the Visual-1 Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kaskel P, Lange U, Sander S, Huber M, Utikal J, Leiter U, Krähn G, Meurer M, Kron M. Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden, Germany. J Eur Acad Dermatol Venereol 2014; 29:134-42. [DOI: 10.1111/jdv.12488] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 02/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - U. Lange
- Department of Dermatology; Technical University of Dresden; Dresden Germany
| | - S. Sander
- Institute of Epidemiology and Medical Biometry; University of Ulm; Ulm Germany
| | - M.A. Huber
- Department of Dermatology; University of Ulm; Ulm Germany
| | - J. Utikal
- Department of Dermatology; University of Ulm; Ulm Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
| | - U. Leiter
- Department of Dermatology; University of Ulm; Ulm Germany
- Center of Dermato-Oncology; Department of Dermatology; University of Tübingen; Tübingen Germany
| | - G. Krähn
- Department of Dermatology; University of Ulm; Ulm Germany
| | - M. Meurer
- Department of Dermatology; Technical University of Dresden; Dresden Germany
| | - M. Kron
- Institute of Epidemiology and Medical Biometry; University of Ulm; Ulm Germany
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Sandborn WJ, Colombel JF, D'Haens G, Van Assche G, Wolf D, Kron M, Lazar A, Robinson AM, Yang M, Chao JD, Thakkar R. One-year maintenance outcomes among patients with moderately-to-severely active ulcerative colitis who responded to induction therapy with adalimumab: subgroup analyses from ULTRA 2. Aliment Pharmacol Ther 2013; 37:204-13. [PMID: 23173821 DOI: 10.1111/apt.12145] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 10/03/2012] [Accepted: 10/27/2012] [Indexed: 12/27/2022]
Abstract
BACKGROUND Patients with moderately-to-severely active ulcerative colitis (UC) are unlikely to continue anti-TNF therapy in the absence of early therapeutic response. AIM To assess week 52 efficacy, safety and benefit/risk balance of adalimumab treatment in patients with moderately-to-severely active UC failing conventional therapy who achieved clinical response at week 8 in the 52-week ULTRA 2 trial. METHODS Patients randomised to adalimumab (160/80 mg, week 0/2; 40 mg, every other week thereafter) in ULTRA 2 who achieved clinical response at week 8 per partial Mayo score (Mayo score without endoscopy subscore) were assessed for week 52 clinical remission, clinical response, mucosal healing, steroid-free remission and steroid discontinuation rates, overall and by prior anti-TNF use. Benefit/risk balance for the overall ITT population (regardless of week 8 responder status) was assessed using 'net efficacy adjusted for risk' (NEAR) odds ratios. Safety was assessed using adverse event rates. RESULTS Of 248 adalimumab-treated patients, 123 (49.6%) achieved clinical response at week 8. Of these, 30.9%, 49.6%, and 43.1% achieved clinical remission, clinical response, and mucosal healing, respectively, at week 52. Of the week 8 responders using corticosteroids at baseline (N = 90), 21.1% achieved steroid-free remission and 37.8% were steroid-free at week 52. NEAR odds ratios indicated a positive benefit/risk balance for achievement of week 8 and week 52 response or remission without serious adverse events or serious infections. No safety concerns were identified. CONCLUSIONS Adalimumab treatment was associated with a positive benefit/risk balance in the overall population of patients with moderately-to-severely active ulcerative colitis in ULTRA 2; early response was predictive of a positive outcome at 1 year (NCT00408629).
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Affiliation(s)
- W J Sandborn
- University of California San Diego, La Jolla, CA 92093-0956, USA.
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Kornmann M, Staib L, Wiegel T, Kreuser ED, Kron M, Baumann W, Henne-Bruns D, Link KH. Adjuvant chemoradiotherapy of advanced resectable rectal cancer: results of a randomised trial comparing modulation of 5-fluorouracil with folinic acid or with interferon-α. Br J Cancer 2010; 103:1163-72. [PMID: 20877353 PMCID: PMC2967051 DOI: 10.1038/sj.bjc.6605871] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Standard adjuvant chemoradiotherapy of rectal cancer still consists of 5-fluorouracil (5-FU) only. Its cytotoxicity is enhanced by folinic acid (FA) and interferon-α (INFα). In this trial, the effects of FA and IFNα on adjuvant 5-FU chemoradiotherapy in locally advanced rectal cancer were investigated. Methods: Patients with R0-resected rectal cancer (UICC stage II and III) were stratified and randomised to a 12-month adjuvant chemoradiotherapy with 5-FU, 5-FU+FA, or 5-FU+IFNα. All patients received levamisol and local irradiation with 50.4 Gy. Results: Median follow-up was 4.9 years (n=796). Toxicities (WHO III+IV) were observed in 32, 28, and 58% of patients receiving 5-FU, 5-FU+FA, and 5-FU+IFNα, respectively. No differences between the groups were observed for local or distant recurrence. Five-year overall survival (OS) rates were 60.3% (95% confidence interval (CI): 54.3–65.8), 60.4% (54.4–65.8), and 59.9% (53.0–66.1) for 5-FU, 5-FU+FA, and 5-FU+IFNα, respectively. A subgroup analysis in stage II (pT3/4pN0) disease (n=271) revealed that the addition of FA tended to reduce the 5-year local recurrence (LR) rate by 55% and increase recurrence-free survival and OS rates by 12 and 13%, respectively, relative to 5-FU alone. Conclusions: Interferon-α cannot be recommended for adjuvant chemoradiotherapy of rectal cancer. In UICC stage II disease, the addition of FA tended to lower LR and increased survival. The addition of FA to 5-FU may be an effective option for adjuvant chemoradiotherapy of UICC stage II rectal cancer.
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Affiliation(s)
- M Kornmann
- Department of General, Visceral, and Transplantation Surgery, University of Ulm, Steinhoevelstrasse, Ulm 89075, Germany.
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Kron M, Müller M. Impaired hippocampal Ca2+ homeostasis and concomitant K+ channel dysfunction in a mouse model of Rett syndrome during anoxia. Neuroscience 2010; 171:300-15. [PMID: 20732392 DOI: 10.1016/j.neuroscience.2010.08.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 08/12/2010] [Accepted: 08/16/2010] [Indexed: 11/19/2022]
Abstract
Methyl-CpG-binding protein 2 (MeCP2) deficiency causes Rett syndrome (RTT), a neurodevelopmental disorder characterized by severe cognitive impairment, synaptic dysfunction, and hyperexcitability. Previously we reported that the hippocampus of MeCP2-deficient mice (Mecp2(-/y)), a mouse model for RTT, is more susceptible to hypoxia. To identify the underlying mechanisms we now focused on the anoxic responses of wildtype (WT) and Mecp2(-/y) CA1 neurons in acute hippocampal slices. Intracellular recordings revealed that Mecp2(-/y) neurons show only reduced or no hyperpolarizations early during cyanide-induced anoxia, suggesting potassium channel (K(+) channel) dysfunction. Blocking adenosine-5'-triphosphate-sensitive K(+) channels (K(ATP-)) and big-conductance Ca(2+)-activated K(+) channels (BK-channels) did not affect the early anoxic hyperpolarization in either genotype. However, blocking Ca(2+) release from the endoplasmic reticulum almost abolished the anoxic hyperpolarizations in Mecp2(-/y) neurons. Single-channel recordings confirmed that neither K(ATP)- nor BK-channels are the sole mediators of the early anoxic hyperpolarization. Instead, anoxia Ca(2+)-dependently activated various small/intermediate-conductance K(+) channels in WT neurons, which was less evident in Mecp2(-/y) neurons. Yet, pharmacologically increasing the Ca(2+) sensitivity of small/intermediate-conductance K(Ca) channels fully restored the anoxic hyperpolarization in Mecp2(-/y) neurons. Furthermore, Ca(2+) imaging unveiled lower intracellular Ca(2+) levels in resting Mecp2(-/y) neurons and reduced anoxic Ca(2+) transients with diminished Ca(2+) release from intracellular stores. In conclusion, the enhanced hypoxia susceptibility of Mecp2(-/y) hippocampus is primarily associated with disturbed Ca(2+) homeostasis and diminished Ca(2+) rises during anoxia. This secondarily attenuates the activation of K(Ca) channels and thereby increases the hypoxia susceptibility of Mecp2(-/y) neuronal networks. Since cytosolic Ca(2+) levels also determine neuronal excitability and synaptic plasticity, Ca(2+) homeostasis may constitute a promising target for pharmacotherapy in RTT.
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Affiliation(s)
- M Kron
- DFG Research Center Molecular Physiology of the Brain, Abteilung Neuro- und Sinnesphysiologie, Georg-August-Universität Göttingen, Humboldtallee 23, D-37073 Göttingen, Germany
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Seibel J, Bodié K, Weber S, Bury D, Kron M, Blaich G. Comparison of haematology, coagulation and clinical chemistry parameters in blood samples from the sublingual vein and vena cava in Sprague-Dawley rats. Lab Anim 2010; 44:344-51. [PMID: 20679324 DOI: 10.1258/la.2010.009049] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The investigation of clinical pathology parameters (haematology, clinical chemistry and coagulation) is an important part of the preclinical evaluation of drug safety. However, the blood sampling method employed should avoid or minimize stress and injury in laboratory animals. In the present study, we compared the clinical pathology results from blood samples collected terminally from the vena cava (VC) immediately before necropsy with samples taken from the sublingual vein (VS) also prior to necropsy in order to determine whether the sampling method has an influence on clinical pathology parameters. Forty-six 12-week-old male Sprague-Dawley rats were assigned to two groups (VC or VS; n = 23 each). All rats were anaesthetized with isoflurane prior to sampling. In the VC group, blood was withdrawn from the inferior VC. For VS sampling, the tongue was gently pulled out and the VS was punctured. The haematology, coagulation and clinical chemistry parameters were compared. Equivalence was established for 13 parameters, such as mean corpuscular volume, white blood cells and calcium. No equivalence was found for the remaining 26 parameters, although they were considered to be similar when compared with the historical data and normal ranges. The most conspicuous finding was that activated prothrombin time was 30.3% less in blood taken from the VC (16.6 ± 0.89 s) than that in the VS samples (23.8 ± 1.58 s). Summing up, blood sampling from the inferior VC prior to necropsy appears to be a suitable and reliable method for terminal blood sampling that reduces stress and injury to laboratory rats in preclinical drug safety studies.
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Affiliation(s)
- J Seibel
- Abbott GmbH & Co. KG, Preclinical Safety, D-67061 Ludwigshafen, Germany.
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Van den Bosch F, Manger B, Goupille P, McHugh N, Rødevand E, Holck P, van Vollenhoven RF, Leirisalo-Repo M, Fitzgerald O, Kron M, Frank M, Kary S, Kupper H. Effectiveness of adalimumab in treating patients with active psoriatic arthritis and predictors of good clinical responses for arthritis, skin and nail lesions. Ann Rheum Dis 2009; 69:394-9. [PMID: 19815494 PMCID: PMC2800202 DOI: 10.1136/ard.2009.111856] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives: To evaluate the effectiveness of adalimumab in patients with psoriatic arthritis (PsA) and identify predictors of good clinical response for joint and skin lesions. Methods: Patients received adalimumab 40 mg every other week in addition to standard therapy in this prospective, 12-week, open-label, uncontrolled study. Four definitions of good clinical response were used: ⩾50% improvement in American College of Rheumatology response criteria (ACR50), good response according to European League Against Rheumatism (EULAR) guidelines, a ⩾3-grade improvement in Physician Global Assessment of psoriasis (PGA) and a ⩾50% improvement in the Nail Psoriasis Severity Index (NAPSI). Response predictors were determined by logistic regression with backward elimination (selection level was 5%). Results: Of 442 patients, 94% completed 12 weeks of treatment. At week 12, 74%, 51% and 32% of the patients had achieved ACR20, 50 and 70, respectively; 87% and 61% experienced moderate and good responses according to EULAR criteria, respectively. The percentage of patients with PGA results of “clear/almost clear” increased from 34% (baseline) to 68%. The mean NAPSI score was reduced by 44%. No new safety signals were detected. A lower Health Assessment Questionnaire Disability Index (HAQ-DI) score, greater pain assessment, male sex and absence of systemic glucocorticoid therapy were strongly associated with achievement of ACR50 and good response according to EULAR criteria. In addition, greater C-reactive protein concentration and polyarthritis predicted ACR50, and non-involvement of large joints predicted a good response according to EULAR criteria. Conclusions: Adalimumab was effective in patients with PsA. Lower impairment of physical function, greater pain, male sex and no systemic treatment with glucocorticoids were factors that increased the chance of achieving a good clinical response.
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Weiss M, Kron M, Hay B, Taenzer M, Huber-Lang M, Radermacher P, Georgieff M. Which variables affect strict glycaemic control with intensive insulin therapy in postoperative/post-traumatic critically ill patients? Crit Care 2009. [PMCID: PMC4084010 DOI: 10.1186/cc7288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rudwaleit M, Olivieri I, Boki KA, Griep EN, Jarvinen P, Wong RL, Kron M, Kary S, Kupper H. Adalimumab is effective and well tolerated in treating patients with ankylosing spondylitis who have advanced spinal fusion. Rheumatology (Oxford) 2008; 48:551-7. [DOI: 10.1093/rheumatology/kep022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Rudwaleit M, Rødevand E, Holck P, Vanhoof J, Kron M, Kary S, Kupper H. Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study. Ann Rheum Dis 2008; 68:696-701. [PMID: 18662932 PMCID: PMC2663712 DOI: 10.1136/ard.2008.092585] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To evaluate the effect of adalimumab on the frequency of anterior uveitis (AU) flares in patients with active ankylosing spondylitis (AS). Methods: We determined the history of ophthalmologist-diagnosed AU in 1250 patients with active AS who were enrolled in a multinational, open-label, uncontrolled clinical study of treatment with adalimumab, 40 mg every other week for up to 20 weeks. All AU flares were documented throughout the adalimumab treatment period plus 70 days. We compared the rates of AU flares per 100 patient years (PYs) reported during the year before adalimumab treatment with rates during adalimumab treatment, in total and by patient subgroups. Results: The AU flare rates before adalimumab treatment were 15/100 PYs in all patients (n = 1250), 68.4/100 PYs in 274 patients with a history of AU flares, 176.9/100 PYs in 106 patients with a recent history of AU flares, 192.9/100 PYs in 28 patients with symptomatic AU at baseline and 129.1/100 PYs in 43 patients with a history of chronic uveitis. During adalimumab treatment, the rate of AU flares was reduced by 51% in all patients, by 58% in 274 patients with a history of AU, by 68% in 106 patients with a recent history of AU, by 50% in 28 patients with symptomatic AU at baseline and by 45% in 43 patients with chronic uveitis. AU flares during adalimumab treatment were predominantly mild. Two patients with periods of high AS disease activity had new-onset AU during the treatment period. Conclusions: Results of this prospective open-label study suggest that adalimumab had a substantial preventive effect on AU flares in patients with active AS, including patients with a recent history of AU flares. Clinical trials: ClinicalTrials.gov Identifier: NCT00478660.
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Affiliation(s)
- M Rudwaleit
- Charité University Medicine Berlin, Benjamin Franklin Campus, Berlin, Germany.
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Kornmann M, Formentini A, Ette C, Henne-Bruns D, Kron M, Sander S, Baumann W, Kreuser ED, Staib L, Link KH. Prognostic factors influencing the survival of patients with colon cancer receiving adjuvant 5-FU treatment. Eur J Surg Oncol 2008; 34:1316-21. [PMID: 18313881 DOI: 10.1016/j.ejso.2008.01.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Accepted: 01/18/2008] [Indexed: 01/15/2023] Open
Abstract
AIM Adjuvant chemotherapy is recommended for stage III colon cancer. The aim of this study was to identify important prognostic factors among patients with colon cancer receiving adjuvant 5-FU-based treatment. METHODS Data sets of 855 colon cancer patients treated between 1992 and 1999 within a multicenter adjuvant trial comparing 5-FU modulation with folinic acid or interfereron-alpha were examined. Backward elimination in a proportional hazards model was used to identify prognostically relevant clinical and pathological factors. RESULTS Tumor recurrence (p<0.001), duration of adjuvant treatment (p<0.001), tumor substage (p=0.004), age (p=0.005), grading (p=0.016), treatment-related toxicity (p=0.021), and treatment (p=0.031) were identified in descending order of importance as prognostic factors for overall survival. CONCLUSIONS Adjuvant 5-FU-based treatment should be performed for at least 6months with a stepwise adjustment of 5-FU doses until toxicity >WHO II. Substages should be reported separately and used for stratification in future trials due to their broad variation in outcome. In the future, this may result in adjuvant treatment of stage III colon cancer adjusted for the risk of substages.
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Affiliation(s)
- M Kornmann
- Clinic of General, Visceral, and Transplantation Surgery, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany.
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Weiss M, Taenzer M, Traeger K, Altherr J, Hay B, Kron M, Huber-Lang M, Schneider M. Applying the 2003 SCCM/ESICM/ACCP/ATS/SIS instead of the 1992 ACCP/SCCM sepsis definitions increases the numbers of patients with systemic inflammatory response syndrome shock and septic shock but decreases mortality rates. Crit Care 2008. [PMCID: PMC4088751 DOI: 10.1186/cc6601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Herwig U, Fallgatter AJ, Höppner J, Eschweiler GW, Kron M, Hajak G, Padberg F, Naderi-Heiden A, Abler B, Eichhammer P, Grossheinrich N, Hay B, Kammer T, Langguth B, Laske C, Plewnia C, Richter MM, Schulz M, Unterecker S, Zinke A, Spitzer M, Schönfeldt-Lecuona C. Antidepressant effects of augmentative transcranial magnetic stimulation: randomised multicentre trial. Br J Psychiatry 2007; 191:441-8. [PMID: 17978325 DOI: 10.1192/bjp.bp.106.034371] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a new treatment option for depression. Previous studies were performed with low sample sizes in single centres and reported heterogeneous results. AIMS To investigate the efficacy of rTMS as augmentative treatment in depression. METHOD In a randomised, double-blind, sham-controlled multicentre trial 127 patients with moderate to severe depressive episodes were randomly assigned to real or sham stimulation for 3 weeks in addition to simultaneously initiated antidepressant medication. RESULTS We found no difference in the responder rates of the real and the sham treatment groups (31% in each) or in the decrease of the scores on the depression rating scales. CONCLUSIONS The data do not support previous reports from smaller samples indicating an augmenting or accelerating antidepressant effect of rTMS. Further exploration of the possible efficacy of other stimulation protocols or within selected sub-populations of patients is necessary.
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Affiliation(s)
- U Herwig
- Psychiatric University Hospital, University of Zürich, Lenggstrasse 31, Zürich, Switzerland.
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Schweizer-Arau A, Böhling B, Kron M. Auswirkung einer systemischen Autoregulationstherapie (SART) auf die Schwangerschafsraten bei einer anschließenden IVF/ICSI-Behandlung. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-989184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Schweizer-Arau A, Böhling B, Kron M. Auswirkung einer systemischen Autoregulationstherapie (SART) auf die Schwangerschaftsraten bei einer anschließenden IVF/ICSI-Behandlung. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-964827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Trotter A, Maier L, Kron M, Pohlandt F. Effect of oestradiol and progesterone replacement on bronchopulmonary dysplasia in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed 2007; 92:F94-8. [PMID: 16905572 PMCID: PMC2675480 DOI: 10.1136/adc.2006.097170] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To study whether postnatal replacement of oestradiol and progesterone may help to prevent bronchopulmonary dysplasia (BPD). METHODS This randomised placebo-controlled double-blind study enrolled 83 infants of <29 weeks gestational age and 1000 g birth weight requiring mechanical ventilation within 12 h after birth. Oestradiol (2.5 mg/kg/day) and progesterone (22.5 mg/kg/day) were given by continuous intravenous infusion of a standard lipid emulsion (15 ml/kg/day) in the replacement group (ESTRA-PRO). The placebo group received the same lipid emulsion without oestradiol or progesterone. A replacement period of at least 2 weeks but not >4 weeks was strived for and defined as "according to protocol". The primary outcome variable was the incidence of BPD or death. RESULTS The median birth weight was 670 g (min-max 400-990 g) and the gestational age 25 weeks (23.1-28.1 weeks). The incidence of BPD or death was 48% in the placebo group and 44% in the ESTRA-PRO group (p = 0.38, one-sided testing, intention to treat analysis). In infants treated according to protocol, 32% (9 of 28) in the placebo group and 14% (3 of 21) in the ESTRA-PRO group developed BPD (p = 0.08). CONCLUSION Replacement of oestradiol and progesterone was not effective for prevention of BPD or death in extremely preterm born infants. Better-powered trials are needed to evaluate this new approach.
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Affiliation(s)
- A Trotter
- Section of Neonatology and Pediatric Critical Care Medicine, Children's Hospital, University of Ulm, Ulm, Germany.
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Steinmacher J, Pohlandt F, Bode H, Mihatsch W, Kron M, Sander S, Franz AR. Intrauterines und postnatales Wachstum beeinflussen die neurokognitive Entwicklung sehr kleiner Frühgeborener mit einem Geburtsgewicht <1500g (VLBW-FG). Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Herkommer K, Paiss T, Merz M, Gschwend JE, Kron M. Assoziation von familiärem Status mit Histologie und klinischem Verlauf beim frühen Prostatakarzinom. Urologe A 2006; 45:1532-9. [PMID: 17004091 DOI: 10.1007/s00120-006-1190-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND In a large number of studies a positive family history is documented as one of the main risk factors for the development of prostate cancer. In a US population an association between early-onset prostate cancer among familial patients and a more differentiated tumour was shown. The aim of this study was to compare clinical parameters between sporadic and familial or hereditary patients with an age at diagnosis < or =55 years. MATERIAL AND METHODS The clinical data of prostate cancer patients with an age at diagnosis < or =55 years and who were recruited between July 1999 and the end of June 2004 to the database "familial prostate cancer in Germany" were analysed. The following data were documented for all patients: PSA at diagnosis, histopathological stage, grading, Gleason score and progression-free survival. RESULTS The clinical data of 685 patients could be completed: 222 (32.4%) had one first-degree relative with prostate cancer, 48 of whom (7.0%) were hereditary; 463 (67.6%) were sporadic. The median age at diagnosis in the hereditary patients was 51.6 (41-55) years, in the familial patients 51.1 (35-55) years and in the sporadic patients 52.0 (38-55) years. The median follow-up was 24 months in hereditary, 36 months in familial and 35 months in sporadic patients. An initial curative therapy with radical prostatectomy or radiotherapy/brachytherapy was planned in 657/685 (95.9%) of the patients. There were no clear differences regarding PSA at diagnosis, the postoperative parameters (organ-confined disease, lymph node involvement, Gleason score, grading) and the progression-free survival in sporadic and familial or hereditary patients. CONCLUSIONS Patients with an age at diagnosis < or =55 years have a positive family history more often than all prostate cancer patients in Germany. No association could be shown between pathohistological stage or clinical course and a positive family history in patients with an age at diagnosis < or =55 years.
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Affiliation(s)
- K Herkommer
- Abteilung für Urologie, Urologische Universitätsklinik, Prittwitzstrasse 43, 89075 Ulm, Deutschland.
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Neurokognitive Entwicklung Frühgeborener (FG) mit einem Geburtsgewicht <1500g im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Frühe versus späte enterale Eisensupplementierung bei Frühgeborenen mit einem Geburtsgewicht <1301g: Neurokognitive Entwicklung im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Neurokognitive Entwicklung nach neonataler systemischer Inflammationsreaktion (NSIR) bei Frühgeborenen (FG) mit einem Geburtsgewicht <1000g im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Becker C, Loy S, Nikolaus T, Rissmann U, Rapp K, Lindemann B, Kron M. A follow-up study on fall and fracture incidence in long-term care including the role of formal caregiver time on fall incidence rates. Z Gerontol Geriatr 2006; 39:292-6. [PMID: 16900449 DOI: 10.1007/s00391-006-0399-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2006] [Accepted: 06/14/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the impact of a fall prevention programme over a 12 month follow-up period after the introduction of a RCT and to describe possible differences between incidence density rate of falls associated with caregiver time during weekends and ordinary working days. DESIGN Prospective observational study, duration 12 months. SETTING Six community nursing homes, Germany. PARTICIPANTS Long-stay residents (n=881); 771 resident years; median age 85.0 years (min 60; max 101); 79.1% female. MEASUREMENTS Incidence density rate of falls and fractures, staff time per resident. RESULTS The incidence density rate over all days was 1367/1000 resident years (RY) for falls [95% confidence interval 1041;1693]. The incidence density rate of hip fractures was 29/1000 RY [95% confidence interval 12;45] and 29/1000 RY [95% confidence interval 12;45] for non-hip fractures. The incidence density rate showed similar results comparing weekends/ public holidays vs normal working days; falls 1193 vs 1447/ 1000 RY; hip fractures 25 vs 30/ 1000 RY and other fractures 16 vs 34/1000 RY. CONCLUSION During the period, we observed a marked decline of the fracture rate compared with the controlled phase of the intervention trial. A lower number of nursing care hours on weekends was not associated with a higher incidence density rate for falls, fallers, or any type of fracture.
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Affiliation(s)
- Clemens Becker
- Robert-Bosch-Krankenhaus, Klinik für Geriatrische Rehabilitation, Auerbachstr. 110, 70397 Stuttgart, Germany
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Voit CA, Schaefer G, Schoengen A, Akkooi AC, Eggermont AM, Rademaker J, Lukowsky A, Schwuerzer M, Sterry W, Kron M. Ultrasound (US) and US-guided fine needle aspiration cytology (FNAC) prior to sentinel lymph node biopsy (SLNB) in melanoma patients: Accuracy of US-FNAC and lack of further improvement by RT-PCR of the aspirate. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8059] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8059 Background: We have previously shown that US guided FNAC identifies positive SNs prior to SLND in 19% of cases (Voit et al., Ann Surg Oncol: 2006, in press). Originally, in this prospective study, we had tested the feasibility of in vivo US as screening tool and FNAC for verification of sentinel nodes (SN) prior to SLNB. Here we report the results of tyrosinase RT-PCR examinations of SNs aspirated pre-SLNB and of post-SLNB FNAC of the excised SN. Additionally, pts were followed up by blood sample tyrosinase RT-PCR at regular intervals. Methods: Between 7/2001 and 7/2003, 127 AJCC staged melanoma pts with a median tumor thickness of 2.1mm [0.4–18] underwent a FNAC to verify SN detected by US. Follow-up data are updated until 1/1/2006 (mean/median FU 29/31 (0 - 51) months). In 127 pts 141 SNs have been excised. SN involvement was predicted with a combined sensitivity for US with FNAC of 82% [65–93%] and a specificity of 72% [62–81%]. 19 patients already identified as SN+ by US guided FNAC reduced the need for the SLNB procedure in 16% (19/121). SN Size pre- and post-SLNB was measured by US. Results: US identified the SN in 121/141 (86%). None of the 20 SNs not identified by US were malignant. Median pre-SLNB SN size was 842 mm3 [35–107,272], median post-SLNB SN size was 714 mm³ [32–13,409]. Pre- and post-SLNB SN sizes were virtually identical. 34/121 SNs were histologically malignant. In 7/34 no measurements were made for various reasons. In 27 SNs histological patterns of involvement were examined. 10/27 showed solitary nests in subcapsular/parenchymal or combined localization. 17/27 SN were involved by multiple nests. RT-PCR of the aspirate of SNs was confirmative pos. in 11/27 and false neg. in 16/27. Size analyses of the lesions showed an av. 2.8 mm2 (median 0.5 [0.005–32.0]) in the false neg. pop. and 28.5 mm2 (median 20 [0.003–80.0]) in the confirmative pos. pop. Blood RT-PCR as well as DFS and OS will be updated and provided at the meeting. Conclusions: US guided FNAC is highly accurate. Additional RT-PCR of the aspirate does not further enhance SN pos. identification rate. US-FNAC can reduce the need of SLNB in 16% of patients. No significant financial relationships to disclose.
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Affiliation(s)
- C. A. Voit
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - G. Schaefer
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - A. Schoengen
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - A. C. Akkooi
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - A. M. Eggermont
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - J. Rademaker
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - A. Lukowsky
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - M. Schwuerzer
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - W. Sterry
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
| | - M. Kron
- Charité Humboldt University, Berlin, Germany; Armed Forces Hospital, Ulm, Germany; Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; Memorial Sloan-Kettering Cancer Center, New York, NY; University of Ulm, Ulm, Germany
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Neurokognitive Entwicklung Frühgeborener (FG) mit einem Geburtsgewicht <1500g im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Frühe versus späte enterale Eisensupplementierung bei Frühgeborenen mit einem Geburtsgewicht <1301g: Neurokognitive Entwicklung im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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45
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Steinmacher J, Pohlandt F, Bode H, Kron M, Franz AR. Neurokognitive Entwicklung nach neonataler systemischer Inflammationsreaktion (NSIR) bei Frühgeborenen (FG) mit einem Geburtsgewicht <1000g im korrigierten Alter von 5,7 Jahren. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Voit CA, Mayer T, Schäfer G, Gellrich S, Kron M, Sterry W, Schwürzer M, Schoengen A. Ultrasound (US) and ultrasound guided fine needle aspiration cytology (FNAC) reduces surgical procedures, sentinel node (SN) dissection in melanoma patients and reliably predicts lymph node involvement in cutaneous lymphoma patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7537] [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: 11/20/2022] Open
Affiliation(s)
- C. A. Voit
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - T. Mayer
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - G. Schäfer
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - S. Gellrich
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - M. Kron
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - W. Sterry
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - M. Schwürzer
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
| | - A. Schoengen
- Charite, Humboldt Univ, Berlin, Germany; Armed Forces Hosp, Ulm, Germany; Univ of Ulm, Ulm, Germany
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Koczy P, Klie T, Kron M, Bredthauer D, Rissmann U, Branitzki S, Guerra V, Klein A, Pfundstein T, Nikolaus T, Sander S, Becker C. Effektivit�t einer multifaktoriellen Intervention zur Reduktion von k�rpernaher Fixierung bei demenzerkrankten Heimbewohnern. Z Gerontol Geriatr 2005; 38:33-9. [PMID: 15756485 DOI: 10.1007/s00391-005-0289-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 01/24/2005] [Indexed: 11/24/2022]
Abstract
At present, observational studies and expert opinion are the best evidence for the use of physical restraints. Large regional and national disparities are described in acute and long-term care. Epidemiological data demonstrate a prevalence of 3-5% body-fixed or near body restraint devices. The hip fracture rate in Germany are approximately 50 per 1000 resident years. Between 40-50% of the residents in nursing homes are treated with psycho-tropic medication potentially limiting their physical mobility. The presented study protocol was designed to test the effectiveness of a multifactorial intervention to reduce physical restraints in long-term care (LTC) residents particularly with cognitive impairment. The intervention consists of an educational and an organizational part to empower staff members to improve their skills and practice in using restraints. Technical devices to reduce fall related injuries are additionally offered to the LTC facilities. The study population includes 200 LTC residents in 54 facilities in three states in Germany. The sample size calculation was based upon a 5% prevalence rate in the control group and an expected reduction of 50% in the intervention group. The protocol is a waiting-list control design. All waiting facilities will be offered to participate after their waiting period. Primary endpoints are the number of restrained residents and resident time (hours) of being restrained. The use of psychotropics, falls, fall-related injuries and the incidence of residents newly being restrained is being monitored. The study starts with a baseline documentation of all facilities followed by randomization and a three month intervention. Change agents will be responsible for the intervention. Technical devices will include a newly developed soft hip protector and sensor mats which notice the intent of leaving the bed. The aim of the study is to develop an evidence-based model for a knowledge transfer project to implement minimum restraint environments in LTC.
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Affiliation(s)
- P Koczy
- Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Akademisches Lehrkrankenhaus der Universität Tübingen, Auerbachstrasse 110, 70376 Stuttgart, Germany.
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Voit CA, Kron M, Schoengen A, Audring H, Lukowsky A, Sterry W, Winter H, Hasert R, Mayer T, Schaefer G. In vivo and ex vivo ultrasound, fine needle aspiration and molecular biology of sentinel nodes (SN) in melanoma patients. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. A. Voit
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - M. Kron
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - A. Schoengen
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - H. Audring
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - A. Lukowsky
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - W. Sterry
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - H. Winter
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - R. Hasert
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - T. Mayer
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
| | - G. Schaefer
- Charite, Humboldt University, Berlin, Germany; University of Ulm, Biometrie & Medical Documentation, Ulm, Germany; Armed Forces Hospital, University of Ulm, Ulm, Germany
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Walther U, Kron M, Sander S, Sebastian G, Sander R, Peter RU, Meurer M, Krähn G, Kaskel P. Risk and protective factors for sporadic basal cell carcinoma: results of a two-centre case-control study in southern Germany. Clinical actinic elastosis may be a protective factor. Br J Dermatol 2004; 151:170-8. [PMID: 15270887 DOI: 10.1111/j.1365-2133.2004.06030.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND There are very few data regarding sun exposure behaviour of patients with basal cell carcinoma (BCC) in central Europe. OBJECTIVES A case-control study of patients with sporadic BCC was conducted to assess the risk of occupational and leisure-time sun exposure behaviour, precursor lesions for skin cancer and phenotypic factors on the development of sporadic BCC in Ulm and Dresden, Germany. METHODS A comparison was made of 213 patients with BCC (128 from Ulm, 85 from Dresden; 103 men and 110 women; median age at diagnosis 69 years) and 411 controls (237 from Ulm, 174 from Dresden; 197 men and 214 women; median age 58 years). Crude odds ratios (ORs) and corresponding 95% confidence intervals for all of 64 possible risk factors revealed strong associations in 33 items. Selection of important risk factors was performed in a multiple logistic regression. RESULTS For sporadic BCC, an increased risk was shown for persons with actinic cheilitis (OR 7.1), actinic keratosis (OR 2.7) and solar lentigo (OR 2.5). The only phenotypic factor indicating risk of sporadic BCC was hair colour, with a higher risk for red/fair than brown/black hair (OR 4.3). There was an increased risk for persons with BCC in first-degree relatives (OR 5.1) and those with sunburn 20 years before sporadic BCC was diagnosed (OR 3.6). Additionally, occupational ultraviolet (UV) exposure appeared to be a risk factor (OR 2.4). In contrast, clinical actinic elastosis showed a protective effect (OR 0.1). CONCLUSIONS In contrast to earlier reports, clinical actinic elastosis turned out to be the only protective factor for sporadic BCC. A special relationship between wrinkling and BCC risk could not be shown. For basic research, future work should be aimed at elucidating further the different forms of collagen repair processes after intermittent and/or chronic UV exposure. The data strongly support the recommendation that a change in recreational UV exposure habits in individuals, and sunburn avoidance in particular, are necessary not only because of the increased long-term risk of melanoma, but also because of the risk of other skin cancers such as sporadic BCC.
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Affiliation(s)
- U Walther
- Department of Dermatology, Technical University of Dresden, Dresden, Germany
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Mihatsch WA, Vossbeck S, Franz AR, Kron M, Eikmanns B, Pohlandt F. Einfluss von Bifidusbakterium lactis auf die Inzidenz nosokomialer Infektionen bei Frühgeborenen. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2004-829354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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