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Buschmann C, Unverdorben L, Knabl J, Hutter S, Meister S, Beyer S, Burgmann M, Zati Zehni A, Schmoeckel E, Kessler M, Jeschke U, Eggersmann TK, Mahner S, Kolben T, Ganster F. Placental expression of inflammatory Galectin-12 is associated with gestational diabetes. J Reprod Immunol 2024; 163:104240. [PMID: 38492532 DOI: 10.1016/j.jri.2024.104240] [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: 04/24/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Gestational diabetes mellitus (GDM) is a growing health concern. Since members of the galectin-family are identified to play a role in the pathogenesis of GDM, we determined galectin-12 as an essential protein due to its influence in lipolysis and inflammation processes. This study investigates the expression of galectin-12 in the placentas of women with GDM. STUDY DESIGN The study population includes 40 expectant women suffering from GDM and 40 healthy controls. The expression of galectin-12 in the syncytiotrophoblast (SCT) and the extra villous trophoblast (EVT) of the placenta was analyzed by immunohistological staining and double immunofluorescence. Immunoreactivity Score (IRS) was used for evaluation. RESULTS The results demonstrate a significant overexpression of galectin-12 in the nucleus of the SCT and the EVT of placentas with GDM compared to the healthy control group. Additionally, double immunofluorescence visualizes corresponding results with an overexpression of galectin-12 in the extra villous trophoblast of GDM placentas representing maternal cells. CONCLUSION This study identifies galectin-12 to be associated with the process of gestational diabetes mellitus. These findings are in correspondence with the involvement of galectin-12 in inflammatory processes. Maternal BMI and male sex seem to be confounder for the expression of galectin-12 in the nuclear syncytiotrophoblast, but not in other parts of the investigated placental areas. Further investigations are necessary to verify the correlation between gestational diabetes mellitus and the expression of galectin-12 in the placenta and to further elucidate its distinct role.
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Affiliation(s)
- Christina Buschmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Laura Unverdorben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Julia Knabl
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Hutter
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Alaleh Zati Zehni
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, University Hospital, LMU Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Germany.
| | - Tanja K Eggersmann
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Franziska Ganster
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
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Buschmann C, Unverdorben L, Knabl J, Hutter S, Meister S, Beyer S, Burgmann M, Keilmann L, Zati zehni A, Schmoeckel E, Kessler M, Jeschke U, Mahner S, Kolben T, Ganster F, Burges A. Galectin-10 Expression in Placentas of Women with Gestational Diabetes. Curr Issues Mol Biol 2023; 45:8840-8851. [PMID: 37998731 PMCID: PMC10670440 DOI: 10.3390/cimb45110554] [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: 06/16/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Galectins are known to play an important role in immunoregulatory processes and autoimmune diseases. Galectin-10 is a cytoplasmic protein of human eosinophils and is involved in various eosinophilic diseases. Since increased galectin expression is already detected in the placentas of mothers with gestational diabetes mellitus (GDM), this study focuses on the specific role of galectin-10 and hints at consequences for the diagnosis and therapeutic options of GDM. It is hypothesized that the difference in galectin-10 expression will raise the pathophysiological understanding of gestational diabetes. The study population consists of 80 women: 40 healthy mothers and 40 women suffering from gestational diabetes mellitus. The expression of galectin-10 was analyzed in the syncytiotrophoblast (SCT) and the decidua of the placenta via immunohistochemistry and immunofluorescence double staining. The immunoreactivity score (IRS) was used for evaluation. The results in this study were significant for an overexpression of galectin-10 in GDM placentas compared with the control group. The syncytiotrophoblast showed overexpression in the nucleus and the cytoplasm, whereas expression of galectin-10 in the decidua was significant in the cytoplasm only. This study identified the expression changes in galectin-10 in placental tissue between healthy and GDM mothers and intensified the understanding of gestational diabetes. Assuming that gestational diabetes mellitus is involved in inflammatory processes, galectin-10 might play a role in the development and maintenance of GDM. Further investigation is required to strengthen these findings.
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Affiliation(s)
- Christina Buschmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Laura Unverdorben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Julia Knabl
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Stefan Hutter
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Lucia Keilmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Alaleh Zati zehni
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Franziska Ganster
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Alexander Burges
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
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Ansorge N, Dannecker C, Jeschke U, Schmoeckel E, Heidegger HH, Vattai A, Burgmann M, Czogalla B, Mahner S, Fuerst S. Regulatory T Cells with Additional COX-2 Expression Are Independent Negative Prognosticators for Vulvar Cancer Patients. Int J Mol Sci 2022; 23:ijms23094662. [PMID: 35563052 PMCID: PMC9099805 DOI: 10.3390/ijms23094662] [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] [Received: 02/01/2022] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Vulvar cancer incidence numbers have been steadily rising over the past decades. In particular, the number of young patients with vulvar cancer has recently increased. Therefore, the need to identify new prognostic factors and, in addition, therapeutic options for vulvar carcinoma is more apparent. The aim of this study was to analyze the influx of COX-2 positive tumor-infiltrating lymphocytes and monocytes and their influence on prognosis. Using subtyping by immunofluorescence, the majority of COX-2 expressing immune cells were identified as FOXP3-positive regulatory T cells. In addition, peri- and intra-tumoral macrophages in the same tumor tissue were detected simultaneously as M2-polarized macrophages. COX-2 positive immune cells were independent negative prognostic markers in long-term overall survival of patients with vulvar cancer. These results show an influence of immune cell infiltration for vulvar carcinoma patients. Immune cell infiltration and immune checkpoint expression may, therefore, become interesting targets for further research on new vulvar cancer treatment strategies.
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Affiliation(s)
- Nadine Ansorge
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany;
| | - Christian Dannecker
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany;
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany;
- Correspondence: ; Tel.: +49-821-400-165505
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Thalkirchner Str. 36, 80337 Munich, Germany;
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
| | - Sophie Fuerst
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81337 Munich, Germany; (N.A.); (H.H.H.); (A.V.); (M.B.); (B.C.); (S.M.); (S.F.)
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Jegen M, Reichenbach J, Hasbargen U, Hübener C, Burgmann M. Nekrotisierender Uterustumor – eine lebensgefährlicher Verlauf. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718281] [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: 10/23/2022] Open
Affiliation(s)
- M Jegen
- Klinikum der LMU München, Gynäkologie und Geburtshilfe
| | - J Reichenbach
- Klinikum der LMU München, Gynäkologie und Geburtshilfe
| | - U Hasbargen
- Klinikum der LMU München, Gynäkologie und Geburtshilfe
| | - C Hübener
- Klinikum der LMU München, Gynäkologie und Geburtshilfe
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Burgmann M, Jueckstock J, Hoehn H, Reichenbach J, Docheva V, Hasbargen U, Mahner S, Trillsch F. Rezidivierte Ovarialtorsion in graviditate. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718254] [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: 10/23/2022] Open
Affiliation(s)
- M Burgmann
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - J Jueckstock
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - H Hoehn
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - J Reichenbach
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - V Docheva
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - U Hasbargen
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
| | - F Trillsch
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München
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Burgmann M, Hermelink K, Farr A, van Meegen F, Heiduschk A, Engel J, Kolben T, Degenhardt T, Ditsch N, Mahner S, Harbeck N, Würstlein R. Evaluation of Reproductive Concerns and Biographical Impact of Breast Cancer in Young Patients. Breast Care (Basel) 2018; 13:126-130. [PMID: 29887790 DOI: 10.1159/000481340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background This study evaluates interventions offered to young breast cancer (BC) patients, including fertility preservation, genetic testing, and counseling for parenthood concerns, and analyzes the effect of BC on biographical issues. Methods Women who were diagnosed with BC at the age of 18-40 years and who underwent treatment at the Breast Center, Ludwig-Maximilian University (LMU) in Munich between 2006 and 2013, were eligible for this study. Patients received a self-developed questionnaire which covered the following topics: fertility preservation, family planning, genetic testing, parenthood concerns and children's needs, partnership status, and employment situation. Results Re-evaluating their initial decision on fertility preservation, 76.4% of patients reported satisfaction with their decision. After BC diagnosis, 45.8% reported to have maternal desire, but only 21.7% actually planned to have children. 41.7% of patients missed sufficient counseling regarding parenthood concerns. Analysis of individual employment situations showed that the time period until the return to work was longer in patients who received chemotherapy. The majority of patients (71.6%) did not report changes in their partnership status. Conclusion Young BC survivors report a lack of communication related to parenthood concerns and future conception, but are satisfied with counseling regarding fertility preservation and genetics.
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Affiliation(s)
- Maximiliane Burgmann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Kerstin Hermelink
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Alex Farr
- Breast Center (Comprehensive Cancer Center), Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
| | - Friederike van Meegen
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Annika Heiduschk
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Jutta Engel
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Thomas Kolben
- Munich Cancer Registry (MCR) of the Munich Tumor Center at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany
| | - Tom Degenhardt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Nina Ditsch
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Sven Mahner
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Rachel Würstlein
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
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Kolben T, Haberland B, Degenhardt T, Burgmann M, Koenig A, Kolben TM, Ulbach K, Mahner S, Bausewein C, Harbeck N, Wuerstlein R. Evaluation of an interdisciplinary palliative care inhouse training for professionals in gynecological oncology. Arch Gynecol Obstet 2018; 297:767-773. [PMID: 29362923 DOI: 10.1007/s00404-018-4681-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 01/17/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of a pilot interdisciplinary inhouse training in palliative care (PC) for gynecological oncologists. METHODS Competencies of participants from a gynecological university department were evaluated taking part in an interdisciplinary PC course in a pre and post design. The multiprofessional course covered basic principles of PC, symptom management and communication taught by PC specialists. Competencies were evaluated using self-designed questionnaires before (ISPG-1), right after (ISPG-2), and 6 months after the training (ISPG-3) (inhouse seminar palliative care in gynecology: ISPG). RESULTS 31 persons from the department of gynecology took part in the course, of which 27 answered the first questionnaire (seven nurses (26%), 19 doctors (71%), one profession not indicated (3%), median working experience in gynecological oncology: 5 years). Return rates were: ISPG-1 27/31 (87.1%), ISPG-2 20/31 (64.5%) and IPSG-3 14/31 (45.2%). A more positive attitude towards PC could be observed in the majority of participants after the course (ISPG-2 62%, ISPG-3 71%). They felt more competent in the care of palliative patients (46%). PC would be initiated earlier and the interaction with other disciplines was improved (ISPG-2 85%, ISPG-3 100%). The participants assessed a significant improvement of their skills in all palliative fields which were analyzed. CONCLUSION PC inhouse training improves the understanding of PC and the interdisciplinary approach in the management of patients with advanced disease. It is a feasible and useful instrument to improve the competencies in generalist PC of specialists in gynecological oncology.
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Affiliation(s)
- Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Birgit Haberland
- Department for Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Tom Degenhardt
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Koenig
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Theresa Maria Kolben
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Kristina Ulbach
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Claudia Bausewein
- Department for Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Rachel Wuerstlein
- Department of Obstetrics and Gynecology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany
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Burgmann M, Aicher J, Teichmann L, Hasbargen U, Schulze A, Flemmer AW. Postnatale Sauerstoffsättigung reifer Neugeborener. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592947] [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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Göß C, Heublein S, Sattler C, Kolben T, Kolben TM, Burgmann M, Mayr D, Gallwas J, Burges A, Mahner S, Jeschke U, Ditsch N. Expression of nuclear hormone receptors in ovarian cancer. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592700] [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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Burgmann M, Hermelink K, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Wuerstlein R. Abstract P4-11-13: Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-11-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
It is known that young breast cancer (BC) patients tend to suffer more psychological stress and have lower quality of life than older women, are less sexually active and have more body image issues than healthy women of the same age. They may also be challenged by reproductive concerns. To our knowledge, no data exist about the effect of the disease on the life satisfaction of premenopausal BC patients. This study tries to elucidate life satisfaction in several aspects of daily life in this special cohort as well as aspects of cancer-specific distress and parenting concerns in order to improve our support strategies.
Materials and methods
In a cross-sectional study design, all patients with < 40 years at primary BC diagnosis treated at Breast Center, CCC LMU Munich (Germany) between 2006 and 2013 were eligible for participation. Standardized questionnaires assessing life satisfaction (Life Satisfaction Questionnaire; Fahrenberg et al, 2000) and cancer-specific distress (Questionnaire on Stress in Cancer patients; Herschbach et al, 2003), as well as a self-developed questionnaire on partnership, employment situation, family planning, demographic and medical data were mailed in 2014.
Results
88 patients responded (55%). Compared with population data stratified for age and sex, patients showed significantly less satisfaction in the domains of health (p<0.001) and sexuality (p=0.002) but not in any other domains or overall life satisfaction. The patients' most pronounced cancer-specific problems were fear of cancer recurrence and fear of further hospital stays, diminished sexual activity, and psychosomatic problems like nervousness, fatigue and insomnia. Of those patients who retrospectively evaluated their decision for or against fertility preservation, 76.4% were satisfied with their choice. Current desire to have children was reported by 45.8% of patients and another 15.6% were uncertain, but only 21.7% actually planned to have children. The most frequently reported reasons to refrain from childbearing were shortened life expectancy, negative impact of pregnancy on prognosis, and treatment-related infertility.
Discussion
In our cohort, the general life satisfaction of young breast cancer survivors showed no difference from women without cancer, but these patients were not satisfied with their general health status and with their sexuality. Also, cancer-related fears and psychosomatic problems considerably stress young patients and thus need to be addressed by supportive care programs. There is also a need for counselling regarding childbearing after BC treatment. In contrast, fertility preservation seems to be well established in medical consultations. In conclusion, tailored supportive care programs have to be realized to respond the unique needs of young BC patients.
Citation Format: Burgmann M, Hermelink K, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Wuerstlein R. Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-13.
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Affiliation(s)
- M Burgmann
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - K Hermelink
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - A Farr
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - A Heiduschka
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - F van Meegen
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - J Engel
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - N Harbeck
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - R Wuerstlein
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
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Ensenauer R, Brandlhuber L, Burgmann M, Sobotzki C, Zwafink C, Anzill S, Holdt L, Teupser D, Hasbargen U, Netz H, Roscher AA, von Kries R. Obese Nondiabetic Pregnancies and High Maternal Glycated Hemoglobin at Delivery as an Indicator of Offspring and Maternal Postpartum Risks: The Prospective PEACHES Mother-Child Cohort. Clin Chem 2015; 61:1381-90. [PMID: 26265704 DOI: 10.1373/clinchem.2015.242206] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/16/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND We investigated whether obese pregnant women negative for gestational diabetes (GDM) still experience dysglycemia, as indicated by high glycated hemoglobin (Hb A1c) at delivery, and whether this impacts offspring and long-term maternal outcomes. METHODS Data of 462 mother-child pairs of our prospective Programming of Enhanced Adiposity Risk in Childhood - Early Screening (PEACHES) cohort study were analyzed. Of 885 obese and normal-weight pregnancies prospectively enrolled after GDM testing according to the International Association of Diabetes and Pregnancy Study Groups criteria, 462 GDM-negative mothers and their offspring were investigated. We assessed associations of maternal Hb A1c at delivery with large-for-gestational-age (LGA) birth weights, cord-blood C-peptide, and biomarkers of glucose metabolism and inflammation in obese mothers followed for 2.9 years (median) postpartum (n = 42). RESULTS Cumulative distribution analysis in GDM-negative normal-weight women (n = 155) revealed that 12% had Hb A1c ≥5.7% at delivery (high Hb A1c). Among obese GDM-negative women (n = 307), 31.9% (95% CI, 26.7%-37.4%) equaled or exceeded this cutoff. In obese GDM-negative women with Hb A1c ≥5.7% (n = 98) vs <5.7% (n = 209) at delivery, newborns were more likely to be born LGA [adjusted odds ratio 3.56 (95% CI, 1.64-8.02)], and mean cordblood serum C-peptide was increased by 0.09 ng/mL (95% CI, 0.01-0.17 ng/mL). In the mothers at follow-up, mean postpartum Hb A1c, fasting glucose, high-sensitivity C-reactive protein, and fibrinogen concentrations were higher by 0.3% (95% CI, 0.1%-0.5%), 6.0 mg/dL (95% CI, 2.4-9.5 mg/dL), 6.8 mg/L (95% CI, 1.4-12.3 mg/L), and 74.9 mg/dL (95% CI, 13.6-136.2 mg/dL), respectively. CONCLUSIONS Increased Hb A1c in obese GDM-negative women at delivery indicates gestational dysglycemia, potentially conferring offspring and long-term maternal health risks. These findings should raise awareness as to careful monitoring of obese pregnancies. Measurement of Hb A1c at delivery could help select women who may need closer postpartum health checks.
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Affiliation(s)
- Regina Ensenauer
- Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany; Experimental Pediatrics, Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany;
| | - Lena Brandlhuber
- Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany; Department of Pediatric Cardiology and Intensive Care, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology, Campus Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christina Sobotzki
- Institute for Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Carina Zwafink
- Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sabine Anzill
- Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lesca Holdt
- Institute of Laboratory Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Uwe Hasbargen
- Department of Obstetrics and Gynecology, Campus Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Heinrich Netz
- Department of Pediatric Cardiology and Intensive Care, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Adelbert A Roscher
- Research Center, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Rüdiger von Kries
- Institute for Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
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Schlager V, Burgmann M, Lotz A, Engel J, Harbeck N, Hermelink K, Würstlein R. Gesundheitsbezogene Lebensqualität der älteren Mammakarzinom-Patientin unter besonderer Berücksichtigung der Therapiewahl – Eine Interimsanalyse. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555069] [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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Lotz A, Burgmann M, Schlager V, Engel J, Harbeck N, Hermelink K, Würstlein R. Eine Interimsanalyse zur Lebenszufriedenheit bei der älteren Mammakarzinompatientin. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555068] [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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Burgmann M, Hermelink K, Heiduschka A, Farr A, Engel J, Harbeck N, Wuerstlein R. Die junge Mammakarzinom-Patientin – Lebenszufriedenheit und krebsspezifische Beschwerden. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555083] [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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Khoder W, Stief C, Burgmann M, Burges A. V7-05 IMMEDIATE LAPAROSCOPIC RECONSTRUCTION OF AN ACUTE IATROGENIC VESICO-VAGINAL FISTULA BY A NEO-VAGINAL DILATOR IN A PATIENT WITH MAYER-ROKITANSKY-KÜSTER-HAUSER-SYNDROME. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1936] [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: 11/30/2022]
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Wuerstlein R, Hermelink K, Heiduschka A, Engel J, Harbeck N, Burgmann M. P157 Life satisfaction and biographic changes in young breast cancer survivors. Breast 2015. [DOI: 10.1016/s0960-9776(15)70199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Khoder WY, Stief CG, Burgmann M, Burges A. Laparoscopic reconstruction of an iatrogenic perforation of the neovagina and urinary bladder by a neovaginal dilator in a patient with Mayer–Rokitansky–Küster–Hauser syndrome. Int Urogynecol J 2015; 26:1083-7. [DOI: 10.1007/s00192-014-2609-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 12/02/2014] [Indexed: 11/29/2022]
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Burgmann M, Wuerstlein R, Neff J, Engel J, Hermelink K, Harbeck N. PR50 Life satisfaction among young breast cancer survivors. Breast 2014. [DOI: 10.1016/s0960-9776(14)70060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Wuerstlein R, Burgmann M, Neff J, Engel J, Hermelink K, Harbeck N. PO46 Unmet needs and biographic changes among young breast cancer survivors. Breast 2014. [DOI: 10.1016/s0960-9776(14)70056-6] [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: 11/26/2022] Open
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Burgmann M, Wuerstlein R, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Hermelink K. Die junge Mammakarzinompatientin: Biographische Veränderungen, Belastung und Lebenszufriedenheit in den ersten Jahren nach Diagnose. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Franz MB, Burgmann M, Neubauer A, Zeisler H, Sanani R, Gottsauner-Wolf M, Schiessl B, Andreas M. Augmentation index and pulse wave velocity in normotensive and pre-eclamptic pregnancies. Acta Obstet Gynecol Scand 2013; 92:960-6. [DOI: 10.1111/aogs.12145] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 04/10/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Maximilian B. Franz
- Department of Obstetrics and Gynecology; Medical University of Vienna; Vienna; Austria
| | - Maximiliane Burgmann
- Department of Obstetrics and Gynecology; University Clinic of Munich; Ludwig-Maximilians-University; Munich; Germany
| | - Anna Neubauer
- Department of Obstetrics and Gynecology; University Clinic of Munich; Ludwig-Maximilians-University; Munich; Germany
| | - Harald Zeisler
- Department of Obstetrics and Gynecology; Medical University of Vienna; Vienna; Austria
| | - Ramona Sanani
- Department of Obstetrics and Gynecology; Hospital Rudolfsstiftung; Vienna; Austria
| | | | - Barbara Schiessl
- Department of Obstetrics and Gynecology; University Clinic of Munich; Ludwig-Maximilians-University; Munich; Germany
| | - Martin Andreas
- Department of Surgery; Medical University of Vienna; Vienna; Austria
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Franz M, Burgmann M, Zeisler H, Schiessl B. Postpartal erhöhter peripherer-arterielle Widerstand nach Präeklampsie – Zeichen fortbestehender kardiovaskulärer Schädigung? Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1225086] [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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Franz M, Neubauer A, Burgmann M, Kainer F, Zeisler H, Schiessl B. Augmentation Index und Pulswellengeschwindigkeit bei hypertensiven Erkrankungen in der Schwangerschaft. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983584] [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] Open
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Neubauer A, Franz M, Burgmann M, Kainer F, Friese K, Schiessl B. Der Augmentation Index als neuer Risikomarker hypertensiver Erkrankungen in der Schwangerschaft – Normwerte im Schwangerschaftsverlauf. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983465] [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] Open
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Franz M, Neubauer A, Burgmann M, Kainer F, Hess G, Schiessl B. B-Natriuretic Peptide als kardiovaskulärer Verlaufsparameter in der Schwangerschaft. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983586] [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] Open
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Burgmann M, Franz M, Neubauer A, Kainer F, Friese K, Schiessl B. Augmentation Index und Pulswellengeschwindigkeit bei Gestationsdiabetes. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983463] [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] Open
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Schiessl B, Burgmann M, Sauer V, Neubauer A, Kainer F, Franz M. Augmentation Index und Pulse Wave Velocity in Schwangerschaften mit Präeklampsie oder Gestationsdiabetes. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002846] [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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Franz M, Neubauer A, Burgmann M, Hess G, Schiessl B. Normwerte für NT-proBNP als kardioavskulärer Parameter im Schwangerschaftsverlauf. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002895] [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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