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Steinert RE, Mueller M, Serra M, Lehner-Sigrist S, Frost G, Gero D, Gerber PA, Bueter M. Effect of inulin on breath hydrogen, postprandial glycemia, gut hormone release, and appetite perception in RYGB patients: a prospective, randomized, cross-over pilot study. Nutr Diabetes 2024; 14:9. [PMID: 38448413 PMCID: PMC10918168 DOI: 10.1038/s41387-024-00267-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Large intestinal fermentation of dietary fiber may control meal-related glycemia and appetite via the production of short-chain fatty acids (SCFA) and the secretion of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY). We investigated whether this mechanism contributes to the efficacy of the Roux-en-Y gastric bypass (RYGB) by assessing the effect of oligofructose-enriched inulin (inulin) vs. maltodextrin (MDX) on breath hydrogen (a marker of intestinal fermentation), plasma SCFAs, gut hormones, insulin and blood glucose concentrations as well as appetite in RYGB patients. METHOD Eight RYGB patients were studied on two occasions before and ~8 months after surgery using a cross-over design. Each patient received 300 ml orange juice containing 25 g inulin or an equicaloric load of 15.5 g MDX after an overnight fast followed by a fixed portion snack served 3 h postprandially. Blood samples were collected over 5 h and breath hydrogen measured as well as appetite assessed using visual analog scales. RESULTS Surgery increased postprandial secretion of GLP-1 and PYY (P ≤ 0.05); lowered blood glucose and plasma insulin increments (P ≤ 0.05) and reduced appetite ratings in response to both inulin and MDX. The effect of inulin on breath hydrogen was accelerated after surgery with an increase that was earlier in onset (2.5 h vs. 3 h, P ≤ 0.05), but less pronounced in magnitude. There was, however, no effect of inulin on plasma SCFAs or plasma GLP-1 and PYY after the snack at 3 h, neither before nor after surgery. Interestingly, inulin appeared to further potentiate the early-phase glucose-lowering and second-meal (3-5 h) appetite-suppressive effect of surgery with the latter showing a strong correlation with early-phase breath hydrogen concentrations. CONCLUSION RYGB surgery accelerates large intestinal fermentation of inulin, however, without measurable effects on plasma SCFAs or plasma GLP-1 and PYY. The glucose-lowering and appetite-suppressive effects of surgery appear to be potentiated with inulin.
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Affiliation(s)
- R E Steinert
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland.
| | - M Mueller
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - M Serra
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - S Lehner-Sigrist
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - G Frost
- Section for Nutrition Research, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - D Gero
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - P A Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - M Bueter
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
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2
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Wilkinson R, Mleczko MM, Brewin RJW, Gaston KJ, Mueller M, Shutler JD, Yan X, Anderson K. Environmental impacts of earth observation data in the constellation and cloud computing era. Sci Total Environ 2024; 909:168584. [PMID: 37979853 DOI: 10.1016/j.scitotenv.2023.168584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
Numbers of Earth Observation (EO) satellites have increased exponentially over the past decade reaching the current population of 1193 (January 2023). Consequently, EO data volumes have mushroomed and data storage and processing have migrated to the cloud. Whilst attention has been given to the launch and in-orbit environmental impacts of satellites, EO data environmental footprints have been overlooked. These issues require urgent attention given data centre water and energy consumption, high carbon emissions for computer component manufacture, and difficulty of recycling computer components. Doing so is essential if the environmental good of EO is to withstand scrutiny. We provide the first assessment of the EO data life-cycle and estimate that the current size of the global EO data collection is ~807 PB, increasing by ~100 PB/year. Storage of this data volume generates annual CO2 equivalent emissions of 4101 t. Major state-funded EO providers use 57 of their own data centres globally, and a further 178 private cloud services, with considerable duplication of datasets across repositories. We explore scenarios for the environmental cost of performing EO functions on the cloud compared to desktop machines. A simple band arithmetic function applied to a Landsat 9 scene using Google Earth Engine (GEE) generated CO2 equivalent (e) emissions of 0.042-0.69 g CO2e (locally) and 0.13-0.45 g CO2e (European data centre; values multiply by nine for Australian data centre). Computation-based emissions scale rapidly for more intense processes and when testing code. When using cloud services such as GEE, users have no choice about the data centre used and we push for EO providers to be more transparent about the location-specific impacts of EO work, and to provide tools for measuring the environmental cost of cloud computation. The EO community as a whole needs to critically consider the broad suite of EO data life-cycle impacts.
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Affiliation(s)
- R Wilkinson
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - M M Mleczko
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - R J W Brewin
- Department of Earth and Environmental Science, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - K J Gaston
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - M Mueller
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - J D Shutler
- Department of Earth and Environmental Science, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - X Yan
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - K Anderson
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom.
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Zifarelli A, Cantatore A, Sampaolo A, Mueller M, Rueck T, Hoelzl C, Rossmadl H, Patimisco P, Spagnolo V. Multivariate analysis and digital twin modelling: Alternative approaches to evaluate molecular relaxation in photoacoustic spectroscopy. Photoacoustics 2023; 33:100564. [PMID: 38021285 PMCID: PMC10658604 DOI: 10.1016/j.pacs.2023.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023]
Abstract
A comparative analysis of two different approaches developed to deal with molecular relaxation in photoacoustic spectroscopy is here reported. The first method employs a statistical analysis based on partial least squares regression, while the second method relies on the development of a digital twin of the photoacoustic sensor based on the theoretical modelling of the occurring relaxations. Methane detection within a gas matrix of synthetic air with variable humidity level is selected as case study. An interband cascade laser emitting at 3.345 µm is used to target methane absorption features. Two methane concentration ranges are explored targeting different absorptions, one in the order of part-per-million and one in the order of percent, while water vapor absolute concentration was varied from 0.3 % up to 2 %. The results achieved employing the detection techniques demonstrated the possibility to efficiently retrieve the target gas concentrations with accuracy > 95 % even in the case of strong influence of relaxation effects.
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Affiliation(s)
- A. Zifarelli
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
| | - A.F.P. Cantatore
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
| | - A. Sampaolo
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
| | - M. Mueller
- Sensorik-ApplikationsZentrum (SappZ), Regensburg University of Applied Sciences, 93053 Regensburg, Germany
- Institute of Analytical Chemistry, Chemo, and Biosensors, University of Regensburg, 93053 Regensburg, Germany
| | - T. Rueck
- Sensorik-ApplikationsZentrum (SappZ), Regensburg University of Applied Sciences, 93053 Regensburg, Germany
| | - C. Hoelzl
- Thorlabs GmbH, Münchner Weg 1, 85232 Bergkirchen, Germany
| | - H. Rossmadl
- Thorlabs GmbH, Münchner Weg 1, 85232 Bergkirchen, Germany
| | - P. Patimisco
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
| | - V. Spagnolo
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
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4
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Dekkiche S, Dubruc E, Kanbar M, Feki A, Mueller M, Meuwly JY, Mathevet P. Accessory and cavitated uterine masses: a case series and review of the literature. Front Reprod Health 2023; 5:1197931. [PMID: 37662068 PMCID: PMC10469797 DOI: 10.3389/frph.2023.1197931] [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: 03/31/2023] [Accepted: 07/04/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives The purpose of this study is to report nine patients of young women who underwent a surgical treatment of an accessory and cavitated uterine mass (ACUM) in our hospital between 2014 and 2022 and review all cases described in the literature. Material and methods The principal outcomes measured are the imaging techniques used to determine the diagnosis, the type of surgery used and the post-operative evolution of symptoms. We also report and analyse the 79 patients found in the literature since 1996 in addition to our 9 patients. Results Surgical excision is the only long-lasting treatment. Small invasive surgery with laparoscopic access is the gold standard and most widely used (83.0%). Some new therapeutic procedures have been recently described of which ethanol sclerotherapy seems very promising. Post-operatively, 54.5% of patients have a complete relief of symptoms. MRI is the best imaging technique to identify ACUM. Finally, we refine the description of this pathology and give a more precise definition of it. Conclusion Through our literature review and the analysis of our cases, we want to underline an important diagnostic criterion of this pathology: the fallopian tube on the homolateral side of the ACUM never communicates with the latter. It is a capital element for differential diagnosis.
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Affiliation(s)
- S. Dekkiche
- Gynaecology Department, Department Women-Mother-Child, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - E. Dubruc
- Institute of Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - M. Kanbar
- Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - A. Feki
- Department of Obstetrics and Gynaecology, HFR Fribourg Hôpital Cantonal, Fribourg, Switzerland
| | - M. Mueller
- Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland
| | - J-Y. Meuwly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
| | - P. Mathevet
- Gynaecology Department, Department Women-Mother-Child, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
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Perotti G, Christiaens V, Henning T, Tabone B, Waters LBFM, Kamp I, Olofsson G, Grant SL, Gasman D, Bouwman J, Samland M, Franceschi R, van Dishoeck EF, Schwarz K, Güdel M, Lagage PO, Ray TP, Vandenbussche B, Abergel A, Absil O, Arabhavi AM, Argyriou I, Barrado D, Boccaletti A, Caratti O Garatti A, Geers V, Glauser AM, Justannont K, Lahuis F, Mueller M, Nehmé C, Pantin E, Scheithauer S, Waelkens C, Guadarrama R, Jang H, Kanwar J, Morales-Calderón M, Pawellek N, Rodgers-Lee D, Schreiber J, Colina L, Greve TR, Östlin G, Wright G. Water in the terrestrial planet-forming zone of the PDS 70 disk. Nature 2023; 620:516-520. [PMID: 37488359 PMCID: PMC10432267 DOI: 10.1038/s41586-023-06317-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/13/2023] [Indexed: 07/26/2023]
Abstract
Terrestrial and sub-Neptune planets are expected to form in the inner (less than 10 AU) regions of protoplanetary disks1. Water plays a key role in their formation2-4, although it is yet unclear whether water molecules are formed in situ or transported from the outer disk5,6. So far Spitzer Space Telescope observations have only provided water luminosity upper limits for dust-depleted inner disks7, similar to PDS 70, the first system with direct confirmation of protoplanet presence8,9. Here we report JWST observations of PDS 70, a benchmark target to search for water in a disk hosting a large (approximately 54 AU) planet-carved gap separating an inner and outer disk10,11. Our findings show water in the inner disk of PDS 70. This implies that potential terrestrial planets forming therein have access to a water reservoir. The column densities of water vapour suggest in-situ formation via a reaction sequence involving O, H2 and/or OH, and survival through water self-shielding5. This is also supported by the presence of CO2 emission, another molecule sensitive to ultraviolet photodissociation. Dust shielding, and replenishment of both gas and small dust from the outer disk, may also play a role in sustaining the water reservoir12. Our observations also reveal a strong variability of the mid-infrared spectral energy distribution, pointing to a change of inner disk geometry.
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Affiliation(s)
- G Perotti
- Max Planck Institute for Astronomy, Heidelberg, Germany.
| | | | - Th Henning
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - B Tabone
- Université Paris-Saclay, CNRS, Institut d'Astrophysique Spatiale, Orsay, France
| | - L B F M Waters
- Department of Astrophysics/IMAPP, Radboud University, Nijmegen, the Netherlands
- SRON Netherlands Institute for Space Research, Leiden, the Netherlands
| | - I Kamp
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - G Olofsson
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - S L Grant
- Max-Planck Institut für Extraterrestrische Physik (MPE), Garching, Germany
| | - D Gasman
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - J Bouwman
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - M Samland
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - R Franceschi
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - E F van Dishoeck
- Max-Planck Institut für Extraterrestrische Physik (MPE), Garching, Germany
- Leiden Observatory, Leiden University, Leiden, the Netherlands
| | - K Schwarz
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - M Güdel
- Max Planck Institute for Astronomy, Heidelberg, Germany
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
- ETH Zürich, Institute for Particle Physics and Astrophysics, Zürich, Switzerland
| | - P-O Lagage
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - T P Ray
- Dublin Institute for Advanced Studies, Dublin, Ireland
| | | | - A Abergel
- Université Paris-Saclay, CNRS, Institut d'Astrophysique Spatiale, Orsay, France
| | - O Absil
- STAR Institute, Université de Liège, Liège, Belgium
| | - A M Arabhavi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - I Argyriou
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - D Barrado
- Centro de Astrobiología (CAB), CSIC-INTA, Villanueva de la Cañada, Spain
| | - A Boccaletti
- LESIA, Observatoire de Paris, Université PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - A Caratti O Garatti
- Dublin Institute for Advanced Studies, Dublin, Ireland
- INAF - Osservatorio Astronomico di Capodimonte, Napoli, Italy
| | - V Geers
- UK Astronomy Technology Centre, Royal Observatory Edinburgh, Edinburgh, UK
| | - A M Glauser
- ETH Zürich, Institute for Particle Physics and Astrophysics, Zürich, Switzerland
| | - K Justannont
- Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - F Lahuis
- SRON Netherlands Institute for Space Research, Groningen, the Netherlands
| | - M Mueller
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - C Nehmé
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - E Pantin
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - S Scheithauer
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - C Waelkens
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - R Guadarrama
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
| | - H Jang
- Department of Astrophysics/IMAPP, Radboud University, Nijmegen, the Netherlands
| | - J Kanwar
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- TU Graz, Fakultät für Mathematik, Physik und Geodäsie, Graz, Austria
| | - M Morales-Calderón
- Centro de Astrobiología (CAB), CSIC-INTA, Villanueva de la Cañada, Spain
| | - N Pawellek
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
| | - D Rodgers-Lee
- Dublin Institute for Advanced Studies, Dublin, Ireland
| | - J Schreiber
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - L Colina
- Centro de Astrobiología (CAB, CSIC-INTA), Carretera de Ajalvir, Torrejón de Ardoz, Spain
| | - T R Greve
- DTU Space, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - G Östlin
- Department of Astronomy, Oskar Klein Centre, Stockholm University, Stockholm, Sweden
| | - G Wright
- UK Astronomy Technology Centre, Royal Observatory Edinburgh, Edinburgh, UK
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Hoermandinger C, Kaufmann F, Mulzer J, Mueller M, Falk V, Potapov E, Schoenrath F, Just I. Lysis Therapy vs. Pump Exchange for Intra-Pump Thrombosis of Left Ventricular Assist Devices. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.150] [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: 04/05/2023] Open
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Macken WL, Falabella M, McKittrick C, Pizzamiglio C, Ellmers R, Eggleton K, Woodward CE, Patel Y, Labrum R, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Lakey A, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Mitchell J, Moutsianas L, Mueller M, Murugaesu N, Need AC, O’Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM, Zarowiecki M, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS. Specialist multidisciplinary input maximises rare disease diagnoses from whole genome sequencing. Nat Commun 2022; 13:6324. [PMID: 36344503 PMCID: PMC9640711 DOI: 10.1038/s41467-022-32908-7] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022] Open
Abstract
Diagnostic whole genome sequencing (WGS) is increasingly used in rare diseases. However, standard, semi-automated WGS analysis may overlook diagnoses in complex disorders. Here, we show that specialist multidisciplinary analysis of WGS, following an initial 'no primary findings' (NPF) report, improves diagnostic rates and alters management. We undertook WGS in 102 adults with diagnostically challenging primary mitochondrial disease phenotypes. NPF cases were reviewed by a genomic medicine team, thus enabling bespoke informatic approaches, co-ordinated phenotypic validation, and functional work. We enhanced the diagnostic rate from 16.7% to 31.4%, with management implications for all new diagnoses, and detected strong candidate disease-causing variants in a further 3.9% of patients. This approach presents a standardised model of care that supports mainstream clinicians and enhances diagnostic equity for complex disorders, thereby facilitating access to the potential benefits of genomic healthcare. This research was made possible through access to the data and findings generated by the 100,000 Genomes Project: http://www.genomicsengland.co.uk .
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Affiliation(s)
- William L. Macken
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Micol Falabella
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline McKittrick
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Chiara Pizzamiglio
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rebecca Ellmers
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Kelly Eggleton
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Cathy E. Woodward
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Yogen Patel
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Robyn Labrum
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | | | - Rahul Phadke
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Mary M. Reilly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine DeVile
- grid.424537.30000 0004 5902 9895Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Sarkozy
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Footitt
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - James Davison
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.420468.cNational Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Shamima Rahman
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.83440.3b0000000121901201Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Henry Houlden
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Enrico Bugiardini
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rosaline Quinlivan
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael G. Hanna
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Jana Vandrovcova
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Robert D. S. Pitceathly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
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Das D, Squires N, Mueller M, Collins S, Lewicky-Gaupp C, Bretschneider C, Geynisman-Tan J, Kenton K. Use of Novel Configuration with Suture Kit Device for Robotic-assisted Minimally Invasive Sacrocolpopexy. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.067] [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: 11/25/2022]
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9
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Shoemark A, Griffin H, Wheway G, Hogg C, Lucas JS, Camps C, Taylor J, Carroll M, Loebinger MR, Chalmers JD, Morris-Rosendahl D, Mitchison HM, De Soyza A, Brown D, Ambrose JC, Arumugam P, Bevers R, Bleda M, Boardman-Pretty F, Boustred CR, Brittain H, Caulfield MJ, Chan GC, Fowler T, Giess A, Hamblin A, Henderson S, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Moutsianas L, Mueller M, Murugaesu N, Need AC, O'Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM. Genome sequencing reveals underdiagnosis of primary ciliary dyskinesia in bronchiectasis. Eur Respir J 2022; 60:13993003.00176-2022. [PMID: 35728977 DOI: 10.1183/13993003.00176-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60-80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis. METHODS This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK. RESULTS Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5-10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing. CONCLUSIONS PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.
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Affiliation(s)
- Amelia Shoemark
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Helen Griffin
- Primary Immunodeficiency Group, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Gabrielle Wheway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Hogg
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Carme Camps
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Jenny Taylor
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Mary Carroll
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - James D Chalmers
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
| | - Deborah Morris-Rosendahl
- Clinical Genetics and Genomics, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust and NHLI, Imperial College London, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Department, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
- These authors contributed equally to this manuscript
| | - Anthony De Soyza
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
- These authors contributed equally to this manuscript
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10
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Calvo-Schimmel A, Newman S, Sterba K, Mueller M, Miaskowski C, Qanungo S. Besoins non satisfaits en soins de soutien chez les survivants du cancer de la prostate à un stade avancé : exploration par méthodes mixtes. Can Oncol Nurs J 2022. [DOI: 10.5737/23688076324526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
But : Les hommes souffrant d’un cancer avancé de la prostate connaissent un large éventail d’effets secondaires découlant du cancer et de ses traitements qui nuisent à leur qualité de vie (QDV). Peu d’études ont évalué les besoins de soins de soutien chez ces personnes. Cette étude a été réalisée pour effectuer une évaluation globale des besoins en soins de soutien chez ces survivants en se fondant sur un cadre de soins de soutien en oncologie (Supportive Care Framework for Cancer Care, ou SCFCC). Méthodes : Dans le cadre d’une recherche menée selon une approche mixte, parallèle et convergente, des survivants du cancer de la prostate à un stade avancé (n = 188) ont répondu à un questionnaire d’enquête transversale. Quelques-uns de ces survivants (n = 20) ont participé à un entretien afin de mieux évaluer leurs besoins non satisfaits. Résultats : Les survivants ont déclaré des besoins non satisfaits de soins de soutien dans tous les domaines du cadre d’évaluation utilisé. Pas moins de 95,2 % des survivants avaient au moins un besoin non satisfait, avec une moyenne de 14,9 besoins (fourchette : 0–42). Plusieurs domaines de convergence entre les données quantitatives et qualitatives (fatigue, dysfonctionnement sexuel, domaines pratique et émotionnel/psychologique) et de divergence (domaines informationnel et spirituel, dépression, dysfonctionnement urinaire) ont été trouvés durant le processus d’intégration. Conclusion : Cette étude confirme que les survivants du cancer de la prostate à un stade avancé présentent des taux élevés de besoins non satisfaits en soins de soutien. Les résultats soulignent également une grande diversité dans ces besoins non satisfaits. Ces résultats pourraient contribuer au développement de plans de soins de soutien centrés sur le patient, adaptés aux besoins particuliers de ce groupe vulnérable de survivants du cancer. Mots-clés : cancer de la prostate; stade avancé; survivants; soins de soutien; besoins non satisfaits; qualité de vie; méthodes mixtes
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11
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Calvo-Schimmel A, Newman S, Sterba K, Mueller M, Miaskowski C, Qanungo S. Unmet supportive care needs in prostate cancer survivors with advanced disease: A mixed-methods exploration. Can Oncol Nurs J 2022. [DOI: 10.5737/23688076324512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: Men with advanced prostate cancer experience a wide range of side effects from the cancer and its therapies, which have a negative effect on their quality of life (QOL). Few studies have evaluated supportive care needs in these individuals. The purpose of this study was to conduct a holistic supportive care needs assessment among these survivors guided by the Supportive Care Framework for Cancer Care. Methods: Using a convergent parallel mixed-methods approach, prostate cancer survivors with advanced disease (n = 188) completed a cross-sectional survey. A subset of these survivors (n = 20) participated in an interview to further explore their experience of unmet needs. Results: Survivors reported unmet supportive care needs in every domain of the framework. Up to 95.2% of the survivors had at least one unmet need, with a mean of 14.9 (range: 0–42). Several areas of convergence among the quantitative and qualitative data (fatigue, sexual dysfunction, practical, and emotional/psychological domains), as well as divergence (informational and spiritual domains, depression, urinary dysfunction) were found through the integration process. Conclusions: This study confirms that prostate cancer survivors with advanced disease experience high rates of unmet supportive care needs. The findings also highlight the diversity of those unmet needs. These results may assist with future development of patient-centered supportive care interventions that better meet the specific needs of this vulnerable group of cancer survivors. Keywords: prostate cancer; advanced disease; survivors; supportive care; unmet needs; quality of life; mixed-methods
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12
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Kokot K, Kneuer J, John D, Rebs S, Mueller M, Haas J, Thiele H, Mueller OJ, Hille S, Leuschner F, Dimmeler S, Streckfuss-Boemeke K, Meder B, Laufs U, Boeckel JN. Decrease of RNA editing in the failing heart leads to induction of circRNAs. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and purpose
Adenosine-to-Inosine (A-to-I) RNA editing is a post-transcriptional modification process that affects the secondary structure of RNAs. Changes in RNA editing have been associated with human diseases. We therefore aimed to analyze editing in the healthy and failing human heart.
Methods and results
Transcriptome sequencing of human heart samples of heart failure (HF) patients (n=20) and controls (n=10) revealed A-to-I editing as the major type of editing (>80%). In HF patients, RNA editing was reduced, which was primarily attributable to Alu elements in introns of protein-coding genes. We identified 166 upregulated circRNAs in HF, with the majority showing reduced RNA editing in their parental host gene (88.3%). CircRNA expression did not correlate with their corresponding host gene (R=0.07, P<0.05), suggesting that an alternative splicing mechanism gives rise to the elevated circRNA levels in HF. The RNA editing enzyme ADAR2, which binds to RNA regions that are edited from adenosine to inosine, was decreased in failing human hearts (−68.2%). In vitro, reduction of ADAR2 increased circRNA levels suggesting a causal effect of reduced ADAR2 levels on increased circRNAs in the failing human heart. To gain mechanistic insight, we examined the formation of circRNAs on one exemplary candidate. AKAP13 was among the top edited mRNAs in the human heart and gave rise to a circular transcript, which was elevated in HF. ADAR2 reduced the formation of double-stranded structures in AKAP13 pre-mRNA, thereby reducing the stability of Alu elements and the circularization of the resulting circRNA. Overexpression of circAKAP13 impaired the sarcomere regularity of human induced pluripotent stem cell-derived cardiomyocytes (−31.0%).
Conclusion
Our study shows that ADAR2 mediates A-to-I RNA editing in the human heart. We describe an alternative splicing mechanism of circRNAs in the human heart. In the healthy human heart, A-to-I RNA editing represses the formation of dsRNA structures of Alu elements thereby favoring linear mRNA splicing. Our results contribute to a better mechanistic understanding into the human-specific regulation of circRNA formation and are relevant to diseases with reduced RNA editing and increased circRNA levels.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Kokot
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - J Kneuer
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - D John
- Institute of Cardiovascular Regeneration , Frankfurt , Germany
| | - S Rebs
- Institute of Pharmacology and Toxicology , Würzburg , Germany
| | - M Mueller
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum , Bad Oeynhausen , Germany
| | - J Haas
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - H Thiele
- Heart Center of Leipzig , Leipzig , Germany
| | - O J Mueller
- University of Kiel, Department of Internal Medicine III , Kiel , Germany
| | - S Hille
- University of Kiel, Department of Internal Medicine III , Kiel , Germany
| | - F Leuschner
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - S Dimmeler
- Institute of Cardiovascular Regeneration , Frankfurt , Germany
| | | | - B Meder
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - U Laufs
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - J N Boeckel
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
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Drake T, Tan E, Georgakopoulou A, May S, Mueller M, Horrigan S, Holloway K, Chang J, Aras R, Bird T. The TBL1 inhibitor, Tegavivint, suppresses tumour growth and enhances T-cell infiltration in preclinical murine β-Catenin mutant hepatocellular carcinoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00852-8] [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: 11/27/2022]
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14
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Karolyi M, Pawelka E, Omid S, Koenig F, Kauer V, Rumpf B, Hoepler W, Kuran A, Laferl H, Seitz T, Traugott M, Rathkolb V, Mueller M, Abrahamowicz A, Schoergenhofer C, Hecking M, Assinger A, Wenisch C, Zeitlinger M, Jilma B, Zoufaly A. Camostat Mesylate Versus Lopinavir/Ritonavir in Hospitalized Patients With COVID-19—Results From a Randomized, Controlled, Open Label, Platform Trial (ACOVACT). Front Pharmacol 2022; 13:870493. [PMID: 35935856 PMCID: PMC9354138 DOI: 10.3389/fphar.2022.870493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background: To date, no oral antiviral drug has proven to be beneficial in hospitalized patients with COVID-19.Methods: In this randomized, controlled, open-label, platform trial, we randomly assigned patients ≥18 years hospitalized with COVID-19 pneumonia to receive either camostat mesylate (CM) (considered standard-of-care) or lopinavir/ritonavir (LPV/RTV). The primary endpoint was time to sustained clinical improvement (≥48 h) of at least one point on the 7-category WHO scale. Secondary endpoints included length of stay (LOS), need for mechanical ventilation (MV) or death, and 29-day mortality.Results: 201 patients were included in the study (101 CM and 100 LPV/RTV) between 20 April 2020 and 14 May 2021. Mean age was 58.7 years, and 67% were male. The median time from symptom onset to randomization was 7 days (IQR 5–9). Patients in the CM group had a significantly shorter time to sustained clinical improvement (HR = 0.67, 95%-CI 0.49–0.90; 9 vs. 11 days, p = 0.008) and demonstrated less progression to MV or death [6/101 (5.9%) vs. 15/100 (15%), p = 0.036] and a shorter LOS (12 vs. 14 days, p = 0.023). A statistically nonsignificant trend toward a lower 29-day mortality in the CM group than the LPV/RTV group [2/101 (2%) vs. 7/100 (7%), p = 0.089] was observed.Conclusion: In patients hospitalized for COVID-19, the use of CM was associated with shorter time to clinical improvement, reduced need for MV or death, and shorter LOS than the use of LPV/RTV. Furthermore, research is needed to confirm the efficacy of CM in larger placebo-controlled trials.Systematic Review Registration: [https://clinicaltrials.gov/ct2/show/NCT04351724, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-001302-30/AT], identifier [NCT04351724, EUDRACT-NR: 2020–001302-30].
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Affiliation(s)
- M. Karolyi
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
- *Correspondence: M. Karolyi,
| | - E. Pawelka
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - S. Omid
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - F. Koenig
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - V. Kauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Rumpf
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - W. Hoepler
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - A. Kuran
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - H. Laferl
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - T. Seitz
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Traugott
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - V. Rathkolb
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - M. Mueller
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Abrahamowicz
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - C. Schoergenhofer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M. Hecking
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - A. Assinger
- Department of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C. Wenisch
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Zoufaly
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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15
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Gierschke P, Grebing C, Abdelaal M, Lenski M, Buldt J, Wang Z, Heuermann T, Mueller M, Gebhardt M, Rothhardt J, Limpert J. Nonlinear pulse compression to 51-W average power GW-class 35-fs pulses at 2-µm wavelength in a gas-filled multi-pass cell. Opt Lett 2022; 47:3511-3514. [PMID: 35838716 DOI: 10.1364/ol.462647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
We report on the generation of GW-class peak power, 35-fs pulses at 2-µm wavelength with an average power of 51 W at 300-kHz repetition rate. A compact, krypton-filled Herriott-type cavity employing metallic mirrors is used for spectral broadening. This multi-pass compression stage enables the efficient post compression of the pulses emitted by an ultrafast coherently combined thulium-doped fiber laser system. The presented results demonstrate an excellent preservation of the input beam quality in combination with a power transmission as high as 80%. These results show that multi-pass cell based post-compression is an attractive alternative to nonlinear spectral broadening in fibers, which is commonly employed for thulium-doped and other mid-infrared ultrafast laser systems. Particularly, the average power scalability and the potential to achieve few-cycle pulse durations make this scheme highly attractive.
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16
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Wüest A, Imboden S, Dingeldein I, Mueller M. 063 Awareness of endometriosis for adolescence thru education in schools. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.092] [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: 11/25/2022]
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17
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Al-Zawity J, Afzal F, Awan A, Nordhoff D, Montier T, Le Gall T, Mueller M. P144 Impact of the sex steroid hormone estradiol on biofilm formation and phenotype of Pseudomonas aeruginosa isolates from cystic fibrosis patients. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Saad A, Mueller M, Pillai D. 25 Tender Is the Spine: Thoracolumbar Fractures and Patterns of Referrals. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.015] [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: 11/13/2022]
Abstract
Abstract
Introduction
This study investigates the pattern of referrals of thoracolumbar fractures between trauma and orthopaedic department in a district general trauma unit (TU) and the affiliated Major Trauma Centre (MTC). Our TU has got no out of hour emergency spinal surgeons on site. Patients who are admitted with thoracolumbar fractures get referred to MTC for advice on management. The TLICS score and the AO Thoracolumbar fracture classification system are two well recognized classification systems for thoracolumbar fractures. The main aim of this project is to evaluate current practice and its effectiveness.
Method
Data was retrospectively collected from the trauma board for patients referred to the orthopaedic on call services for thoracolumbar fractures over a 16-month period. Patients’ demographics, mechanism of injury, TLICS scores and AO classification were recorded, and outcome registered.
Results
From 92 patients identified most had low energy trauma and the majority had low TLICS score (<2) and AO class (A1,2,3). 24 of the patients were referred to MTC of whom 10 required a follow-up appointment. 39 were discussed with the local spinal consultants. 91 were treated conservatively and locally.
Conclusions
Most thoracolumbar fractures are treated locally. It can be argued that the emergency spinal services at MTC are unnecessarily burdened for advice and reassurance. A change of the current pathway can possibly be put in place for patients with low AO classification (A1,2,3), that can be treated with local spinal surgeon input. This calls for a follow-on multi-centre study.
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Affiliation(s)
- A.R. Saad
- Medway NHS Foundation Trust, Medway, United Kingdom
| | - M. Mueller
- Medway NHS Foundation Trust, Medway, United Kingdom
| | - D. Pillai
- Medway NHS Foundation Trust, Medway, United Kingdom
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19
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Kokot K, Kneuer J, John D, Moebius-Winkler M, Mueller M, Andritschke M, Gaul S, Sheikh B, Haas J, Thiele H, Leuschner F, Dimmeler S, Meder B, Laufs U, Boeckel JN. Reduced RNA editing in the failing human heart mediates alternative circular RNA splicing. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
Post-transcriptional RNA editing is an important mechanism in the development of human diseases. RNA editing can affect RNA stability and alternative splicing. The aim of our study was to characterize RNA editing and its impact on alternative RNA splicing in the healthy and failing human heart.
Methods and results
Human heart samples of heart failure (HF) patients (n=20) and controls (n=10) were analyzed using RNA sequencing with subsequent analysis of RNA editing. We identified adenosine-to-inosine (A-to-I) editing as the major form of RNA editing in human hearts, being reduced in HF patients. Consistently, we found the editing enzyme ADAR2 reduced in HF patients. A-to-I RNA editing predominantly occurred in intronic regions of protein-coding genes, specifically in repetitive, primate-specific Alu elements which can affect RNA splicing. Indeed, we found 173 circular RNAs (circRNAs) regulated by alternative mRNA splicing in the failing heart.
Loss of ADAR2 led to reduced RNA editing concomitant with an increase of circRNA, while overexpression reduced circRNA expression and enhanced RNA editing.
Conclusion
A-to-I editing is the major type of RNA editing in the human heart, being reduced in HF. We demonstrate a primate-specific alternative RNA splicing mechanism mediated by RNA editing in human hearts. The findings may be relevant to diseases with reduced RNA editing such as cancer, neurological and cardiac diseases.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Kokot
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - J Kneuer
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - D John
- Goethe University Hospital, Institute for Cardiovascular Regeneration, Frankfurt, Germany
| | - M Moebius-Winkler
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - M Mueller
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum, Bad Oeynhausen, Germany
| | - M Andritschke
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - S Gaul
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - B Sheikh
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), Leipzig, Germany
| | - J Haas
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - H Thiele
- Heart Center at University of Leipzig, Leipzig, Germany
| | - F Leuschner
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - S Dimmeler
- Goethe University Hospital, Institute for Cardiovascular Regeneration, Frankfurt, Germany
| | - B Meder
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - U Laufs
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - J N Boeckel
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
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Gruebl T, Ploeger B, Wranze-Bielefeld E, Mueller M, Schmidbauer W, Kill C, Betz S. Point-of-care testing in out-of-hospital cardiac arrest: a retrospective analysis of relevance and consequences. Scand J Trauma Resusc Emerg Med 2021; 29:128. [PMID: 34461967 PMCID: PMC8406837 DOI: 10.1186/s13049-021-00943-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/03/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background Metabolic and electrolyte imbalances are some of the reversible causes of cardiac arrest and can be diagnosed even in the pre-hospital setting with a mobile analyser for point-of-care testing (POCT).
Methods We conducted a retrospective observational study, which included analysing all pre-hospital resuscitations in the study region between October 2015 and December 2016. A mobile POCT analyser (Alere epoc®) was available at the scene of each resuscitation. We analysed the frequency of use of POCT, the incidence of pathological findings, the specific interventions based on POCT as well as every patient’s eventual outcome. Results N = 263 pre-hospital resuscitations were included and in n = 98 of them, the POCT analyser was used. Of these measurements, 64% were performed using venous blood and 36% using arterial blood. The results of POCT showed that 63% of tested patients had severe metabolic acidosis (pH < 7.2 + BE < − 5 mmol/l). Of these patients, 82% received buffering treatment with sodium bicarbonate. Potassium levels were markedly divergent normal (> 6.0 mmol/l/ < 2.5 mmol/l) in 17% of tested patients and 14% of them received a potassium infusion. On average, the pre-hospital treatment time between arrival of the first emergency medical responders and the beginning of transport was 54 (± 20) min without POCT and 60 (± 17) min with POCT (p = 0.07). Overall, 21% of patients survived to hospital discharge (POCT 30% vs no POCT 16%, p = 0.01, Φ = 0.16). Conclusions Using a POCT analyser in pre-hospital resuscitation allows rapid detection of pathological acid–base imbalances and potassium concentrations and often leads to specific interventions on scene and could improve the probability of survival.
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Affiliation(s)
- Tobias Gruebl
- Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, Ruebenacher Straße 170, 56072, Koblenz, Germany. .,Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany.
| | - B Ploeger
- Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - E Wranze-Bielefeld
- Department of Hazard Prevention and Emergency Service, District of Vogelsberg, Goldhelg 20, 36341, Lauterbach, Germany
| | - M Mueller
- German Red Cross Emergency Service of Mittelhessen gGmbH, Am Krekel 41, 35039, Marburg, Germany
| | - W Schmidbauer
- Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, Ruebenacher Straße 170, 56072, Koblenz, Germany
| | - C Kill
- Center of Emergency Medicine, University Hospital of Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - S Betz
- Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany
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Mueller M, Poulsen P, Verbakel W, Berbeco R, Ferguson D, Wang L, Ren L, Mori S, Roeske J, Zhang P, Keall P. OC-0357 The MArkerless Lung target Tracking CHallenge (MATCH). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06872-9] [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: 11/28/2022]
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Schnaubelt S, Oppenauer J, Tihanyi D, Mueller M, Maldonado-Gonzalez E, Zejnilovic S, Haslacher H, Perkmann T, Strassl R, Anders S, Stefenelli T, Zehetmayer S, Koppensteiner R, Domanovits H, Schlager O. Arterial stiffness in acute COVID-19 and potential associations with clinical outcome. J Intern Med 2021; 290:437-443. [PMID: 33651387 PMCID: PMC8013324 DOI: 10.1111/joim.13275] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/17/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) interferes with the vascular endothelium. It is not known whether COVID-19 additionally affects arterial stiffness. METHODS This case-control study compared brachial-ankle pulse wave (baPWV) and carotid-femoral pulse wave velocities (cfPWV) of acutely ill patients with and without COVID-19. RESULTS Twenty-two COVID-19 patients (50% females, 77 [67-84] years) were compared with 22 age- and sex-matched controls. In COVID-19 patients, baPWV (19.9 [18.4-21.0] vs. 16.0 [14.2-20.4], P = 0.02) and cfPWV (14.3 [13.4-16.0] vs. 11.0 [9.5-14.6], P = 0.01) were higher than in the controls. In multiple regression analysis, COVID-19 was independently associated with higher cfPWV (β = 3.164, P = 0.004) and baPWV (β = 3.532, P = 0.003). PWV values were higher in nonsurvivors. In survivors, PWV correlated with length of hospital stay. CONCLUSION COVID-19 appears to be related to an enhanced PWV reflecting an increase in arterial stiffness. Higher PWV might be related to an increased length of hospital stay and mortality.
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Affiliation(s)
- S Schnaubelt
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - J Oppenauer
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - D Tihanyi
- Department of Pulmonology, Clinic Penzing, Vienna Health Care Group, Vienna, Austria
| | - M Mueller
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - E Maldonado-Gonzalez
- Department of Medicine I, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - S Zejnilovic
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - H Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - T Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - R Strassl
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - S Anders
- Department of Pulmonology, Clinic Penzing, Vienna Health Care Group, Vienna, Austria
| | - T Stefenelli
- Department of Medicine I, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - S Zehetmayer
- Centre for Medical Statistics, Information Technology and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - R Koppensteiner
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - H Domanovits
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - O Schlager
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
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Brown O, Mou T, Lim S, Jones S, Kwasny M, Mueller M, Kenton K. 05 Do letters of recommendations for obstetrics and gynecology residency applicants differ by gender and race? a mixed-methods study. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.006] [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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24
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Di Giovanni R, Solaro C, Grange E, Masuccio FG, Brichetto G, Mueller M, Tacchino A. A comparison of upper limb function in subjects with multiple sclerosis and healthy controls using an inertial measurement unit. Mult Scler Relat Disord 2021; 53:103036. [PMID: 34051695 DOI: 10.1016/j.msard.2021.103036] [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: 03/09/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Upper limbs (UL) dysfunction is frequent in people with Multiple Sclerosis (PwMS). Several objective measures of UL function are proposed; however, their use is mostly confined to assess subjects with mild-to-moderate disability and requires fine motor skills, often impaired in high disability level subjects. Thus, a tool to score UL function in the advanced disease stage is lacking. The aim of the study is to analyse and compare UL unilateral and bilateral movements of healthy control (HC) and PwMS, at different disability levels, using an instrumented version (Inertial Measurement Unit, IMU) of the 15-seconds finger-to-nose test (FNT). Each movement cycle was segmented in going/adjusting/returning phases. The inter-hand interval (IHI) allowed assessing bilateral coordination (i.e. synchrony) in each phase. The larger IHI, the more severe the bilateral coordination impairment is. After stratifying PwMS for disability level (PwMSLOW, Expanded Disability Status Scale, EDSS≤5.5 and PwMSHIGH, EDSS≥6), the ANOVA on IHI showed significant differences between PwMS and HC (p<0.001) in all phases. However, only the going phase IHI showed significantly higher asynchrony in PwMSHIGH than PwMSLOW and HC (p<0.001) and no differences between PwMSLOW and HC. The going phase IHI seems to be a clinical marker specific for high disability level PwMS. These findings suggest inertial sensors during FNT could be an easy-to-use method for a more detailed quantitative characterization of UL function in PwMS also in subjects with EDSS greater than 6.
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Affiliation(s)
| | - C Solaro
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy.
| | - E Grange
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - F G Masuccio
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - G Brichetto
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
| | - M Mueller
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
| | - A Tacchino
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
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Lewin D, Nersesian G, Roehrich L, Mueller M, Mulzer J, Kukucka M, Starck C, Falk V, Potapov E. Impact of Cardiopulmonary Bypass for Implantation of Left Ventricular Assist Device on Postoperative Outcome. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725617] [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: 10/21/2022]
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26
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Lanmueller P, Eulert-Grehn JJ, Felix S, Pieske B, Mulzer J, Mueller M, Falk V, Potapov E. Long-Term Mechanical Circulatory Support in Patients with Heart Failure with Preserved Ejection Fraction. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725791] [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: 10/21/2022]
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27
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Frey K, Goetze S, Mueller M, Rohrer L, Von Eckardstein A, Wollscheid B. The HDL synapse: Decoding a complex interaction network of HDL residing proteins and endothelial cell surface receptors. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Bongiovanni D, Klug M, Mueller M, Santovito D, Weber C, Peano C, Laugwitz K, Bernlochner I. The pro-thrombotic transcriptomic signature of reticulated platelets in patients with chronic coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Reticulated or immature platelets (RPs) are hyper-reactive young platelets that are larger and contain significantly more RNA compared to mature platelets (MPs). High levels of RPs in peripheral blood are predictors of an insufficient response to dual antiplatelet therapy and of adverse cardiovascular events in cardiovascular patients. Recently, we reported for the first time an enrichment of prothrombotic transcripts in RPs transcriptome of healthy donors. However, the biology of RPs in patients with coronary artery disease has not been investigated yet.
Purpose
We aimed to compare for the first time the transcriptomic profiles of RPs and MPs in patients with chronic coronary syndrome (CCS).
Methods
RPs and MPs from peripheral blood of CCS patients were isolated using fluorescent activated cell sorting (FACS) based on their RNA-content. After sorting, RNA was extracted and quality, concentration and integrity were assessed with the Tapestation 4200 platform (Agilent). Total-RNA libraries were prepared, multiplexed and sequenced on a NextSeq 500 Illumina platform obtaining 80 to 100 million paired-end reads per sample. RNA-sequencing analysis was performed with R and DESeq2.
Results
Total-RNA-sequencing detected 538 genes differentially expressed (300 downregulated, 238 upregulated) in RPs compared to MPs in CCS patients (Figure 1A). In particular, transcripts for the collagen receptor GP6 (FC 1.89, p=4.7x10–23), thrombin receptor PAR4 (F2RL3, FC 1.97, p=3.5x10–11), the ATP receptor P2RX1 (FC 1.94, p=3.1x10–15) and the ADP receptor P2RY1 (FC 1.82, p=3.15x10–10) were significantly enriched in RPs, whereas RNA regulators as the RISC-component TNRC6A (FC 0.5, p=7.98x10–13) and the splicing factor LUC7L3 (log2FC 0.55, p=1.76x10–11) were downregulated in RPs. Gene ontology analysis revealed an enrichment of relevant biological categories in RPs including “platelet activation” (fold enrichment = 10.5, p=1.8x10–8) and “blood coagulation” (fold enrichment = 4.4, p=2.4x10–3). Splicing analysis detected several differential splicing events. Of note, we detected an alternative splicing on GP6 transcript present only in RPs and absent in MPs (p=0.03, Figure 1B) At last, backsplicing analysis detected an enrichment of circular-RNAs in MPs.
Conclusions
This study represents the first deep transcriptomic profiling of RPs and MPs in patients with CCS and reports for the first time a differential enrichment of transcripts involved in platelet activation. Moreover, we could detect for the first time alternative splicing events in RPs and an enrichment of circular-RNAs in MPs. The clear upregulation of prothrombotic signaling in RPs (schematic overview Figure 1C) could explain, at least in part, their hyper-activity and their correlation with cardiovascular events in different pathological settings at it may offer a new therapeutic niche in patients with CCS.
Figure 1
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): German society of cardiology (DGK)
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Affiliation(s)
- D Bongiovanni
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - M Klug
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - M Mueller
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - D Santovito
- Ludwig-Maximilians University, Institut für Prophylaxe und Epidemiologie der Kreislaufkrankheiten, Munich, Germany
| | - C Weber
- Ludwig-Maximilians University, Institut für Prophylaxe und Epidemiologie der Kreislaufkrankheiten, Munich, Germany
| | - C Peano
- Clinical Institute Humanitas IRCCS, Department of Cardiovascular Medicine, Rozzano, Italy
| | - K.L Laugwitz
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
| | - I Bernlochner
- Hospital Rechts der Isar, I. Medizinische Klinik und Poliklinik, Munich, Germany
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Solaro C, Di Giovanni R, Grange E, Mueller M, Messmer Uccelli M, Bertoni R, Brichetto G, Tacchino A, Patti F, Pappalardo A, Prosperini L, Castelli L, Rosato R, Cattaneo D, Marengo D. Box and block test, hand grip strength and nine-hole peg test: correlations between three upper limb objective measures in multiple sclerosis. Eur J Neurol 2020; 27:2523-2530. [PMID: 32619066 DOI: 10.1111/ene.14427] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Limited data are available in the literature for upper limb impairment in multiple sclerosis (MS). This study aimed to report the distribution of values of hand grip strength (HGS), of the box and block test (BBT) and of the nine-hole peg test (9HPT) correlated with demographic and clinical data in subjects with MS. METHODS This study involved five Italian neurological centres. The inclusion criteria were age ≥ 18, MS diagnosis, stable disease phase, right-hand dominance. All subjects underwent HGS, BBT and 9-HPT evaluation. RESULTS In all, 202 subjects with MS were enrolled: 137 females; mean age 48.4 years; mean Expanded Disability Status Scale (EDSS) 4.17; mean disease duration 14.12 years; disease course 129 relapsing-remitting, 21 primary progressive and 52 secondary progressive MS subjects; mean right HGS 25.3 kg, left 23.2 kg; mean right BBT 45.7 blocks, left 44.9 blocks; mean right 9-HPT 30.7 s, left 33.4 s. All results were statistically significantly different compared to healthy controls. HGS, BBT and 9-HPT were associated with age, EDSS and disease duration, whilst disease course correlated with BBT and 9-HPT. The BBT and 9-HPT scores significantly differed according to level of disability (EDSS ≤3.0, 3.5-5.5, ≥6.0). CONCLUSION Hand grip strength and BBT value distribution in a large MS population is reported. Correlations between HGS, BBT and 9-HPT were generally low.
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Affiliation(s)
- C Solaro
- Department of Rehabilitation, CRRF 'Mons. Luigi Novarese', Moncrivello, Italy
| | - R Di Giovanni
- Department of Rehabilitation, CRRF 'Mons. Luigi Novarese', Moncrivello, Italy
| | - E Grange
- Department of Rehabilitation, CRRF 'Mons. Luigi Novarese', Moncrivello, Italy
| | - M Mueller
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
| | - M Messmer Uccelli
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
| | - R Bertoni
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy
| | - G Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
| | - A Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
| | - F Patti
- MS Center Institute of Neurological Sciences - University of Catania, Catania, Italy
| | - A Pappalardo
- MS Center Institute of Neurological Sciences - University of Catania, Catania, Italy
| | - L Prosperini
- Department of Neurosciences, S. Camillo-Forlanini Hospital, Roma, Italy
| | - L Castelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC neuroriabilitazione ad Alta Intensità, Roma, Italy
| | - R Rosato
- Department of Psychology, University of Turin, Torino, Italy
| | - D Cattaneo
- IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy
| | - D Marengo
- Department of Psychology, University of Turin, Torino, Italy
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Pasluosta C, Lauck TB, Krauskopf T, Klein L, Mueller M, Herget GW, Stieglitz T. Intermuscular coupling and postural control in unilateral transfemoral amputees - a pilot study . Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3815-3818. [PMID: 33018832 DOI: 10.1109/embc44109.2020.9176850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The dynamics of the adjustment of center of pressure (CoP) has been utilized to understand motor control in human pathologies characterized by impairments in postural balance. The control mechanisms that maintain balance can be investigated via the analysis of muscle recruitment using electromyography (EMG) signals. In this work, we combined these two techniques to investigate balance control during upright standing in transfemoral unilateral amputees wearing a prosthesis. The dynamics of the CoP adjustments and EMG-EMG coherence between four muscles of the trunk and lower limb of 5 unilateral transfemoral amputees and 5 age-matched able-bodied participants were quantified during 30 s of quiet standing using the entropic half-life (EnHL) method. Two visual conditions, eyes open and eyes closed, were tested. Overall, the group of amputees presented lower EnHL values (higher dynamics) in their CoP adjustments than controls, especially in their intact limb. The EnHL values of the EMG-EMG coherence time series in the amputee group were lower than the control group for almost all muscle pairs under both visual conditions. Different correlations between the EnHL values of the CoP data and the EMG-EMG coherence data were observed in the amputee and control groups. These preliminary results suggest the onset of distinct neuromuscular adaptations following a unilateral amputation.Clinical Relevance - Understanding neuromuscular adaptation mechanisms after an amputation may serve to design better rehabilitation treatments and novel prosthetic devices with sensory feedback.
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Solaro C, de Sire A, Messmer Uccelli M, Mueller M, Bergamaschi R, Gasperini C, Restivo DA, Stabile MR, Patti F. Efficacy of levetiracetam on upper limb movement in multiple sclerosis patients with cerebellar signs: a multicenter double-blind, placebo-controlled, crossover study. Eur J Neurol 2020; 27:2209-2216. [PMID: 32558044 DOI: 10.1111/ene.14403] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The literature provides contrasting results on the efficacy of levetiracetam (LEV) in multiple sclerosis (MS) patients with cerebellar signs. It was sought to evaluate the efficacy of LEV on upper limb movement in MS patients. METHODS In this multicenter double-blind placebo-controlled crossover study, MS patients with prevalently cerebellar signs were randomly allocated into two groups: LEV followed by placebo (group 1) or placebo followed by LEV (group 2). Clinical assessments were performed by a blinded physician at T0 (day 1), T1 (day 22), T2 (2-week wash-out period, day 35) and T3 (day 56). The primary outcome was dexterity in the arm with greater deficit, assessed by the nine-hole peg test (9HPT). Secondary clinical outcomes included responders on the 9HPT (∆9HPT >20%), tremor activity of the daily living questionnaire and self-defined upper limb impairment, through a numeric rating scale. Kinematic evaluation was performed using a digitizing tablet, providing data on normalized jerk, aiming error and centripetal acceleration. RESULTS Forty-eight subjects (45.2 ± 10.4 years) were randomly allocated into two groups (n = 24 each). 9HPT significantly improved in the LEV phase in both groups (P < 0.001). The LEV treatment phase led to a significant improvement (P < 0.01) of all clinical outcomes in group 1 and in dexterity in group 2. No significant changes were reported during both placebo phases in the two groups. Considering the kinematic analysis, only normalized jerk significantly improved after treatment with LEV (T0-T1) in group 1. CONCLUSIONS Levetiracetam treatment seems to be effective in improving upper limb dexterity in MS patients with cerebellar signs.
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Affiliation(s)
- C Solaro
- Rehabilitation Unit, 'Mons. L. Novarese' Hospital, Moncrivello, Italy
| | - A de Sire
- Rehabilitation Unit, 'Mons. L. Novarese' Hospital, Moncrivello, Italy.,Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont 'A. Avogadro', Novara, Italy
| | | | - M Mueller
- Department of Neurology, ASL 3 Genovese, Genoa, Italy
| | - R Bergamaschi
- Department of Neurology, Neurology Institute 'C. Mondino', Pavia, Italy
| | - C Gasperini
- Neurology Division, San Camillo Hospital, Rome, Italy
| | - D A Restivo
- Neurological Unit, 'Garibaldi' Hospital, Catania, Italy
| | - M R Stabile
- Brain Imaging and Neural Dynamics Research Group, San Camillo Hospital IRCCS, Venice, Italy
| | - F Patti
- Department of Medical, Surgical Science and Advanced Technology 'GF Ingrassia', University of Catania, Catania, Italy
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Tolchin D, Yeager JP, Prasad P, Dorrani N, Russi AS, Martinez-Agosto JA, Haseeb A, Angelozzi M, Santen G, Ruivenkamp C, Mercimek-Andrews S, Depienne C, Kuechler A, Mikat B, Ludecke HJ, Bilan F, Le Guyader G, Gilbert-Dussardier B, Keren B, Heide S, Haye D, Van Esch H, Keldermans L, Ortiz D, Lancaster E, Krantz ID, Krock BL, Pechter KB, Arkader A, Medne L, DeChene ET, Calpena E, Melistaccio G, Wilkie AO, Suri M, Foulds N, Begtrup A, Henderson LB, Forster C, Reed P, McDonald MT, McConkie-Rosell A, Thevenon J, Le Tanno P, Coutton C, Tsai AC, Stewart S, Maver A, Gorazd R, Pichon O, Nizon M, Cogné B, Isidor B, Martin-Coignard D, Stoeva R, Lefebvre V, Le Caignec C, Ambrose J, Bleda M, Boardman-Pretty F, Boissiere J, Boustred C, Caulfield M, Chan G, Craig C, Daugherty L, de Burca A, Devereau A, Elgar G, Foulger R, Fowler T, Furió-Tarí P, Hackett J, Halai D, Holman J, Hubbard T, Kasperaviciute D, Kayikci M, Lahnstein L, Lawson K, Leigh S, Leong I, Lopez F, Maleady-Crowe F, Mason J, McDonagh E, Moutsianas L, Mueller M, Need A, Odhams C, Patch C, Perez-Gil D, Polychronopoulos D, Pullinger J, Rahim T, Rendon A, Rogers T, Ryten M, Savage K, Scott R, Siddiq A, Sieghart A, Smedley D, Smith K, Sosinsky A, Spooner W, Stevens H, Stuckey A, Thomas E, Thompson S, Tregidgo C, Tucci A, Walsh E, Watters S, Welland M, Williams E, Witkowska K, Wood S, Zarowiecki M. De Novo SOX6 Variants Cause a Neurodevelopmental Syndrome Associated with ADHD, Craniosynostosis, and Osteochondromas. Am J Hum Genet 2020; 106:830-845. [PMID: 32442410 DOI: 10.1016/j.ajhg.2020.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022] Open
Abstract
SOX6 belongs to a family of 20 SRY-related HMG-box-containing (SOX) genes that encode transcription factors controlling cell fate and differentiation in many developmental and adult processes. For SOX6, these processes include, but are not limited to, neurogenesis and skeletogenesis. Variants in half of the SOX genes have been shown to cause severe developmental and adult syndromes, referred to as SOXopathies. We here provide evidence that SOX6 variants also cause a SOXopathy. Using clinical and genetic data, we identify 19 individuals harboring various types of SOX6 alterations and exhibiting developmental delay and/or intellectual disability; the individuals are from 17 unrelated families. Additional, inconstant features include attention-deficit/hyperactivity disorder (ADHD), autism, mild facial dysmorphism, craniosynostosis, and multiple osteochondromas. All variants are heterozygous. Fourteen are de novo, one is inherited from a mosaic father, and four offspring from two families have a paternally inherited variant. Intragenic microdeletions, balanced structural rearrangements, frameshifts, and nonsense variants are predicted to inactivate the SOX6 variant allele. Four missense variants occur in residues and protein regions highly conserved evolutionarily. These variants are not detected in the gnomAD control cohort, and the amino acid substitutions are predicted to be damaging. Two of these variants are located in the HMG domain and abolish SOX6 transcriptional activity in vitro. No clear genotype-phenotype correlations are found. Taken together, these findings concur that SOX6 haploinsufficiency leads to a neurodevelopmental SOXopathy that often includes ADHD and abnormal skeletal and other features.
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Solowjowa N, Zimpfer D, Mueller M, Krastev H, Falk V, Schloeglhofer TH, Starck CH, Potapov E, Netuka I. P819 Outflow graft twist occlusion in the heartmate 3 left ventricular assist system in 7 cases: analysis of potential mechanisms using computed tomography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Twist of the outflow graft (OG) of the HeartMate 3 left ventricular (LV) assist device (HM3) with subsequent occlusion is a rare, but life-threatening complication.
Purpose
We evaluated if potential implantation technique dependent mechanisms of OG twist can be predicted by multislice computed tomography (MSCT).
Methods
We retrospectively analyzed clinical, echocardiographic and MSCT data of 7 patients with angiographically proven and surgically corrected OG twist and of 11 consecutive patients without any type of pump obstruction. MSCT parameters were: position of inflow cannula related to anatomical LV apex (1), angulation of axis of inflow cannula related to LV axis (2), orientation of outflow channel of the pump housing related to LV axis (3), OG course (4). Echocardiographic parameters were LV end-diastolic diameter (LVEDD) and aortic valve opening.
Results
Mean time from implantation to twist was 563 ± 161 days. Preoperative LVEDD (64.6 ± 9.8 mm vs. 67.4 ± 10.2 mm, p = 0.563) was similar. LVEDD reduction after implantation (20% vs. 28%) and prevalence of aortic valve opening was higher in the twist group (71% vs. 45%). The MSCT measurements showed a high degree of heterogeneity in both groups: (1) differed from superior to infero-lateral; (2) varied from cranial to caudal, lateral and medial; (3) varied from antero-septal to inferior. (4) showed an incidence of non-obstructive kinking of 29% and 36%, respectively.
Conclusion
Marked heterogeneity of the measured MSCT parameters was observed in both groups. No specific pattern or geometric relation could be attributed to the OG twist phenomenon.
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Affiliation(s)
- N Solowjowa
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - D Zimpfer
- Medical University of Vienna, Division of Cardiac Surgery, Vienna, Austria
| | - M Mueller
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - H Krastev
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - V Falk
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - T H Schloeglhofer
- Medical University of Vienna, Division of Cardiac Surgery, Vienna, Austria
| | - C H Starck
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - E Potapov
- German Heart Institute of Berlin, Cardiothoracic and Vascular Surgery, Berlin, Germany
| | - I Netuka
- Institute for Clinical and Experimenal Medicine, Department of Cardiac Surgery, Praque, Czechia
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Goss F, Rybak K, Seige M, Haerer W, Schuetz B, Mitusch R, Mueller M, Heinrich U, Stoehring R, Turschner O, Knapp A, Jauernig M, Drexler M, Bosch R. 3049Equally high detection rates of atrial fibrillation in patients after a TIA and stroke by systematic ECG monitoring with an implanted device: SPIDER-AF study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The risk of neurovascular and cardiovascular morbidity is substantially increased by undetected atrial fibrillation (AF). Therefore, early detection of AF is crucial to initiate appropriate therapy in persons at risk and may improve outcome. An implantable loop recorder (ILR) can monitor the heart rhythm for up to three years, modern devices provide dedicated algorithms to detect AF.
Hypothesis
We aimed to investigate the AF detection rate by the use of an ILR in patients after a recent cerebrovascular event (TIA n=137 or stroke n=363) presenting in sinus rhythm and no history of AF in the ambulatory setting by office based cardiologists.
Purpose
Observational study in patients with no prior diagnosis of AF, who had (presumably thromboembolic) transient ischemic attack (TIA) or stroke within 12 months and were implanted an ILR in the last 6 months. Follow-up visits every 3 months for 1 year overall.
Results
In 34 outpatient cardiology centers in Germany, a total of 500 patients were documented (mean age 63.1±12.7 years, 35.4% >70 years; 60.8% males). The qualifying event - diagnosed by neurologists - was a TIA in 137 (27.4%) and a stroke in 363 (72.6%) with typical thromboembolic pattern in NMR imaging (29.2% TIA/45.2% stroke, p<0.001), in CT imaging (7.3% TIA/7.7% stroke, n.s.), in both (6.6% TIA/19.6% stroke, p<0.001).
During follow-up, AF was newly detected by the device in TIA patients in 29.9% and in stroke patients in 25.6% (n.s.). The mean screening period until detection of AF with the Reveal LinQ device was 170±134 days in TIA, 145±128 in stroke respectively (n.s.). 95.7% had paroxysmal and 4.3% persistent AF in stroke, TIA patients had 100% paroxysmal AF (n.s.), median duration was 5.0 min in TIA and 5.2 min in stroke, respectively (n.s.). Most AF patients were asymptomatic (68.3% TIA/ 83.9% stroke, p<0.03).
The mean CHA2DS2Vasc score in patients with AF was 4.0 and 4.1 in those with TIA and stroke (n.s.), for patients in sinus rhythm 3.7 and 3.9, respectively (n.s.). Arterial hypertension was present in 71.5% with TIA/76.0% with stroke (n.s.), diabetes mellitus in 15.3% with TIA/25.1% with stroke (p<0.05), coronary artery disease in 12.4% with TIA/14.6% with stroke (n.s.), vascular disease in 3.6% with TIA/5.0% with stroke (n.s.).
Conclusions
In patients in sinus rhythm and no history of AF after a TIA or stroke, during 1-year follow-up AF could be newly detected in a quarter of patients by means of systematic continuous screening with an implantable ECG device. As AF diagnosis usually leads to immediate secondary prevention with long-term anticoagulation, such screening is useful not only in stroke but also in TIA patients and may substantially reduce the risk of recurrent stroke and cardiovascular morbidity.
Acknowledgement/Funding
SPIDER-AF registry was performed by BNK Service GmbH, Munich (Germany) and supported by Bayer Vital GmbH and Medtronic GmbH in equal parts
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Affiliation(s)
- F Goss
- Heart Center Alter Hof, Munich, Germany
| | - K Rybak
- Praxis für Kardiologie und Angiologie, Dessau, Germany
| | - M Seige
- Krankenhaus Martha-Maria, Klinik für Innere Medizin I, Halle-Dölau, Germany
| | | | - B Schuetz
- Praxis für Kardiologie, Luenen, Germany
| | - R Mitusch
- Kardiologische Praxis Priv.-Doz. Dr. med. Rolf Mitusch, Stralsund, Germany
| | | | | | - R Stoehring
- Kardiologische Praxis Dr. Stöhring, Bad Homburg, Germany
| | - O Turschner
- Kardiologische Gemeinschaftspraxis Dr. Oliver Turschner, Coburg, Germany
| | - A Knapp
- Kardiologische Praxis Dr. Andreas Knapp, Parchim, Germany
| | - M Jauernig
- Kardiologisch-angiologische Gemeinschaftspraxis, Reutlingen, Germany
| | | | - R Bosch
- Cardio Centrum Ludwigsburg Bietigheim, Ludwigsburg, Germany
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Mueller M, Kamp M, Sabel M, Stoffels G, Galldiks N, Langen K, Rapp M. P04.07 Correlation of 18F-fluorethyl-L-tyrosine (18F-FET) uptake in positron emission tomography (PET) and MRI growth rate in low-grade glioma. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.102] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Low-grade gliomas (LGGs, WHO grade II) are a heterogeneous group of tumors of the central nervous system with diverse behavior in histopathology, genetics and growth patterns. Therefore, different therapeutic strategies are discussed ranging from watchful waiting to radical resection and adjuvant radio-/chemotherapy. For a better evaluation of tumor progression or malignant transformation, the O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) uptake in PET or the tumor growth rate assessed on MRI are used depending on the neurooncological center. Here, we correlated both methods.
MATERIAL AND METHODS
Inclusion criteria for this retrospective study were (1) newly diagnosed and neuropathologically confirmed low-grade glioma; (2) at least two MRIs at initial diagnosis and follow-up for calculation of the tumor growth rate (using IDS7 by Sectra AB, Sweden, 2018); (3) and an additional preoperative 18F-FET PET scan.
RESULTS
From 2008 to 2018, 34 patients were identified (mean age 39.7 years; 68% diffuse astrocytoma). The mean tumor growth rate on MRI was 0.091 cm3/d. The average mean 18F-FET uptake was 1.42; the average maximum 18F-FET uptake was 2.18. The Pearson correlation coefficient between the tumor growth rate and the mean and maximum 18F-FET uptake was r=0.19, and r=0.10. In the group of diffuse astrocytomas, the mean growth rate in tumors with a mean 18F-FET uptake of >1.5 was significantly higher than the mean growth rate of those with a mean 18F-FET uptake of ≤1.5 (p<0.1).
CONCLUSION
Data suggest that astrocytic LGGs with increased 18F-FET uptake may show a more aggressive behaviour, with a potentially higher risk for an earlier tumor progression or malignant transformation. For further elucidation of a correlation between the tumor growth rate and the 18F-FET uptake, larger prospective studies are needed. In the future, the combination of both methods in the management of low-grade gliomas could help to detect tumor progression as well as tumor malignization more precisely.
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Affiliation(s)
- M Mueller
- Department of Neurosurgery University Medical Center Duesseldorf, Duesseldorf, Germany
| | - M Kamp
- Department of Neurosurgery University Medical Center Duesseldorf, Duesseldorf, Germany
| | - M Sabel
- Department of Neurosurgery University Medical Center Duesseldorf, Duesseldorf, Germany
| | - G Stoffels
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3, -4), Juelich, Germany
| | - N Galldiks
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3, -4), Juelich, Germany
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - K Langen
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3, -4), Juelich, Germany
| | - M Rapp
- Department of Neurosurgery University Medical Center Duesseldorf, Duesseldorf, Germany
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Basholli-Salihu M, Kryeziu TL, Nebija D, Salar-Behzadi S, Viernstein H, Mueller M. Prebiotics as excipients for enhancement of stability and functionality of Bifidobacterium longum ssp. infantis with potential application as symbiotics in food and pharmaceuticals. Pharmazie 2019; 74:326-333. [PMID: 31138368 DOI: 10.1691/ph.2019.9007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Objective: Formulations containing probiotics are promoted due to health benefits. During lyophilization and subsequent storage in the gastrointestinal tract, bacteria are exposed to stress conditions that can lead to impairment and loss of viability. Methods: The suitability of various excipients for enhancing the stability and functionality of Bifidobacterium longum subsp. infantis during storage as freeze-dried powder and through exposure to acid and bile was investigated. Cells were lyophilized in the presence of sucrose, trehalose, lactose, cellobiose and fructooligosaccharide (FOS) and stored at 4 °C or 25 °C. The effect of diverse protectants on the persistence after exposure to acid and bile environment was examined through determination of the colony forming units, the β-glucosidase and β-galactosidase activity and the membrane integrity changes. Results: Cells freeze-dried in the presence of cryoprotectants had comparable survivability during storage at 4 °C whereas the survival rate at 25 °C of cells protected by cellobiose and FOS was higher than for those protected with sucrose and trehalose. Furthermore, the respective excipients used as cryoprotectants enhanced the stability of cells exposed to simulated gastric and small intestinal medium. Stabilization may be achieved through different mechanism of action such as protecting the membrane integrity and as metabolizable substrates. Overall, prebiotic and thus metabolizable protectants including cellobiose and FOS were superior to other protectants used. Conclusion: In symbiotic formulas with B. infantis, these sugars might serve as prebiotics and stabilizers of this probiotic strain during lyophilization, storage and in gastrointestinal conditions simultaneously, potentially increasing its health-promoting effects.
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Potapov E, Kaufmann F, Mueller M, Mulzer J, Starck C, Falk V. Avoidance of Outflow Graft Extrinsic Compression in Polytetrafluoroethylene Reinforcements of the Bend Relief Component. J Heart Lung Transplant 2019; 38:474-475. [DOI: 10.1016/j.healun.2019.01.1311] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/22/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022] Open
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Bierschenk AM, Mueller M, Pander J, Geist J. Impact of catchment land use on fish community composition in the headwater areas of Elbe, Danube and Main. Sci Total Environ 2019; 652:66-74. [PMID: 30359803 DOI: 10.1016/j.scitotenv.2018.10.218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 06/08/2023]
Abstract
Intensification of catchment land-use and the corresponding habitat degradation pose a threat to freshwater biodiversity and ecosystem health, yet few studies comprehensively quantified the effects of specific land-use variables on fish communities for different catchments within the same climatic region. Herein, we investigated the influence of catchment land use on fish community composition in the headwater areas of the European main river systems Elbe, Danube and Main/Rhine. The analyses comprising 289 streams and rivers in Bavaria, southern Germany, revealed that the influence of urbanization (e.g. ground sealing), potamalisation (impoundment of water courses), and erosion-prone, agricultural land-use types (e.g. root crop, maize) were significantly related to the fish community composition. In addition, multiple stressors were effective indicators and their importance differed between survey-area scales, geographical regions, and stream sizes. The findings suggest that terrestrial effects of land-use and urbanization need to be more strongly considered in the conservation of endangered stream fishes, ideally including combined measures of erosion control, restoration of environmental flows and mitigation of structural degradation.
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Affiliation(s)
- A M Bierschenk
- Aquatic Systems Biology Unit, Department of Ecology and Ecosystem Management, Technical University of Munich, Muehlenweg 18-22, 85350 Freising, Germany
| | - M Mueller
- Aquatic Systems Biology Unit, Department of Ecology and Ecosystem Management, Technical University of Munich, Muehlenweg 18-22, 85350 Freising, Germany
| | - J Pander
- Aquatic Systems Biology Unit, Department of Ecology and Ecosystem Management, Technical University of Munich, Muehlenweg 18-22, 85350 Freising, Germany
| | - J Geist
- Aquatic Systems Biology Unit, Department of Ecology and Ecosystem Management, Technical University of Munich, Muehlenweg 18-22, 85350 Freising, Germany.
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de la Oliva N, Del Valle J, Delgado-Martinez I, Mueller M, Stieglitz T, Navarro X. Long-Term Functionality of Transversal Intraneural Electrodes Is Improved By Dexamethasone Treatment. IEEE Trans Neural Syst Rehabil Eng 2019; 27:457-464. [PMID: 30716042 DOI: 10.1109/tnsre.2019.2897256] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Neuroprostheses aimed to restore lost functions after a limb amputation are based on the interaction with the nervous system by means of neural interfaces. Among the different designs, intraneural electrodes implanted in peripheral nerves represent a good strategy to stimulate nerve fibers to send sensory feedback and to record nerve signals to control the prosthetic limb. However, intraneural electrodes, as any device implanted in the body, induce a foreign body reaction (FBR) that results in the tissue encapsulation of the device. The FBR causes a progressive decline of the electrode functionality over time due to the physical separation between the electrode active sites and the axons to interface. Modulation of the inflammatory response has arisen as a good strategy to reduce the FBR and maintain electrode functionality. In this study transversal intraneural multi-channel electrodes (TIMEs) were implanted in the rat sciatic nerve and tested for 3 months to evaluate stimulation and recording capabilities under chronic administration of dexamethasone. Dexamethasone treatment significantly reduced the threshold for evoking muscle responses during the follow-up compared to saline-treated animals, without affecting the selectivity of stimulation. However, dexamethasone treatment did not improve the signal-to-noise ratio of the recorded neural signals. Dexamethasone treatment allowed to maintain more working active sites along time than saline treatment. Thus, systemic administration of dexamethasone appears as a useful treatment in chronically implanted animals with neural electrodes as it increases the number of functioning contacts of the implanted TIME and reduces the intensity needed to stimulate the nerve.
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Romer CAE, Broglie Daeppen MA, Mueller M, Huber GF, Guesewell S, Stoeckli SJ. Long-term speech and swallowing function after primary resection and sentinel node biopsy for early oral squamous cell carcinoma. Oral Oncol 2019; 89:127-132. [PMID: 30732950 DOI: 10.1016/j.oraloncology.2018.12.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 12/16/2018] [Accepted: 12/25/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Analysis of long-term speech and swallowing function and subjective quality of life (QOL) after primary resection and sentinel node biopsy (SNB) in patients with early stage (cT1/T2) oral squamous cell carcinomas (OSCC). MATERIAL AND METHODS Eighty-one consecutive patients treated primarily by transoral resection without flap reconstruction and SNB for a cT1/T2 OSCC were included. Completion neck dissection (CND) was indicated in case of occult disease in the sentinel nodes. Adjuvant radiation (aRT) was administered according to the ultimate lymph node status. All patients showed no evidence of disease at time of analysis. Speech and swallowing function were assessed using standardized clinical examinations (11-item, articulation test) and validated questionnaires on subjective QOL (MDADI, FIGS). Median follow-up was 60 months (range 13-159 months) after initial treatment. RESULTS In all assessments for speech and swallowing, the entire study cohort achieved very high scores, with mean values located in the highest 10% of the scales. Neither tumor size nor site, age, pN-category, CND, and aRT had significant impact on functional outcomes and subjective QOL with the exception of lower scores in the global and physical scores of MDADI after CND or aRT, and articulation in the population over 60 years of age. CONCLUSION Transoral resection without reconstruction and SNB for early OSCC achieves excellent outcome with regard to speech, swallowing and subjective QOL.
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Affiliation(s)
- C A E Romer
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland.
| | - M A Broglie Daeppen
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland
| | - M Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland
| | - G F Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland
| | - S Guesewell
- Clinical Trials Unit, Kantonsspital St. Gallen, Switzerland
| | - S J Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Switzerland
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Ashida S, Hejna E, Robinson E, Williams K, Mueller M. DEMENTIA CAREGIVING IN RURAL AREAS: SOCIAL RELATIONSHIPS BETWEEN FAMILY AND COMMUNITY-BASED PAID CAREGIVERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1074] [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: 11/15/2022] Open
Affiliation(s)
| | - E Hejna
- University of Iowa College of Public Health
| | - E Robinson
- University of Missouri School of Social Work
| | | | - M Mueller
- University of Iowa College of Public Health
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Spinelli M, Ornaghi S, Schoeberlein A, Bordey A, Barnea E, Paidas M, Surbek D, Mueller M. Pre-implantation factor promotes neuroprotection by modulating long non-coding RNA H19 of the neuronal stem cells. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671458] [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: 10/28/2022] Open
Affiliation(s)
- M Spinelli
- University Hospital Bern, Clinical Research, Bern, Schweiz
| | - S Ornaghi
- Yale University School of Medicine, Neurosurgery and Cellular and Molecular Physiology, New Haven, Vereinigte Staaten von Amerika
| | - A Schoeberlein
- University Hospital Bern, Clinical Research, Bern, Schweiz
| | - A Bordey
- Yale University School of Medicine, Neurosurgery and Cellular and Molecular Physiology, New Haven, Vereinigte Staaten von Amerika
| | - E Barnea
- Society for the Investigation of Early Pregnancy (SIEP) and BioIncept, LLC, New York, Vereinigte Staaten von Amerika
| | - M Paidas
- Yale School of Medicine, Obstetrics, Gynecology and Reproductive Sciences, New Haven, Vereinigte Staaten von Amerika
| | - D Surbek
- University Hospital Bern, Obstetrics and Gynecology, Bern, Schweiz
| | - M Mueller
- Yale School of Medicine, Obstetrics, Gynecology and Reproductive Sciences, New Haven, Vereinigte Staaten von Amerika
- University Hospital Bern, Obstetrics and Gynecology, Bern, Schweiz
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Papadia A, Gasparri ML, Radan AP, Stämpfli CAL, Mueller M. A retrospective validation study of the laparoscopic ICG SLN mapping in patients with grade 3 endometrial cancer. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671638] [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: 10/28/2022] Open
Affiliation(s)
- A Papadia
- Universitätsklinik für Frauenheilkunde Inselspital Bern, Gynäkologie und Geburtshilfe, Bern, Schweiz
| | - ML Gasparri
- Universitätsklinik Sapienza, Rom, Gynäkologie und Geburtshilfe, Rom, Italien
| | - AP Radan
- Universitätsklinik für Frauenheilkunde Inselspital Bern, Gynäkologie und Geburtshilfe, Bern, Schweiz
| | | | - M Mueller
- Universitätsklinik für Frauenheilkunde Inselspital Bern, Gynäkologie und Geburtshilfe, Bern, Schweiz
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Braicu E, Sehouli J, Richter R, Vergote I, Concin N, van Nieuwenhuysen E, Achimas P, Berger A, Fetica B, Mahner S, Glajzer J, Papadia A, Woelber L, Gasparri M, Vanderstichele A, Benedetti Panici P, Mueller M, Ruscito I, Zimmer J, Woopen H. Preoperative c-reactive protein and thrombocyte count as potential markers for longterm survival in ovarian cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Meier S, Gillon T, Mitter V, Fink A, Mueller M, Rau T, Von Wolff M, Kohl Schwartz A. Antibiotic treatment of chronic endometritis seems to preserve pregnancy in women with recurrent miscarriages or recurrent implantation failure. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670983] [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: 10/28/2022] Open
Affiliation(s)
- S Meier
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital and University of Bern, Bern, Schweiz
| | - T Gillon
- Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, Bern, Schweiz
| | - V Mitter
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital and University of Bern, Bern, Schweiz
| | - A Fink
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital and University of Bern, Bern, Schweiz
| | - M Mueller
- Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, Bern, Schweiz
| | - T Rau
- Institute of Pathology, University of Bern, Bern, Schweiz
| | - M Von Wolff
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital and University of Bern, Bern, Schweiz
| | - A Kohl Schwartz
- Division of Gynecological Endocrinology and Reproductive Medicine, Bern University Hospital and University of Bern, Bern, Schweiz
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Teping F, Albanna W, Clusmann H, Schulze-Steinen H, Mueller M, Hoellig A, Schubert GA. Spontaneous Elevation of Blood Pressure After SAH: An Epiphenomenon of Disease Severity and Demand, But Not a Surrogate for Outcome? Neurocrit Care 2018; 29:214-224. [PMID: 29619659 DOI: 10.1007/s12028-018-0528-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Spontaneous blood pressure increase is frequently observed after aneurysmal subarachnoid hemorrhage (aSAH). These episodes of spontaneous blood pressure alterations are usually tolerated under the assumption of an endogenous response to maintain cerebral perfusion. The relevance of blood pressure variability and its relationship to disease severity and outcome, however, remain obscure. METHODS A total of 115 consecutive patients with aSAH were included for this retrospective analysis of a continuously collected data pool. Demographics, initial clinical severity of aSAH (HH°, mFS), treatment modality, clinical course, and outcome (development of DCI, cerebral infarction, and GOS after 3 months) were recorded. Hemodynamic information-recorded automatically with a frequency of 1/15 min-was analyzed for spontaneous blood pressure increase (SBI) and endogenous persistent hypertension (EPH) after exclusion of iatrogenic factors and relevant co-medication. Subgroup analysis included stratification for day 0-3, 4-14, and 14-21. RESULTS SBI and EPH incidence varied from 17 to 84% depending on detection threshold (15-35 mmHg) and time period under scrutiny. Incidence of blood pressure increase correlated with disease severity upon admission (p < 0.05), but the anticipated association with outcome was not observed. SBI and EPH were more likely to occur between day 4 and 14 (p < 0.001), but only early occurrence (day 0-3) was associated with higher incidence of DCI (p < 0.05). Persistent blood pressure elevation between day 4 and 21 was associated with fewer DCI. However, no influence of spontaneous upregulation on clinical outcome after three months was observed. CONCLUSIONS Spontaneous hemodynamic upregulation is a frequent phenomenon after aSAH. Our data support the hypothesis that spontaneous blood pressure alterations reflect an endogenous, demand-driven response correlating with disease severity. Early alterations may indicate an aggravated clinical course, while later upregulation in particular-if permitted-does not translate into a higher risk of unfavorable outcome.
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Affiliation(s)
- F Teping
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - W Albanna
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - H Clusmann
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - H Schulze-Steinen
- Department of Operative Intensive Care and Intermediate Care, RWTH Aachen University, Aachen, Germany
| | - M Mueller
- Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany
| | - A Hoellig
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - G A Schubert
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
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Mueller M, Mulzer J, Hoermandinger C, Kaufmann F, Dreysse S, Falk V, Potapov E. A Single Center Experience: Four Cases of Late Twisting of Outflow Grafts in HeartMate 3. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.353] [Citation(s) in RCA: 1] [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] [Indexed: 10/17/2022] Open
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Knabben L, Imboden S, Genoud S, Mueller M, Guenthert A. Risk factors for axillar recurrence after negative sentinel lymph node biopsy for invasive breast cancer: A case-control study. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30472-6] [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: 10/17/2022]
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Mueller M, Gschwandtner ME, Gamper J, Giurgea GA, Kiener HP, Perkmann T, Koppensteiner R, Schlager O. Chronic inflammation predicts long-term mortality in patients with Raynaud's phenomenon. J Intern Med 2018; 283:293-302. [PMID: 29068146 DOI: 10.1111/joim.12705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Subclinical chronic inflammation could be the driving force behind the recently revealed association between abnormal nailfold capillaries as well as autoantibodies and long-term mortality in patients with incipient Raynaud's phenomenon. Whether laboratory markers that reflect a chronic inflammatory process are directly related to mortality in Raynaud's phenomenon is not known. METHODS In total, 2958 patients with incipient Raynaud's phenomenon without previously known connective tissue disease (CTD) were enrolled. At their initial presentation, laboratory tests for C-reactive protein (CRP), leucocytes, fibrinogen and the haemoglobin concentration were obtained. In addition, nailfold capillaries and antinuclear antibodies (ANA) were assessed. Patients' mortality was recorded through a median follow-up period of 9.3 years. RESULTS Baseline CRP, fibrinogen and haemoglobin concentration were associated with long-term mortality in an individual analysis of patients with incipient Raynaud's phenomenon. In a multivariable model including patients' age, nailfold capillaries and ANA, a low haemoglobin concentration remained independently related to future mortality. Amongst potential predictors for mortality in patients with Raynaud's phenomenon, a low haemoglobin concentration was most strongly related to patients' mortality risk. CONCLUSION In Raynaud's phenomenon, laboratory markers that can be attributed to a chronic inflammatory state independently yield prognostic information in addition to the presence of abnormal nailfold capillaries and ANA. Amongst all prognostic markers, the haemoglobin concentration is most strongly related to patients' mortality in Raynaud's phenomenon.
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Affiliation(s)
- M Mueller
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - M E Gschwandtner
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - J Gamper
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - G-A Giurgea
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - H P Kiener
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - T Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - R Koppensteiner
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - O Schlager
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
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Dueckelmann AM, Fink D, Harter P, Heinzelmann V, Marth C, Mueller M, Reinthaller A, Tamussino K, Wimberger P, Sehouli J. The use of PIPAC (pressurized intraperitoneal aerosol chemotherapy) in gynecological oncology: a statement by the "Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR)", the Swiss and Austrian AGO, and the North-Eastern German Society of Gynaecologic Oncology. Arch Gynecol Obstet 2018; 297:837-846. [PMID: 29356953 DOI: 10.1007/s00404-018-4673-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 01/06/2018] [Accepted: 01/12/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Ovarian, tubal, and peritoneal carcinomas primarily affect the peritoneal cavity, and they are typically diagnosed at an advanced tumor stage (Foley, Rauh-Hain, del Carmen in Oncology (Williston Park) 27:288-294, 2013). In the course of primary surgery, postoperative tumor residuals are, apart from the tumor stage, the strongest independent factors of prognosis (du Bois, Reuss, Pujade-Lauraine, Harter, Ray-Coquard, Pfisterer in Cancer 115:1234-1244, 2009). Due to improved surgical techniques, including the use of multi-visceral procedures, macroscopic tumor clearance can be achieved in oncological centers, in most cases (Harter, Muallem, Buhrmann et al in Gynecol Oncol 121:615-619, 2011). However, to date, it has not been shown that peritoneal carcinomatosis is, per se, an independent factor of prognosis or that it excludes the achievement of tumor clearance. Several studies have shown that a preceding drug therapy in peritoneal carcinomatosis could positively influence the overall prognosis (Trimbos, Trimbos, Vergote et al in J Natl Cancer Inst 95:105-112, 2003). In relapses of ovarian carcinoma, studies have shown that peritoneal carcinomatosis is a negative predictor of complete tumor resection; however, when it is possible to resect the tumor completely, peritoneal carcinomatosis does not play a role in the prognosis (Harter, Hahmann, Lueck et al in Ann Surg Oncol 16:1324-1330, 2009). RESULTS PIPAC is a highly experimental method for treating patients with ovarian, tubal, and peritoneal cancer. To date, only three studies have investigated a total of 184 patients with peritoneal carcinomatosis (Grass, Vuagniaux, Teixeira-Farinha, Lehmann, Demartines, Hubner in Br J Surg 104:669-678, 2017). Only some of those studies were phase I/II studies that included PIPAC for patients with different indications and different cancer entities. It is important to keep in mind that the PIPAC approach is associated with relatively high toxicity. To date, no systematic dose-finding studies have been reported. Moreover, no studies have reported improvements in progression-free or overall survival associated with PIPAC therapy. CONCLUSIONS Randomized phase III studies are required to evaluate the effect of this therapy compared to other standard treatments (sequential or simultaneous applications with systemic chemotherapy). In cases of ovarian, tubal, and peritoneal cancer, PIPAC should not be performed outside the framework of prospective, controlled studies.
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Affiliation(s)
| | - D Fink
- University Hospital of Zurich, Zürich, Switzerland
| | - P Harter
- Kliniken Essen-Mitte, Essen, Germany
| | | | - C Marth
- Medical University Innsbruck, Innsbruck, Austria
| | - M Mueller
- University Hospiatl Bern, Bern, Switzerland
| | | | | | - P Wimberger
- University Hospital Dresden, Dresden, Germany
| | - J Sehouli
- Charité Universitätsmedizin Berlin, Berlin, Germany
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