1
|
Simms V, Abas MA, Müller M, Munetsi E, Dzapasi L, Weiss HA, Chibanda D. Effect of a brief psychological intervention for common mental disorders on HIV viral suppression: A non-randomised controlled study of the Friendship Bench in Zimbabwe. PLOS Glob Public Health 2024; 4:e0001492. [PMID: 38236786 PMCID: PMC10796049 DOI: 10.1371/journal.pgph.0001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 09/19/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND For people living with co-morbid HIV and common mental disorders (CMD), it is not known whether a brief psychological intervention for CMD can improve HIV viral suppression. METHODS We conducted a prospective cohort study in eight primary care clinics in Harare, Zimbabwe, enrolling adults with co-morbid HIV and CMD. Six clinics provided the Friendship Bench (FB), a brief psychological intervention for CMD based on problem-solving therapy, delivered by lay counsellors. Two clinics provided enhanced usual care (EUC). The primary outcome was viral non-suppression after six months (viral load ≥400 copies/mL). Data were analysed using a difference-in-difference approach with linear regression of cluster-level proportions, adjusted for baseline viral non-suppression (aDiD). The secondary outcome was presence of CMD measured by the Shona Symptom Questionnaire. RESULTS In FB clinics, 407/500 (81.4%) participants had viral load results at baseline and endline: 58 (14.3%) had viral non-suppression at baseline and 41 (10.1%) at endline. In EUC clinics, 172/200 (86.0%) had viral load results at baseline and endline: 22 (12.8%) were non-suppressed at baseline and 26 (15.1%) at endline (aDiD = -7.3%; 95%CI 14.7% to -0.01%; p = 0.05). Of the 499 participants virally suppressed at baseline, the FB group had lower prevalence of non-suppression at endline compared to the EUC group (2.9% vs 9.3%; p = 0.002). There was no evidence of a difference in endline viral non-suppression by group among the 80 participants with non-suppression at baseline (53.5% vs 54.6%; p = 0.93). The FB group was less likely to screen positive for CMD at endline than the EUC group (aDiD = -21.6%; 95%CI -36.5% to -6.7%; p = 0.008). CONCLUSION People living with co-morbid HIV and CMD may benefit from receiving a low-cost mental health intervention to enhance viral suppression, especially if they are already virally suppressed. Research is needed to understand if additional adherence counselling could further improve viral suppression.
Collapse
Affiliation(s)
- Victoria Simms
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Melanie A. Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Monika Müller
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- University Hospital of Psychiatry Bern, Bern, Switzerland
| | | | | | - Helen A. Weiss
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Dixon Chibanda
- Friendship Bench, Harare, Zimbabwe
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe
- Centre For Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
2
|
Guguchia Z, Das D, Simutis G, Adachi T, Küspert J, Kitajima N, Elender M, Grinenko V, Ivashko O, Zimmermann MV, Müller M, Mielke C, Hotz F, Mudry C, Baines C, Bartkowiak M, Shiroka T, Koike Y, Amato A, Hicks CW, Gu GD, Tranquada JM, Klauss HH, Chang JJ, Janoschek M, Luetkens H. Designing the stripe-ordered cuprate phase diagram through uniaxial-stress. Proc Natl Acad Sci U S A 2024; 121:e2303423120. [PMID: 38150501 PMCID: PMC10769840 DOI: 10.1073/pnas.2303423120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/02/2023] [Indexed: 12/29/2023] Open
Abstract
The ability to efficiently control charge and spin in the cuprate high-temperature superconductors is crucial for fundamental research and underpins technological development. Here, we explore the tunability of magnetism, superconductivity, and crystal structure in the stripe phase of the cuprate La[Formula: see text]Ba[Formula: see text]CuO[Formula: see text], with [Formula: see text] = 0.115 and 0.135, by employing temperature-dependent (down to 400 mK) muon-spin rotation and AC susceptibility, as well as X-ray scattering experiments under compressive uniaxial stress in the CuO[Formula: see text] plane. A sixfold increase of the three-dimensional (3D) superconducting critical temperature [Formula: see text] and a full recovery of the 3D phase coherence is observed in both samples with the application of extremely low uniaxial stress of [Formula: see text]0.1 GPa. This finding demonstrates the removal of the well-known 1/8-anomaly of cuprates by uniaxial stress. On the other hand, the spin-stripe order temperature as well as the magnetic fraction at 400 mK show only a modest decrease under stress. Moreover, the onset temperatures of 3D superconductivity and spin-stripe order are very similar in the large stress regime. However, strain produces an inhomogeneous suppression of the spin-stripe order at elevated temperatures. Namely, a substantial decrease of the magnetic volume fraction and a full suppression of the low-temperature tetragonal structure is found under stress, which is a necessary condition for the development of the 3D superconducting phase with optimal [Formula: see text]. Our results evidence a remarkable cooperation between the long-range static spin-stripe order and the underlying crystalline order with the three-dimensional fully coherent superconductivity. Overall, these results suggest that the stripe- and the SC order may have a common physical mechanism.
Collapse
Affiliation(s)
- Z. Guguchia
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - D. Das
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - G. Simutis
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
| | - T. Adachi
- Department of Engineering and Applied Sciences, Sophia University, Tokyo102-8554, Japan
| | - J. Küspert
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - N. Kitajima
- Department of Applied Physics, Tohoku University, Sendai980-8579, Japan
| | - M. Elender
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - V. Grinenko
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Pudong, 201210Shanghai, China
| | - O. Ivashko
- Deutsches Elektronen-Synchrotron, 22607Hamburg, Germany
| | | | - M. Müller
- Condensed Matter Theory Group, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. Mielke
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - F. Hotz
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. Mudry
- Condensed Matter Theory Group, Paul Scherrer Institute, CH-5232Villigen, Switzerland
- Institut de Physique, École Polytechnique Fédérale de Lausanne, LausanneCH-1015, Switzerland
| | - C. Baines
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - M. Bartkowiak
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
| | - T. Shiroka
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
- Laboratorium für Festkörperphysik, ETH Zürich, CH-8093Zürich, Switzerland
| | - Y. Koike
- Department of Applied Physics, Tohoku University, Sendai980-8579, Japan
| | - A. Amato
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. W. Hicks
- Max Planck Institute for Chemical Physics of Solids, D-01187Dresden, Germany
- School of Physics and Astronomy, University of Birmingham, BirminghamB15 2TT, United Kingdom
| | - G. D. Gu
- Condensed Matter Physics and Materials Science Division, Brookhaven National Laboratory, Upton, NY11973
| | - J. M. Tranquada
- Condensed Matter Physics and Materials Science Division, Brookhaven National Laboratory, Upton, NY11973
| | - H.-H. Klauss
- Institute for Solid State and Materials Physics, Technische Universitat Dresden, D-01069Dresden, Germany
| | - J. J. Chang
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - M. Janoschek
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - H. Luetkens
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| |
Collapse
|
3
|
Kempa S, Tessmann V, Prantl L, Schmid S, Müller M, Jung EM, Tews HC. The value of sonographic microvascular imaging in the diagnosis of lipedema. Clin Hemorheol Microcirc 2024; 86:99-108. [PMID: 37638423 DOI: 10.3233/ch-238103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Lipedema is a chronic disease marked by symmetric enlargement of painful nodular and fibrotic adipose tissue, predominantly affecting the limbs. Since there is no specific test or biomarker for this condition, years often pass before the diagnosis of lipedema is established for the first time, thereby causing psychosocial distress, including depression, eating disorders, and social isolation. Over the last few years several advanced Doppler-based technologies have been developed to visualize slow flow blood vessels and superficial microvascular architecture undetectable by traditional color Doppler flow imaging (CDFI). OBJECTIVE The aim of this study was to evaluate the superficial microvascular anatomy in lipedema patients compared to healthy controls and investigate the clinical significance of the Ultra Micro Angiography (UMA) technology in the diagnosis of lipedema. This new technique may contribute to reduce the diagnostic delay and, eventually, establish and guide treatment strategies toward a better therapeutic outcome in lipedema patients. METHODS 25 patients with lipedema and ten healthy controls with no history of lipedema were included in this study. All ultrasound examinations were performed on a novel high-performance ultrasound system (Resona R9/Mindray) using CDFI and the UMA technique. RESULTS In all of the patients, Ultra Micro Angiography achieved the excellent visualization of microvascular structures, revealing that most lipedema patients showed grade 3 (n = 13) or grade 2 (n = 8) flow. UMA was superior to CDFI for depicting the microvascular structures. CONCLUSIONS Here we show that UMA imaging characterizes the subcutaneous microvasculature with an unprecedented accuracy. The method has the advantage of being sensitive to small, slow-flowing vessels. This allows for the assessment of the course of vessels and vascular pathologies in great detail. Thus, UMA as a non-invasive diagnostic method can improve diagnostic accuracy in lipedema.
Collapse
Affiliation(s)
- S Kempa
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V Tessmann
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Prantl
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - E-M Jung
- Institute for Diagnostic Radiology and Interdisciplinary Ultrasound, University Hospital Regensburg, Regensburg, Germany
| | - H C Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
4
|
Müller M, Bullinger Y, Pohlemann T, Orth M. [Clavicle fractures: practical approach in clinical routine]. Chirurgie (Heidelb) 2023; 94:1045-1056. [PMID: 37702744 DOI: 10.1007/s00104-023-01958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/14/2023]
Abstract
Fractures of the clavicle are among the most common fractures. They typically result from a fall onto the lateral shoulder or the extended arm and are often related to sports and bicycle accidents. Obtaining the exact trauma mechanism, proper clinical findings and adequate X‑rays usually lead to the correct diagnosis. Non-displacement fractures can be treated conservatively with good results. Unstable and displaced fractures should be treated operatively. Open fractures or looming penetration are emergencies und should be treated immediately. In addition to fracture classification and morphology, other factors such as additional injuries and patient-related factors need to be considered in order to make an individualized therapy decision. In operative treatment, angular stable plating is the therapy of choice, and in most cases early functional aftercare is possible.
Collapse
Affiliation(s)
- M Müller
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
| | - Y Bullinger
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
| | - T Pohlemann
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
| | - M Orth
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
| |
Collapse
|
5
|
Nies L, Canete L, Dao DD, Giraud S, Kankainen A, Lunney D, Nowacki F, Bastin B, Stryjczyk M, Ascher P, Blaum K, Cakirli RB, Eronen T, Fischer P, Flayol M, Girard Alcindor V, Herlert A, Jokinen A, Khanam A, Köster U, Lange D, Moore ID, Müller M, Mougeot M, Nesterenko DA, Penttilä H, Petrone C, Pohjalainen I, de Roubin A, Rubchenya V, Schweiger C, Schweikhard L, Vilen M, Äystö J. Further Evidence for Shape Coexistence in ^{79}Zn^{m} near Doubly Magic ^{78}Ni. Phys Rev Lett 2023; 131:222503. [PMID: 38101393 DOI: 10.1103/physrevlett.131.222503] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/16/2023] [Accepted: 10/25/2023] [Indexed: 12/17/2023]
Abstract
Isomers close to doubly magic _{28}^{78}Ni_{50} provide essential information on the shell evolution and shape coexistence near the Z=28 and N=50 double shell closure. We report the excitation energy measurement of the 1/2^{+} isomer in _{30}^{79}Zn_{49} through independent high-precision mass measurements with the JYFLTRAP double Penning trap and with the ISOLTRAP multi-reflection time-of-flight mass spectrometer. We unambiguously place the 1/2^{+} isomer at 942(10) keV, slightly below the 5/2^{+} state at 983(3) keV. With the use of state-of-the-art shell-model diagonalizations, complemented with discrete nonorthogonal shell-model calculations which are used here for the first time to interpret shape coexistence, we find low-lying deformed intruder states, similar to other N=49 isotones. The 1/2^{+} isomer is interpreted as the bandhead of a low-lying deformed structure akin to a predicted low-lying deformed band in ^{80}Zn, and points to shape coexistence in ^{79,80}Zn similar to the one observed in ^{78}Ni. The results make a strong case for confirming the claim of shape coexistence in this key region of the nuclear chart.
Collapse
Affiliation(s)
- L Nies
- European Organization for Nuclear Research (CERN), Meyrin, 1211 Geneva, Switzerland
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - L Canete
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Department of Physics, University of Surrey, Guildford GU2 7X5, United Kingdom
| | - D D Dao
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - S Giraud
- GANIL, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - A Kankainen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - D Lunney
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - F Nowacki
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - B Bastin
- GANIL, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - M Stryjczyk
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - P Ascher
- Université de Bordeaux, CNRS/IN2P3-Université, CNRS/IN2P3, LP2I Bordeaux, UMR 5797, F-33170 Gradignan, France
| | - K Blaum
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - R B Cakirli
- Department of Physics, Istanbul University, Istanbul 34134, Turkey
| | - T Eronen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - P Fischer
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - M Flayol
- Université de Bordeaux, CNRS/IN2P3-Université, CNRS/IN2P3, LP2I Bordeaux, UMR 5797, F-33170 Gradignan, France
| | | | - A Herlert
- FAIR GmbH, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Jokinen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - A Khanam
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Department of Applied Physics, Aalto University, P.O. Box 15100, FI-00076 Aalto, Finland
- Department of Physics, University of Helsinki, P.O. Box 43, FI-00014 Helsinki, Finland
| | - U Köster
- European Organization for Nuclear Research (CERN), Meyrin, 1211 Geneva, Switzerland
- Institut Laue-Langevin, 38000 Grenoble, France
| | - D Lange
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - I D Moore
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - M Müller
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - M Mougeot
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - D A Nesterenko
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - H Penttilä
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - C Petrone
- IFIN-HH, P.O. Box MG-6, 077125 Bucharest-Magurele, Romania
| | - I Pohjalainen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - A de Roubin
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - V Rubchenya
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - Ch Schweiger
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - L Schweikhard
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - M Vilen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - J Äystö
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| |
Collapse
|
6
|
Müller M, Förschler S, Wehrmann T, Marini F, Gockel I, Eckardt AJ. Atypical presentations and pitfalls of achalasia. Dis Esophagus 2023; 36:doad029. [PMID: 37158189 DOI: 10.1093/dote/doad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/04/2023] [Indexed: 05/10/2023]
Abstract
Achalasia is a rare disease with significant diagnostic delay and association with false diagnoses and unnecessary interventions. It remains unclear, whether atypical presentations, misinterpreted symptoms or inconclusive diagnostics are the cause. The aim of this study was the characterization of typical and atypical features of achalasia and their impact on delays, misinterpretations or false diagnoses. A retrospective analysis of prospective database over a period of 30 years was performed. Data about symptoms, delays and false diagnoses were obtained and correlated with manometric, endoscopic and radiologic findings. Totally, 300 patients with achalasia were included. Typical symptoms (dysphagia, regurgitation, weight loss and retrosternal pain) were present in 98.7%, 88%, 58.4% and 52.4%. The mean diagnostic delay was 4.7 years. Atypical symptoms were found in 61.7% and led to a delay of 6 months. Atypical gastrointestinal symptoms were common (43%), mostly 'heartburn' (16.3%), 'vomiting' (15.3%) or belching (7.7%). A single false diagnosis occurred in 26%, multiple in 16%. Major gastrointestinal misdiagnoses were GERD in 16.7% and eosinophilic esophagitis in 4%. Other false diagnosis affected ENT-, psychiatric, neurologic, cardiologic or thyroid diseases. Pitfalls were the description of 'heartburn' or 'nausea'. Tertiary contractions at barium swallows, hiatal hernias and 'reflux-like' changes at endoscopy or eosinophils in the biopsies were misleading. Atypical symptoms are common in achalasia, but they are not the sole source for diagnostic delays. Misleading descriptions of typical symptoms or misinterpretation of diagnostic studies contribute to false diagnoses and delays.
Collapse
Affiliation(s)
- M Müller
- Department of Gastroenterology, University Hospital Giessen and Marburg, Marburg, Germany
| | - S Förschler
- Department of General and Visceral Surgery, St. Josefs-Hospital, Wiesbaden, Germany
| | - T Wehrmann
- Department of Gastroenterology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| | - F Marini
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Division Biostatistics and Bioinformatics, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - I Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Medical Center of Leipzig, Leipzig, Germany
| | - A J Eckardt
- Department of Gastroenterology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| |
Collapse
|
7
|
Boldt J, Müller M, Heesen M, Martin K, Hempelmann G. Retraction Note: The effects of pentoxifylline on circulating adhesion molecules in critically ill patients with acute renal failure treated by continuous veno-venous hemofiltration. Intensive Care Med 2023; 49:1154. [PMID: 37490057 DOI: 10.1007/s00134-023-07158-w] [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: 07/26/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen, Anesthesiology and Intensive Care Medicine, Bremerstrasse 79, D-67063, Ludwigshafen am Rhein, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - M Heesen
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - K Martin
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| |
Collapse
|
8
|
Schwarz F, Klee E, Schenk P, Katscher S, Schnake KJ, Bäumlein M, Zimmermann V, Schmeiser G, Scherer MA, Müller M, Sprengel K, Spiegl U, Osterhoff G, Schramm S, Siekmann H, Franck A, Scheyerer MJ, Ullrich BW. Impact of Anxiety During Hospitalization on the Clinical Outcome of Patients With Osteoporotic Thoracolumbar Vertebral Fracture. Global Spine J 2023:21925682231192847. [PMID: 37549640 DOI: 10.1177/21925682231192847] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
STUDY DESIGN Multicenter prospective cohort study. OBJECTIVES Anxiety in combination with osteoporotic vertebral compression fractures (OVCFs) of the spine remains understudied. The purpose of this study was to analyze whether anxiety has an impact on the short-term functional outcome of patients with an OVCF. Furthermore, a direct impact of the fracture on the patient's anxiety during hospitalization should be recognized. METHODS All inpatients with an OVCF of the thoracolumbar spine from 2017 to 2020 were included. Trauma mechanism, analgetic medication, anti-osteoporotic therapy, timed-up-and-go test (TuG), mobility, Barthel index, Oswestry-Disability Index (ODI) and EQ5D-5L were documented.For statistical analysis, the U test, chi-square independence test, Spearman correlation, General Linear Model for repeated measures, Bonferroni analysis and Wilcoxon test were used. The item anxiety/depression of the EQ5D-5L was analyzed to describe the patients' anxiousness. RESULTS Data from 518 patients from 17 different hospitals were evaluated. Fracture severity showed a significant correlation (r = .087, P = .0496) with anxiety. During the hospital stay, pain medication (P < .001), anti-osteoporotic medication (P < .001), and initiation of surgical therapy (P < .001) were associated with less anxiety. The anxiety of a patient at discharge was negatively related to the functional outcomes at the individual follow-up: TuG (P < .001), Barthel index (P < .001), ODI (P < .001) and EQ5D-5L (P < .001). CONCLUSIONS Higher anxiety is associated with lower functional outcome after OVCF. The item anxiety/depression of the EQ5D-5L provides an easily accessible, quick and simple tool that can be used to screen for poor outcomes and may also offer the opportunity for a specific anxiety intervention.
Collapse
Affiliation(s)
- F Schwarz
- Department of Neurosurgery, University Hospital Jena, Jena, Germany
| | - E Klee
- Department of Neurosurgery, University Hospital Jena, Jena, Germany
| | - P Schenk
- Department of Science and Research, BG Clinic Bergmannstrost Halle (Saale), Halle, Deutschland
| | - S Katscher
- Interdisciplinary Center for Spine and Neurotrauma, Sana Clinic Borna, Borna, Germany
| | - K J Schnake
- Interdisciplinary Center for Spinal and Scoliosis Surgery, Waldkrankenhaus Erlangen, Erlangen, Germany
- Department of Orthopaedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
| | - M Bäumlein
- Department of Orthopaedics and Traumatology, University Hospital Marburg, Marburg, Germany
| | - V Zimmermann
- Department of Trauma and Orthopedic Surgery, Klinikum Traunstein, Traunstein, Germany
| | - G Schmeiser
- Department of Spinal Surgery, Schön Clinic Hamburg Eilbek, Hamburg, Germany
| | - M A Scherer
- Medical Practice Clinic Orthopedics and Surgery Munich West, Munich, Germany
| | - M Müller
- Department of Orthopaedics and Traumatology, University Hospital Kiel, Kiel, Germany
| | - K Sprengel
- Department of Traumatology, Hirslanden Clinic St. Anna, University of Lucerne, Lucerne, Switzerland
- Department of Traumatology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - U Spiegl
- Department of Orthopaedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - G Osterhoff
- Department of Orthopaedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - S Schramm
- Department of Trauma and Orthopaedic Surgery, University Hospital Erlangen, Erlangen, Germany
| | - H Siekmann
- Department of Traumatology and Reconstructive Surgery, AMEOS Klinikum Halberstadt, Halberstadt, Germany
| | - A Franck
- Department of Orthopaedics and Traumatology, Regiomed-Clinic of Coburg, Coburg, Germany
| | - M-J Scheyerer
- Department of Orthopaedics and Traumatology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - B W Ullrich
- Department of Traumatology and Reconstructive Surgery, BG Clinic Bergmannstrost Halle (Saale), Halle, Germany
- Department of Hand, Trauma- and Reconstructive Surgery, University Hospital Jena, Jena, Germany
| |
Collapse
|
9
|
Kalitukha IV, Yalcin E, Ken OS, Korenev VL, Akimov IA, Harkort C, Dimitriev GS, Kudlacik D, Sapega VF, Nedelea V, Zhukov EA, Yakovlev DR, Banshchikov AG, Kaveev AK, Karczewski G, Wojtowicz T, Müller M, Bayer M. Universal magnetic proximity effect in ferromagnet-semiconductor quantum well hybrid structures. J Chem Phys 2023; 159:014702. [PMID: 37403857 DOI: 10.1063/5.0153310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/12/2023] [Indexed: 07/06/2023] Open
Abstract
Hybrid ferromagnet-semiconductor systems possess new outstanding properties, which emerge when bringing magnetic and semiconductor materials into contact. In such structures, the long-range magnetic proximity effect couples the spin systems of the ferromagnet and semiconductor on distances exceeding the carrier wave function overlap. The effect is due to the effective p-d exchange interaction of acceptor-bound holes in the quantum well with d-electrons of the ferromagnet. This indirect interaction is established via the phononic Stark effect mediated by the chiral phonons. Here, we demonstrate that the long-range magnetic proximity effect is universal and observed in hybrid structures with diverse magnetic components and potential barriers of various thicknesses and compositions. We study hybrid structures consisting of a semimetal (magnetite Fe3O4) or dielectric (spinel NiFe2O4) ferromagnet and a CdTe quantum well separated by a nonmagnetic (Cd,Mg)Te barrier. The proximity effect is manifested in the circular polarization of the photoluminescence corresponding to the recombination of photoexcited electrons with holes bound to shallow acceptors in the quantum well induced by magnetite or spinel itself, in contrast to interface ferromagnet in case of metal-based hybrid systems. A nontrivial dynamics of the proximity effect is observed in the studied structures due to recombination-induced dynamic polarization of electrons in the quantum well. It enables the determination of the exchange constant Δexch ≈ 70 μeV in a magnetite-based structure. The universal origin of the long-range exchange interaction along with the possibility of its electrical control offers prospects for the development of low-voltage spintronic devices compatible with existing solid-state electronics.
Collapse
Affiliation(s)
- I V Kalitukha
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - E Yalcin
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - O S Ken
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - V L Korenev
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - I A Akimov
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - C Harkort
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - G S Dimitriev
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - D Kudlacik
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - V F Sapega
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - V Nedelea
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - E A Zhukov
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - D R Yakovlev
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - A G Banshchikov
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - A K Kaveev
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
- Saint-Petersburg Alferov University, 194021 St. Petersburg, Russia
| | - G Karczewski
- Institute of Physics, Polish Academy of Sciences, PL-02668 Warsaw, Poland
| | - T Wojtowicz
- International Research Centre MagTop, Institute of Physics, Polish Academy of Sciences, PL-02668 Warsaw, Poland
| | - M Müller
- Fachbereich Physik, Universität Konstanz, 78457 Konstanz, Germany
| | - M Bayer
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| |
Collapse
|
10
|
Asadollahi R, Delvendahl I, Muff R, Tan G, Rodríguez DG, Turan S, Russo M, Oneda B, Joset P, Boonsawat P, Masood R, Mocera M, Ivanovski I, Baumer A, Bachmann-Gagescu R, Schlapbach R, Rehrauer H, Steindl K, Begemann A, Reis A, Winkler J, Winner B, Müller M, Rauch A. Pathogenic SCN2A variants cause early-stage dysfunction in patient-derived neurons. Hum Mol Genet 2023; 32:2192-2204. [PMID: 37010102 PMCID: PMC10281746 DOI: 10.1093/hmg/ddad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/23/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023] Open
Abstract
Pathogenic heterozygous variants in SCN2A, which encodes the neuronal sodium channel NaV1.2, cause different types of epilepsy or intellectual disability (ID)/autism without seizures. Previous studies using mouse models or heterologous systems suggest that NaV1.2 channel gain-of-function typically causes epilepsy, whereas loss-of-function leads to ID/autism. How altered channel biophysics translate into patient neurons remains unknown. Here, we investigated iPSC-derived early-stage cortical neurons from ID patients harboring diverse pathogenic SCN2A variants [p.(Leu611Valfs*35); p.(Arg937Cys); p.(Trp1716*)] and compared them with neurons from an epileptic encephalopathy (EE) patient [p.(Glu1803Gly)] and controls. ID neurons consistently expressed lower NaV1.2 protein levels. In neurons with the frameshift variant, NaV1.2 mRNA and protein levels were reduced by ~ 50%, suggesting nonsense-mediated decay and haploinsufficiency. In other ID neurons, only protein levels were reduced implying NaV1.2 instability. Electrophysiological analysis revealed decreased sodium current density and impaired action potential (AP) firing in ID neurons, consistent with reduced NaV1.2 levels. In contrast, epilepsy neurons displayed no change in NaV1.2 levels or sodium current density, but impaired sodium channel inactivation. Single-cell transcriptomics identified dysregulation of distinct molecular pathways including inhibition of oxidative phosphorylation in neurons with SCN2A haploinsufficiency and activation of calcium signaling and neurotransmission in epilepsy neurons. Together, our patient iPSC-derived neurons reveal characteristic sodium channel dysfunction consistent with biophysical changes previously observed in heterologous systems. Additionally, our model links the channel dysfunction in ID to reduced NaV1.2 levels and uncovers impaired AP firing in early-stage neurons. The altered molecular pathways may reflect a homeostatic response to NaV1.2 dysfunction and can guide further investigations.
Collapse
Affiliation(s)
- R Asadollahi
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
- Faculty of Engineering and Science, University of Greenwich London, Medway Campus, Chatham Maritime ME4 4TB, UK
| | - I Delvendahl
- Department of Molecular Life Sciences, University of Zurich, Zurich 8057, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
| | - R Muff
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - G Tan
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - D G Rodríguez
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - S Turan
- Department of Stem Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - M Russo
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - B Oneda
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - P Joset
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - P Boonsawat
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Masood
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - M Mocera
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - I Ivanovski
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Baumer
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Bachmann-Gagescu
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Schlapbach
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - H Rehrauer
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - K Steindl
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Begemann
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - J Winkler
- Department of Molecular Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
- Center for Rare Diseases Erlangen, University Hospital Erlangen, Erlangen 91054, Germany
| | - B Winner
- Department of Stem Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
- Center for Rare Diseases Erlangen, University Hospital Erlangen, Erlangen 91054, Germany
| | - M Müller
- Department of Molecular Life Sciences, University of Zurich, Zurich 8057, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
- University of Zurich Clinical Research Priority Program (CRPP) Praeclare – Personalized prenatal and reproductive medicine, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) AdaBD: Adaptive Brain Circuits in Development and Learning, Zurich 8006, Switzerland
| | - A Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
- University of Zurich Clinical Research Priority Program (CRPP) Praeclare – Personalized prenatal and reproductive medicine, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) AdaBD: Adaptive Brain Circuits in Development and Learning, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) ITINERARE: Innovative Therapies in Rare Diseases, Zurich 8006, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich 8057, Switzerland
- University Children's Hospital Zurich, University of Zurich, Zurich 8032, Switzerland
| |
Collapse
|
11
|
Luisi CA, Amiri A, Büsen M, Sichermann T, Nikoubashman O, Wiesmann M, Steinseifer U, Müller M, Neidlin M. Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup. Cardiovasc Eng Technol 2023; 14:393-403. [PMID: 36814059 PMCID: PMC10412675 DOI: 10.1007/s13239-023-00660-8] [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: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration. METHODS We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions. RESULTS Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data. CONCLUSION The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.
Collapse
Affiliation(s)
- C A Luisi
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - A Amiri
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Büsen
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - T Sichermann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - O Nikoubashman
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Wiesmann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - U Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Müller
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany.
| |
Collapse
|
12
|
Biller ML, Böhm M, Kolb C, Bucur J, Müller M, Kohnen T. [Pneumocephalus after high-pressure trauma to the conjunctiva]. Ophthalmologie 2023; 120:660-662. [PMID: 35925342 DOI: 10.1007/s00347-022-01671-x] [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] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 06/13/2023]
Affiliation(s)
- M L Biller
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | | | | | | | | | - T Kohnen
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| |
Collapse
|
13
|
Müller M, Mészáros EP, Walter M, Baltes-Flückiger L, Herdener M, Auer R, Thorens G, Rothen S, Nordt C, Zullino D. Cannabis Consumers' View of Regulated Access to Recreational Cannabis: A Multisite Survey in Switzerland. Eur Addict Res 2023:1-9. [PMID: 37231849 PMCID: PMC10389784 DOI: 10.1159/000530194] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/06/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION There is considerable effort in legalizing recreational use of cannabis globally. The successful implementation of a program of regulated access to recreational cannabis (PRAC) depends on the consumers' engagement. The aim of this study was to examine the acceptability of twelve different regulatory aspects by cannabis users including those obtaining cannabis from the illicit market and vulnerable populations such as young adults and problematic users. METHODS The current study is a multisite online survey conducted in Switzerland. A total of 3,132 adult Swiss residents who consumed cannabis within the previous 30 days represented the studied population. Mean age was 30.5 years, 80.5% were men, and 64.2% of the participants stated that they always or often obtain cannabis from the illicit market. We described consumers' acceptability of twelve regulatory aspects concerning THC content control, disclosure of sensitive personal data, security aspects, and follow-up procedures by applying descriptive statistics and multiple regression models. RESULTS THC content regulation showed most discrepancy with 89.4% of the participants stating to engage in a PRAC if five different THC contents were available as compared to 54% if only 12% THC was available. The least accepted regulatory aspect was disposal of contact details with an acceptability rate of 18.1%. Consumers mainly obtaining cannabis from the illicit market, young adults, and problematic users showed similar acceptability patterns. Participants obtaining cannabis from the illicit market were more likely to engage in a PRAC if five different THC contents were available as compared to participants obtaining cannabis from other sources (OR 1.94, 95% CI: 1.53-2.46). CONCLUSION A carefully designed PRAC that takes into account the consumers' perspective is likely to transfer them to the regulated market and to engage vulnerable populations. We cannot recommend the distribution of cannabis with only 12% THC content as this is unlikely to engage the target population.
Collapse
Affiliation(s)
- Monika Müller
- Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals Geneva, Geneva, Switzerland
- Translational Research Center, University Hospital of Psychiatry of Bern, Bern, Switzerland
| | - Edith Paula Mészáros
- Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals Geneva, Geneva, Switzerland,
| | - Marc Walter
- Psychiatric and Psychotherapeutic Clinic, Psychiatric Services Aargau, Windisch, Switzerland
| | | | - Marcus Herdener
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Gabriel Thorens
- Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Stephane Rothen
- Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Carlos Nordt
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Daniele Zullino
- Department of Mental Health and Psychiatry, Service of Addiction Medicine, University Hospitals Geneva, Geneva, Switzerland
| |
Collapse
|
14
|
Müller M, Passegger O, Zehnder P, Hanschen M, Muggleton E, Biberthaler P, Wegmann H, Greve F. [Use of regional anesthesia for preoperative analgesia for proximal femoral fractures in the emergency department : A survey on current practice in German-speaking countries and the United Kingdom]. Unfallchirurgie (Heidelb) 2023; 126:456-462. [PMID: 37084002 DOI: 10.1007/s00113-023-01315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Regional anesthesia (RA) techniques such as femoral nerve block (FNB) or fascia iliaca compartment block (FICB) are effective analgesia techniques in the treatment of pain from proximal femoral fractures (PFF). While in Great Britain (GB) these are already frequently used in the emergency department for preoperative analgesia, in the German-speaking D‑A-CH area (Germany, Austria, Switzerland) this seems to occur much less frequently. Therefore, the aim of this study was to survey the type and frequency of RA procedures used and to compare international practice. MATERIAL AND METHODS In the D‑A-CH area as well as in GB, registered emergency departments were contacted and invited to participate in an online survey. The survey included questions on the frequency and type of RA procedures, reasons for non-use, equipment used, person performing the procedure and medications used. RESULTS The participation rate was 17.4% (142/818 emergency departments). RA procedures for preoperative analgesia in PFF were used in 18.3% (21/115) of hospitals in the D‑A-CH region and in 96.3% (26/27) in GB. The most commonly used block was the FICB in GB at 96.2% (25/26) and the FNB in Germany at 66.7% (14/21). In the D‑A-CH area, RA procedures are primarily performed by anesthesiology specialists 71.4% (15/21), and in GB by emergency department residents 65.4% (17/26). DISCUSSION RA procedures are still performed too rarely following PFF in emergency departments in the D‑A-CH area. In international comparison with GB there is potential for improvement.
Collapse
Affiliation(s)
- M Müller
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - O Passegger
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - P Zehnder
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - M Hanschen
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - E Muggleton
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik für Anästhesiologie, Technische Universität München, München, Deutschland
- Anästhesie am Josephinum, Klinik Josephinum, München, Deutschland
| | - P Biberthaler
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - H Wegmann
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - F Greve
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| |
Collapse
|
15
|
Boldt J, Müller M, Rothe A, Lenzen P, Hempelmann G. Retraction Note: Does continuous heparinization influence platelet function in the intensive care patient? Intensive Care Med 2023:10.1007/s00134-023-07057-0. [PMID: 37039886 DOI: 10.1007/s00134-023-07057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Affiliation(s)
- J Boldt
- Department of Anesthesiology and Intensive Care Medicine, Bremserstrasse 79, 67063, Ludwigshafen, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - A Rothe
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - P Lenzen
- Department of Neurosurgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| |
Collapse
|
16
|
Boldt J, Müller M, Heesen M, Heyn O, Hempelmann G. Retraction Note: Influence of different volume therapies on platelet function in the critically ill. Intensive Care Med 2023:10.1007/s00134-023-07056-1. [PMID: 37041369 DOI: 10.1007/s00134-023-07056-1] [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: 04/13/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen Anesthesiology and Intensive Care Medicine, Bremserstrasse 79, D-67063, Ludwigshafen am Rhein, Germany
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - M Heesen
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - O Heyn
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| |
Collapse
|
17
|
Von Matthey F, Rammensee J, Müller M, Biberthaler P, Abel H. Can elderly patients regain their preoperative functional level after distal radius fracture type A? Results from a fracture register study using PROM. Front Surg 2023; 10:877252. [PMID: 37091269 PMCID: PMC10113482 DOI: 10.3389/fsurg.2023.877252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/08/2023] [Indexed: 04/09/2023] Open
Abstract
IntroductionAlthough distal radius fractures (DRFs) are the most common fractures of the human body, there are still ongoing debates concerning the treatment for type A fractures, especially in elderly patients. In spite of good clinical outcomes, it remains unclear whether elderly patients, especially, could regain the preoperative functional level of the wrist. Therefore, we have quantified wrist function within a retrospective study design using patient-reported outcome measures (PROM) and we have analyzed the influence of age between control and patient collective and young vs. old, respectively.Patients and methodsThe retrospective study included all patients with a surgically treated DRF type A and a control group of healthy patients, age and gender matched. The function of the wrist was examined by using a self-assessment questionnaire called the Munich Wrist Questionnaire (MWQ) according to the patient-related outcome measurements PROM.ResultsWe could enroll 110 patients and controls, and the average follow-up was 66 months. Subgroup matching induced similar age group distribution: in both groups, 7 individuals <30 years, 67 between 31 and 64 years, 29 between 65 and 79 years, and 7 individuals >80 years, were enrolled, respectively. In the fracture group, women were significantly older than men (59 ± 15 vs. 47 ± 17 (M ± SD). There was no significant difference between the control and the patient groups (96 ± 6 vs. 95 ± 7). The function was significantly different between controls and patients <30 years (100 ± 1 vs. 98 ± 2). In the control group, there was a functional difference in the age group <30 compared with 65–79 and >80 and in the age group 30–64 compared with 65–79 and >80. In the control group, the function was found to be significantly decreasing with advancing age, whereas in the patient group, this influence was absent. A correlation analysis showed a worse function with increasing age in the control group and therefore a negative correlation. In the fracture group, a similar result could not be obtained.DiscussionAge has a relevant influence on wrist function. Although the wrist function decreases significantly with aging, in the patient group, this influence is absent, and the functional results after surgery are excellent. Even elderly patients can regain their preoperative functional level.
Collapse
|
18
|
Boldt J, Müller M, Kuhn D, Linke LC, Hempelmann G. Retraction Note: Circulating adhesion molecules in the critically ill: A comparison between trauma and sepsis patients. Intensive Care Med 2023; 49:612. [PMID: 37016204 DOI: 10.1007/s00134-023-07055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen, Anesthesiology and Intensive Care Medicine, Bremserstr. 79, D-67063, Ludwigshafen, Germany
| | - M Müller
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - D Kuhn
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - L C Linke
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| |
Collapse
|
19
|
Abas MA, Müller M, Gibson LJ, Derveeuw S, Dissanayake N, Smith P, Verhey R, Danese A, Chibanda D. Prevalence of post-traumatic stress disorder and validity of the Impact of Events Scale - Revised in primary care in Zimbabwe, a non-war-affected African country. BJPsych Open 2023; 9:e37. [PMID: 36794523 PMCID: PMC9970167 DOI: 10.1192/bjo.2022.621] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND A critical step in research on the epidemiology of post-traumatic stress disorder (PTSD) in low-resource settings is the validation of brief self-reported psychometric tools available in the public domain, such as the Impact Event Scale - Revised (IES-R). AIMS We aimed to investigate the validity of the IES-R in a primary healthcare setting in Harare, Zimbabwe. METHOD We analysed data from a survey of 264 consecutively sampled adults (mean age 38 years; 78% female). We estimated the area under the receiver operating characteristic curve and sensitivity, specificity and likelihood ratios for different cut-off points of the IES-R, against a diagnosis of PTSD made using the Structured Clinical Interview for DSM-IV. We performed factor analysis to evaluate construct validity of the IES-R. RESULTS The prevalence of PTSD was 23.9% (95% CI 18.9-29.5). The area under the curve for the IES-R was 0.90. At a cut-off of ≥47, the sensitivity of the IES-R to detect PTSD was 84.1 (95% CI 72.7-92.1) and specificity was 81.1 (95% CI 75.0-86.3). Positive and negative likelihood ratios were 4.45 and 0.20, respectively. Factor analysis revealed a two-factor solution, with both factors showing good internal consistency (Cronbach's factor-1 α = 0.95, factor-2 α = 0.76). In a post hoc analysis, we found the brief six-item IES-6 also performed well, with an area under the curve of 0.87 and optimal cut-off of 15. CONCLUSIONS The IES-R and IES-6 had good psychometric properties and performed well for indicating possible PTSD, but at higher cut-off points than those recommended in the Global North.
Collapse
Affiliation(s)
- Melanie A Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Monika Müller
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Clinic for Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Bern, Switzerland
| | - Lorna J Gibson
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Sarah Derveeuw
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nirosha Dissanayake
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Patrick Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, UK
| | - Dixon Chibanda
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK; Friendship Bench, Harare, Zimbabwe; and Department of Psychiatry, University of Zimbabwe, Zimbabwe
| |
Collapse
|
20
|
Maier J, Kandulski A, Donlon NE, Werner JM, Mehrl A, Müller M, Doenecke A, Schlitt HJ, Hornung M, Weiss ARR. Endoscopic vacuum therapy significantly improves clinical outcomes of anastomotic leakages after 2-stage, 3-stage, and transhiatal esophagectomies. Langenbecks Arch Surg 2023; 408:90. [PMID: 36790506 PMCID: PMC9931828 DOI: 10.1007/s00423-023-02826-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Anastomotic leakages after esophagectomies continue to constitute significant morbidity and mortality. Intrathoracic anastomoses pose a high risk for mediastinitis, sepsis, and death, if a leak is not addressed timely and appropriately. However, there are no standardized treatment recommendations or algorithms as for how to treat these leakages. METHODS The study included all patients at the University Hospital Regensburg, who developed an anastomotic leakage after esophagectomy with gastric pull-up reconstruction from 2007 to 2022. Patients receiving conventional treatment options for an anastomotic leakage (stents, drainage tubes, clips, etc.) were compared to patients receiving endoscopic vacuum-assisted closure (eVAC) therapy as their mainstay of treatment. Treatment failure was defined as cervical esophagostomy formation or death. RESULTS In total, 37 patients developed an anastomotic leakage after esophagectomy with a gastric pull-up reconstruction. Twenty patients were included into the non-eVAC cohort, whereas 17 patients were treated with eVAC. Treatment failure was observed in 50% of patients (n = 10) in the non-eVAC cohort and in 6% of patients (n = 1) in the eVAC cohort (p < 0.05). The 90-day mortality in the non-eVAC cohort was 15% (n = 3) compared to 6% (n = 1) in the eVAC cohort. Cervical esophagostomy formation was required in 40% of cases (n = 8) in the non-eVAC cohort, whereas no patient in the eVAC cohort underwent cervical esophagostomy formation. CONCLUSION eVAC therapy for leaking esophagogastric anastomoses appears to be superior to other treatment strategies as it significantly reduces morbidity and mortality. Therefore, we suggest eVAC as an essential component in the treatment algorithm for anastomotic leakages following esophagectomies, especially in patients with intrathoracic anastomoses.
Collapse
Affiliation(s)
- Jonas Maier
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - N E Donlon
- Department of Surgery, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - J M Werner
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A Mehrl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Doenecke
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - H J Schlitt
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - M Hornung
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A R R Weiss
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| |
Collapse
|
21
|
Pechmann A, Behrens M, Dörnbrack K, Tassoni A, Stein S, Vogt S, Zöller D, Bernert G, Hagenacker T, Schara-Schmidt U, Schwersenz I, Walter MC, Baumann M, Baumgartner M, Deschauer M, Eisenkölbl A, Flotats-Bastardas M, Hahn A, Horber V, Husain RA, Illsinger S, Johannsen J, Köhler C, Kölbel H, Müller M, von Moers A, Schlachter K, Schreiber G, Schwartz O, Smitka M, Steiner E, Stögmann E, Trollmann R, Vill K, Weiß C, Wiegand G, Ziegler A, Lochmüller H, Kirschner J. Effect of nusinersen on motor, respiratory and bulbar function in early-onset spinal muscular atrophy. Brain 2023; 146:668-677. [PMID: 35857854 DOI: 10.1093/brain/awac252] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/22/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022] Open
Abstract
5q-associated spinal muscular atrophy is a rare neuromuscular disorder with the leading symptom of a proximal muscle weakness. Three different drugs have been approved by the European Medicines Agency and Food and Drug Administration for the treatment of spinal muscular atrophy patients, however, long-term experience is still scarce. In contrast to clinical trial data with restricted patient populations and short observation periods, we report here real-world evidence on a broad spectrum of patients with early-onset spinal muscular atrophy treated with nusinersen focusing on effects regarding motor milestones, and respiratory and bulbar insufficiency during the first years of treatment. Within the SMArtCARE registry, all patients under treatment with nusinersen who never had the ability to sit independently before the start of treatment were identified for data analysis. The primary outcome of this analysis was the change in motor function evaluated with the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders and motor milestones considering World Health Organization criteria. Further, we evaluated data on the need for ventilator support and tube feeding, and mortality. In total, 143 patients with early-onset spinal muscular atrophy were included in the data analysis with a follow-up period of up to 38 months. We observed major improvements in motor function evaluated with the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders. Improvements were greater in children >2 years of age at start of treatment than in older children. 24.5% of children gained the ability to sit independently. Major improvements were observed during the first 14 months of treatment. The need for intermittent ventilator support and tube feeding increased despite treatment with nusinersen. Our findings confirm the increasing real-world evidence that treatment with nusinersen has a dramatic influence on disease progression and survival in patients with early-onset spinal muscular atrophy. Major improvements in motor function are seen in children younger than 2 years at the start of treatment. Bulbar and respiratory function needs to be closely monitored, as these functions do not improve equivalent to motor function.
Collapse
Affiliation(s)
- Astrid Pechmann
- Department of Neuropediatrics and Muscle Disorders, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany
| | - Max Behrens
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center-University of Freiburg, D-70196 Freiburg, Germany
| | - Katharina Dörnbrack
- Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany
| | - Adrian Tassoni
- Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany
| | - Sabine Stein
- Department of Neuropediatrics and Muscle Disorders, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany
| | - Sibylle Vogt
- Department of Neuropediatrics and Muscle Disorders, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany
| | - Daniela Zöller
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center-University of Freiburg, D-70196 Freiburg, Germany
| | - Günther Bernert
- Clinic Favoriten, Department of Pediatrics, A-1100 Vienna, Austria
| | - Tim Hagenacker
- Department of Neurology, and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Hufelands.tr 55, 45147 Essen, Germany
| | - Ulrike Schara-Schmidt
- Department of Neuropediatrics and Neuromuscular Centre for children and Adolescents, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Inge Schwersenz
- Deutsche Gesellschaft für Muskelkranke, D-79112 Freiburg, Germany
| | - Maggie C Walter
- Friedrich-Baur-Institute, Department of Neurology, Ludwig-Maximilians-University of Munich, D-80336 Munich, Germany
| | - Matthias Baumann
- Department of Pediatrics I, Division of Pediatric Neurology, Medical University of Innsbruck, A-6020 Innsbruck, Austria
| | - Manuela Baumgartner
- Ordensklinikum Linz, Barmherzige Schwestern, Department of Pediatrics and Adolescent medicine, A-4020 Linz, Austria
| | - Marcus Deschauer
- Department of Neurology, Technical University of Munich, School of Medicine, D-81675 Munich, Germany
| | - Astrid Eisenkölbl
- Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Kepler University Hospital, 4020 Linz, Austria
| | | | - Andreas Hahn
- Department of Child Neurology, Justus-Liebig University, D-35392 Giessen, Germany
| | - Veronka Horber
- Department of Paediatric Neurology, University Children's Hospital, D-72076 Tübingen, Germany
| | - Ralf A Husain
- Department of Neuropediatrics, Jena University Hospital, D-07747 Jena, Germany
| | - Sabine Illsinger
- Clinic for Pediatric Kidney-, Liver- and Metabolic Diseases, Hannover Medical School, D-30625 Hannover, Germany
| | - Jessika Johannsen
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany
| | - Cornelia Köhler
- Ruhr-Universität Bochum, St. Josef-Hospital, Universitätsklinik für Kinder- und Jugendmedizin, Abteilung für Neuropädiatrie und Sozialpädiatrie, D-44791 Bochum, Germany
| | - Heike Kölbel
- Department of Neuropediatrics and Neuromuscular Centre for children and Adolescents, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Monika Müller
- Department of Neuropediatrics, University Children's Hospital Würzburg, D-97080 Würzburg, Germany
| | - Arpad von Moers
- Department of Pediatrics und Neuropediatrics, DRK Kliniken Berlin, D-14050 Berlin, Germany
| | - Kurt Schlachter
- Department of Pediatrics, State Hospital of Bregenz (LKH Bregenz), A-6900 Bregenz, Austria
| | - Gudrun Schreiber
- Department of Pediatric Neurology, Klinikum Kassel, D-34125 Kassel, Germany
| | - Oliver Schwartz
- Department of Pediatric Neurology, Münster University Hospital, D-48149 Münster, Germany
| | - Martin Smitka
- Abteilung Neuropaediatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, D-01307 Dresden, Germany
| | - Elisabeth Steiner
- Department of Pediatrics, Klinikum Wels-Grieskirchen, A-4600 Wels, Austria
| | - Eva Stögmann
- Department of Pediatrics, LK-Banden-Mödling, A-2340 Mödling, Austria
| | - Regina Trollmann
- Department of Pediatrics, Division of Pediatric Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, D-91054 Erlangen, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity, Dr. von Hauner Children's Hospital, LMU Hospital, Ludwig-Maximilians-University, D-80337 Munich, Germany
| | - Claudia Weiß
- Department of Pediatric Neurology and Center for Chronically Sick Children, Charité-University Medicine Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Gert Wiegand
- Neuropediatrics Section of the Department of Pediatrics, Asklepios Clinic Hamburg Nord-Heidberg, D-22417 Hamburg, Germany
| | - Andreas Ziegler
- Department of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, D-69120 Heidelberg, Germany
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada.,Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada.,Brain and Mind Research Institute, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Janbernd Kirschner
- Department of Neuropediatrics and Muscle Disorders, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany.,Department of Neuropediatrics, University Hospital Bonn, Faculty of Medicine, D-53127 Bonn, Germany
| | | |
Collapse
|
22
|
Tews HC, Kandulski A, Schmid S, Schlosser S, Schirner S, Putz FJ, Cosma L, Gülow K, Müller M, Jung EM. Multimodal ultrasound imaging with conventional B-mode, elastography, and parametric analysis of contrast-enhanced ultrasound (CEUS): A novel approach to assess small bowel manifestation in severe COVID-19 disease. Clin Hemorheol Microcirc 2022; 82:341-360. [PMID: 35871323 DOI: 10.3233/ch-221540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim was to describe the small bowel morphology with conventional B-mode and elastography and additionally to evaluate dynamic effects of COVID-19 associated small bowel microvascularization using CEUS with color coded perfusion parameters.Thirteen patients with severe COVID-19 acute respiratory distress syndrome (ARDS) were investigated. 13 patients required intensive care treatment with mechanical ventilation. Five patients required extracorporeal membrane oxygenation (ECMO). Contrast-enhanced ultrasound (CEUS) was performed by an experienced investigator as a bolus injection of up to 2.4 ml sulfur hexafluoride microbubbles via a central venous catheter. In the parametric analysis of CEUS, the flare of microbubbles over time is visualized with colors. This is the first work using parametric analysis of CEUS to detect perfusion differences in the small bowel.Parametric analysis of CEUS in the intestinal phase was carried out, using DICOM loops for 20 seconds. In 5 patients, parametric analysis revealed intraindividual differences in contrast agent behavior in the small bowel region. Analogous to the computed tomography (CT) images parametric analysis showed regions of simultaneous hyper- and hypoperfusion of the small intestine in a subgroup of patients. In 5 patients, the parametric image of transmural global contrast enhancement was visualized.Our results using CEUS to investigate small bowel affection in COVID-19 suggest that in severe COVID-19 ARDS systemic inflammation and concomitant micro embolisms may lead to disruption of the epithelial barrier of the small intestine.This is the first study using parametric analysis of CEUS to evaluate the extent of small bowel involvement in severe COVID-19 disease and to detect microemboli. In summary, we show that in COVID-19 the small bowel may also be an important interaction site. This is in line with the fact that enterocytes have been shown to a plenitude of angiotensin converting enzyme (ACE)-2 receptors as entry sites of the virus.
Collapse
Affiliation(s)
- H C Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - A Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schlosser
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schirner
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - F J Putz
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - L Cosma
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - K Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
23
|
Salanti G, Peter N, Tonia T, Holloway A, White IR, Darwish L, Low N, Egger M, Haas AD, Fazel S, Kessler RC, Herrman H, Kieling C, De Quervain DJF, Vigod SN, Patel V, Li T, Cuijpers P, Cipriani A, Furukawa TA, Leucht S, Sambo AU, Onishi A, Sato A, Rodolico A, Oliveira Solis ACD, Antoniou A, Kapfhammer A, Ceraso A, O'Mahony A, Lasserre AM, Ipekci AM, Concerto C, Zangani C, Igwesi-Chidobe C, Diehm C, Demir DD, Wang D, Ostinelli EG, Sahker E, Beraldi GH, Erzin G, Nelson H, Elkis H, Imai H, Wu H, Kamitsis I, Filis I, Michopoulos I, Bighelli I, Hong JSW, Ballesteros J, Smith KA, Yoshida K, Omae K, Trivella M, Tada M, Reinhard MA, Ostacher MJ, Müller M, Jaramillo NG, Ferentinos PP, Toyomoto R, Cortese S, Kishimoto S, Covarrubias-Castillo SA, Siafis S, Thompson T, Karageorgiou V, Chiocchia V, Zhu Y, Honda Y. The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population : A Systematic Review and Dose-Response Meta-analysis. Ann Intern Med 2022; 175:1560-1571. [PMID: 36252247 PMCID: PMC9579966 DOI: 10.7326/m22-1507] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear. PURPOSE To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment. DATA SOURCES Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered. STUDY SELECTION Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible. DATA EXTRACTION An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths. DATA SYNTHESIS In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations. LIMITATIONS The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships. CONCLUSION Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures. PRIMARY FUNDING SOURCE Swiss National Science Foundation. (PROSPERO: CRD42020180049).
Collapse
Affiliation(s)
- Georgia Salanti
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (G.S., T.T., A.H., N.L., A.D.H.)
| | - Natalie Peter
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany (N.P., L.D., S.L.)
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (G.S., T.T., A.H., N.L., A.D.H.)
| | - Alexander Holloway
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (G.S., T.T., A.H., N.L., A.D.H.)
| | - Ian R White
- University College London, London, United Kingdom (I.R.W.)
| | - Leila Darwish
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany (N.P., L.D., S.L.)
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (G.S., T.T., A.H., N.L., A.D.H.)
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland, and Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (M.E.)
| | - Andreas D Haas
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (G.S., T.T., A.H., N.L., A.D.H.)
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, and Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom (A.C., S.F.)
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (R.C.K.)
| | - Helen Herrman
- Orygen National Centre for Excellence in Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia (H.H.)
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, and Child and Adolescent Psychiatry Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil (C.K.)
| | | | - Simone N Vigod
- Women's College Hospital, Women's College Research Institute and Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (S.N.V.)
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts (V.P.)
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado (T.L.)
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, and World Health Organization Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit, Amsterdam, the Netherlands (P.C.)
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford Precision Psychiatry Lab, National Institute for Health and Care Research Oxford Health Biomedical Research Centre, and Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom (A.C., S.F.)
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behaviour, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan (T.A.F.)
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany (N.P., L.D., S.L.)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Pechmann A, Behrens M, Dörnbrack K, Tassoni A, Wenzel F, Stein S, Vogt S, Zöller D, Bernert G, Hagenacker T, Schara-Schmidt U, Walter MC, Bertsche A, Vill K, Baumann M, Baumgartner M, Cordts I, Eisenkölbl A, Flotats-Bastardas M, Friese J, Günther R, Hahn A, Horber V, Husain RA, Illsinger S, Jahnel J, Johannsen J, Köhler C, Kölbel H, Müller M, von Moers A, Schwerin-Nagel A, Reihle C, Schlachter K, Schreiber G, Schwartz O, Smitka M, Steiner E, Trollmann R, Weiler M, Weiß C, Wiegand G, Wilichowski E, Ziegler A, Lochmüller H, Kirschner J, Ameshofer L, Andres B, Angelova-Toshkina D, Banholzer D, Bant C, Baum P, Baumann S, Baur U, Becker B, Behring B, Bellut J, Bevot A, Bischofberger J, Bitzan L, Bjelica B, Blankenburg M, Böger S, Bonetti F, Bongartz A, Brakemeier S, Bratka L, Braun N, Braun S, Brauner B, Bretschneider C, Burgenmeister N, Burke B, Cirak S, Dall A, de Vries H, Marina AD, Denecke J, Deschauer M, Dibrani Z, Diebold U, Dondit L, Drebes J, Driemeyer J, Dukic V, Eckenweiler M, Eminger M, Fischer M, Fischer C, Freigang M, Gaiser P, Gangfuß A, Geitmann S, George A, Gosk-Tomek M, Grinzinger S, Gröning K, Groß M, Güttsches AK, Hagenmeyer A, Hartmann H, Haverkamp J, Hiebeler M, Hoevel A, Hoffmann GF, Holtkamp B, Holzwarth D, Homma A, Horneff V, Hörnig C, Hotter A, Hubert A, Huppke P, Jansen E, Jung L, Kaiser N, Kappel S, Katharina B, Koch J, Kölke S, Korschinsky B, Kostede F, Krause K, Küpper H, Lang A, Lange I, Langer T, Lechner Y, Lehmann H, Leypold C, Lingor P, Lipka J, Löscher W, Luiking A, Machetanz G, Malm E, Martakis K, Menzen B, Metelmann M, zu Hörste GM, Montagnese F, Mörtlbauer K, Müller P, Müller A, Müller A, Müschen L, Neuwirth C, Niesert M, Pauschek J, Pernegger E, Petri S, Pilshofer V, Plecko B, Pollok J, Preisel M, Pühringer M, Quinten AL, Raffler S, Ramadan B, Rappold M, Rauscher C, Reckmann K, Reinhardt T, Röder M, Roland-Schäfer D, Roth E, Ruß L, Saffari A, Schimmel M, Schlag M, Schlotter-Weigel B, Schneider J, Schöne-Bake JC, Schorling D, Schreiner I, Schüssler S, Schwarzbach M, Schwippert M, Semmler L, Smuda K, Sprenger-Svacina A, Stadler T, Steffens P, Steuernagel D, Stolte B, Stoltenburg C, Tasch G, Thimm A, Tiefenthaler E, Topakian R, Türk M, van der Stam L, Vettori K, Vollmann P, Vorgerd M, Weiss D, Wenninger S, Werring S, Wessel M, Weyen U, Wider S, Wiebe NO, Wiesenhofer A, Wiethoff S, Wirner C, Wohnrade C, Wunderlich G, Zeller D, Zemlin M, Zobel J. Improved upper limb function in non-ambulant children with SMA type 2 and 3 during nusinersen treatment: a prospective 3-years SMArtCARE registry study. Orphanet J Rare Dis 2022; 17:384. [PMID: 36274155 PMCID: PMC9589836 DOI: 10.1186/s13023-022-02547-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background The development and approval of disease modifying treatments have dramatically changed disease progression in patients with spinal muscular atrophy (SMA). Nusinersen was approved in Europe in 2017 for the treatment of SMA patients irrespective of age and disease severity. Most data on therapeutic efficacy are available for the infantile-onset SMA. For patients with SMA type 2 and type 3, there is still a lack of sufficient evidence and long-term experience for nusinersen treatment. Here, we report data from the SMArtCARE registry of non-ambulant children with SMA type 2 and typen 3 under nusinersen treatment with a follow-up period of up to 38 months. Methods SMArtCARE is a disease-specific registry with data on patients with SMA irrespective of age, treatment regime or disease severity. Data are collected during routine patient visits as real-world outcome data. This analysis included all non-ambulant patients with SMA type 2 or 3 below 18 years of age before initiation of treatment. Primary outcomes were changes in motor function evaluated with the Hammersmith Functional Motor Scale Expanded (HFMSE) and the Revised Upper Limb Module (RULM). Results Data from 256 non-ambulant, pediatric patients with SMA were included in the data analysis. Improvements in motor function were more prominent in upper limb: 32.4% of patients experienced clinically meaningful improvements in RULM and 24.6% in HFMSE. 8.6% of patients gained a new motor milestone, whereas no motor milestones were lost. Only 4.3% of patients showed a clinically meaningful worsening in HFMSE and 1.2% in RULM score. Conclusion Our results demonstrate clinically meaningful improvements or stabilization of disease progression in non-ambulant, pediatric patients with SMA under nusinersen treatment. Changes were most evident in upper limb function and were observed continuously over the follow-up period. Our data confirm clinical trial data, while providing longer follow-up, an increased number of treated patients, and a wider range of age and disease severity.
Collapse
|
25
|
Müller M. Hybrid photon-counting detectors – black boxes or powerful tools? Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322089860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
|
26
|
Müller M, Broadhead J, Simpson T, Abas MA. Effect of acute depression associated with COVID-19 infection on health-seeking behaviour: a psychiatrist's personal account and case report. BJPsych Open 2022; 8:e119. [PMID: 35770387 PMCID: PMC9253444 DOI: 10.1192/bjo.2022.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite the abundant research on COVID-19-related mental health problems, little attention has been paid to acute depression occurring concurrently with the infection as a neuropsychiatric manifestation. This is important because depression is known to adversely affect help-seeking. Decreased help-seeking is likely to be aggravated by the isolation measures demanded as part of fighting the pandemic, given the disruption of social support networks. AIMS To study the effects of acute depression associated with COVID-19 infection on help-seeking behaviour. METHOD We present a case report and personal account of a patient psychiatrist who developed a first onset of acute depression as part of COVID-19 infection. RESULTS Despite being a mental health expert the patient lacked insight into his mood change and its negative effect on help-seeking behaviour, resulting in reliance on a family caregiver to raise the alarm. CONCLUSIONS For those experiencing this complex interaction between COVID-19 infection and the brain, social support will be needed to ensure timely presentation to the healthcare system. Greater attention to behavioural change as part of COVID-19 infection is needed to optimise treatment outcome.
Collapse
Affiliation(s)
- Monika Müller
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and University Hospital of Psychiatry, Bern, Switzerland
| | | | - Thomas Simpson
- University Hospital Lewisham, Lewisham and Greenwich NHS Trust, London, UK
| | - Melanie A Abas
- Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| |
Collapse
|
27
|
Birrenbach T, Bühlmann F, Exadaktylos AK, Hautz WE, Müller M, Sauter TC. Virtual Reality for Pain Relief in the Emergency Room (VIPER) - a prospective, interventional feasibility study. BMC Emerg Med 2022; 22:113. [PMID: 35729502 PMCID: PMC9210626 DOI: 10.1186/s12873-022-00671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including acute and chronic pain management, as well as anxiety disorders. However, studies in the busy environment of an adult ED are scarce. The aim of this study is to explore the feasibility and effectiveness of a VR simulation for pain and anxiety control in a convenience sample of adult ED patients presenting with traumatic and non-traumatic pain triaged 2–5 (i.e., urgent to non-urgent) with a pain rating of ≥ 3 on a numeric rating scale (NRS 0–10). Methods Prospective within-subject, repeated measures interventional feasibility pilot study at a Swiss University ED. The intervention consisted of a virtual reality simulation in addition to usual care. Pain and anxiety levels were measured using a verbally administered numeric rating scale (NRS) before and after the intervention. Information on patient experience was collected using established rating scales. Results Fifty-two patients were enrolled. The most common pain localisations were extremities (n = 15, 28.8%) and abdomen (n = 12, 23.1%). About one third of patients presented with trauma-associated pain (n = 16, 30.8%). Duration of pain was mainly acute (< 24 h) (n = 16, 30.8%) or subacute (> 24 h) (n = 32, 61.5%). The majority of patients were triage category 3, i.e. semi-urgent (n = 48, 92.3%). Significant reduction in pain (NRS median pre-VR simulation 4.5 (IQR 3–7) vs. median post-VR simulation 3 (IQR 2–5), p < 0.001), and anxiety levels (NRS median pre-VR simulation 4 (IQR 2–5) vs. median post-VR simulation 2 (IQR 0–3), p < 0.001) was achieved, yielding moderate to large effect sizes (Cohen’s d estimate for pain reduction = 0.59 (95% CI 0.19—0.98), for anxiety level on NRS = 0.75 (95% CI 0.34—1.15). With medium immersion and good tolerability of the VR simulation, user satisfaction was high. Conclusions Virtual reality analgesia for pain and anxiety reduction in the busy setting of an ED is feasible, effective, with high user satisfaction. Further randomized controlled studies are needed to better characterize its impact on pain perception and resource utilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00671-z.
Collapse
Affiliation(s)
- T Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland.
| | - F Bühlmann
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - A K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - W E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - M Müller
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - T C Sauter
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| |
Collapse
|
28
|
Mey F, Treccani G, Schmitt U, Müller M. Distinct behavior in early life stress dams predicts heterogeneity in future stress response in offspring over lifespan. Eur Psychiatry 2022. [PMCID: PMC9565095 DOI: 10.1192/j.eurpsy.2022.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Exposure to early life stress (ELS) strongly predicts prevalent, impairing, and costly psychiatric illness throughout life including mental disorders. The reason, some individuals are more vulnerable to ELS whereas others remain resilient, is poorly understood. There is a need for better understanding of early biological changes triggered by ELS with responsibility to negative outcomes in health. Objectives We stratify animals after ELS according to corticosterone levels. [1] Re-challenging the animals to a second stressor, chronic social defeat (CSD) [2], in adulthood was performed to understand individual trajectories depending on corticosterone exposure during early adverse conditions. Methods We performed ELS as previously reported [1]. Behavior of mothers was observed during ELS. Correlation between level of corticosterone and behavior observed in dams. ELS animals were exposed to a second stress in adulthood. A battery of tests for different behavioral domains was performed. Behavioral analyses was combined with assessment of litter HPA system reactivity and observed behavior in dams. Results Stress dams where significantly higher in number of sorties over whole observation period, time dams spent outside the nest differed. We could correlate the number of sorties on p3 with corticosterone plasma level at p9. Control dams spent significantly more time outside in 9pm recordings than stress animals. We could show reduced interaction with social juvenile targets in sociability test for CSD mice. Light dark transition was significantly higher for control mice compared to CSD but lower for control vs ELS animals. Conclusions Behavior in dams during ELS correlates with chronic stress coping mechanisms in offspring’s adulthood. Disclosure No significant relationships.
Collapse
|
29
|
Wasser C, Schmid N, Müller M, Günther M, Beller C, Rudolph B. [Management of critically ill nontrauma patients in a nonuniversity emergency department]. Notf Rett Med 2022:1-11. [PMID: 35502426 PMCID: PMC9045234 DOI: 10.1007/s10049-022-01027-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
Purpose Today there exists only limited knowledge regarding the care of critically ill nontrauma (CINT) patients in the resuscitation room (RR) in Germany. The goal of this observational study was to describe the management of CINT patients in the RR of a nonuniversity emergency department. Methods Data of adult nontrauma patients in the RR were prospectively collected in this study from 26 January 2019 to 18 May 2021 using the OBSERvE‑2 evaluation protocol. Results In all, 213 patients were included in the study (age: 70 ± 15 years, 55% male; admission to the RR by emergency medical service 93%). 28% were brought in after out-of-hospital cardiac arrest. Leading admission causes were C (47%) and B problems (39%). Diagnoses at the end of RR treatment were 30% pulmonary and 26% cardiovascular diseases without myocardial infarction as well as pulmonary embolism (8% and 5%, respectively). Measures performed were airway protection (20%), invasive (46%) and noninvasive ventilation (25%), cardiopulmonary resuscitation (13%), catecholamine therapy (34%), emergency ultrasound (62%). The initial treatment lasted for 41 ± 22 min. Computed tomography was subsequently performed in 51%. On average 4-5 persons were involved in the treatment during the RR period. In total, 9% of the patients died during RR treatment and 40% in the hospital. Conclusion Patients in a nonuniversity nontrauma RR are resource-intensive and have a high in-hospital lethality. RR care can be completed within 60 min. In order to achieve better comparability between patient populations of different locations, it is necessary to uniformly define admission criteria for the nontrauma resuscitation room.
Collapse
Affiliation(s)
- C. Wasser
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - N. Schmid
- AG IT-Forschung, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - M. Müller
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - M. Günther
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - C. Beller
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - B. Rudolph
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| |
Collapse
|
30
|
Raspe K, Müller M, Iwe N, Wolf RN, Oelßner P, Martinez F, Schweikhard L, Meiwes-Broer KH, Tiggesbäumker J. A versatile setup for studying size and charge-state selected polyanionic nanoparticles. Rev Sci Instrum 2022; 93:043301. [PMID: 35489944 DOI: 10.1063/5.0085187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Using the example of metal clusters, an experimental setup and procedure is presented, which allows for the generation of size and charge-state selected polyanions from monoanions in a molecular beam. As a characteristic feature of this modular setup, the further charging process via sequential electron attachment within a three-state digital trap takes place after mass-selection. In contrast to other approaches, the rf-based concept permits access to heavy particles. The procedure is highly flexible with respect to the preparation process and potentially suitable for a wide variety of anionic species. By adjusting the storage conditions, i.e., the radio frequency, to the change in the mass-to-charge ratio, we succeeded in producing clusters in highly negative charge states, i.e., Ag800 7-. The capabilities of the setup are demonstrated by experiments extracting electronic and optical properties of polyanionic metal clusters by analyzing the corresponding photoelectron spectra.
Collapse
Affiliation(s)
- K Raspe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - M Müller
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - N Iwe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - R N Wolf
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - P Oelßner
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - F Martinez
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - L Schweikhard
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - K-H Meiwes-Broer
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - J Tiggesbäumker
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| |
Collapse
|
31
|
Spoelstra S, Müller M. The (not so) new corporation. Organization 2022. [DOI: 10.1177/13505084221083915] [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: 11/17/2022]
|
32
|
Juselius T, Ravolainen V, Zhang H, Piilo S, Müller M, Gallego-Sala A, Väliranta M. Newly initiated carbon stock, organic soil accumulation patterns and main driving factors in the High Arctic Svalbard, Norway. Sci Rep 2022; 12:4679. [PMID: 35304558 PMCID: PMC8933566 DOI: 10.1038/s41598-022-08652-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
High latitude organic soils form a significant carbon storage and deposition of these soils is largely driven by climate. Svalbard, Norway, has experienced millennial-scale climate variations and in general organic soil processes have benefitted from warm and humid climate phases while cool late Holocene has been unfavourable. In addition to direct effect of cool climate, the advancing glaciers have restricted the vegetation growth, thus soil accumulation. Since the early 1900's climate has been warming at unprecedented rate, assumingly promoting organic soil establishment. Here we present results of multiple organic soil profiles collected from Svalbard. The profiles have robust chronologies accompanied by soil property analyses, carbon stock estimations and testate amoeba data as a proxy for soil moisture. Our results reveal relatively recent initiation of organic soils across the Isfjorden area. The initiation processes could be linked to glacier retreat, and improvement of growing conditions and soil stabilization. Carbon stock analyses suggested that our sites are hot spots for organic matter accumulation. Testate amoebae data suggested drying of soil surfaces, but the reason remained unresolved. If continued, such a process may lead to carbon release. Our data suggest that detailed palaeoecological data from the Arctic is needed to depict the on-going processes and to estimate future trajectories.
Collapse
Affiliation(s)
- T. Juselius
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
| | - V. Ravolainen
- grid.418676.a0000 0001 2194 7912Fram Centre, Norwegian Polar Institute (NPI), 9296 Tromsø, Norway
| | - H. Zhang
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland ,grid.9227.e0000000119573309Key Laboratory of Cenozoic Geology and Environment, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
| | - S. Piilo
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
| | - M. Müller
- grid.7737.40000 0004 0410 2071Department of Geosciences and Geography, Faculty of Science, University of Helsinki, Yliopistonkatu 3, P.O. Box 4, 00014 Helsinki, Finland
| | - A. Gallego-Sala
- grid.8391.30000 0004 1936 8024Geography, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - M. Väliranta
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
| |
Collapse
|
33
|
Oeckenpöhler S, Domnick C, Raschke MJ, Müller M, Wähnert D, Kösters C. A lateral fracture step-off of 2mm increases intra-articular pressure following tibial plateau fracture. Injury 2022; 53:1254-1259. [PMID: 35016775 DOI: 10.1016/j.injury.2021.12.053] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of increasing posttraumatic step-offs after lateral tibial plateau fracture reduction on the intra-articular pressure. MATERIALS AND METHODS In eight fresh-frozen human cadaveric knees with intact menisci, a standardized sagittal osteotomy of the lateral tibial condyle was performed as an OTA/AO type 41-B1 fracture-model. The fragment was fixed by a customized sled including an angular stable tibia plate to evaluate step-offs from 0 mm to 8 mm in 1mm increments. In a servo-hydraulic testing machine, an axial force was applied to the tibial plateau in 0° (700N), 15° (700N), 30° (700N), 60° (350N), and 90 ° (350N) of flexion while the joint pressure was recorded by two pressure sensors. RESULTS A 1mm step-off did not result in an increased joint pressure. At 60° of flexion a 2mm step-off increased the lateral joint pressure by 61.84kPa (P = 0.0027). In 30° of flexion, a 3mm step raised the lateral joint pressure by 66.80kPa (p = 0.0017), whereas in 0°, 15° and 90° of flexion, a 4mm step increased the pressure by >50kPa (P < 0.05). Concomitant medial joint pressure increments were lower than those in the lateral plateau. A significant increase of 19-24kPa in the medial joint pressure was detected in 90° of flexion with a 1mm lateral step (P = 0.0075), in 15° and 60° of flexion with a 2mm step (P < 0.05), in 0° of flexion with a 4mm step (P = 0.0215) and in 30° of flexion with a 7mm step (P = 0.0487). CONCLUSION Lateral fracture step-offs of 2mm or larger should be reduced intraoperatively to avoid large increases in lateral joint pressure.
Collapse
Affiliation(s)
- S Oeckenpöhler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - C Domnick
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Department of Trauma, Hand and Orthopedic Surgery, Euregio-Hospital, Nordhorn, Germany.
| | - M J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - M Müller
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - D Wähnert
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Institute for Musculoskeletal Medicine, Westfaelische-Wilhelms-University Muenster, Muenster, Germany; Department of Trauma and Orthopedic Surgery, Protestant Hospital of Bethel Foundation, Burgsteig 13, 33617 Bielefeld, Germany
| | - C Kösters
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Department of Trauma and Orthopedic Surgery, Maria and Joseph Hospital Greven, Greven, Germany
| |
Collapse
|
34
|
Müller M, Kutscherauer M, Böcklein S, Wehinger G, Turek T, Mestl G. Modeling the selective oxidation of n-butane to maleic anhydride: From active site to industrial reactor. Catal Today 2022. [DOI: 10.1016/j.cattod.2021.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
35
|
Tews H, Kandulski A, Schmid S, Peschel G, Gülow K, Schlosser S, Schirner S, Stroszczynski C, Müller M, Jung E. Contrast enhanced ultrasonography (CEUS) a novel tool to detect intestinal epithelial barrier dysfunction in severe COVID-19 disease. Clin Hemorheol Microcirc 2022; 81:177-190. [DOI: 10.3233/ch-221407] [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: 11/15/2022]
Abstract
Ten patients with confirmed COVID-19 disease were studied. Nine patients required intensive care treatment, among them four needed extracorporeal membrane oxygenation (ECMO). Contrast enhanced ultrasonography (CEUS) was performed by one experienced investigator as a bolus injection of up to 2.4 ml of sulphur hexafluoride microbubbles via a central venous catheter. B-Mode evaluation and strain elastography showed mural edema of the small bowel with a thickness of up to 10 mm in all patients. We applied color coded Doppler sonography (CCDS) and power mode with flow-adapted parameters and early, dynamic capillary arterial contrast enhancement of bowel wall structures <10 s to assess perfusion of the small bowel. In all patients, reactive hyperemia was seen in the entire small bowel. In a subgroup of seven patients microbubbles translocated into the intestinal lumen. Thus, high-grade intestinal barrier disruption secondary to SARSCoV-2 infection can be postulated in these patients. This is the first description of perfusion changes and a disruption of the small bowel epithelial barrier in COVID-19 Patients using contrast ultrasonography and elastography.
Collapse
Affiliation(s)
- H.C. Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - A. Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S. Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - G. Peschel
- Departement of Internal Medicine, Fürstenfeldbruck, Germany
| | - K. Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | | | - S. Schirner
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - C. Stroszczynski
- Institute of Diagnostic Radiology, University Hospital, Regensburg, Germany
| | - M. Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - E.M. Jung
- Institute of Diagnostic Radiology, University Hospital, Regensburg, Germany
| |
Collapse
|
36
|
Blank AE, Zajonz TS, Herrmann R, Akintürk H, Müller M, Jux C, Neuhäuser C, Backhoff DJ. Postoperative Heart Rate Control with Esmolol in Newborn Cardiac Surgery with Cardiopulmonary Bypass. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A.-E. Blank
- Pediatric Heart Center, Giessen, Deutschland
| | - T. S. Zajonz
- Department of Anesthesiology, Pediatric Heart Center, Giessen, Deutschland
| | - R. Herrmann
- Pediatric Heart Center, Giessen, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Department of Anesthesiology, Pediatric Heart Center, Giessen, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
| | | | | |
Collapse
|
37
|
Lanmueller P, Eulert-Grehn JJ, Unbehaun A, Klein C, Hommel M, Kofler M, Kempfert J, Hörmadinger C, Kaufmann F, Stawowy P, Dreysse S, Mulzer J, Müller M, Falk V, Schönrath F, Potapov E, Just I. Transcatheter Aortic Valve Implantation for Severe Aortic Regurgitation in Patients with Left Ventricular Assist Device Support. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - C. Klein
- Augustenburger Platz 1, Berlin, Deutschland
| | - M. Hommel
- German Heart Institute Berlin, Berlin, Deutschland
| | - M. Kofler
- Augustenburger Platz 1, Berlin, Deutschland
| | - J. Kempfert
- German Heart Institute Berlin, Berlin, Deutschland
| | | | - F. Kaufmann
- German Heart Center Berlin, Berlin, Deutschland
| | - P. Stawowy
- German Heart Institute Berlin, Berlin, Deutschland
| | - S. Dreysse
- German Heart Center Berlin, Berlin, Deutschland
| | - J. Mulzer
- German Heart Institute Berlin, Berlin, Deutschland
| | - M. Müller
- German Heart Institute Berlin, Berlin, Deutschland
| | - V. Falk
- Department of Cardiovascular Surgery, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Schönrath
- German Heart Institute Berlin, Berlin, Deutschland
| | - E. Potapov
- Augustenburger Platz 1, Berlin, Deutschland
| | - I. Just
- German Heart Institute Berlin, Berlin, Deutschland
| |
Collapse
|
38
|
Brunner CF, Harres E, Yörüker U, Sen-Hild B, Valeske K, Müller M, Thul J, Hahn A, Pons-Kühnemann J, Schranz D, Jux C, Akintürk H. Neurological Outcome of Aortic Arch Reconstruction Using Selective Cerebral Perfusion Compared to Standard Open-Heart Surgery in Pediatric Patients: A Prospective Single-Center Study. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - E. Harres
- Pediatric Heart Center, Giessen, Deutschland
| | - U. Yörüker
- Pediatric Heart Center, Giessen, Deutschland
| | - B. Sen-Hild
- Pediatric Heart Center, Giessen, Deutschland
| | - K. Valeske
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Pediatric Heart Center, Giessen, Deutschland
| | - J. Thul
- Pediatric Heart Center, Giessen, Deutschland
| | - A. Hahn
- Kinderneurologie Gießen, Gießen, Deutschland
| | - J. Pons-Kühnemann
- Institute for Medical Statistics, University of Giessen, Gießen, Deutschland
| | - D. Schranz
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
| |
Collapse
|
39
|
Müller M, Biermann D, Righa M, Carstens H, Kozlik-Feldmann R, Hübler M, Sachweh JS. The Bigger, the Better! Does Biological Valve Diameter Influence Longevity of Right Ventricular Outflow Tract (RVOT) Reconstruction in Tetralogy of Fallot (ToF)? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Müller
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Interdisziplinäres Kinderherzprogramm, Hamburg, Deutschland
| | - D. Biermann
- Department of Pediatric Cardiac Surgery, University Heart and Vascular Center, Hamburg, Deutschland
| | - M. Righa
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Interdisziplinäres Kinderherzprogramm, Hamburg, Deutschland
| | - H. Carstens
- Heart Centre Huttrop, Essen University Hospital, Essen, Deutschland
| | | | - M. Hübler
- University Hospital of Zürich, Zürich, Switzerland
| | | |
Collapse
|
40
|
Yörüker U, Khalil M, Müller M, Kerst G, Esmaeili A, Jux C, Schranz D, Akintürk H. Nonsurgical Palliation for Hypoplastic Left Heart. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- U. Yörüker
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Khalil
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Pediatric Heart Center, Giessen, Deutschland
| | - G. Kerst
- Department of Pediatric Cardiology, University Hospital RWTH Aachen, Pauwelsstr. 30, Aachen, Deutschland
| | - A. Esmaeili
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
| | - D. Schranz
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
| |
Collapse
|
41
|
Müller M, Greve F, Crönlein M, Zyskowski M, Pesch S, Biberthaler P, Kirchhoff C, Beirer M. Correction to: Reconstruction or replacement? A challenging question in surgical treatment of complex humeral head fractures in the elderly. Arch Orthop Trauma Surg 2022; 142:3255. [PMID: 34817671 PMCID: PMC9522736 DOI: 10.1007/s00402-021-04267-3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Müller
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - F. Greve
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Crönlein
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Zyskowski
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - S. Pesch
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - P. Biberthaler
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - C. Kirchhoff
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Beirer
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| |
Collapse
|
42
|
Glasbrenner J, Fischer M, Raschke MJ, Briese T, Müller M, Herbst E, Kittl C, Schliemann B, Kösters C. Primary stability of single-stage revision reconstruction of the anterior cruciate ligament in case of failure of dynamic intraligamentary stabilization depends on implant position during ACL repair. Arch Orthop Trauma Surg 2022; 142:1589-1595. [PMID: 34331580 PMCID: PMC9217861 DOI: 10.1007/s00402-021-04088-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The object of this study was to evaluate the primary stability of tibial interference screw (IFS) fixation in single-stage revision surgery of the anterior cruciate ligament (ACL) in the case of recurrent instability after ACL repair with dynamic intraligamentary stabilization (DIS), dependent on the implant position during DIS. MATERIALS AND METHODS Tibial aperture fixation in ACL reconstruction (ACL-R) was performed in a porcine knee model using an IFS. Native ACL-R was performed in the control group (n = 15). In the intervention groups DIS and subsequent implant removal were performed prior to single-stage revision ACL-R. A distance of 20 mm in group R-DIS1 (n = 15) and 5 mm in group R-DIS2 (n = 15) was left between the joint line and the implant during DIS. Specimens were mounted in a material-testing machine and load-to-failure was applied in a worst-case-scenario. RESULTS Load to failure was 454 ± 111 N in the R-DIS1 group, 154 ± 71 N in the R-DIS2 group and 405 ± 105 N in the primary ACL-R group. Load-to-failure, stiffness and elongation of the group R-DIS2 were significantly inferior in comparison to R-DIS1 and ACL-R respectively (p < 0.001). No significant difference was found between load-to-failure, stiffness and elongation of R-DIS1 and the control group. CONCLUSION Primary stability of tibial aperture fixation in single-stage revision ACL-R in case of recurrent instability after DIS depends on monobloc position during ACL repair. Primary stability is comparable to aperture fixation in primary ACL-R, if a bone stock of 20 mm is left between the monobloc and the tibial joint line during the initial procedure.
Collapse
Affiliation(s)
- J Glasbrenner
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany.
| | - M Fischer
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - M J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - T Briese
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - M Müller
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - E Herbst
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - C Kittl
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - B Schliemann
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - C Kösters
- Department of Traumatology and Orthopedics, Maria-Josef-Hospital Greven, Lindenstraße 29, 48268, Greven, Germany
| |
Collapse
|
43
|
Müller M, Greve F, Crönlein M, Zyskowski M, Pesch S, Biberthaler P, Kirchhoff C, Beirer M. Reconstruction or replacement? A challenging question in surgical treatment of complex humeral head fractures in the elderly. Arch Orthop Trauma Surg 2022; 142:3247-3254. [PMID: 34432097 PMCID: PMC9522728 DOI: 10.1007/s00402-021-04124-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Surgical treatment of complex humeral head fractures in the elderly is challenging due to osteoporotic bone, comorbidities and reduced compliance. The treatment strategy (reconstruction versus replacement) should allow for a functional aftercare and result in a high patient satisfaction. Major complications leading to surgical revision are crucial and should be avoided. The purpose of this study was to analyse the major complication rate leading to surgical revision and the patient-based outcome in complex humeral head fractures of the elderly population treated either using locking plate fixation (LCP) or reversed total shoulder arthroplasty (rTSA). MATERIALS AND METHODS All patients older than 65 years surgically treated due to a four-part fracture of the proximal humerus between 2003 and 2015 were enrolled in our retrospective study. Major complications and revision rates were recorded and functional outcome was assessed using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self-assessment of the Shoulder Pain and Disability Index (SPADI), of the Disability of the Arm, Shoulder and Hand (DASH) score and of the Constant Score. RESULTS A cohort of 103 patients with a mean age of 73.4 ± 6.2 years suffering from four-part fractures of the humeral head were enrolled. 63 patients were treated using the LCP fixation compared to 40 rTSAs. There were no significant differences in the patient-reported functional outcome. The revision rate was significantly higher in the LCP group (10/63; 15.9%) compared to the rTSA group (1/40; 2.5%). Reasons for revision were avascular head necrosis, cut-out of screws, secondary dislocation of the greater tuberosity and hypersensitivity to metal. CONCLUSIONS Reversed total shoulder arthroplasty and locking plate fixation are both established surgical procedures for the management of complex proximal humerus fractures in the elderly leading to similar functional results. However the revision rate in the rTSA group was significantly lower. Primary rTSA should, therefore, be favoured in multimorbid elderly patients with an increased complication risk to avoid repeated anaesthesia.
Collapse
Affiliation(s)
- M. Müller
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - F. Greve
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Crönlein
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Zyskowski
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - S. Pesch
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - P. Biberthaler
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - C. Kirchhoff
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Beirer
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| |
Collapse
|
44
|
Müller M, Igarashi A, Hashiguchi K, Kappel M, Paolini F, Yoshisue H, Funakubo M, Sharma H, Okano M. The impact of omalizumab on paid and unpaid work productivity among severe Japanese cedar pollinosis (JCP) patients. J Med Econ 2022; 25:220-229. [PMID: 35072591 DOI: 10.1080/13696998.2022.2033051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS Japanese cedar pollinosis (JCP) is a form of seasonal allergic rhinitis that affects 38.8% of the Japanese population. Particularly severe and most severe symptoms among JCP patients can lead to impairments of paid work productivity and unpaid work activities. Indeed, the current standard of care (SoC) is not always able to relieve these symptoms. Omalizumab, a novel JCP treatment recently approved in Japan, provides an effective add-on therapy to the SoC. This study estimates the effect of omalizumab on paid and unpaid work activities (i.e. its social impact) in patients with severe and most severe JCP symptoms in Japan. METHODS The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties. RESULTS Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD. CONCLUSIONS Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.
Collapse
Affiliation(s)
- M Müller
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - A Igarashi
- Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Yokohama, Japan
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - K Hashiguchi
- Unit of Otorhinolaryngology, Futaba Clinic, Tokyo, Japan
| | - M Kappel
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - F Paolini
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - H Yoshisue
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - M Funakubo
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - H Sharma
- Novartis Corporation Sdn. Bhd, Selangor, Malaysia
| | - M Okano
- School of Medicine, International University of Health and Welfare, Narita, Japan
| |
Collapse
|
45
|
Holfelder I, Wansleben M, Kayser Y, Gnewkow R, Müller M, Weser J, Zech C, Beckhoff B. A double crystal von Hamos spectrometer for traceable x-ray emission spectroscopy. Rev Sci Instrum 2021; 92:123105. [PMID: 34972394 DOI: 10.1063/5.0061183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/21/2021] [Indexed: 06/14/2023]
Abstract
A novel double full-cylinder crystal x-ray spectrometer for x-ray emission spectroscopy (XES) has been realized based on a modified von Hamos geometry. The spectrometer is characterized by its compact dimensions, its versatility with respect to the number of crystals used in series in the detection path, and the option to perform calibrated XES measurements. The full-cylinder crystals used are based on highly annealed pyrolytic graphite with a thickness of 40 μm, which was bent to a radius of curvature of 50 mm. The flexible design of the spectrometer allows for an easy change-within the same setup-between measurements with one crystal for maximized efficiency or two crystals for increased spectral resolving power. The spectrometer realized can be used at different end-stations of synchrotron radiation beamlines or can be laboratory-based. The main application focus of the spectrometer is the determination of x-ray fundamental atomic parameters in the photon energy range from 2.4 to 18 keV. The evaluation of chemical speciation is also an area of application, as demonstrated in the example of battery electrodes using resonant inelastic x-ray scattering.
Collapse
Affiliation(s)
- I Holfelder
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - M Wansleben
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - Y Kayser
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - R Gnewkow
- Analytical X-ray Physics, TU Berlin, Hardenbergstr. 36, 10623 Berlin, Germany
| | - M Müller
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - J Weser
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - C Zech
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - B Beckhoff
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| |
Collapse
|
46
|
Von Cossel M, Lebendig F, Müller M, Hieber C, Iqbal Y, Cohnen J, Jablonowski ND. Comparison of thermochemical conversion and anaerobic digestion of perennial flower-rich herbaceous wild plant species for bioenergy production. Bioresour Technol 2021; 340:125724. [PMID: 34391188 DOI: 10.1016/j.biortech.2021.125724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
The combustion quality of three perennial wild plant species Tanacetum vulgare L., Centaurea nigra L. and Artemisia vulgaris L. was investigated in comparison to the energy yield obtained from anaerobic digestions of these biomasses. Combustion resulted in 1.5-2.8 times higher energy yield compared to anaerobic digestion. All wild plants showed a similar higher heating value to Miscanthus × giganteus Greef et Deuter and Panicum virgatum L. (16.0-17.0 MJ kg-1). The ash-melting behavior of all wild plants was like Sida hermaphrodita L. Rusby, since the ash did not sinter at 1200 °C. However, Artemisia vulgaris L. had highest ash content (5.2-5.7% of dry matter) with a low ash melting behavior (1000 °C) attributed to a high potassium content and calculated phase composition. Therefore, careful consideration should be given to select the wild plants to meet the requirements for their use as solid biofuels in residential and commercial applications.
Collapse
Affiliation(s)
- M Von Cossel
- Biobased Resources in the Bioeconomy (340b), Institute of Crop Science, University of Hohenheim, Stuttgart, Germany.
| | - F Lebendig
- Institute of Energy and Climate Research, IEK-2, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - M Müller
- Institute of Energy and Climate Research, IEK-2, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - C Hieber
- Biobased Resources in the Bioeconomy (340b), Institute of Crop Science, University of Hohenheim, Stuttgart, Germany
| | - Y Iqbal
- College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha 410128, China
| | - J Cohnen
- Institute of Bio- and Geosciences, IBG-2: Plant Sciences, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - N D Jablonowski
- Institute of Bio- and Geosciences, IBG-2: Plant Sciences, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| |
Collapse
|
47
|
Lakatos LB, Christ M, Müller M, Bolognese M. „Stroke mimics“ – Differenzialdiagnose des Schlaganfalls in der Notfallmedizin. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00877-x] [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: 11/24/2022]
|
48
|
Iwe N, Raspe K, Müller M, Martinez F, Schweikhard L, Meiwes-Broer KH, Tiggesbäumker J. Size and charge-state dependence of detachment energies of polyanionic silver clusters. J Chem Phys 2021; 155:164303. [PMID: 34717355 DOI: 10.1063/5.0068278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The electronic properties of silver clusters (N up to 800) charged by attachment of up to z = 7 excess electrons are investigated. As an essential preparation step, the technique of in-trap electron attachment to size-selected monoanions within a linear Paul trap is applied. By taking advantage of tunable laser pulses, the photoelectron spectra allow us to evaluate details of the electronic structure of polyanionic metal clusters, giving a multidimensional dataset. The subsequent analysis based on the liquid drop model provides information about the atomic structure and the bulk work function at a hitherto unknown quality.
Collapse
Affiliation(s)
- N Iwe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - K Raspe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - M Müller
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - F Martinez
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - L Schweikhard
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - K-H Meiwes-Broer
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - J Tiggesbäumker
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| |
Collapse
|
49
|
Evert K, Kocher T, Schindler A, Müller M, Müller K, Pink C, Holtfreter B, Schmidt A, Dombrowski F, Schubert A, von Woedtke T, Rupf S, Calvisi DF, Bekeschus S, Jablonowski L. Repeated exposure of the oral mucosa over 12 months with cold plasma is not carcinogenic in mice. Sci Rep 2021; 11:20672. [PMID: 34667240 PMCID: PMC8526716 DOI: 10.1038/s41598-021-99924-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/28/2021] [Indexed: 01/20/2023] Open
Abstract
Peri-implantitis may result in the loss of dental implants. Cold atmospheric pressure plasma (CAP) was suggested to promote re-osseointegration, decrease antimicrobial burden, and support wound healing. However, the long-term risk assessment of CAP treatment in the oral cavity has not been addressed. Treatment with two different CAP devices was compared against UV radiation, carcinogen administration, and untreated conditions over 12 months. Histological analysis of 406 animals revealed that repeated CAP exposure did not foster non-invasive lesions or squamous cell carcinoma (SCCs). Carcinogen administration promoted non-invasive lesions and SCCs. Molecular analysis by a qPCR screening of 144 transcripts revealed distinct inflammatory profiles associated with each treatment regimen. Interestingly, CAP treatment of carcinogen-challenged mucosa did not promote but instead left unchanged or reduced the proportion of non-invasive lesions and SCC formation. In conclusion, repeated CAP exposure of murine oral mucosa was well tolerated, and carcinogenic effects did not occur, motivating CAP applications in patients for dental and implant treatments in the future.
Collapse
Affiliation(s)
- K Evert
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - T Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schindler
- Leibniz Institute of Surface Modification (IOM Leipzig), Leipzig, Germany.,Consultants PILOTO, Ion Beam & Plasma Surface Technologies, Grimma, Germany
| | - M Müller
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - K Müller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schmidt
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - F Dombrowski
- Institute of Pathology, University Medicine Greifswald, Greifswald, Germany
| | - A Schubert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
| | - T von Woedtke
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany.,Department of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - S Rupf
- Clinic of Operative Dentistry, Saarland University, Homburg, Germany
| | - D F Calvisi
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - S Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - L Jablonowski
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| |
Collapse
|
50
|
Sachno D, Carstensen S, Dahlmann F, Tillmann T, Sewald K, Müller M, Dasenbrock C, Bitsch A. Childhood Leukemia - Influence of Extremely Low Frequency Magnetic Fields on the Development of the Disease. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00691-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|