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Morrison CA, Auniņš A, Benkő Z, Brotons L, Chodkiewicz T, Chylarecki P, Escandell V, Eskildsen DP, Gamero A, Herrando S, Jiguet F, Kålås JA, Kamp J, Klvaňová A, Kmecl P, Lehikoinen A, Lindström Å, Moshøj C, Noble DG, Øien IJ, Paquet JY, Reif J, Sattler T, Seaman BS, Teufelbauer N, Trautmann S, van Turnhout CAM, Vořišek P, Butler SJ. Bird population declines and species turnover are changing the acoustic properties of spring soundscapes. Nat Commun 2021; 12:6217. [PMID: 34728617 PMCID: PMC8564540 DOI: 10.1038/s41467-021-26488-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Natural sounds, and bird song in particular, play a key role in building and maintaining our connection with nature, but widespread declines in bird populations mean that the acoustic properties of natural soundscapes may be changing. Using data-driven reconstructions of soundscapes in lieu of historical recordings, here we quantify changes in soundscape characteristics at more than 200,000 sites across North America and Europe. We integrate citizen science bird monitoring data with recordings of individual species to reveal a pervasive loss of acoustic diversity and intensity of soundscapes across both continents over the past 25 years, driven by changes in species richness and abundance. These results suggest that one of the fundamental pathways through which humans engage with nature is in chronic decline, with potentially widespread implications for human health and well-being.
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Affiliation(s)
- C A Morrison
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - A Auniņš
- Faculty of Biology, University of Latvia, Jelgavas iela 1, Riga, LV-1004, Latvia
- Latvian Ornithological Society, Skolas iela 3, Riga, LV-1010, Latvia
| | - Z Benkő
- Romanian Ornithological Society/BirdLife Romania, Cluj-Napoca, Romania
- Evolutionary Ecology Group, Hungarian Department of Biology and Ecology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - L Brotons
- InForest JRU (CTFC-CREAF), Solsona, 25280, Spain
- CREAF, Cerdanyola del Vallès, 08193, Barcelona, Spain
- CSIC, Cerdanyola del Vallès, 08193, Barcelona, Spain
| | - T Chodkiewicz
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, 00-679, Warszawa, Poland
- Polish Society for the Protection of Birds (OTOP), ul. Odrowaza 24, 05-270, Marki, Poland
| | - P Chylarecki
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, 00-679, Warszawa, Poland
| | - V Escandell
- Sociedad Española de Ornitología (SEO/BirdLife), Madrid, Spain
| | - D P Eskildsen
- Dansk Ornitologisk Forening, BirdLife Denmark, Vesterbrogade 138-140, DK-1620, København V, Denmark
| | - A Gamero
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
| | - S Herrando
- CREAF, Cerdanyola del Vallès, 08193, Barcelona, Spain
- European Bird Census Council-Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, 08019, Barcelona, Catalonia, Spain
| | - F Jiguet
- Centre d'Ecologie et des Sciences de la Conservation, UMR7204 MNHN-CNRS-SU, Paris, France
| | - J A Kålås
- Norwegian Institute for Nature Research, P.O. Box 5685, Torgarden, NO-7485, Trondheim, Norway
| | - J Kamp
- University of Göttingen, Department of Conservation Science, Bürgerstr. 50, 37073, Göttingen, Germany
- Dachverband Deutscher Avifaunisten (DDA), An den Speichern 2, 48157, Münster, Germany
| | - A Klvaňová
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
| | - P Kmecl
- DOPPS - BirdLife Slovenia, Tržaška cesta 2, SI-1000, Ljubljana, Slovenia
| | - A Lehikoinen
- Finnish Museum of Natural History, FI-00014 University of Helsinki, P.O. Box 17, Helsinki, Finland
| | - Å Lindström
- Biodiversity Unit, Department of Biology, Lund University, Ecology Building, S-223 62, Lund, Sweden
| | - C Moshøj
- Dansk Ornitologisk Forening, BirdLife Denmark, Vesterbrogade 138-140, DK-1620, København V, Denmark
| | - D G Noble
- British Trust for Ornithology, The Nunnery, Thetford, Norfolk, IP24 2PU, UK
| | - I J Øien
- NOF-BirdLife Norway, Sandgata 30 B, NO-7012, Trondheim, Norway
| | - J-Y Paquet
- Natagora, Département Études, Traverse des Muses 1, B-5000, Namur, Belgium
| | - J Reif
- Institute for Environmental Studies, Faculty of Science, Charles University in Prague, Prague, Czechia
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University Olomouc, 17 Listopadu 50, 771 43, Olomouc, Czechia
| | - T Sattler
- Swiss Ornithological Institute, Seerose 1, 6204, Sempach, Switzerland
| | - B S Seaman
- BirdLife Österreich, Museumsplatz 1/10/8, A-1070, Wien, Austria
| | - N Teufelbauer
- BirdLife Österreich, Museumsplatz 1/10/8, A-1070, Wien, Austria
| | - S Trautmann
- Dachverband Deutscher Avifaunisten (DDA), An den Speichern 2, 48157, Münster, Germany
| | - C A M van Turnhout
- Sovon Dutch Centre for Field Ornithology, P.O. Box 6521, 6503 GA, Nijmegen, Netherlands
- Department of Animal Ecology and Ecophysiology, Institute for Water and Wetland Research, Radboud University, P.O. Box 9010, 6500 GL, Nijmegen, Netherlands
| | - P Vořišek
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University Olomouc, 17 Listopadu 50, 771 43, Olomouc, Czechia
| | - S J Butler
- School of Biological Sciences, University of East Anglia, Norwich, UK.
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Pellissier V, Schmucki R, Pe'er G, Aunins A, Brereton TM, Brotons L, Carnicer J, Chodkiewicz T, Chylarecki P, Del Moral JC, Escandell V, Evans D, Foppen R, Harpke A, Heliölä J, Herrando S, Kuussaari M, Kühn E, Lehikoinen A, Lindström Å, Moshøj CM, Musche M, Noble D, Oliver TH, Reif J, Richard D, Roy DB, Schweiger O, Settele J, Stefanescu C, Teufelbauer N, Touroult J, Trautmann S, van Strien AJ, van Swaay CAM, van Turnhout C, Vermouzek Z, Voříšek P, Jiguet F, Julliard R. Effects of Natura 2000 on nontarget bird and butterfly species based on citizen science data. Conserv Biol 2020; 34:666-676. [PMID: 31701577 DOI: 10.1111/cobi.13434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
The European Union's Natura 2000 (N2000) is among the largest international networks of protected areas. One of its aims is to secure the status of a predetermined set of (targeted) bird and butterfly species. However, nontarget species may also benefit from N2000. We evaluated how the terrestrial component of this network affects the abundance of nontargeted, more common bird and butterfly species based on data from long-term volunteer-based monitoring programs in 9602 sites for birds and 2001 sites for butterflies. In almost half of the 155 bird species assessed, and particularly among woodland specialists, abundance increased (slope estimates ranged from 0.101 [SD 0.042] to 3.51 [SD 1.30]) as the proportion of landscape covered by N2000 sites increased. This positive relationship existed for 27 of the 104 butterfly species (estimates ranged from 0.382 [SD 0.163] to 4.28 [SD 0.768]), although most butterflies were generalists. For most species, when land-cover covariates were accounted for these positive relationships were not evident, meaning land cover may be a determinant of positive effects of the N2000 network. The increase in abundance as N2000 coverage increased correlated with the specialization index for birds, but not for butterflies. Although the N2000 network supports high abundance of a large spectrum of species, the low number of specialist butterflies with a positive association with the N2000 network shows the need to improve the habitat quality of N2000 sites that could harbor open-land butterfly specialists. For a better understanding of the processes involved, we advocate for standardized collection of data at N2000 sites.
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Affiliation(s)
- V Pellissier
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
- Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Aarhus, DK 8000, Denmark
| | - R Schmucki
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
- Centre de Synthèse et d'Analyse sur la Biodiversité, Immeuble Henri Poincaré, Domaine du Petit Arbois, Avenue Louis Philibert, Aix-en-Provence, 13857, France
- NERC Centre for Ecology & Hydrology, Wallingford, Oxfordshire, OX10 8EF, U.K
| | - G Pe'er
- German Centre for Integrative Biodiversity Research (iDiv), Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department Economics and Department Ecosystem Services, UFZ - Helmholtz Centre for Environmental Research, Permoserstr. 15, Leipzig, 04318, Germany
| | - A Aunins
- Faculty of Biology, University of Latvia, Jelgavas iela 1, Riga, LV-1004, Latvia
- Latvian Ornithological Society, Skolas iela 3, Riga, LV-1010, Latvia
| | - T M Brereton
- Butterfly Conservation, Manor Yard, East Lulworth, Wareham, Dorset, BH20 5QP, U.K
| | - L Brotons
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, Barcelona, Catalonia, 08019, Spain
- InForest JRU (CEMFOR-CTFC), Solsona, Catalonia, 25280, Spain
| | - J Carnicer
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Department of Evolutionary Biology, Ecology, and Environmental Sciences, University of Barcelona, Catalonia, 08028, Spain
| | - T Chodkiewicz
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, Warszawa, 00-679, Poland
- Polish Society for the Protection of Birds (OTOP), ul. Odrowaza 24, Marki, 05-270, Poland
| | - P Chylarecki
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, Warszawa, 00-679, Poland
| | - J C Del Moral
- Sociedad Española de Ornitología (SEO/BirdLife), Melquíades Biencinto 34 ES-28053, Madrid, Spain
| | - V Escandell
- Sociedad Española de Ornitología (SEO/BirdLife), Melquíades Biencinto 34 ES-28053, Madrid, Spain
| | - D Evans
- European Topic Centre on Biological Diversity, 57 rue Cuvier, Paris, 75005, France
| | - R Foppen
- Sovon Dutch Centre for Field Ornithology, PO Box 6521, Nijmegen, 6503 GA, The Netherlands
| | - A Harpke
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - J Heliölä
- Finnish Environment Institute (SYKE), Biodiversity Centre, P.O. Box 140, Helsinki, FI-00251, Finland
| | - S Herrando
- Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, Barcelona, Catalonia, 08019, Spain
- InForest JRU (CEMFOR-CTFC), Solsona, Catalonia, 25280, Spain
| | - M Kuussaari
- Finnish Environment Institute (SYKE), Biodiversity Centre, P.O. Box 140, Helsinki, FI-00251, Finland
| | - E Kühn
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - A Lehikoinen
- Finnish Museum of Natural History, University of Helsinki, P.O. Box 17, Helsinki, FI-00014, Finland
| | - Å Lindström
- Department of Biology, Biodiversity Unit, Lund University, Ecology Building, Lund, SE-223 62, Sweden
| | - C M Moshøj
- DOF-BirdLife Denmark, Vesterbrogade 140, Copenhagen V, DK-1620, Denmark
| | - M Musche
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - D Noble
- BTO, The Nunnery, Thetford, Norfolk, IP24 2PU, U.K
| | - T H Oliver
- School of Biological Sciences, Harborne Building, Whiteknights Campus, University of Reading, Berkshire, RG6 6AS, U.K
| | - J Reif
- Institute for Environmental Studies, Faculty of Science, Charles University, Prague, Czech Republic
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University in Olomouc, 17. listopadu 50, Olomouc, 771 43, Czech Republic
| | - D Richard
- European Topic Centre on Biological Diversity, 57 rue Cuvier, Paris, 75005, France
| | - D B Roy
- NERC Centre for Ecology & Hydrology, Wallingford, Oxfordshire, OX10 8EF, U.K
| | - O Schweiger
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - J Settele
- German Centre for Integrative Biodiversity Research (iDiv), Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - C Stefanescu
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Museu de Ciències Naturals de Granollers, Francesc Macià 51, Granollers, Catalonia, 08402, Spain
| | - N Teufelbauer
- BirdLife Austria, Museumplatz 1/10/8, Wien, A-1070, Austria
| | - J Touroult
- UMS 2006 PatriNat AFB, CNRS, MNHN; CP41, 36 rue Geoffroy Saint-Hilaire, Paris, 75005, France
| | - S Trautmann
- DDA, An den Speichern 6, Münster, 48157, Germany
| | | | - C A M van Swaay
- Dutch Butterfly Conservation and Butterfly Conservation Europe, P.O. Box 506 NL 6700 AM, Wageningen, The Netherlands
| | - C van Turnhout
- Sovon Dutch Centre for Field Ornithology, PO Box 6521, Nijmegen, 6503 GA, The Netherlands
- Department of Animal Ecology & Ecophysiology, Institute for Water and Wetland Research, Radboud University, P.O. Box 9010, Nijmegen, 6500 GL, The Netherlands
| | - Z Vermouzek
- Czech Society for Ornithology, Na Bělidle 252/34, Prague, CZ-150 00, Czech Republic
| | - P Voříšek
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University in Olomouc, 17. listopadu 50, Olomouc, 771 43, Czech Republic
- Czech Society for Ornithology, Na Bělidle 252/34, Prague, CZ-150 00, Czech Republic
| | - F Jiguet
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
| | - R Julliard
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
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Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
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Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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Trautmann S, Richard-Lacroix M, Dathe A, Schneidewind H, Dellith J, Fritzsche W, Deckert V. Plasmon response evaluation based on image-derived arbitrary nanostructures. Nanoscale 2018; 10:9830-9839. [PMID: 29774907 DOI: 10.1039/c8nr02783h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The optical response of realistic 3D plasmonic substrates composed of randomly shaped particles of different size and interparticle distance distributions in addition to nanometer scale surface roughness is intrinsically challenging to simulate due to computational limitations. Here, we present a Finite Element Method (FEM)-based methodology that bridges in-depth theoretical investigations and experimental optical response of plasmonic substrates composed of such silver nanoparticles. Parametrized scanning electron microscopy (SEM) images of surface enhanced Raman spectroscopy (SERS) active substrate and tip-enhanced Raman spectroscopy (TERS) probes are used to simulate the far-and near-field optical response. Far-field calculations are consistent with experimental dark field spectra and charge distribution images reveal for the first time in arbitrary structures the contributions of interparticle hybridized modes such as sub-radiant and super-radiant modes that also locally organize as basic units for Fano resonances. Near-field simulations expose the spatial position-dependent impact of hybridization on field enhancement. Simulations of representative sections of TERS tips are shown to exhibit the same unexpected coupling modes. Near-field simulations suggest that these modes can contribute up to 50% of the amplitude of the plasmon resonance at the tip apex but, interestingly, have a small effect on its frequency in the visible range. The band position is shown to be extremely sensitive to particle nanoscale roughness, highlighting the necessity to preserve detailed information at both the largest and the smallest scales. To the best of our knowledge, no currently available method enables reaching such a detailed description of large scale realistic 3D plasmonic systems.
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Affiliation(s)
- S Trautmann
- Leibniz Institute of photonic technology (IPHT), Albert-Einstein-Straße 9, D-07745 Jena, Germany.
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Trautmann S, Goodwin L, Höfler M, Jacobi F, Strehle J, Zimmermann P, Wittchen HU. Prevalence and severity of mental disorders in military personnel: a standardised comparison with civilians. Epidemiol Psychiatr Sci 2017; 26:199-208. [PMID: 27086743 PMCID: PMC6998688 DOI: 10.1017/s204579601600024x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 10/27/2015] [Accepted: 03/22/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS Provision and need for mental health services among military personnel are a major concern across nations. Two recent comparisons suggest higher rates of mental disorders in US and UK military personnel compared with civilians. However, these findings may not apply to other nations. Previous studies have focused on the overall effects of military service rather than the separate effects of military service and deployment. This study compared German military personnel with and without a history of deployment to sociodemographically matched civilians regarding prevalence and severity of 12-month DSM-IV mental disorders. METHOD 1439 deployed soldiers (DS), 779 never deployed soldiers (NS) and 1023 civilians were assessed with an adapted version of the Munich Composite International Diagnostic interview across the same timeframe. Data were weighted using propensity score methodology to assure comparability of the three samples. RESULTS Compared with adjusted civilians, the prevalence of any 12-month disorder was lower in NS (OR: 0.7, 95% CI: 0.5-0.99) and did not differ in DS. Significant differences between military personnel and civilians regarding prevalence and severity of individual diagnoses were only apparent for alcohol (DS: OR: 0.3, 95% CI: 0.1-0.6; NS: OR: 0.2, 95% CI: 0.1-0.6) and nicotine dependence (DS: OR: 0.5, 95% CI: 0.3-0.6; NS: OR: 0.5, 95% CI: 0.3-0.7) with lower values in both military samples. Elevated rates of panic/agoraphobia (OR: 2.7, 95% CI: 1.4-5.3) and posttraumatic stress disorder (OR: 3.2, 95% CI: 1.3-8.0) were observed in DS with high combat exposure compared with civilians. CONCLUSIONS Rates and severity of mental disorders in the German military are comparable with civilians for internalising and lower for substance use disorders. A higher risk of some disorders is reduced to DS with high combat exposure. This finding has implications for mental health service provision and the need for targeted interventions. Differences to previous US and UK studies that suggest an overall higher prevalence in military personnel might result from divergent study methods, deployment characteristics, military structures and occupational factors. Some of these factors might yield valuable targets to improve military mental health.
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Affiliation(s)
- S. Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L. Goodwin
- Department of Psychological Medicine, King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - F. Jacobi
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J. Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - P. Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H.-U. Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Trautmann S, Aizpurua J, Götz I, Undisz A, Dellith J, Schneidewind H, Rettenmayr M, Deckert V. A classical description of subnanometer resolution by atomic features in metallic structures. Nanoscale 2017; 9:391-401. [PMID: 27924333 DOI: 10.1039/c6nr07560f] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Recent experiments have evidenced sub-nanometer resolution in plasmonic-enhanced probe spectroscopy. Such a high resolution cannot be simply explained using the commonly considered radii of metallic nanoparticles on plasmonic probes. In this contribution the effects of defects as small as a single atom found on spherical plasmonic particles acting as probing tips are investigated in connection with the spatial resolution provided. The presence of abundant edge and corner sites with atomic scale dimensions in crystalline metallic nanoparticles is evident from transmission electron microscopy (TEM) images. Electrodynamic calculations based on the Finite Element Method (FEM) are implemented to reveal the impact of the presence of such atomic features in probing tips on the lateral spatial resolution and field localization. Our analysis is developed for three different configurations, and under resonant and non-resonant illumination conditions, respectively. Based on this analysis, the limits of field enhancement, lateral resolution and field confinement in plasmon-enhanced spectroscopy and microscopy are inferred, reaching values below 1 nanometer for reasonable atomic sizes.
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Affiliation(s)
- S Trautmann
- Leibniz Institute of photonic technology (IPHT), Albert-Einstein-Straße 9, D-07745 Jena, Germany.
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Trautmann S, Schönfeld S, Heinrich A, Schäfer J, Zimmermann P, Wittchen H. Risk Factors for Common Mental Disorders in the Context of Military Deployment: a Longitudinal Study. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30244-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Trautmann S, Schönfeld S, Behrendt S, Heinrich A, Höfler M, Siegel S, Zimmermann P, Wittchen HU. Predictors of changes in daily alcohol consumption in the aftermath of military deployment. Drug Alcohol Depend 2015; 147:175-82. [PMID: 25499731 DOI: 10.1016/j.drugalcdep.2014.11.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/22/2014] [Accepted: 11/21/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have documented factors related to increase in alcohol consumption in the context of stressful experiences. However, little is known about predictors of different courses of alcohol use in this context. This study aims to investigate diverse predictors and correlates of increase and decrease of average daily alcohol consumption (aDAC) in the aftermath of military deployment taking into account a variety of potentially relevant factors. METHODS N=358 soldiers were examined before (T1) and 12 months after return from deployment (T2) using standardized interviews. Change in aDAC was categorized into decreased (n=72), stable (n=215) and increased (n=71) aDAC. RESULTS Overall, aDAC did not change significantly between T1 and T2 (median change=0.0 g, inter quartile range=11.3g). Compared to stable aDAC, increase was characterized by a lower proportion of high-educated individuals (OR: 0.3 (0.1-0.7), p=0.008), lower rank (marginally significant: OR: 2.0 (1.0-4.1), p=0.050), and less acceptance (trend: MR: 0.97 (0.93-1.00), p=0.053). Correlates of increased aDAC were less social support (MR: 0.84 (0.71-0.99), p=0.043), more sleeping problems (MR: 1.15 (1.00-1.31), p=0.045) and more negative post-event cognitions following deployment (MR: 2.32 (1.28-4.21), p=0.006). Decrease in aDAC was predicted by lower PTSD symptom severity before deployment (MR: 0.34 (0.16-0.72), p=0.005) and less childhood emotional neglect (marginally significant: MR: 0.78 (0.60-1.00), p=0.050). CONCLUSIONS Increase and decrease in alcohol use after stressful experiences might have differential risk factors and correlates. Findings might stimulate future research that could result in improved measures to prevent increases as well as in interventions that could foster decreases in alcohol consumption in the context of stressful experiences.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - A Heinrich
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - S Siegel
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - P Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
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Trautmann S, Schönfeld S, Behrendt S, Schäfer J, Höfler M, Zimmermann P, Wittchen HU. Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD. J Anxiety Disord 2015; 29:93-100. [PMID: 25527901 DOI: 10.1016/j.janxdis.2014.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 07/01/2014] [Revised: 11/16/2014] [Accepted: 11/17/2014] [Indexed: 11/30/2022]
Abstract
This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Schäfer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - P Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Trautmann S, Schönfeld S, Behrendt S, Höfler M, Zimmermann P, Wittchen HU. Substance use and substance use disorders in recently deployed and never deployed soldiers. Drug Alcohol Depend 2014; 134:128-135. [PMID: 24210162 DOI: 10.1016/j.drugalcdep.2013.09.024] [Citation(s) in RCA: 20] [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: 05/28/2013] [Revised: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Military studies investigating the prevalence of substance use (SU) and substance use disorders (SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. METHODS Cross-sectional examination of n=1483 soldiers recently deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI) including a comprehensive substance section. RESULTS Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1% were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates in some measures, there were no significant differences to the never deployed regarding SU und SUD except that recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders was substantially different though, revealing significant associations between SU and mental disorders only among recently deployed soldiers. CONCLUSIONS We do not find remarkable differences in the prevalence of SU and SUD between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders are only associated in recently deployed soldiers might have implications for improved screening and prevention and suggests that deployment might promote different pathways and mechanisms involved in the evolution of SU and mental disorders.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - P Zimmermann
- "Center of Military Mental Health" (Zentrum für Psychiatrie und Psychotraumatologie am Bundeswehrkrankenhaus), 10115 Berlin, Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
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Beckmann H, Rumpf S, Bechtel N, Lange H, Saft C, Hoffmann R, Kraus P, Barth K, Trautmann S, Landwehrmeyer B, Reilmann R. Gait and posture in pre-manifest and symptomatic huntington's disease. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Beckmann H, Rumpf S, Bechtel N, Lange HW, Saft C, Hoffmann R, Kraus P, Barth K, Trautmann S, Landwehrmeyer B, Reilmann R. Objective motor phenotype assessment of gait and posture in pre-manifest and symptomatic Huntington's disease. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hochauf K, Bandt D, Pöhlmann C, Monecke S, Toma M, Trautmann S. Fatal varicella zoster virus infection as first manifestation of idiopathic CD4+ T-cell lymphocytopenia. Eur J Clin Microbiol Infect Dis 2006; 24:706-8. [PMID: 16261302 DOI: 10.1007/s10096-005-0033-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- K Hochauf
- Institute of Medical Microbiology and Hygiene, Faculty of Medicine Carl Gustav Carus, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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Abstract
The study presents a case of non-fatal poisoning with oleander blooms in a 47-year-old female, with emphasis on the importance of toxicological service in a clinical emergency. After repeated vomiting at home, the patient was admitted at the hospital with cardiac symptoms more than 18 h after the ingestion. Serum samples were assayed immunochemically for digitoxin-related compounds by electrochemiluminescent immunoassay, and using HPLC/MS/MS analysis for oleandrin, the main cardiac glycoside of Nerium oleander. Confirming the non-specific immunoassay results, which are often clinically over-interpreted, oleandrin was detected by HPLC/MS/MS in the serum sample in a concentration of 1.6 ng/ml upon admission. Comparison with previous reports indicates that single compound analysis only permits a toxicological assessment for oleander poisoning and results in the proposal to classify an oleandrin level between 1.0 and 2.0 ng/ml as toxic blood plasma/serum concentration.
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Affiliation(s)
- J Pietsch
- Institute of Legal Medicine, Medical Faculty Carl Gustav Carus, Dresden Technical University, Fetscherstr. 74, 01307, Dresden, Germany.
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Trautmann S, Wolfe BA, Jorgensen P, Tyers M, Gould KL, McCollum D. Fission yeast Clp1p phosphatase regulates G2/M transition and coordination of cytokinesis with cell cycle progression. Curr Biol 2001; 11:931-40. [PMID: 11448769 DOI: 10.1016/s0960-9822(01)00268-8] [Citation(s) in RCA: 154] [Impact Index Per Article: 6.7] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Saccharomyces cerevisiae the mitotic-exit network (MEN) functions in anaphase to promote the release of the Cdc14p phosphatase from the nucleolus. This release causes mitotic exit via inactivation of the cyclin-dependent kinase (Cdk). Cdc14p-like proteins are highly conserved; however, it is unclear if these proteins regulate mitotic exit as in S. cerevisiae. In Schizosaccharomyces pombe a signaling pathway homologous to the MEN and termed the septation initiation network (SIN) is required not for mitotic exit, but for initiation of cytokinesis and for a cytokinesis checkpoint that inhibits further cell cycle progression until cytokinesis is complete. RESULTS We have identified the S. pombe Cdc14p homolog, Clp1p, and show that it is not required for mitotic exit but rather functions together with the SIN in coordinating cytokinesis with the nuclear-division cycle. As cells enter mitosis, Clp1p relocalizes from the nucleolus to the spindle and site of cell division. Clp1p exit from the nucleolus does not depend on the SIN, but the SIN is required for keeping Clp1p out of the nucleolus until completion of cytokinesis. Clp1p, in turn, may promote the activation of the SIN by antagonizing Cdk activity until cytokinesis is complete and thus ensuring that cytokinesis is completed prior to the initiation of the next cell cycle. In addition to its roles in anaphase, Clp1p regulates the G2/M transition since cells deleted for clp1 enter mitosis precociously and cells overexpressing Clp1p delay mitotic entry. Unlike Cdc14p, Clp1p appears to antagonize Cdk activity by preventing dephosphorylation of Cdc2p on tyrosine. CONCLUSIONS S. pombe Clp1p affects cell cycle progression in a markedly different manner than its S. cerevisiae homolog, Cdc14p. This finding raises the possibility that related phosphatases in animal cells will prove to have important roles in coordinating the onset of cytokinesis with the events of mitosis.
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Affiliation(s)
- S Trautmann
- Department of Molecular Genetics and Microbiology, University of Massachusetts Medical School, Worcester, MA 01605, USA
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Abstract
In eukaryotes, mitotic cyclins localize differently in the cell and regulate different aspects of the cell cycle. We investigated the relationship between subcellular localization of cyclins A and B and their functions in syncytial preblastoderm Drosophila embryos. During early embryonic cycles, cyclin A was always concentrated in the nucleus and present at a low level in the cytoplasm. Cyclin B was predominantly cytoplasmic, and localized within nuclei only during late prophase. Also, cyclin B colocalized with metaphase but not anaphase spindle microtubules. We changed maternal gene doses of cyclins A and B to test their functions in preblastoderm embryos. We observed that increasing doses of cyclin B increased cyclin B-Cdk1 activity, which correlated with shorter microtubules and slower microtubule-dependent nuclear movements. This provides in vivo evidence that cyclin B-Cdk1 regulates microtubule dynamics. In addition, the overall duration of the early nuclear cycles was affected by cyclin A but not cyclin B levels. Taken together, our observations support the hypothesis that cyclin B regulates cytoskeletal changes while cyclin A regulates the nuclear cycles. Varying the relative levels of cyclins A and B uncoupled the cytoskeletal and nuclear events, so we speculate that a balance of cyclins is necessary for proper coordination during these embryonic cycles.
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Affiliation(s)
- L A Stiffler
- Department of Zoology, Box 351800, University of Washington, Seattle, WA 98195-1800, USA
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18
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Espinola-Klein C, Rupprecht HJ, Trautmann S, Nafe B, Erbel R, Brennecke R, Pop T, Meyer J. [Long term course over 10 years after balloon dilatation in stable and unstable angina pectoris]. Dtsch Med Wochenschr 1996; 121:577-82. [PMID: 8625784 DOI: 10.1055/s-2008-1043042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To assess the cardiac status of patients ten years after percutaneous transluminal coronary artery angioplasty (PTCA). PATIENTS AND METHODS Data of 534 patients (436 men, 98 women; mean age 53.2 +/- 8 years) in whom a PTCA had been performed between 1983 and 1986 were analysed, based on a questionnaire answered 121 +/- 11 months after the initial procedure. At the time of PTCA 184 patients (35%) had unstable angina, 350 (65%) stable angina. RESULTS 116 patients (63%) with unstable angina and 164 (47%) with stable angina had at least one cardiac event after the initial PTCA (repeat PTCA, bypass operation, myocardial infarction, death). None of these events occurred in 68 patients (37%) with unstable or in 186 (53%) with stable angina (P < 0.001). After 10 years 196 of the 302 surviving patients with stable angina (65%) and 104 of the 153 surviving patients with unstable angina (68%) were symptom-free. CONCLUSIONS Ten-year follow-up after PTCA has shown that cardiac events are significantly more frequent in patients who had had unstable angina than in those with stable angina. This difference already develops in the first year post-PTCA, with no increase later. Symptoms are lastingly improved after 10 years in both groups of patients.
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Nixdorff U, Erbel R, Rupprecht HJ, Kearney P, Trautmann S, Meyer J. Noninvasive visualization of an apparent patent intracoronary stent by transesophageal echocardiography. Echocardiography 1995; 12:391-5. [PMID: 10150782 DOI: 10.1111/j.1540-8175.1995.tb00563.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In the area of increasing interventional techniques there is a need for noninvasive imaging modalities to provide postinterventional follow-up. We were able to visualize the apparent patency and measure the dimensions of an intracoronary Palmaz-Schatz stent in the left circumflex coronary artery using transesophageal two-dimensional echocardiography. This report indicates the potential of echocardiography to directly assess coronary stents.
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Affiliation(s)
- U Nixdorff
- II. Medical Clinic, Johannes Gutenberg-University, Mainz, Germany
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Rupprecht HJ, Oelert H, Trautmann S, Pop T, Iversen S, Erbel R, Meyer J. PTCA of the left main stem following protective coronary artery bypass grafting. Eur J Cardiothorac Surg 1991; 5:326-9. [PMID: 1873040 DOI: 10.1016/1010-7940(91)90044-k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Percutaneous transluminal coronary angioplasty (PTCA) was performed in 14 patients with significant left main stem stenosis following protective coronary artery bypass grafting (CABG). The procedure was successful in 13/14 patients (93%), achieving a decrease in mean diameter stenosis from 74% +/- 7% to 31% +/- 12% (P less than 0.01). Accordingly, the absolute stenosis diameter increased from 0.9 mm +/- 0.3 mm to 2.4 mm +/- 0.5 mm (P less than 0.01). Dissection of the left main stem artery and a transient significant fall of blood pressure each occurred in one patient. No other serious complications were noted. Eight of 13 patients (62%) with successful PTCA underwent control angiography. Restenosis had occurred in 3 of 8 patients (38%) with total occlusion of the left main stem in 1 patient. All bypass grafts were found to be patent at follow-up. Clinical evaluation in all 14 patients revealed no serious events (death, myocardial infarction, repeat revascularization procedure) during a mean follow-up period of 27 months (range 6-39 months). PTCA of the left main stem following CABG can be considered a relatively safe and effective procedure with a marked restenosis-rate but beyond that, an uncomplicated long-term follow-up.
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Affiliation(s)
- H J Rupprecht
- Second Medical Clinic, Johannes Gutenberg University, Mainz, FRG
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