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van der Weijden J, De Hoogt PA, Leufkens MME, Keijbeck AA, van Goor H, van den Heuvel MC, Cleutjens JPM, Moers C, Snoeijs MG, Navis GJ, van Londen M, Nolte IM, Berger SP, De Borst MH, Peutz-Kootstra CJ. The relationship of peritubular capillary density with glomerular volume and kidney function in living kidney donors. J Nephrol 2023; 36:2111-2124. [PMID: 37768545 PMCID: PMC10543576 DOI: 10.1007/s40620-023-01734-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/03/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Peritubular capillary rarefaction plays an important role in the progression of chronic kidney disease. Little is known about the relation between peritubular capillary density, glomerular volume and filtration rate in the healthy kidney. METHODS In this single-center study, we included 69 living kidney donors who donated between 2005 and 2008 and had representative renal biopsies available. In all donors, glomerular filtration rate was measured using 125I-Iothalamate before donation and at five years after donation. Before donation, the increase in glomerular filtration rate after dopamine stimulation was measured. Glomerular volume and peritubular capillary density were determined in biopsies taken at the time of transplantation. Pearson's correlation coefficient and linear regression were used to assess relations between parameters. RESULTS Mean donor age was 52 ± 11 years and mean measured glomerular filtration rate was 119 ± 22 mL/min before donation and 82 ± 15 mL/min at five years after donation. While peritubular capillary density (measured by either number of peritubular capillaries/50,000 μm2 or number of peritubular capillaries/tubule) was not associated with measured glomerular filtration rate before or after donation, number of peritubular capillaries/tubule was associated with the increase in measured glomerular filtration rate after dopamine stimulation (St.β = 0.33, p = 0.004), and correlated positively with glomerular volume (R = 0.24, p = 0.047). Glomerular volume was associated with unstimulated measured glomerular filtration rate before donation (St.β = 0.31, p = 0.01) and at five years (St.β = 0.30, p = 0.01) after donation, independent of age. CONCLUSIONS In summary, peritubular capillary density was not related to unstimulated kidney function before or after kidney donation, in contrast to glomerular volume. However, number of peritubular capillaries/tubule correlated with the increase in glomerular filtration rate after dopamine stimulation in healthy kidneys, and with glomerular volume. These findings suggest that peritubular capillary density and glomerular volume differentially affect kidney function in healthy living kidney donors.
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Affiliation(s)
- J van der Weijden
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box AA53, 9713 GZ, Groningen, The Netherlands.
| | - P A De Hoogt
- Department of Vascular Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M M E Leufkens
- Department of Pathology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - A A Keijbeck
- Department of Pathology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - H van Goor
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M C van den Heuvel
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J P M Cleutjens
- Department of Pathology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - C Moers
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M G Snoeijs
- Department of Vascular Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - G J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box AA53, 9713 GZ, Groningen, The Netherlands
| | - M van Londen
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box AA53, 9713 GZ, Groningen, The Netherlands
| | - I M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S P Berger
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box AA53, 9713 GZ, Groningen, The Netherlands
| | - M H De Borst
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box AA53, 9713 GZ, Groningen, The Netherlands
| | - C J Peutz-Kootstra
- Department of Pathology, Maastricht University Medical Center+, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
- Department of Pathology, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
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Berger S, Barnett N, Thakur S. Using Auto-Videosomnography to Study the Relation between Sleep and Nightwaking in Infancy. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Berger S, Barnett N, Thakur S. Parents’ Values Shape Parenting Practices and Beliefs that Impact Infant Sleep. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Berger S, Hinse P, Eschenburg S, Reubold T. Structural and functional characterization of altronate oxidoreductase from Escherichia coli. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322093561] [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]
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Grootjans H, Verschuuren E, van Gemert A, Berger S, Kerstjens H, Droogh J, Gan T. Long-Term Renal Outcome in Patients Bridged on ICU for Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1058] [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: 11/16/2022] Open
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Joachim A, Cavalleri JMV, Berger S. [Equine anaplasmosis and equine piroplasmosis in Germany, Austria and Switzerland - previously anecdotal, now relevant?]. SCHWEIZ ARCH TIERH 2022; 164:35-50. [PMID: 34983738 DOI: 10.17236/sat00335] [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: 11/06/2022]
Abstract
INTRODUCTION Equine granulocytic anaplasmosis (EGA) and equine piroplasmosis (EP) are triggered by tick-borne pathogens - the intracellular bacterium Anaplasma phagocytophilum and the intracellular protozoa Babesia caballi and Theileria equi. These pathogens attack cells in the blood stream and cause similar clinical symptoms and changes in laboratory values. Although the treatment principles are naturally different, similarities in prophylaxis exists due to the transmission route. Tick transmitted pathogens can play a greater role in equine medicine in the future due to various factors, such as the tendency of relevant tick species to spread, but also the increasing import and travel activities of and with pets (both in the context of sporting events and as a leisure activity). While EGA is endemic in Central Europe, EP is a sporadic disease in Switzerland, Austria and Germany. However, EP must be viewed as underdiagnosed, as horses persistently infected with T. equi are also repeatedly detected in Central Europe. These diseases should be considered in horses with a fever and corresponding laboratory changes. Available diagnostic tests are direct pathogen detection by blood smear or PCR, and, indirect antibody detection, which is considered to be highly sensitive and (as a competitive ELISA) also very specific. Acute infections can be detected with PCR, serology is more suitable for chronic infections. A pathogen-free condition after treatment can be demonstrated with decreasing antibody titers in combination with repeated PCR tests. In addition, clinically healthy horses infected with T. equi should be identified by antibody detection and appropriate preventative transmission measures must be initiated. The prophylaxis of tick bites in horses is difficult due to the high exposure, and long-term tick bite prevention can hardly be guaranteed. Monitoring of tick activity and strict measures to prevent the spread of the pathogen within the tick population are therefore of great importance.
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Affiliation(s)
- A Joachim
- Institut für Parasitologie, Vetmeduni Wien, Österreich
| | | | - S Berger
- Universitätsklinik für Pferde, Vetmeduni Wien, Österreich
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Berger S, Shaw DR, Berben T, Ouboter HT, In 't Zandt MH, Frank J, Reimann J, Jetten MSM, Welte CU. Current production by non-methanotrophic bacteria enriched from an anaerobic methane-oxidizing microbial community. Biofilm 2021; 3:100054. [PMID: 34308332 PMCID: PMC8258643 DOI: 10.1016/j.bioflm.2021.100054] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
In recent years, the externalization of electrons as part of respiratory metabolic processes has been discovered in many different bacteria and some archaea. Microbial extracellular electron transfer (EET) plays an important role in many anoxic natural or engineered ecosystems. In this study, an anaerobic methane-converting microbial community was investigated with regard to its potential to perform EET. At this point, it is not well-known if or how EET confers a competitive advantage to certain species in methane-converting communities. EET was investigated in a two-chamber electrochemical system, sparged with methane and with an applied potential of +400 mV versus standard hydrogen electrode. A biofilm developed on the working electrode and stable low-density current was produced, confirming that EET indeed did occur. The appearance and presence of redox centers at −140 to −160 mV and at −230 mV in the biofilm was confirmed by cyclic voltammetry scans. Metagenomic analysis and fluorescence in situ hybridization of the biofilm showed that the anaerobic methanotroph ‘Candidatus Methanoperedens BLZ2’ was a significant member of the biofilm community, but its relative abundance did not increase compared to the inoculum. On the contrary, the relative abundance of other members of the microbial community significantly increased (up to 720-fold, 7.2% of mapped reads), placing these microorganisms among the dominant species in the bioanode community. This group included Zoogloea sp., Dechloromonas sp., two members of the Bacteroidetes phylum, and the spirochete Leptonema sp. Genes encoding proteins putatively involved in EET were identified in Zoogloea sp., Dechloromonas sp. and one member of the Bacteroidetes phylum. We suggest that instead of methane, alternative carbon sources such as acetate were the substrate for EET. Hence, EET in a methane-driven chemolithoautotrophic microbial community seems a complex process in which interactions within the microbial community are driving extracellular electron transfer to the electrode.
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Affiliation(s)
- S Berger
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - D R Shaw
- Biological and Environmental Science and Engineering Division, Water Desalination and Reuse Research Center, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - T Berben
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - H T Ouboter
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - M H In 't Zandt
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Netherlands Earth System Science Center, Utrecht University, Utrecht, the Netherlands
| | - J Frank
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - J Reimann
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands
| | - M S M Jetten
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Netherlands Earth System Science Center, Utrecht University, Utrecht, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
| | - C U Welte
- Institute for Water and Wetland Research, Department of Microbiology, Radboud University, Nijmegen, the Netherlands.,Soehngen Institute of Anaerobic Microbiology, Radboud University, Nijmegen, the Netherlands
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de Boer SE, Sanders JSF, Bemelman FJ, Betjes MGH, Burgerhof JGM, Hilbrands L, Kuypers D, van Munster BC, Nurmohamed SA, de Vries APJ, van Zuilen AD, Hesselink DA, Berger SP. Rationale and design of the OPTIMIZE trial: OPen label multicenter randomized trial comparing standard IMmunosuppression with tacrolimus and mycophenolate mofetil with a low exposure tacrolimus regimen In combination with everolimus in de novo renal transplantation in Elderly patients. BMC Nephrol 2021; 22:208. [PMID: 34078323 PMCID: PMC8172178 DOI: 10.1186/s12882-021-02409-8] [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: 04/09/2021] [Accepted: 05/18/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In 2019, more than 30 % of all newly transplanted kidney transplant recipients in The Netherlands were above 65 years of age. Elderly patients are less prone to rejection, and death censored graft loss is less frequent compared to younger recipients. Elderly recipients do have increased rates of malignancy and infection-related mortality. Poor kidney transplant function in elderly recipients may be related to both pre-existing (i.e. donor-derived) kidney damage and increased susceptibility to nephrotoxicity of calcineurin inhibitors (CNIs) in kidneys from older donors. Hence, it is pivotal to shift the focus from prevention of rejection to preservation of graft function and prevention of over-immunosuppression in the elderly. The OPTIMIZE study will test the hypothesis that reduced CNI exposure in combination with everolimus will lead to better kidney transplant function, a reduced incidence of complications and improved health-related quality of life for kidney transplant recipients aged 65 years and older, compared to standard immunosuppression. METHODS This open label, randomized, multicenter clinical trial will include 374 elderly kidney transplant recipients (≥ 65 years) and consists of two strata. Stratum A includes elderly recipients of a kidney from an elderly deceased donor and stratum B includes elderly recipients of a kidney from a living donor or from a deceased donor < 65 years. In each stratum, subjects will be randomized to a standard, tacrolimus-based immunosuppressive regimen with mycophenolate mofetil and glucocorticoids or an adapted immunosuppressive regimen with reduced CNI exposure in combination with everolimus and glucocorticoids. The primary endpoint is 'successful transplantation', defined as survival with a functioning graft and an eGFR ≥ 30 ml/min per 1.73 m2 in stratum A and ≥ 45 ml/min per 1.73 m2 in stratum B, after 2 years, respectively. CONCLUSIONS The OPTIMIZE study will help to determine the optimal immunosuppressive regimen after kidney transplantation for elderly patients and the cost-effectiveness of this regimen. It will also provide deeper insight into immunosenescence and both subjective and objective outcomes after kidney transplantation in elderly recipients. TRIAL REGISTRATION ClinicalTrials.gov: NCT03797196 , registered January 9th, 2019. EudraCT: 2018-003194-10, registered March 19th, 2019.
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Affiliation(s)
- S E de Boer
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - J S F Sanders
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F J Bemelman
- Department of Internal Medicine, Division of Nephrology, Amsterdam Universal Medical Center, Amsterdam, The Netherlands
| | - M G H Betjes
- Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J G M Burgerhof
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L Hilbrands
- Department of Internal Medicine, Division of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D Kuypers
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - B C van Munster
- Department of Internal Medicine, Divison of Geriatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - S A Nurmohamed
- Department of Internal Medicine, Division of Nephrology, Amsterdam Universal Medical Center, Amsterdam, The Netherlands
| | - A P J de Vries
- Department of Internal Medicine, Division of Nephrology; and Leiden Transplant Center, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
| | - A D van Zuilen
- Department of Internal Medicine, Division of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D A Hesselink
- Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S P Berger
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ducoli L, Agrawal S, Sibler E, Kouno T, Tacconi C, Hon C, Berger S, Müllhaupt D, He Y, Kim J, D’Addio M, Dieterich L, Carninci P, de Hoon M, Shin J, Detmar M. 152 LETR1 is a lymphatic endothelial-specific lncRNA governing cell proliferation and migration through KLF4 and SEMA3C. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.172] [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: 11/17/2022]
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Zehetner V, Lipnik K, Url A, de Heus P, Fröhlich W, Cavalleri JMV, Berger S. Pulmonary fibrosis in a donkey. PFERDEHEILKUNDE 2021. [DOI: 10.21836/pem20210505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Scabia G, Cancello R, Dallanoce C, Berger S, Matera C, Dattilo A, Zulian A, Barone I, Ceccarini G, Santini F, De Amici M, Di Blasio AM, Maffei M. ICH3, a selective alpha7 nicotinic acetylcholine receptor agonist, modulates adipocyte inflammation associated with obesity. J Endocrinol Invest 2020; 43:983-993. [PMID: 31965518 DOI: 10.1007/s40618-020-01182-z] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The alpha7 nicotinic acetylcholine receptor (α7nAChR), involved in the modulation of inflammation and insulin sensitivity, is downregulated in white adipose tissue (WAT) of obese patients. This study aims to test the ability of a selective synthetic α7nAChR agonist, the spirocyclic Δ2-isoxazoline derivative (R)-(-)-ICH3 (ICH3), to counteract acute inflammation and obesity-associated modifications in WAT. METHODS We employed the LPS-septic shock murine model, human primary adipocytes and diet-induced obese (DIO) mice. Inflammatory factor expression was assessed by ELISA and quantitative real-time PCR. Flow cytometry was employed to define WAT inflammatory infiltrate. Insulin signaling was monitored by quantification of AKT phosphorylation. RESULTS In the septic shock model, ICH3 revealed antipyretic action and reduced the surge of circulating cytokines. In vitro, ICH3 stimulation (10 µM) preserved viability of human adipocytes, decreased IL-6 mRNA (P < 0.05) and blunted LPS-induced peak of TNFα (P < 0.05) and IL-6 (P < 0.01). Chronic administration of ICH3 to DIO mice was associated with lower numbers of CD8+ T cells (P < 0.05) and to changed WAT expression of inflammatory factors (Hp, P < 0.05; CD301/MGL1, P < 0.01; Arg-1, P < 0.05). As compared to untreated, ICH3 DIO mice exhibited improved insulin signaling in the skeletal muscle (P < 0.01) mirrored by an improved response to glucose load (ipGTT: P < 0.05 at 120 min). CONCLUSIONS We proved that ICH3 is an anti-inflammatory drug, able to reduce inflammatory cytokines in human adipocytes and to blunt the effects of obesity on WAT inflammatory profile, on glucose tolerance and on tissue insulin sensitivity.
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Affiliation(s)
- G Scabia
- CNR Institute of Clinical Physiology, Pisa, Italy
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
| | - R Cancello
- Laboratorio di Ricerche Sull'Obesità, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - C Dallanoce
- Department of Pharmaceuticals Sciences, University of Milano, Milan, Italy
| | - S Berger
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
- Dulbecco Telethon Institute, Pisa, Italy
| | - C Matera
- Department of Pharmaceuticals Sciences, University of Milano, Milan, Italy
| | - A Dattilo
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
- Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - A Zulian
- Laboratorio di Ricerche Sull'Obesità, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - I Barone
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
| | - G Ceccarini
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
| | - F Santini
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy
| | - M De Amici
- Department of Pharmaceuticals Sciences, University of Milano, Milan, Italy
| | - A M Di Blasio
- Laboratorio di Ricerche di Biologia Molecolare, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
| | - M Maffei
- CNR Institute of Clinical Physiology, Pisa, Italy.
- Obesity and Lipodystrophy Center at Endocrinology Unit, University Hospital of Pisa, Pisa, Italy.
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Kutschar P, Berger S, Brandauer A, Freywald N, Osterbrink J, Seidenspinner D, Gnass I. Nursing Education Intervention Effects on Pain Intensity of Nursing Home Residents with Different Levels of Cognitive Impairment: A Cluster-Randomized Controlled Trial. J Pain Res 2020; 13:633-648. [PMID: 32273749 PMCID: PMC7105359 DOI: 10.2147/jpr.s237056] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/07/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Pain management in nursing homes is challenging and pain prevalence remains high. The objective of this study was to improve the pain situation of nursing home residents following a nursing-related educational intervention within a cluster-randomized controlled trial (2016-2018). PARTICIPANTS Clusters were nursing homes from one nursing home operator in Bavaria, Germany. Nursing home residents who were permanently registered in the facilities, at least 60 years of age, and who themselves or their legal guardians provided informed consent were included. INTERVENTION In addition to the implementation of pain nurses and pain care assistants, staff of the intervention group received an educational intervention in pain management, containing classroom (quality circles) and web-based training for nurses. METHODS Based on the Mini-Mental State Examination (MMSE), residents were either interviewed (MMSE 10-30) using self-report instruments or observed (MMSE 0-9) by proxy assessment. The primary outcome in residents able to self-report was maximum pain intensity according to Brief Pain Inventory (BPI); in those not able to self-report treatment-relevant pain above cut-off (≥2) on the Pain Assessment in Advanced Dementia (PAINAD). RESULTS Out of 20 randomly selected clusters, 9 nursing homes from the control, and 6 nursing homes from the intervention group participated. Multilevel linear (n=347 residents, MMSE 10-30) and logistic regression (n=222 residents, MMSE 0-9) analyses were conducted. Maximum pain intensity was higher after intervention (B=1.32, p<0.01), decreased with a better quality of life (B=-0.07, p<0.001), and was lower when dementia diagnoses were present (B=-1.12, p<0.01). PAINAD scores before and after intervention did not differ significantly (OR=0.89, p=0.724), but chances to exhibit treatment-related pain were higher with decreasing MMSE (OR=0.94, p<0.05). CONCLUSION While no significant positive intervention effect was measured, findings suggest nurses' raised awareness towards pain management. Overall results indicate that large-scale educational interventions seem to be less effective in complex nursing home settings without also including specific individual-based intervention measures.
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Affiliation(s)
- P Kutschar
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - S Berger
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - A Brandauer
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - N Freywald
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - J Osterbrink
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
- Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - D Seidenspinner
- Nursing Science and Practice Development, University Hospital of Munich-Großhadern (LMU), Munich, Germany
| | - I Gnass
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Poitevin E, Nicolas M, Graveleau L, Richoz J, Andrey D, Monard F, Abrahamson A, Baillon A, Barrios J, Berger S, Berrocal R, Bos R, Brullebaut L, Caseiro C, Choo LF, Cole G, Daix G, Dekussche C, Dhillon GS, Fortineau A, Gaudin C, Gonzales MJ, Leal R, Mabiog RO, Noorlos T, Reba R, Senechal C. Improvement of AOAC Official Method 984.27 for the Determination of Nine Nutritional Elements in Food Products by Inductively Coupled Plasma-Atomic Emission Spectroscopy After Microwave Digestion: Single-Laboratory Validation and Ring Trial. J AOAC Int 2019. [DOI: 10.1093/jaoac/92.5.1484] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
A single-laboratory validation (SLV) and a ring trial (RT) were undertaken to determine nine nutritional elements in food products by inductively coupled plasma-atomic emission spectroscopy in order to improve and update AOAC Official Method 984.27. The improvements involved optimized microwave digestion, selected analytical lines, internal standardization, and ion buffering. Simultaneous determination of nine elements (calcium, copper, iron, potassium, magnesium, manganese, sodium, phosphorus, and zinc) was made in food products. Sample digestion was performed through wet digestion of food samples by microwave technology with either closed or open vessel systems. Validation was performed to characterize the method for selectivity, sensitivity, linearity, accuracy, precision, recovery, ruggedness, and uncertainty. The robustness and efficiency of this method was proved through a successful internal RT using experienced food industry laboratories. Performance characteristics are reported for 13 certified and in-house reference materials, populating the AOAC triangle food sectors, which fulfilled AOAC criteria and recommendations for accuracy (trueness, recovery, and z-scores) and precision (repeatability and reproducibility RSD and HorRat values) regarding SLV and RT. This multielemental method is cost-efficient, time-saving, accurate, and fit-for-purpose according to ISO 17025 Norm and AOAC acceptability criteria, and is proposed as an improved version of AOAC Official Method 984.27 for fortified food products, including infant formula.
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Affiliation(s)
- Eric Poitevin
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
| | - Marine Nicolas
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
| | - Laetitia Graveleau
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
| | - Janique Richoz
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
| | - Daniel Andrey
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
| | - Florence Monard
- Nestlé Research Center, Vers-Chez-Les-Blanc, CH-1000 Lausanne 26, Switzerland
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Krause A, Aries PM, Berger S, Fiehn C, Kellner H, Lorenz HM, Meier L, Müller GA, Müller-Ladner U, Schwarting A, Tony HP, Peters MA, Wendler J. Rituximab in routine care of severe active rheumatoid arthritis : A prospective, non-interventional study in Germany. Z Rheumatol 2019; 78:881-888. [PMID: 30276727 DOI: 10.1007/s00393-018-0552-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess safety, effectiveness and onset of effect of rituximab (RTX) in routine clinical treatment of severe, active rheumatoid arthritis (RA). METHODS Prospective, multi-centre, non-interventional study in rheumatological outpatient clinics or private practices in Germany. RTX-naïve adult patients were to receive RTX according to marketing authorisation and at their physician's discretion. Also according to their physician's discretion, patients could receive a second cycle of RTX (re-treatment = treatment continuation). Major outcome was the change in Disease Activity Score based on 28-joints count and erythrocyte sedimentation rate (DAS28-ESR) over 24 weeks and during 6 months of re-treatment. RESULTS Overall, 1653 patients received at least one cycle RTX; 99.2% of these had received disease-modifying antirheumatic drugs (DMARD) pre-treatment and 75.5% anti-tumor necrosis factor(TNF)‑α pre-treatment. After a mean interval of 8.0 months, 820 patients received RTX re-treatment. Mean DAS28-ESR decreased from 5.3 at baseline to 3.8 after 24 weeks (-1.5 [95% confidence interval, CI: -1.6; -1.4]), and from 4.1 at start of cycle 2 to 3.5 at study end (change from baseline: -1.8 [95% CI: -2.0; -1.7]). Improvements in DAS28-ESR and Health Assessment Questionnaire (HAQ) score occurred mainly during the first 12 weeks of RTX treatment, with further DAS28-ESR improvement until week 24 or month 6 of re-treatment. Improvements in DAS28-ESR and EULAR responses were more pronounced in seropositive patients. RF was a predictor of DAS28-ESR change to study end. Safety analysis showed the established profile of RTX. CONCLUSION RTX was safe and effective in a real-life setting with rapid and sustained improvement in RA signs and symptoms.
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Affiliation(s)
- A Krause
- Abteilung Rheumatologie und Klinische Immunologie, Klinik für Innere Medizin, Immanuel Krankenhaus, Königstraße 63, 14109, Berlin, Germany.
| | - P M Aries
- Rheumatologie im Struenseehaus, Hamburg, Germany
| | - S Berger
- Private Practice, Naunhof, Germany
| | - C Fiehn
- Praxis für Rheumatologie und klinische Immunologie, Baden-Baden, Germany
| | - H Kellner
- Private Practice and Division of Rheumatology, KH Neuwittelsbach, Munich, Germany
| | - H-M Lorenz
- Division of Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - L Meier
- RheumaPraxis, Hofheim, Germany
| | - G A Müller
- Department of Nephrology and Rheumatology, University Hospital Göttingen, Göttingen, Germany
| | - U Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Kerckhoff Hospital GmbH, Bad Nauheim, Germany
| | - A Schwarting
- First Department of Medicine, University Hospital, Johannes Gutenberg-University, Mainz, Germany
| | - H-P Tony
- Division of Clinical Immunology/Rheumatology, Department of Internal Medicine II, University of Würzburg, Würzburg, Germany
| | - M A Peters
- Medical Management Rheumatology, Roche Pharma AG, Grenzach-Wyhlen, Germany
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Fenaux H, Chassaing M, Berger S, Gantzer C, Bertrand I, Schvoerer E. Transmission of hepatitis E virus by water: An issue still pending in industrialized countries. Water Res 2019; 151:144-157. [PMID: 30594083 DOI: 10.1016/j.watres.2018.12.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 09/07/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 06/09/2023]
Abstract
Hepatitis E virus (HEV) is an enteric virus divided into eight genotypes. Genotype 1 (G1) and G2 are specific to humans; G3, G4 and G7 are zoonotic genotypes infecting humans and animals. Transmission to humans through water has been demonstrated for G1 and G2, mainly in developing countries, but is only suspected for the zoonotic genotypes. Thus, the water-related HEV hazard may be due to human and animal faeces. The high HEV genetic variability allows considering the presence in wastewater of not only different genotypes, but also quasispecies adding even greater diversity. Moreover, recent studies have demonstrated that HEV particles may be either quasi-enveloped or non-enveloped, potentially implying differential viral behaviours in the environment. The presence of HEV has been demonstrated at the different stages of the water cycle all over the world, especially for HEV G3 in Europe and the USA. Concerning HEV survival in water, the virus does not have higher resistance to inactivating factors (heat, UV, chlorine, physical removal), compared to viral indicators (MS2 phage) or other highly resistant enteric viruses (Hepatitis A virus). But the studies did not take into account genetic (genogroups, quasispecies) or structural (quasi- or non-enveloped forms) HEV variability. Viral variability could indeed modify HEV persistence in water by influencing its interaction with the environment, its infectivity and its pathogenicity, and subsequently its transmission by water. The cell culture methods used to study HEV survival still have drawbacks (challenging virus cultivation, time consuming, lack of sensitivity). As explained in the present review, the issue of HEV transmission to humans through water is similar to that of other enteric viruses because of their similar or lower survival. HEV transmission to animals through water and how the virus variability affects its survival and transmission remain to be investigated.
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Affiliation(s)
- H Fenaux
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54511 Vandoeuvre lès Nancy, France; Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, LCPME UMR 7564 CNRS-UL, F-54600 Villers lès Nancy, France
| | - M Chassaing
- Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, LCPME UMR 7564 CNRS-UL, F-54600 Villers lès Nancy, France
| | - S Berger
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54511 Vandoeuvre lès Nancy, France
| | - C Gantzer
- Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, LCPME UMR 7564 CNRS-UL, F-54600 Villers lès Nancy, France
| | - I Bertrand
- Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, LCPME UMR 7564 CNRS-UL, F-54600 Villers lès Nancy, France
| | - E Schvoerer
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54511 Vandoeuvre lès Nancy, France; Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, LCPME UMR 7564 CNRS-UL, F-54600 Villers lès Nancy, France.
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Nieuwenhuijs-Moeke GJ, Nieuwenhuijs VB, Seelen MAJ, Berger SP, van den Heuvel MC, Burgerhof JGM, Ottens PJ, Ploeg RJ, Leuvenink HGD, Struys MMRF. Propofol-based anaesthesia versus sevoflurane-based anaesthesia for living donor kidney transplantation: results of the VAPOR-1 randomized controlled trial. Br J Anaesth 2018; 118:720-732. [PMID: 28510740 DOI: 10.1093/bja/aex057] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 12/22/2022] Open
Abstract
Background Kidney transplantation is associated with harmful processes affecting the viability of the graft. One of these processes is associated with the phenomenon of ischaemia-reperfusion injury. Anaesthetic conditioning is a widely described strategy to attenuate ischaemia-reperfusion injury. We therefore conducted the Volatile Anaesthetic Protection of Renal Transplants-1 trial, a pilot project evaluating the influence of two anaesthetic regimens, propofol- vs sevoflurane-based anaesthesia, on biochemical and clinical outcomes in living donor kidney transplantation. Methods Sixty couples were randomly assigned to the following three groups: PROP (donor and recipient propofol), SEVO (donor and recipient sevoflurane), and PROSE (donor propofol and recipient sevoflurane). The primary outcome was renal injury reflected by urinary biomarkers. The follow-up period was 2 yr. Results Three couples were excluded, leaving 57 couples for analysis. Concentrations of kidney injury molecule-1 (KIM-1), N -acetyl-β- d -glucosaminidase (NAG), and heart-type fatty acid binding protein (H-FABP) in the first urine upon reperfusion showed no differences. On day 2, KIM-1 concentrations were higher in SEVO [952.8 (interquartile range 311.8-1893.0) pg mmol -1 ] compared with PROP [301.2 (202.0-504.7) pg mmol -1 ]. This was the same for NAG: SEVO, 1.835 (1.162-2.457) IU mmol -1 vs PROP, 1.078 (0.819-1.713) IU mmol -1 . Concentrations of H-FABP showed no differences. Measured glomerular filtration rate at 3, 6, and 12 months showed no difference. After 2 yr, there was a difference in the acute rejection rate ( P =0.039). Post hoc testing revealed a difference between PROP (35%) and PROSE (5%; P =0.020). The difference between PROP and SEVO (11%) was not significant ( P =0.110). Conclusions The SEVO group showed higher urinary KIM-1 and NAG concentrations in living donor kidney transplantation on the second day after transplantation. This was not reflected in inferior graft outcome. Clinical trial registration NCT01248871.
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Affiliation(s)
| | - V B Nieuwenhuijs
- Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Surgery, Isala, Zwolle, The Netherlands
| | | | | | | | - J G M Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - P J Ottens
- Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - R J Ploeg
- Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - H G D Leuvenink
- Department of Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - M M R F Struys
- Department of Anaesthesiology.,Department of Anaesthesia, Ghent University, Ghent, Belgium
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Hagelskamp L, Berger S, Villalobos M, Thomas M, Wensing M, Mahler C. Nurse navigators in thoracic oncology: A qualitative study of German nurses’ attitudes to nursing role expansion. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy276.003] [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: 11/14/2022] Open
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Meyre P, Blum S, Berger S, Aeschbacher S, Schoepfer H, Briel M, Niessner A, Osswald S, Conen D. P975Incidence and risk factors for all-cause hospitalizations in patients with atrial fibrillation: a systematic review and meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p975] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Meyre
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - S Blum
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - S Berger
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - S Aeschbacher
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - H Schoepfer
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - M Briel
- University Hospital Basel, Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, Basel, Switzerland
| | - A Niessner
- Medical University of Vienna, Division of Cardiology, Department of Internal Medicine II, Vienna, Austria
| | - S Osswald
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - D Conen
- McMaster University, Population Health Research Institute, Hamilton, Canada
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Fenaux H, Chassaing M, Berger S, Jeulin H, Gentilhomme A, Bensenane M, Bronowicki J, Gantzer C, Bertrand I, Schvoerer E. Molecular features of Hepatitis E Virus circulation in environmental and human samples. J Clin Virol 2018; 103:63-70. [DOI: 10.1016/j.jcv.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/20/2018] [Accepted: 04/03/2018] [Indexed: 12/20/2022]
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Berger S, Pho H, Fleury Curado T, Schwartz A, Polotsky V. 0077 Intranasal Leptin Approach To Treat Sleep-disordered Breathing. Sleep 2018. [DOI: 10.1093/sleep/zsy061.076] [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: 11/13/2022] Open
Affiliation(s)
- S Berger
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - H Pho
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - T Fleury Curado
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Schwartz
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - V Polotsky
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
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PHO H, Berger S, Fleury Curado T, Schwartz AR, Polotsky VY. 0133 Leptin Signaling In Dorsal Medial Hypothalamus Regulates Upper Airway Patency And Reverses Sleep Disordered Breathing In Leptin-resistant Db/db Mice. Sleep 2018. [DOI: 10.1093/sleep/zsy061.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- H PHO
- Johns Hopkins, Baltimore, MD
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Fleury Curado TA, Pho H, Berger S, Lee R, Sennes L, Schwartz AR, Polotsky VY. 0067 Chemogenetic Silencing of Hypoglossal Motor Neurons Creates a Model of Upper Airway Obstruction During Sleep. Sleep 2018. [DOI: 10.1093/sleep/zsy061.066] [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: 11/12/2022] Open
Affiliation(s)
- T A Fleury Curado
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
| | - H Pho
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
| | - S Berger
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
| | - R Lee
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
| | - L Sennes
- Otolaryngology Department, University of Sao Paulo, Sao Paulo, Brazil, Sao Paulo, BRAZIL
| | - A R Schwartz
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
| | - V Y Polotsky
- The Johns Hopkins Asthma and Allergy Center, Baltimore, MD, United States, Baltimore, MD
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Berger S, Gökeri C, Dietert K, Behrendt U, Lienau J, Gruber AD, Suttorp N, Witzenrath M, Nouailles G. Delay in Adequate Antiobiotic Therapy Results in Fatal Disease Outcome in a Mouse Model of CAP. Pneumologie 2018. [DOI: 10.1055/s-0037-1619425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Berger
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - C Gökeri
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - K Dietert
- Department of Veterinary Pathology, Freie Universität Berlin
| | - U Behrendt
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - J Lienau
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - AD Gruber
- Department of Veterinary Pathology, Freie Universität Berlin
| | - N Suttorp
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - M Witzenrath
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
| | - G Nouailles
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine
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Soulie C, Morand-Joubert L, Cottalorda J, Charpentier C, Bellecave P, Le Guen L, Yerly S, Montes B, Fafi-Kremer S, Dina J, Avettand-Fenoel V, Amiel C, Roussel C, Pallier C, Zafilaza K, Sayon S, Signori-Schmuck A, Mirand A, Trabaud MA, Berger S, Calvez V, Marcelin AG. Performance of genotypic algorithms for predicting tropism for HIV-1 CRF01_AE recombinant. J Clin Virol 2018; 99-100:57-60. [PMID: 29331843 DOI: 10.1016/j.jcv.2017.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/04/2017] [Accepted: 12/28/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES There is no consensus about the performances of genotypic rules for predicting HIV-1 non-B subtype tropism. Three genotypic methods were compared for CRF01_AE HIV-1 tropism determination. METHODS The V3 env region of 207 HIV-1 CRF01_AE and 178 B subtypes from 17 centers in France and 1 center in Switzerland was sequenced. Tropism was determined by Geno2Pheno algorithm with false positive rate (FPR) 5% or 10%, the 11/25 rule or the combined criteria of the 11/25, net charge rule and NXT/S mutations. RESULTS Overall, 72.5%, 59.4%, 86.0%, 90.8% of the 207 HIV-1 CRF01_AE were R5-tropic viruses determined by Geno2pheno FPR5%, Geno2pheno FPR10%, the combined criteria and the 11/25 rule, respectively. A concordance of 82.6% was observed between Geno2pheno FPR5% and the combined criteria for CRF01_AE. The results were nearly similar for the comparison between Geno2pheno FPR5% and the 11/25 rule. More mismatches were observed when Geno2pheno was used with the FPR10%. Neither HIV viral load, nor current or nadir CD4 was associated with the discordance rate between the different algorithms. CONCLUSION Geno2pheno predicted more X4-tropic viruses for this set of CRF01_AE sequences than the combined criteria or the 11/25 rule alone. For a conservative approach, Geno2pheno FPR5% seems to be a good compromise to predict CRF01_AE tropism.
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Affiliation(s)
- C Soulie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France.
| | - L Morand-Joubert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Saint Antoine, Service de Virologie, Paris, France
| | | | - C Charpentier
- IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, INSERM, AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - P Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, Univ. Bordeaux, CNRS UMR 5234, Bordeaux, France
| | - L Le Guen
- Laboratoire de virologie, CHU, Nantes, France
| | - S Yerly
- Laboratory of Virology, Geneva University Hospitals, Switzerland
| | - B Montes
- Laboratoire de Virologie, CHU, Montpellier, France
| | | | - J Dina
- Laboratoire de virologie, CHU, Caen, France
| | - V Avettand-Fenoel
- AP-HP, Laboratoire de Virologie, Hôpital Necker, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA7327, France
| | - C Amiel
- AP-HP, Laboratoire de Virologie, Hôpital Tenon, Paris, France
| | | | | | - K Zafilaza
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - S Sayon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | | | | | - M A Trabaud
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Berger
- Laboratoire de Virologie, CHU de Nancy Brabois, EA 7300, Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - A G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
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Leutgeb R, Engeser P, Berger S, Szecsenyi J, Laux G. Erratum to: Out of hours care in Germany - High utilization by adult patients with minor ailments? BMC Fam Pract 2017; 18:64. [PMID: 28499356 PMCID: PMC5429518 DOI: 10.1186/s12875-017-0632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Drews R, Pattyn F, Hewitt IJ, Ng FSL, Berger S, Matsuoka K, Helm V, Bergeot N, Favier L, Neckel N. Actively evolving subglacial conduits and eskers initiate ice shelf channels at an Antarctic grounding line. Nat Commun 2017; 8:15228. [PMID: 28485400 PMCID: PMC5482720 DOI: 10.1038/ncomms15228] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 03/09/2017] [Indexed: 11/08/2022] Open
Abstract
Ice-shelf channels are long curvilinear tracts of thin ice found on Antarctic ice shelves. Many of them originate near the grounding line, but their formation mechanisms remain poorly understood. Here we use ice-penetrating radar data from Roi Baudouin Ice Shelf, East Antarctica, to infer that the morphology of several ice-shelf channels is seeded upstream of the grounding line by large basal obstacles indenting the ice from below. We interpret each obstacle as an esker ridge formed from sediments deposited by subglacial water conduits, and calculate that the eskers' size grows towards the grounding line where deposition rates are maximum. Relict features on the shelf indicate that these linked systems of subglacial conduits and ice-shelf channels have been changing over the past few centuries. Because ice-shelf channels are loci where intense melting occurs to thin an ice shelf, these findings expose a novel link between subglacial drainage, sedimentation and ice-shelf stability.
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Affiliation(s)
- R. Drews
- Université libre de Bruxelles, Laboratoire de Glaciologie, Avenue F.D. Roosevelt 50, Brussels 1050, Belgium
- Bavarian Academy of Sciences and Humanities, Glaziologie, Alfons-Goppel-Str. 11, Munich 80539, Germany
| | - F. Pattyn
- Université libre de Bruxelles, Laboratoire de Glaciologie, Avenue F.D. Roosevelt 50, Brussels 1050, Belgium
| | - I. J. Hewitt
- University of Oxford, Mathematical Institute, Woodstock Road, Oxford OX26GG, UK
| | - F. S. L. Ng
- The University of Sheffield, Department of Geography, Winter street, Sheffield S102TN, UK
| | - S. Berger
- Université libre de Bruxelles, Laboratoire de Glaciologie, Avenue F.D. Roosevelt 50, Brussels 1050, Belgium
| | - K. Matsuoka
- Norwegian Polar Institute, Fram Centre 9296 Tromsø, Norway
| | - V. Helm
- Alfred Wegener Institute, Am Alten Hafen 26, Bremerhaven 27568, Germany
| | - N. Bergeot
- Royal Observatory of Belgium, Av. Circulaire 3, Brussels 1180, Belgium
| | - L. Favier
- Université libre de Bruxelles, Laboratoire de Glaciologie, Avenue F.D. Roosevelt 50, Brussels 1050, Belgium
| | - N. Neckel
- Alfred Wegener Institute, Am Alten Hafen 26, Bremerhaven 27568, Germany
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Bemelman FJ, de Fijter JW, Kers J, Meyer C, Peters-Sengers H, de Maar EF, van der Pant KAMI, de Vries APJ, Sanders JS, Zwinderman A, Idu MM, Berger S, Reinders MEJ, Krikke C, Bajema IM, van Dijk MC, Ten Berge IJM, Ringers J, Lardy J, Roelen D, Moes DJ, Florquin S, Homan van der Heide JJ. Early Conversion to Prednisolone/Everolimus as an Alternative Weaning Regimen Associates With Beneficial Renal Transplant Histology and Function: The Randomized-Controlled MECANO Trial. Am J Transplant 2017; 17:1020-1030. [PMID: 27639190 DOI: 10.1111/ajt.14048] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 08/20/2016] [Accepted: 09/07/2016] [Indexed: 01/25/2023]
Abstract
In renal transplantation, use of calcineurin inhibitors (CNIs) is associated with nephrotoxicity and immunosuppression with malignancies and infections. This trial aimed to minimize CNI exposure and total immunosuppression while maintaining efficacy. We performed a randomized controlled, open-label multicenter trial with early cyclosporine A (CsA) elimination. Patients started with basiliximab, prednisolone (P), mycophenolate sodium (MPS), and CsA. At 6 months, immunosuppression was tapered to P/CsA, P/MPS, or P/everolimus (EVL). Primary outcomes were renal fibrosis and inflammation. Secondary outcomes were estimated glomerular filtration rate (eGFR) and incidence of rejection at 24 months. The P/MPS arm was prematurely halted. The trial continued with P/CsA (N = 89) and P/EVL (N = 96). Interstitial fibrosis and inflammation were significantly decreased and the eGFR was significantly higher in the P/EVL arm. Cumulative rejection rates were 13% (P/EVL) and 19% (P/CsA), (p = 0.08). A post hoc analysis of HLA and donor-specific antibodies at 1 year after transplantation revealed no differences. An individualized immunosuppressive strategy of early CNI elimination to dual therapy with everolimus was associated with decreased allograft fibrosis, preserved allograft function, and good efficacy, but also with more serious adverse events and discontinuation. This can be a valuable alternative regimen in patients suffering from CNI toxicity.
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Affiliation(s)
- F J Bemelman
- Renal Transplant Unit, Amsterdam, the Netherlands
| | - J W de Fijter
- Renal Transplant Unit, Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - J Kers
- Department of Pathology, Academic Medical Centre, Amsterdam, the Netherlands
| | - C Meyer
- University of Amsterdam, Amsterdam, the Netherlands
| | | | - E F de Maar
- Department of Nephrology, Groningen University Hospital, Groningen, the Netherlands
| | | | - A P J de Vries
- Renal Transplant Unit, Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - J-S Sanders
- Department of Nephrology, Groningen University Hospital, Groningen, the Netherlands
| | - A Zwinderman
- Department of Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, the Netherlands
| | - M M Idu
- Department of Surgery, Academic Medical Centre, Amsterdam, the Netherlands
| | - S Berger
- Department of Nephrology, Groningen University Hospital, Groningen, the Netherlands
| | - M E J Reinders
- Renal Transplant Unit, Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands
| | - C Krikke
- Department of Surgery, Groningen University Hospital, Groningen, the Netherlands
| | - I M Bajema
- Department of Pathology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M C van Dijk
- Department of Pathology, Groningen University Hospital, Groningen, the Netherlands
| | | | - J Ringers
- Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - J Lardy
- Sanquin Diagnostic Services, Amsterdam, the Netherlands
| | - D Roelen
- Department of Immunogenetics and Transplantation Immunology, Leiden University Medical Centre, Leiden, the Netherlands
| | - D-J Moes
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, the Netherlands
| | - S Florquin
- Department of Pathology, Academic Medical Centre, Amsterdam, the Netherlands
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Glijn NHP, Roodnat JI, Dor FJ, Betjes MG, Zuidema WC, Weimar W, Berger SP. Kidney transplantation in patients declined by other centres. Neth J Med 2017; 75:74-80. [PMID: 28276326] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Transplant centres show considerable disagreement in the acceptance of transplant candidates with relative contraindications. The aim of this study is to investigate the outcomes of our patients who had been refused at other centres prior to transplantation at our centre. METHODS We included patients who had been excluded from transplantation or wait-listing at other centres before referral to our centre. We scored the reasons for refusal at other centres, the type of transplantation procedure, postoperative and long-term complications, patient and graft survival and how these patients experienced the transplantation and quality of life at our centre. All regular patients transplanted in 2010 functioned as a control group for outcome parameters. RESULTS We identified 23 patients in the period from January 2000 until March 2013. The most frequent reason for the refusal at other centres was obesity. Twenty of the 23 patients (87%) were alive and 19 had a functioning graft (83%) after a median follow-up of 21.0 months after transplantation (range 11.0-48.9). There were significantly more wound-related problems in the study group as compared with the control group (p = 0.029), but their kidney function at one year after transplantation was not significantly different. The patients indicated an improvement of quality of life after transplantation and in general were satisfied with the transplantation. CONCLUSIONS Patients who had previously had been denied transplantation at other centres generally did well after kidney transplantation with an increased risk of wound complications but a satisfactory graft and patient survival.
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Affiliation(s)
- N H P Glijn
- Department of Internal Medicine, section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Gökeri C, Berger S, Behrendt U, Wienhold SM, Dorhoi A, Suttorp N, Witzenrath M, Nouailles-Kursar G. Regulators of Neutrophilic Inflammation in Community Acquired Pneumonia. Pneumologie 2017. [DOI: 10.1055/s-0037-1598365] [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: 10/20/2022]
Affiliation(s)
- C Gökeri
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - S Berger
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - U Behrendt
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - SM Wienhold
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - A Dorhoi
- Department of Immunology, Max Planck Institute for Infection Biology, Berlin
| | - N Suttorp
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - M Witzenrath
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - G Nouailles-Kursar
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
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30
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Berger S, Gökeri C, Behrendt U, Wienhold SM, Lienau J, Suttorp N, Nouailles-Kursar G, Witzenrath M. In vivo Analysis of Murine Pneumococcal Pneumonia for Mathematical Modelling of Community Aquired Pneumonia. Pneumologie 2017. [DOI: 10.1055/s-0037-1598367] [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: 10/20/2022]
Affiliation(s)
- S Berger
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - C Gökeri
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - U Behrendt
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - SM Wienhold
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - J Lienau
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - N Suttorp
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - G Nouailles-Kursar
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - M Witzenrath
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
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31
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Berger S, Wienhold SM, Gökeri C, Behrendt U, Fatykhova D, Zscheppang K, Berg J, Gisch N, Dietert K, Doehn JM, Hocke A, Witzenrath M, Nouailles-Kursar G. Spatial and temporal regulation of neutrophil-attractant CXCL5/LIX in acute streptococcal pneumonia. Pneumologie 2017. [DOI: 10.1055/s-0037-1598372] [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: 10/20/2022]
Affiliation(s)
- S Berger
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - SM Wienhold
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - C Gökeri
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - U Behrendt
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - D Fatykhova
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - K Zscheppang
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - J Berg
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - N Gisch
- Leibniz Center for Medicine and Biosciences, Research Center Borstel
| | - K Dietert
- Institute of Veterinary Pathology, Freie Universität Berlin
| | - JM Doehn
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - A Hocke
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - M Witzenrath
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
| | - G Nouailles-Kursar
- Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin
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Haase-Kromwijk BJJM, Heemskerk MBA, Weimar W, Berger SP, Hoitsma AJ. [Waiting list registration for kidney transplants must improve]. Ned Tijdschr Geneeskd 2017; 161:D812. [PMID: 28378695] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate how the composition of the waiting list for postmortem kidney transplant has developed, and whether the waiting list reflects actual demand. DESIGN Retrospective research and cohort study. METHOD We used data from the period 2000-2014 from the Dutch Transplant Foundation, 'RENINE' and Eurotransplant. This concerned data on postmortem kidney donation, live donor transplants, the waiting list and kidney transplantation. RESULTS The postmortem kidney transplant waiting list included transplantable (T) and non-transplantable (NT) patients. The number of T-patients declined from 1271 in 2000 to 650 in 2014, and the median waiting time between the start of dialysis and postmortem kidney transplant decreased from 4.1 years in 2006 to 3.1 years in 2014. The total number of patients on the waiting list, however, increased from 2263 in 2000 to 2560 in 2014 and in the same period the number of new patient registrations increased from 772 to 1212. In about 80% of the NT-patients the reason for their NT status was not registered. A cohort analysis showed that NT-patients have a 2-times lower chance of a postmortem kidney transplant and a 2-times higher chance of leaving the waiting list without transplantation or of live-donor transplantation. CONCLUSION The demand for donor kidneys remains high. The increased number of transplants resulted in a declining waiting list for T-patients while the total waiting list is getting longer. Waiting list registration and maintenance need to be improved, to give better insight into the real demand.
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Hinner M, Bel Aiba R, Schlosser C, Jaquin T, Allersdorfer A, Berger S, Wiedenmann A, Matschiner G, Schüler J, Moebius U, Rothe C, Olwill S. Costimulatory T-cell engagement by PRS-343, a CD137 (4-1BB)/HER2 bispecific, leads to tumor growth inhibition and TIL expansion in a humanized mouse model. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32894-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Grijpma JW, Tielen M, van Staa AL, Maasdam L, van Gelder T, Berger SP, Busschbach JJ, Betjes MGH, Weimar W, Massey EK. Kidney transplant patients' attitudes towards self-management support: A Q-methodological study. Patient Educ Couns 2016; 99:836-843. [PMID: 26682972 DOI: 10.1016/j.pec.2015.11.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 07/29/2015] [Revised: 11/11/2015] [Accepted: 11/20/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Kidney transplant recipients face many self-management challenges. We aimed to identify profiles of attitudes towards self-management support (SMS) shortly after kidney transplantation. METHODS Profiles were generated using Q-methodology: In face-to-face interviews participants rank-ordered opinion statements on aspects of SMS according to agreement. Socio-demographic and medical characteristics were assessed using a questionnaire. By-person factor analysis was used to analyze the rankings and qualitative data was used to support choice of profiles. The resulting factors represent clusters of patients with similar attitudes towards SMS. RESULTS Forty-three patients (mean age=56; 77% male) participated. Four profiles were identified: (A) transplant-focused and obedient; (B) holistic and collaborative; (C) life-focused and self-determined; and (D) was bipolar. The positive pole (D+) minimalizing and disengaged and the negative pole (D-) coping-focused and needy represent opposing viewpoints within the same profile. Socio-demographic and medical characteristics were not related to profile membership. DISCUSSION Each profile represents a specific attitude on post-transplant life, responsibility for health and decision-making, SMS needs, and preferences for SMS. PRACTICAL IMPLICATIONS Patients vary in their attitude, needs and preferences for SMS indicating the necessity of providing personalized support after kidney transplantation. Health professionals should explore patients' SMS needs and adapt support accordingly.
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Affiliation(s)
- J W Grijpma
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - M Tielen
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - A L van Staa
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands.
| | - L Maasdam
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - T van Gelder
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - S P Berger
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - J J Busschbach
- Erasmus MC, Department of Psychiatry, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - M G H Betjes
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - W Weimar
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - E K Massey
- Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
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Efimov S, Khodov I, Ratkova E, Kiselev M, Berger S, Klochkov V. Detailed NOESY/T-ROESY analysis as an effective method for eliminating spin diffusion from 2D NOE spectra of small flexible molecules. J Mol Struct 2016. [DOI: 10.1016/j.molstruc.2015.09.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bergstrom HC, Darvesh AS, Berger SP. Inducible Nitric Oxide Inhibitors Block NMDA Antagonist-Stimulated Motoric Behaviors and Medial Prefrontal Cortical Glutamate Efflux. Front Pharmacol 2015; 6:292. [PMID: 26696891 PMCID: PMC4678197 DOI: 10.3389/fphar.2015.00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/23/2015] [Indexed: 11/20/2022] Open
Abstract
Nitric oxide (NO) plays a critical role in the motoric and glutamate releasing action of N-methyl-D-aspartate (NMDA)-antagonist stimulants. Earlier studies utilized neuronal nitric oxide synthase inhibitors (nNOS) for studying the neurobehavioral effects of non-competitive NMDA-antagonist stimulants such as dizocilpine (MK-801) and phencyclidine (PCP). This study explores the role of the inducible nitric oxide synthase inhibitors (iNOS) aminoguanidine (AG) and (-)-epigallocatechin-3-gallate (EGCG) in NMDA-antagonist induced motoric behavior and prefrontal cortical glutamate efflux. Adult male rats were administered a dose range of AG, EGCG, or vehicle prior to receiving NMDA antagonists MK-801, PCP, or a conventional psychostimulant (cocaine) and tested for motoric behavior in an open arena. Glutamate in the medial prefrontal cortex (mPFC) was measured using in vivo microdialysis after a combination of AG or EGCG prior to MK-801. Acute administration of AG or EGCG dose-dependently attenuated the locomotor and ataxic properties of MK-801 and PCP. Both AG and EGCG were unable to block the motoric effects of cocaine, indicating the acute pharmacologic action of AG and EGCG is specific to NMDA antagonism and not generalizable to all stimulant class drugs. AG and EGCG normalized MK-801-stimulated mPFC glutamate efflux. These data demonstrate that AG and EGCG attenuates NMDA antagonist-stimulated motoric behavior and cortical glutamate efflux. Our results suggest that EGCG-like polyphenol nutraceuticals (contained in “green tea” and chocolate) may be clinically useful in protecting against the adverse behavioral dissociative and cortical glutamate stimulating effects of NMDA antagonists. Medications that interfere with NMDA antagonists such as MK-801 and PCP have been proposed as treatments for schizophrenia.
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Affiliation(s)
- Hadley C Bergstrom
- Department of Psychology, Program in Neuroscience and Behavior, Vassar College, Poughkeepsie NY, USA
| | - Altaf S Darvesh
- Department of Pharmaceutical Sciences, College of Pharmacy, Northeast Ohio Medical University, Rootstown OH, USA ; Department of Psychiatry, College of Medicine, Northeast Ohio Medical University, Rootstown OH, USA
| | - S P Berger
- Department of Veterans Affairs Medical Center, Portland OR, USA
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37
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Peters HPE, van den Brand JAJ, Berger SP, Wetzels JFM. Immunosuppressive therapy in patients with IgA nephropathy. Neth J Med 2015; 73:284-289. [PMID: 26228193] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND There is limited evidence to support cytotoxic therapy in patients with IgA nephropathy and renal insufficiency. We studied the effect of cytotoxic therapy in patients with IgA nephropathy and renal insufficiency, and evaluated possible predictors of response. METHODS Retrospective analysis of patients with IgA nephropathy who received immunosuppressive therapy. The primary outcome measure was progression of renal disease, defined as an increase in serum creatinine levels of ≥ 50% or development of end-stage renal disease. RESULTS From 1996 to 2008, 19 patients with biopsy-proven IgA nephropathy were treated with cytotoxic agents and prednisone because of renal insufficiency and÷ or severe proteinuria. Characteristics of patients at the start of therapy: age 42±11 years, serum creatinine 208 (96-490) μmol÷l, estimated glomerular filtration rate (eGFR) 33 (12-65) ml÷min÷1.73 m2, and protein- creatinine ratio 3.8 (0.6-18.2) g÷10 mmol. Follow-up after initiation of therapy was 35 (7-133) months. Ten patients had progressive renal disease, whereas eGFR was stable in nine. Serum creatinine levels and proteinuria at the start of treatment were not significantly different between responders and non- responders. Proteinuria response at six months after start of therapy proved a good predictor: proteinuria decreased by ≥ 50% and÷or reached levels below 1 g÷day in 8÷9 responders. In contrast, proteinuria decreased by more than 50% and reached levels < 1 g÷day in only 3÷10 non-responders (p < 0.01). CONCLUSION Prolonged immunosuppressive therapy with cytotoxic agents and prednisone may benefit a subgroup of patients with progressive IgA nephropathy. A reduction of proteinuria ≥ 50% to levels below 1 g÷day within six months predicts a favourable long-term response.
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Affiliation(s)
- H P E Peters
- Department of Internal Medicine, Isala Clinics, Zwolle, the Netherlands
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Misof B, Liu S, Meusemann K, Peters RS, Donath A, Mayer C, Frandsen PB, Ware J, Flouri T, Beutel RG, Niehuis O, Petersen M, Izquierdo-Carrasco F, Wappler T, Rust J, Aberer AJ, Aspock U, Aspock H, Bartel D, Blanke A, Berger S, Bohm A, Buckley TR, Calcott B, Chen J, Friedrich F, Fukui M, Fujita M, Greve C, Grobe P, Gu S, Huang Y, Jermiin LS, Kawahara AY, Krogmann L, Kubiak M, Lanfear R, Letsch H, Li Y, Li Z, Li J, Lu H, Machida R, Mashimo Y, Kapli P, McKenna DD, Meng G, Nakagaki Y, Navarrete-Heredia JL, Ott M, Ou Y, Pass G, Podsiadlowski L, Pohl H, von Reumont BM, Schutte K, Sekiya K, Shimizu S, Slipinski A, Stamatakis A, Song W, Su X, Szucsich NU, Tan M, Tan X, Tang M, Tang J, Timelthaler G, Tomizuka S, Trautwein M, Tong X, Uchifune T, Walzl MG, Wiegmann BM, Wilbrandt J, Wipfler B, Wong TKF, Wu Q, Wu G, Xie Y, Yang S, Yang Q, Yeates DK, Yoshizawa K, Zhang Q, Zhang R, Zhang W, Zhang Y, Zhao J, Zhou C, Zhou L, Ziesmann T, Zou S, Li Y, Xu X, Zhang Y, Yang H, Wang J, Wang J, Kjer KM, Zhou X. Phylogenomics resolves the timing and pattern of insect evolution. Science 2014; 346:763-7. [DOI: 10.1126/science.1257570] [Citation(s) in RCA: 1672] [Impact Index Per Article: 167.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Klinguer-Hamour C, Broussas M, Akla B, Berger S, Boute N, Beau-Larvor C, Robert A, Haeuw J, Goetsch L, Bailly C, Corvaia N. 351 hz515H7, a humanized antibody exerts its antitumor activity via antagonism of the CXCR4/SDF-1 axis, and through effector functions. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70477-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arends S, Berden JHM, Grootscholten C, Derksen RHWM, Berger SP, de Sévaux RGL, Voskuyl AE, Bijl M. Induction therapy with short-term high-dose intravenous cyclophosphamide followed by mycophenolate mofetil in proliferative lupus nephritis. Neth J Med 2014; 72:481-490. [PMID: 25431394] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND For decades, high-dose intravenous cyclophosphamide (ivCY) given for 24-30 months was regarded as the standard therapy for proliferative lupus nephritis, despite serious side effects. Our aim was to evaluate the effect of induction therapy with short-term high-dose ivCY followed by mycophenolate mofetil (MMF) on disease parameters, mortality and health-related quality of life (HRQoL) in patients with proliferative lupus nephritis. METHODS Between January 2003 and November 2006, 71 patients with biopsy-proven proliferative lupus nephritis were included in the second Dutch Lupus Nephritis Study. All patients were treated with ivCY (750 mg÷m2, six monthly pulses) plus oral prednisone, followed by MMF (2000 mg÷day) plus oral prednisone for 18 months, and then azathioprine (2 mg÷kg÷day) plus oral prednisone. Study endpoints included the occurrence of renal relapse, end-stage renal disease (ESRD) and mortality. RESULTS After a median follow-up of 3.8 years (range 0.1-4.5), four (5.6%) of the 71 patients had a renal relapse, one (1.4%) failed treatment, one (1.4%) reached ESRD, and two (2.8%) died. Systemic lupus erythematosus (SLE) Disease Activity Index, serum creatinine, proteinuria and antibodies against anti-dsDNA decreased significantly during treatment and serum levels of complement factor 3 and 4 increased significantly. Furthermore, six of eight domains of the Short Form-36 as well as the number of symptoms and total distress level according to the SLE Symptom Checklist improved significantly over time. CONCLUSIONS This open-label study shows that induction therapy with short-term (six monthly pulses) high-dose ivCY followed by MMF is effective in preventing renal relapses, ESRD and mortality and improving HRQoL in patients with proliferative lupus nephritis.
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Affiliation(s)
- S Arends
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Raman G, Avendano E, Berger S, Menon V, Bartlett J. Initial Inappropriate Antibiotic Therapy in Hospitalized Patients with Gram-Negative Infections: Systematic Review And Meta-Analysis. Value Health 2014; 17:A667. [PMID: 27202442 DOI: 10.1016/j.jval.2014.08.2461] [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] [Indexed: 06/05/2023]
Affiliation(s)
- G Raman
- Tufts University School of Medicine; Tufts Medical Center, Boston, MA, USA
| | | | - S Berger
- Tufts Medical Center, Boston, MA, USA
| | - V Menon
- Cubist Pharmaceuticals, Lexington, MA, USA
| | - J Bartlett
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
Abstract
A low temperature X-ray study of the enol of benzoylacetone indicates fixed positions of the C and O atoms within the enolic ring system and an extensive bond delocalisation over these atoms. The distribution of electron density between the two oxygen atoms shows that the enolic hydrogen is spread over a wide range. This is in accordance with a structural model proposed by de la Vega, whereupon the C and O atoms are kept fixed in their average positions during a tunneling process of the hydrogen between the two oxygen atoms. With this conception, the chemical shifts in the 17O and 13C NMR spectra, the 13C13C spin coupling constants and the temperature independance of these values can be explained.
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Affiliation(s)
- W. Winter
- Institut für Organische Chemie der Universität Tübingen, Auf der Morgenstelle 18, D-7400 Tübingen 1
| | - K.-P. Zeller
- Institut für Organische Chemie der Universität Tübingen, Auf der Morgenstelle 18, D-7400 Tübingen 1
| | - S. Berger
- Fachbereich Chemie der Universität Marburg, Lahnberge, D-3550 Marburg
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Gerhold K, Richter A, Strangfeld A, Herzer P, Bohl-Bühler M, Berger S, Listing J, Zink A. FRI0206 Effectiveness of First, Second or Third Biologic DMARDS – Clinical Characteristics Are More Important than Choice of the Substance. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3586] [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: 11/04/2022]
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Pollastrini M, Holland V, Brüggemann W, Koricheva J, Jussila I, Scherer-Lorenzen M, Berger S, Bussotti F. Interactions and competition processes among tree species in young experimental mixed forests, assessed with chlorophyll fluorescence and leaf morphology. Plant Biol (Stuttg) 2014; 16:323-331. [PMID: 23926925 DOI: 10.1111/plb.12068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 06/01/2013] [Indexed: 06/02/2023]
Abstract
Chlorophyll a fluorescence (ChlF) and leaf morphology were assessed in two sites in Europe (Kaltenborn, Germany, and Satakunta, Finland) within a forest diversity experiment. Trees at Satakunta, planted in 1999, form a stratified canopy, while in Kaltenborn the trees are 7 years old, with no apparent canopy connection among broadleaf species. The following ChlF parameters from measured OJIP transient curves were examined: F(V)/F(M) (a proxy for maximum quantum yield); ΨEo (a proxy for efficiency in transferring an electron from reduced QA to the electron transport chain); I-P phase (a proxy for efficiency of reducing final acceptors beyond PSI); and PItot (total performance index for potential energy conservation from photons absorbed by PSII to reduction of PSI end acceptors). At Satakunta F(V)/F(M) and ΨEo in Betula pendula were higher in monocultures and lower in mixed plots, perhaps due to increasing light availability in mixed plots, which can induce photoinhibition. The opposite trend was observed in Picea abies, which was shaded in mixed plots. At Kaltenborn F(V)/F(M) decreased in Fagus sylvatica and P. abies in mixed plots due to competition both above- and belowground. At Satakunta LMA increased in B. pendula leaves with increasing species richness. Leaf area of ten leaves was reduced in F. sylvatica in mixed plots at Kaltenborn. By up-scaling the overall fluorescence response to plot level (PItot_plot ), a significant positive correlation with tree diversity was found at Kaltenborn, but not at Satakunta. This could suggest that competition/facilitation processes in mixed stands play a significant role in the early stages of forest establishment, but then tend to be compensated in more mature stands.
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Affiliation(s)
- M Pollastrini
- Department of Agri-Food Production and Environmental Sciences, University of Florence, Florence, Italy
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Berger S, Dirk J, VON Lindern L, Wolff D, Mergenhagen D. Temperature Dependency of Circadian Period in a Single Cell (Acetabularia). ACTA ACUST UNITED AC 2014. [DOI: 10.1111/j.1438-8677.1992.tb00317.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rösner T, Derer S, Klausz K, Dechant M, Lohse S, Berger S, Cossham M, Peipp M, Valerius T. Optimization of complement recruitment in EGFR-directed antibody therapy. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weißflog G, Ernst J, Szkoda A, Berger S, Stuhr C, Herschbach P, Book K, Brähler E. [Patient satisfaction in oncological aftercare--differential results of gender aspects in doctor-patient dyads]. Gesundheitswesen 2013; 76:306-11. [PMID: 24046159 DOI: 10.1055/s-0033-1347257] [Citation(s) in RCA: 3] [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: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to explore the role of gender of the physician and gender of the patient in explaining differences in patient satisfaction. MATERIAL AND METHODS Overall, 1,130 patients were assigned to one of 4 possible physician-patient sex dyads and were interviewed with a questionnaire about their patient satisfaction. RESULTS Female patients in a dyad with a female physician were most satisfied with the overall judgment of practice visit and the inclusion of life situation in comparison to all other dyads. Male patients in a dyad with a male physician were least satisfied. CONCLUSION In the future, the specific role of patient-physician dyads has to be considered more in the assessment of subdimensions of patient satisfaction.
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Affiliation(s)
- G Weißflog
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - J Ernst
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - A Szkoda
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - S Berger
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - C Stuhr
- Onkologisches Zentrum, Klinik für Internistische Onkologie/Hämatologie, Klinikum St. Georg gGmbH, Akademisches Lehrkrankenhaus der Universität Leipzig
| | - P Herschbach
- Roman-Herzog-Krebszentrum (RHCCC), Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München
| | - K Book
- Roman-Herzog-Krebszentrum (RHCCC), Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München
| | - E Brähler
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
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Schmiegelow MD, Andersson C, Kober L, Gislason G, Norgaard M, Skott Andersen S, Jensen TB, Berger S, Torp-Pedersen C. Associations between obesity and cardiovascular risk factors requiring intervention in young women. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ernst J, Berger S, Weißflog G, Schröder C, Körner A, Niederwieser D, Brähler E, Singer S. Patient participation in the medical decision-making process in haemato-oncology--a qualitative study. Eur J Cancer Care (Engl) 2013; 22:684-90. [PMID: 23731258 DOI: 10.1111/ecc.12077] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
Abstract
Cancer patients are showing increased interest in shared decision-making. Patients with haematological illnesses, however, express considerably less desire for shared decision-making as compared with other oncological patient groups. The goal of the current project was to identify the reasons for the lower desire for shared decision-making among patients with haematological illness. We conducted qualitative, semi-structured interviews with 11 haematological patients (39-70 years old) after the beginning of therapy concerning the course and evaluation of medical shared decision-making. The patients were often overwhelmed by the complexity of the illness and the therapy and did not want to assume any responsibility in medical decision-making. They reported a great deal of distress and very traditional paternalistic role expectations with regards to their health care providers, which limited the patients' ability to partake in the decision-making process. In contrast to the socio-cultural support for many other oncological diseases, haematological diseases are not as well supported, e.g. there is a lack of self-help materials, systematic provision of information and support groups for patients, which may be related to a lower empowerment of this patient population. Results show the limits of patient participation in the context of highly complicated medical conditions. In addition to already researched preferences of the physicians and patients for shared decision-making, future research should pay greater attention to the process and other variables relevant to this aspect of the doctor-patient relationship.
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Affiliation(s)
- J Ernst
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
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