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Rauch P, Stefanits H, Aichholzer M, Serra C, Vorhauer D, Wagner H, Böhm P, Hartl S, Manakov I, Sonnberger M, Buckwar E, Ruiz-Navarro F, Heil K, Glöckel M, Oberndorfer J, Spiegl-Kreinecker S, Aufschnaiter-Hiessböck K, Weis S, Leibetseder A, Thomae W, Hauser T, Auer C, Katletz S, Gruber A, Gmeiner M. Deep learning-assisted radiomics facilitates multimodal prognostication for personalized treatment strategies in low-grade glioma. Sci Rep 2023; 13:9494. [PMID: 37302994 DOI: 10.1038/s41598-023-36298-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79-0.86) for the training cohort over 10 years and 0.74 (Cl 0.64-0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73-0.82) for training and 0.67 (Cl 0.57-0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate.
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Affiliation(s)
- P Rauch
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - H Stefanits
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria.
| | - M Aichholzer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - C Serra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - D Vorhauer
- Institute of Statistics, Johannes Kepler University, Linz, Austria
| | - H Wagner
- Institute of Statistics, Johannes Kepler University, Linz, Austria
| | - P Böhm
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Hartl
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | | | - M Sonnberger
- Institute of Neuroradiology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - E Buckwar
- Institute of Stochastics, Johannes Kepler University, Linz, Austria
| | - F Ruiz-Navarro
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - K Heil
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - M Glöckel
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - J Oberndorfer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Spiegl-Kreinecker
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - K Aufschnaiter-Hiessböck
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Weis
- Institute of Pathology and Neuropathology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - A Leibetseder
- Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - W Thomae
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - T Hauser
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - C Auer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Katletz
- Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - A Gruber
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - M Gmeiner
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
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2
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Mair MJ, Leibetseder A, Heller G, Puhr R, Tomasich E, Hatziioannou T, Woehrer A, Widhalm G, Dieckmann K, Aichholzer M, Weis S, von Oertzen T, Pichler J, Preusser M, Berghoff AS. P11.27.B Whole genome DNA methylation as predictive biomarker in CNS WHO grade 2 and 3 oligodendroglioma patients receiving early postoperative treatment. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Oligodendrogliomas are glial tumors with a relatively favorable survival prognosis of >10 years. While immediate postoperative treatment prolongs survival, long-term toxicities of adjuvant radio-chemotherapy remain a concern. Predictive biomarkers guiding postoperative treatment decisions are limited.
Material and Methods
In this retrospective study, we included patients treated for a newly diagnosed oligodendroglioma (isocitrate dehydrogenase (IDH)-mutated, 1p/19q-codeleted, CNS WHO grades 2 and 3) in 1992 - 2019 at the Medical University of Vienna or the Kepler University Hospital Linz (Austria). Early treatment was defined as radiotherapy, chemotherapy, or both within 6 months after resection, whereas benefit from early treatment was defined as progression-free survival (PFS) above the median in the overall cohort. DNA methylation analysis was performed using Illumina MethylationEPIC 850k microarrays.
Results
Of all 201 eligible patients, sufficient tumor tissue for DNA methylation analysis was available in 46 patients. Of these, 25/46 (54.3%) were diagnosed with CNS WHO grade 2 and 21/46 (45.6%) with grade 3 oligodendroglioma. Median age at diagnosis was 41 years (range: 23-70). In total, 21/46 (45.6%) patients received early treatment, of whom 13/21 (61.9%) received radio-chemotherapy, 6/21 (28.6%) radiotherapy only and 2/21 (9.5%) chemotherapy only. Median PFS was 134.0 months (95%CI: 78.3 - not reached) in patients receiving early treatment versus 87.2 months (95%CI: 66.8 - 150) in patients who did not. In patients receiving early treatment, differences in DNA methylation profiles could be detected between patients who drew benefit from postoperative treatment (group 1) versus those who did not (group 2). Based on the top 1000 differentially methylated CpG sites between both groups, two clusters were detected which comprised either patients of group 1 or 2. Clustering was independent from gender, WHO grade, extent of resection, type of postoperative treatment, treating center, and O6-methylguanine-methyltransferease (MGMT) promoter methylation status. Gene set enrichment analysis of the top 1000 differentially methylated gene sites mapped to 694 genes showed differential methylation in genes involved in fibroblast growth receptor 1 (FGFR1) signaling, Wnt signaling, integrin signaling, and actin cytoskeleton regulation. Conversely, in patients not receiving early treatment, PFS did neither correlate with DNA methylation clustering nor with MGMT promoter methylation.
Conclusion
In our cohort, whole genome DNA methylation was associated with PFS in patients who received early postoperative treatment, suggesting a predictive but not prognostic role. As the predictive value of MGMT promoter methylation is limited in oligodendroglioma, whole genome DNA methylation should be considered in future clinical trials.
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Affiliation(s)
- M J Mair
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - A Leibetseder
- Department of Neurology 1, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz , Linz , Austria
| | - G Heller
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - R Puhr
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - E Tomasich
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - T Hatziioannou
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - A Woehrer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna , Vienna , Austria
| | - G Widhalm
- Department of Neurosurgery, Medical University of Vienna , Vienna , Austria
| | - K Dieckmann
- Department of Radiation Oncology, Medical University of Vienna , Vienna , Austria
| | - M Aichholzer
- Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz , Linz , Austria
| | - S Weis
- Division of Neuropathology, Department of Pathology and Molecular Pathology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz , Linz , Austria
| | - T von Oertzen
- Department of Neurology 1, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz , Linz , Austria
| | - J Pichler
- Department of Internal Medicine and Neurooncology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz , Linz , Austria
| | - M Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
| | - A S Berghoff
- Division of Oncology, Department of Medicine I, Medical University of Vienna , Vienna , Austria
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Weis S, Peycelon M, Lopez P, Paye-Jaouen A, El Ghoneimi A. Minimally-invasive mitrofanoff procedure in children: An analysis of learning curve over a 18-years period. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Mair MJ, Leibetseder A, Wöhrer A, Widhalm G, Dieckmann K, Aichholzer M, Weis S, von Oertzen T, Pichler J, Preusser M, Berghoff AS. P14.14 Adjuvant treatment versus initial observation in newly diagnosed WHO grade II and grade III oligodendroglioma: real-life data from two academic, tertiary care centers in Austria. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Oligodendrogliomas are rare, slow-growing brain tumors with a survival prognosis of >10 years. Although adjuvant radio-chemotherapy has been shown to prolong survival, aggressive treatment comes at the cost of increased toxicity. Systematic data on the optimal timing of adjuvant treatment in oligodendroglioma are lacking.
MATERIAL AND METHODS
Patients treated for a newly diagnosed IDH-mutated, 1p/19q-codeleted oligodendroglioma (WHO grades II/III) in 2000 - 2018 at the Medical University of Vienna or the Kepler University Hospital Linz (Austria) were included in this retrospective study. Adjuvant treatment was defined as radiotherapy (RT), chemotherapy (CHT) or radio-chemotherapy (R-CHT) within 6 months after resection in the absence of progression. “Wait and see” was defined as regular follow up with magnetic resonance imaging and treatment at progression.
RESULTS
185 patients were identified, comprising 123/185 (66.5%) WHO grade II and 62/185 (33.5%) WHO grade III oligodendrogliomas. Median age at diagnosis was 42 years (range: 20–82). Gross total resection (GTR) could be achieved in 77/178 (42.3%) evaluable patients. Adjuvant treatment was applied in 63/185 (38.2%) patients, of whom 43/63 (68.3%) underwent R-CHT, 9/63 (14.3%) CHT only and 11/63 (17.5%) RT only. 43/52 (82.7%) received temozolomide-based treatment, 1/52 (1.9%) procarbazine, lomustine and vincristine (PCV), 1/52 dacarbazine/fotemustine and in 7/52 (13.5%) patients, no data on used regimens was available. Adjuvant treatment was more frequently applied in WHO grade 3 tumors (p<0.001), while there was no association of adjuvant treatment with extent of resection (p=0.24). Patients after GTR who underwent adjuvant therapy presented with longer progression-free survival (PFS) compared to patients initially managed with observation (median: 150 months, 95%CI: 100 - not reached (n.r.) vs. median: 101 months, 95%CI: 73.2–115; p=0.053). In non-GTR tumors, patients with adjuvant therapy presented with a significantly longer median PFS of 107.5 months (95%CI: 62.8-n.r.) as compared to patients initially managed with observation (45.3 months, 95%CI: 41.2–78.8; p=0.025).
CONCLUSION
The application of adjuvant therapy was associated with favorable PFS in patients who underwent resection of newly diagnosed oligodendroglioma in this retrospective study. Prospective clinical trials should investigate the risks and benefits of adjuvant treatment versus initial observation in patients with oligodendroglioma.
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Affiliation(s)
- M J Mair
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - A Leibetseder
- Department of Neurology 1, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - A Wöhrer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - G Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - K Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - M Aichholzer
- Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - S Weis
- Division of Neuropathology, Department of Pathology and Molecular Pathology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - T von Oertzen
- Department of Neurology 1, Neuromed Campus, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - J Pichler
- Department of Internal Medicine and Neurooncology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - M Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - A S Berghoff
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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5
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Bumes E, Fellner C, Lenz S, Linker R, Weis S, Wendl C, Wimmer S, Hau P, Gronwald W, Hutterer M. OS08.4.A Retrospective analysis of in vivo 1H-magnetic resonance spectroscopy based on a machine learning approach enables reliable prediction of IDH mutation in patients with glioma. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Mutation of isocitrate dehydrogenase (IDH) is not only an important landmark in the development of low-grade gliomas, but also has prognostic significance and is a potential therapeutic target. There is a high need to determinate IDH mutation status at diagnosis and during the course of therapy in a non-invasive and reliable manner. We established a machine learning approach based on a support vector machine to detect IDH mutation status in in vivo standard 1H-magnetic resonance spectroscopy (1H-MRS) at 3T with an accuracy of 88.2%, a sensitivity of 95.5% (95% CI, 77.2–99.9%), and a specificity of 75% (95% CI, 42.85–94.5%) in a prospective monocentric clinical trial. Here, the same method is applied in a retrospective cohort at 1.5T and tested for transferability.
MATERIAL AND METHODS
Validation cohort. The validation cohort comprised 100 patients with glioma for which standard in vivo 1H-MRS spectra had been acquired between 2002 and 2007. Standard single voxel spectroscopy had been measured at 1.5T using a PRESS sequence with a TR of 1500ms and a TE of 30ms. One sample had to be excluded due to non-malignant histology and for 15 samples the IDH mutation status was not available. Therefore, the validation cohort comprised 84 samples, of which 35 were bearing an IDH mutation in immunohistochemistry (sequencing for confirmation is outstanding). Machine learning. To transfer our method to an independent validation cohort our previously established machine learning approach was first trained on all samples of the 3T group. The trained algorithm was then applied to the data of the validation cohort. Here, among other factors the different field strengths, with which the spectra were acquired (3T vs. 1.5T) had to be considered.
RESULTS
27 samples of the validation cohort had to be excluded due to poor spectra quality. Our approach correctly detected IDH mutation status in 47 of 62 patients (75.8%), although the technical conditions were significantly different from our published prospective cohort. 17 of 30 patients bearing an IDH mutation were correctly identified, while 30 of 32 wild type patients were determined successfully.
CONCLUSION
Our approach to detect IDH mutation status has promising application in an unselected retrospective cohort, demonstrating transferability across different technical conditions. Further investigations to improve our technique and an advanced neuropathological processing of the samples are planned.
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Affiliation(s)
- E Bumes
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - C Fellner
- Department of Radiology and Division of Neuroradiology, Regensburg University Hospital, Regensburg, Germany
| | - S Lenz
- Division of Molecularpathology, Clinical Institute of Pathology and Molecularpathology, Neuromed Campus, Kepler University Hospital, Linz, Austria
| | - R Linker
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - S Weis
- Division of Neuropathology, Neuromed Campus, Kepler University Hospital, Linz, Austria
| | - C Wendl
- Department of Radiology and Division of Neuroradiology, Regensburg University Hospital, Regensburg, Germany
| | - S Wimmer
- Institute of Neuroradiology, Neuromed Campus, Kepler University Hospital, Linz, Austria
| | - P Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - W Gronwald
- Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
| | - M Hutterer
- Department of Neurology, Saint John of God Hospital Linz, Linz, Austria
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Camilleri JA, Eickhoff SB, Weis S, Chen J, Amunts J, Sotiras A, Genon S. A machine learning approach for the factorization of psychometric data with application to the Delis Kaplan Executive Function System. Sci Rep 2021; 11:16896. [PMID: 34413412 PMCID: PMC8377093 DOI: 10.1038/s41598-021-96342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
While a replicability crisis has shaken psychological sciences, the replicability of multivariate approaches for psychometric data factorization has received little attention. In particular, Exploratory Factor Analysis (EFA) is frequently promoted as the gold standard in psychological sciences. However, the application of EFA to executive functioning, a core concept in psychology and cognitive neuroscience, has led to divergent conceptual models. This heterogeneity severely limits the generalizability and replicability of findings. To tackle this issue, in this study, we propose to capitalize on a machine learning approach, OPNMF (Orthonormal Projective Non-Negative Factorization), and leverage internal cross-validation to promote generalizability to an independent dataset. We examined its application on the scores of 334 adults at the Delis-Kaplan Executive Function System (D-KEFS), while comparing to standard EFA and Principal Component Analysis (PCA). We further evaluated the replicability of the derived factorization across specific gender and age subsamples. Overall, OPNMF and PCA both converge towards a two-factor model as the best data-fit model. The derived factorization suggests a division between low-level and high-level executive functioning measures, a model further supported in subsamples. In contrast, EFA, highlighted a five-factor model which reflects the segregation of the D-KEFS battery into its main tasks while still clustering higher-level tasks together. However, this model was poorly supported in the subsamples. Thus, the parsimonious two-factors model revealed by OPNMF encompasses the more complex factorization yielded by EFA while enjoying higher generalizability. Hence, OPNMF provides a conceptually meaningful, technically robust, and generalizable factorization for psychometric tools.
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Affiliation(s)
- J A Camilleri
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany.
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany.
| | - S B Eickhoff
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
| | - S Weis
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
| | - J Chen
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - J Amunts
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
| | - A Sotiras
- Mallinckrodt Institute of Radiology, Institute for Informatics, Washington University in Saint Louis, Saint Louis, USA
| | - S Genon
- Institute of Neuroscience and Medicine (INM-7 Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany
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Abstract
Infection with influenza A and B viruses results in a mild to severe respiratory tract infection. It is widely accepted that many factors affect the severity of influenza disease, including viral replication, host adaptation, innate immune signalling, pre-existing immunity, and secondary infections. In this review, we will focus on the interplay between influenza virus RNA synthesis and the detection of influenza virus RNA by our innate immune system. Specifically, we will discuss the generation of various RNA species, host pathogen receptors, and host shut-off. In addition, we will also address outstanding questions that currently limit our knowledge of influenza virus replication and host adaption. Understanding the molecular mechanisms underlying these factors is essential for assessing the pandemic potential of future influenza virus outbreaks.
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Magnes T, Wagner S, Thorner AR, Neureiter D, Klieser E, Rinnerthaler G, Weiss L, Huemer F, Zaborsky N, Steiner M, Weis S, Greil R, Egle A, Melchardt T. Clonal evolution in diffuse large B-cell lymphoma with central nervous system recurrence. ESMO Open 2021; 6:100012. [PMID: 33399078 PMCID: PMC7807834 DOI: 10.1016/j.esmoop.2020.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prognosis of patients with secondary central nervous system lymphoma (SCNSL) is poor and despite massive advances in understanding the mutational landscape of primary diffuse large B-cell lymphoma (DLBCL), the genetic comparison to SCNSL is still lacking. We therefore collected paired samples from six patients with DLBCL with available biopsies from a lymph node (LN) at primary diagnosis and the central nervous system (CNS) at recurrence. PATIENTS AND METHODS A targeted, massively parallel sequencing approach was used to analyze 216 genes recurrently mutated in DLBCL. Healthy tissue from each patient was also sequenced in order to exclude germline mutations. The results of the primary biopsies were compared with those of the CNS recurrences to depict the genetic background of SCNSL and evaluate clonal evolution. RESULTS Sequencing was successful in five patients, all of whom had at least one discordant mutation that was not detected in one of their samples. Four patients had mutations that were found in the CNS but not in the primary LN. Discordant mutations were found in genes known to be important in lymphoma biology such as MYC, CARD11, EP300 and CCND3. Two patients had a Jaccard similarity coefficient below 0.5 indicating substantial genetic differences between the primary LN and the CNS recurrence. CONCLUSIONS This analysis gives an insight into the genetic landscape of SCNSL and confirms the results of our previous study on patients with systemic recurrence of DLBCL with evidence of substantial clonal diversification at relapse in some patients, which might be one of the mechanisms of treatment resistance.
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Affiliation(s)
- T Magnes
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - S Wagner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - A R Thorner
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, USA
| | - D Neureiter
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - E Klieser
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - G Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - N Zaborsky
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - M Steiner
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - S Weis
- Division of Neuropathology, Department of Pathology and Neuropathology, Kepler University Hospital and School of Medicine, Johannes Kepler University, Linz, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - A Egle
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - T Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria.
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9
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Weinmann J, Weis S, Sippel J, Tulalamba W, Remes A, El Andari J, Herrmann AK, Pham QH, Borowski C, Hille S, Schönberger T, Frey N, Lenter M, VandenDriessche T, Müller OJ, Chuah MK, Lamla T, Grimm D. Identification of a myotropic AAV by massively parallel in vivo evaluation of barcoded capsid variants. Nat Commun 2020; 11:5432. [PMID: 33116134 PMCID: PMC7595228 DOI: 10.1038/s41467-020-19230-w] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [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: 02/09/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022] Open
Abstract
Adeno-associated virus (AAV) forms the basis for several commercial gene therapy products and for countless gene transfer vectors derived from natural or synthetic viral isolates that are under intense preclinical evaluation. Here, we report a versatile pipeline that enables the direct side-by-side comparison of pre-selected AAV capsids in high-throughput and in the same animal, by combining DNA/RNA barcoding with multiplexed next-generation sequencing. For validation, we create three independent libraries comprising 183 different AAV variants including widely used benchmarks and screened them in all major tissues in adult mice. Thereby, we discover a peptide-displaying AAV9 mutant called AAVMYO that exhibits superior efficiency and specificity in the musculature including skeletal muscle, heart and diaphragm following peripheral delivery, and that holds great potential for muscle gene therapy. Our comprehensive methodology is compatible with any capsids, targets and species, and will thus facilitate and accelerate the stratification of optimal AAV vectors for human gene therapy. Adeno-associated virus is the basis of many gene therapies and gene transfer vectors. Here the authors report a pipeline to enable side-by-side comparison of pre-selected capsids in a high throughput manner.
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Affiliation(s)
- Jonas Weinmann
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany.,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany
| | - Sabrina Weis
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany.,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany
| | - Josefine Sippel
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany.,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany
| | - Warut Tulalamba
- Vrije Universiteit Brussel, Department of Gene Therapy & Regenerative Medicine, 1090, Brussels, Belgium
| | - Anca Remes
- University Hospital Schleswig-Holstein, Campus Kiel, Innere Medizin III, 24105, Kiel, Germany.,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 24105, Kiel, Germany
| | - Jihad El Andari
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany.,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany
| | - Anne-Kathrin Herrmann
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany.,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany
| | - Quang H Pham
- Vrije Universiteit Brussel, Department of Gene Therapy & Regenerative Medicine, 1090, Brussels, Belgium
| | - Christopher Borowski
- University Hospital Schleswig-Holstein, Campus Kiel, Innere Medizin III, 24105, Kiel, Germany.,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 24105, Kiel, Germany
| | - Susanne Hille
- University Hospital Schleswig-Holstein, Campus Kiel, Innere Medizin III, 24105, Kiel, Germany.,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 24105, Kiel, Germany
| | - Tanja Schönberger
- Boehringer Ingelheim Pharma GmbH & Co. KG, Drug Discovery Sciences, 88400, Biberach an der Riß, Germany
| | - Norbert Frey
- University Hospital Schleswig-Holstein, Campus Kiel, Innere Medizin III, 24105, Kiel, Germany.,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 24105, Kiel, Germany
| | - Martin Lenter
- Boehringer Ingelheim Pharma GmbH & Co. KG, Drug Discovery Sciences, 88400, Biberach an der Riß, Germany
| | - Thierry VandenDriessche
- Vrije Universiteit Brussel, Department of Gene Therapy & Regenerative Medicine, 1090, Brussels, Belgium.,University of Leuven, Center for Molecular & Vascular Biology, Department of Cardiovascular Sciences, Leuven, 3000, Belgium
| | - Oliver J Müller
- University Hospital Schleswig-Holstein, Campus Kiel, Innere Medizin III, 24105, Kiel, Germany.,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 24105, Kiel, Germany
| | - Marinee K Chuah
- Vrije Universiteit Brussel, Department of Gene Therapy & Regenerative Medicine, 1090, Brussels, Belgium.,University of Leuven, Center for Molecular & Vascular Biology, Department of Cardiovascular Sciences, Leuven, 3000, Belgium
| | - Thorsten Lamla
- Boehringer Ingelheim Pharma GmbH & Co. KG, Drug Discovery Sciences, 88400, Biberach an der Riß, Germany
| | - Dirk Grimm
- Heidelberg University Hospital, Dept. of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, 69120, Heidelberg, Germany. .,BioQuant, University of Heidelberg, 69120, Heidelberg, Germany. .,German Center for Infection Research (DZIF) and German Center for Cardiovascular Research (DZHK), partner site Heidelberg, 69120, Heidelberg, Germany.
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10
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Weis S, Kesselmeier M, Davis JS, Morris AM, Lee S, Scherag A, Hagel S, Pletz MW. Cefazolin versus anti-staphylococcal penicillins for the treatment of patients with Staphylococcus aureus bacteraemia. Clin Microbiol Infect 2019; 25:818-827. [PMID: 30928559 DOI: 10.1016/j.cmi.2019.03.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 03/02/2019] [Accepted: 03/09/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND For patients with bacteraemia caused by methicillin-sensitive Staphylococcus aureus anti-staphylococcal penicillins (ASPs) or cefazolin are agents of choice. While ASPs are potentially nephrotoxic, cefazolin may be less effective in some S. aureus strains due to an inoculum effect. OBJECTIVES To perform a systematic literature review and meta-analysis assessing current evidence comparing cefazolin with ASPs for patients with S. aureus bacteraemia (SAB). METHODS We searched MEDLINE, ISI Web of Science (Science Citation Index Expanded) and the Cochrane Database as well as clinicaltrials.gov from inception to 26 June 2018. All studies investigating the effects of cefazolin versus ASP in patients with methicillin-sensitive SAB were eligible for inclusion regardless of study design, publication status or language. Additional information was requested by direct author contact. A meta-analysis to estimate relative risks (RRs) with the corresponding 95% confidence intervals (CIs) was performed. Statistical heterogeneity was estimated using I2. The primary endpoint was 90-day all-cause mortality. The Newcastle-Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used for study and data quality assessment. RESULTS Fourteen non-randomized studies were included. Seven reported the primary endpoint (RR 0.71 (0.50, 1.02), low quality of evidence). Cefazolin treatment may be associated with lower 30-day mortality rates (RR 0.70 (0.54, 0.91), low quality of evidence) and less nephrotoxicity (RR 0.36 (0.21, 0.59), (low quality of evidence)). We are uncertain whether cefazolin and ASP differ regarding treatment failure/relapse as the quality of the evidence has been assessed as very low (RR of 0.84 (0.59, 1.18)). For patients with endocarditis (RR 0.71 (0.12, 4.05)) or abscesses (RR 1.17 (0.30, 4.63)), cefazolin treatment may be associated with equal 30-day and 90-day mortality (low quality of evidence). CONCLUSIONS Cefazolin seemed to be at least equally as effective as ASPs while being associated with less nephrotoxicity.
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Affiliation(s)
- S Weis
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany; Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany.
| | - M Kesselmeier
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany; Research Group Clinical Epidemiology, CSCC, Jena University Hospital, Jena, Germany
| | - J S Davis
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, NT, Australia; Department of Infectious Diseases, John Hunter Hospital, Newcastle, NSW, Australia
| | - A M Morris
- Department of Medicine, Division of Infectious Diseases, Sinai Health System, University Health Network, University of Toronto, Canada
| | - S Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - A Scherag
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany; Research Group Clinical Epidemiology, CSCC, Jena University Hospital, Jena, Germany; Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - S Hagel
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - M W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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11
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Möhnle P, Hirschberger S, Hinske LC, Briegel J, Hübner M, Weis S, Dimopoulos G, Bauer M, Giamarellos-Bourboulis EJ, Kreth S. MicroRNAs 143 and 150 in whole blood enable detection of T-cell immunoparalysis in sepsis. Mol Med 2018; 24:54. [PMID: 30332984 PMCID: PMC6191918 DOI: 10.1186/s10020-018-0056-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 07/30/2018] [Accepted: 10/04/2018] [Indexed: 12/25/2022] Open
Abstract
Background Currently, no suitable clinical marker for detection of septic immunosuppression is available. We aimed at identifying microRNAs that could serve as biomarkers of T-cell mediated immunoparalysis in sepsis. Methods RNA was isolated from purified T-cells or from whole blood cells obtained from septic patients and healthy volunteers. Differentially regulated miRNAs were identified by miRNA Microarray (n = 7). Validation was performed via qPCR (n = 31). Results T-cells of septic patients revealed characteristics of immunosuppression: Pro-inflammatory miR-150 and miR-342 were downregulated, whereas anti-inflammatory miR-15a, miR-16, miR-93, miR-143, miR-223 and miR-424 were upregulated. Assessment of T-cell effector status showed significantly reduced mRNA-levels of IL2, IL7R and ICOS, and increased levels of IL4, IL10 and TGF-β. The individual extent of immunosuppression differed markedly. MicroRNA-143, − 150 and − 223 independently indicated T-cell immunoparalysis and significantly correlated with patient’s IL7R-/ICOS-expression and SOFA-scores. In whole blood, composed of innate and adaptive immune cells, both traits of immunosuppression and hyperinflammation were detected. Importantly, miR-143 and miR-150 – both predominantly expressed in T-cells – retained strong power of discrimination also in whole blood samples. Conclusions These findings suggest miR-143 and miR-150 as promising markers for detection of T-cell immunosuppression in whole blood and may help to develop new approaches for miRNA-based diagnostic in sepsis. Electronic supplementary material The online version of this article (10.1186/s10020-018-0056-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P Möhnle
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany
| | - S Hirschberger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany.,Walter-Brendel-Center of Experimental Medicine, Ludwig Maximilian University (LMU), Munich, Germany
| | - L C Hinske
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany
| | - J Briegel
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany
| | - M Hübner
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany.,Walter-Brendel-Center of Experimental Medicine, Ludwig Maximilian University (LMU), Munich, Germany
| | - S Weis
- Department of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller University, Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany.,Center for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
| | - G Dimopoulos
- 2nd Department of Critical Care Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Bauer
- Department of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller University, Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - E J Giamarellos-Bourboulis
- 4th Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - S Kreth
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital, Ludwig Maximilian University (LMU), Marchioninistraße 15, 81377, Munich, Germany. .,Walter-Brendel-Center of Experimental Medicine, Ludwig Maximilian University (LMU), Munich, Germany.
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12
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Wagner JN, Weis S, Kubasta C, Panholzer J, von Oertzen TJ. CXCL13 as a diagnostic marker of neuroborreliosis and other neuroinflammatory disorders in an unselected group of patients. J Neurol 2017; 265:74-81. [PMID: 29134272 DOI: 10.1007/s00415-017-8669-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/05/2017] [Accepted: 11/06/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The C-X-C motif chemokine ligand 13 (CXCL13) and its receptor CXCR5 play an important role in the homing of B-lymphocytes. As a biomarker in the cerebrospinal fluid (CSF), CXCL13 has increasingly been used for the diagnosis of neuroborreliosis (NB). We evaluated the diagnostic and prognostic potential of CXCL13 for NB and other neuroinflammatory diseases in an unselected cohort, paying attention to those patients particularly who might benefit from newly emerging CXCL13-directed therapies. METHODS We report the CSF CXCL13 concentrations and other relevant baseline characteristics for an unselected cohort of 459 patients. We compare different diagnostic groups and analyse the sensitivity and specificity of CSF CXCL13 as a marker of NB. The course of the CXCL13 concentrations is reported in a subgroup of 19 patients. RESULTS We confirm the high diagnostic yield of CXCL13 for NB in this unselected cohort. The optimal cut-off for the reliable diagnosis of NB was 93.83 pg/ml, resulting in a sensitivity and specificity of 95 and 97%, respectively (positive predictive value 55.9%, negative predictive value 99.8%), surpassing the sensitivity of both serological testing and PCR. CSF CXCL13 concentration showed a swift response to therapy. Non-NB patients with high CSF CXCL13 concentrations suffered from meningeosis neoplastica or infectious encephalitis. CONCLUSIONS CXCL13 is a valuable tool for the diagnosis and assessment of therapeutic response in NB. Furthermore, our data point towards an emerging role of CXCL13 in the diagnosis and prognosis of viral encephalitis and meningeosis neoplastica. These results are of particular interest in the light of recently developed approaches to CXCL13-directed therapeutic interventions.
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Affiliation(s)
- Judith N Wagner
- Department of Neurology 1, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, 4020, Linz, Austria.
| | - S Weis
- Department of Neuropathology, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, 4020, Linz, Austria
| | - C Kubasta
- Department of Clinical Pathology, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, 4020, Linz, Austria
| | - J Panholzer
- Department of Neurology 1, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, 4020, Linz, Austria
| | - T J von Oertzen
- Department of Neurology 1, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, 4020, Linz, Austria
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13
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Hutter HP, Wöhrer A, Damm L, Wanek G, Leiss U, Weis S, Rieger R, Freyschlag C, Furtmüller B, Wallner P, Kundi M. Mobile phone use and brain tumors in young people: Austrian experience within the MOBI-KIDS study. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.267] [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: 11/14/2022] Open
Affiliation(s)
- HP Hutter
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - A Wöhrer
- Institute of Neurology, Medical University Vienna, Vienna, Austria
| | - L Damm
- Institute of Neurology, Medical University Vienna, Vienna, Austria
| | - G Wanek
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - U Leiss
- Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - S Weis
- Wagner-Jauregg Provincial Neuropsychiatric Clinic, Linz, Austria
| | - R Rieger
- State Hospital Gmunden, Gmunden, Austria
| | - Ch Freyschlag
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | | | - P Wallner
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - M Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
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14
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Haller P, Weis S, Jaeger B, Huber K. P3447New frailty assessment based on routine nurse anamnesis before discharge is a strong predictor of all-cause mortality in patients with myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3447] [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: 11/13/2022] Open
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15
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Weis S, Hagel S, Schmitz RPH, Scherag A, Brunkhorst FM, Forstner C, Löffler B, Pletz MW. Study on the utility of a statewide counselling programme for improving mortality outcomes of patients with Staphylococcus aureus bacteraemia in Thuringia (SUPPORT): a study protocol of a cluster-randomised crossover trial. BMJ Open 2017; 7:e013976. [PMID: 28391236 PMCID: PMC5775453 DOI: 10.1136/bmjopen-2016-013976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Staphylococcus aureus bacteraemia (SAB) is a frequent infection with high mortality rates. It requires specific diagnostic and therapeutic management such as prolonged intravenous administration of antibiotics and aggressive search for and control of infectious sources. Underestimation of disease severity frequently results in delayed or inappropriate management of patients with SAB leading to increased mortality rates. According to observational studies, patient counselling by infectious disease consultants (IDC) improves survival and reduces the length of hospital stay as well as complication rates. In many countries, IDC are available only in some tertiary hospitals. In this trial, we aim to demonstrate that the outcome of patients with SAB in small and medium size hospitals that do not employ IDC can be improved by unsolicited ID phone counselling. The SUPPORT trial will be the first cluster-randomised controlled multicentre trial addressing this question. METHODS AND ANALYSIS SUPPORT is a single-blinded, multicentre interventional, cluster-randomised, controlled crossover trial with a minimum of 15 centres that will include 250 patients with SAB who will receive unsolicited IDC counselling and 250 who will receive standard of care. Reporting of SAB will be conducted by an electronic real-time blood culture registry established for the German Federal state of Thuringia (ALERTSNet) or directly by participating centres in order to minimise time delay before counselling. Mortality, disease course and complications will be monitored for 90 days with 30-day all-cause mortality rates as the primary outcome. Generalised linear mixed modelling will be used to detect the difference between the intervention sequences. We expect improved outcome of patients with SAB after IDC. ETHICS AND DISSEMINATION We obtained ethics approval from the Ethics committee of the Jena University Hospital and from the Ethics committee of the State Chamber of Physicians of Thuringia. Results will be published in a peer-reviewed journal and additionally disseminated through public media. TRIAL REGISTRATION NUMBER DRKS00010135.
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Affiliation(s)
- S Weis
- Center for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany
| | - S Hagel
- Center for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - R P H Schmitz
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - A Scherag
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - F M Brunkhorst
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena, Germany
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - C Forstner
- Center for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - B Löffler
- Institute for Medical Microbiology, Jena University Hospital, Jena, Germany
| | - M W Pletz
- Center for Infectious Disease and Infection Control, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
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16
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Weis S, Kimmig A, Hagel S, Pletz MW. [Antibiotic stewardship and Staphylococcus aureus Bacteremia]. Med Klin Intensivmed Notfmed 2017; 112:192-198. [PMID: 28378151 DOI: 10.1007/s00063-017-0270-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
Rates of antibiotic resistance are increasing worldwide and impact on the treatment of patients with bacterial infections. A broad and uncritical application in inpatient and outpatient settings as well as in agriculture has been recognized as the main driving force. Antibiotic stewardship (ABS) programs aim at countering this worrisome development using various direct interventions such as infectious disease counseling. Blood stream infections caused by Staphylococcus (S.) aureus are severe infections associated with high mortality rates. ABS interventions such as de-eskalation of the antibiotic regimen or application of narrow-spectrum beta-lactam antibiotics can significantly reduce mortality rates. In this review, we discuss the importance of ABS programs and infectious disease counseling for the treatment of S. aureus blood stream infection.
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Affiliation(s)
- S Weis
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland.
- Center for Sepsis Control and Care, Universitätsklinikum Jena, Jena, Deutschland.
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland.
| | - A Kimmig
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland
| | - S Hagel
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland
- Center for Sepsis Control and Care, Universitätsklinikum Jena, Jena, Deutschland
| | - M W Pletz
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland
- Center for Sepsis Control and Care, Universitätsklinikum Jena, Jena, Deutschland
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17
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Brandstätter W, Hatzl M, Weis S, Javor A, Gabriel M. Successful resection of TSH-secreting pituitary adenoma demonstrated by serial 99mTc-scintigraphy. Nuklearmedizin 2015. [DOI: 10.1055/s-0037-1616611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Brandstätter W, Hatzl M, Weis S, Javor A, Gabriel M. Successful resection of TSH-secreting pituitary adenoma demonstrated by serial 99mTc-scintigraphy. Nuklearmedizin 2015; 54:N23-N24. [PMID: 26105720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
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Abstract
Diarrheal diseases are among the most common diseases worldwide. In this review the current treatment recommendations for acute (Part 1) and chronic (Part 2) infectious diarrhea are summarized and typical enteropathogens are discussed. The second part of the article describes chronic diarrhea, its related pathogens and treatment. In contrast to acute diarrhea which is mainly caused by viral and typical bacterial pathogens, chronic diarrhea has mainly non-infectious origins. Protozoal pathogens, such as Giardia lamblia and Entamoeba histolytica in particular are found and more rarely bacterial pathogens, such as Tropheryma whipplei. Opportunistic pathogens cause diarrhea in immunocompromised patients, such as in HIV patients. In these patients cytomegalovirus (CMV) colitis or infections with Cryptosporidium spp., Cyclospora cayetanensis, Isospora belli or microsporidia have to be considered. Besides targeted specific antimicrobial therapy, anti-retroviral drugs improving the underlying immunosuppression and thus the reconstitution of the adaptive immune response remain a cornerstone of the treatment in HIV-positive patients.
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Affiliation(s)
- C Lübbert
- Fachbereich Infektions- und Tropenmedizin, Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, AöR, Liebigstr. 20, 04103, Leipzig, Deutschland,
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Spiegl-Kreinecker S, Loetsch D, Laaber M, Pichler J, Weis S, Ghanim B, Webersinke G, Olschowski A, Berger W. P04.24 * MUTATIONS OF THE TERT PROMOTER CORRELATE WITH ENHANCED TELOMERASE ACTIVATION AND PREDICT A WORSE PROGNOSIS IN PRIMARY GLIOBLASTOMA PATIENTS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.156] [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: 11/13/2022] Open
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Dunzinger A, Decker J, Kieberger A, Weis S, Pichler R. Unusual loss of FDG uptake in recurrent GIST. Nuklearmedizin 2014; 53:N35-N37. [PMID: 25100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 05/26/2014] [Indexed: 06/03/2023]
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Weis S, John E, Lippmann N, Mössner J, Lübbert C. Erratum: Clostridium-difficile-Infektionen (CDI) im Wandel der Zeit – ein Thema nur für den Internisten? Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1368432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S. Weis
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
| | - E. John
- Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Deutschland
| | - N. Lippmann
- Institut für Medizinische Mikrobiologie, Universität Leipzig, Leipzig, Deutschland
| | - J. Mössner
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
| | - C. Lübbert
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
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Woehrer A, Hackl M, Waldhör T, Weis S, Pichler J, Olschowski A, Buchroithner J, Maier H, Stockhammer G, Thomé C, Haybaeck J, Payer F, von Campe G, Kiefer A, Würtz F, Vince GH, Sedivy R, Oberndorfer S, Marhold F, Bordihn K, Stiglbauer W, Gruber-Mösenbacher U, Bauer R, Feichtinger J, Reiner-Concin A, Grisold W, Marosi C, Preusser M, Dieckmann K, Slavc I, Gatterbauer B, Widhalm G, Haberler C, Hainfellner JA. Relative survival of patients with non-malignant central nervous system tumours: a descriptive study by the Austrian Brain Tumour Registry. Br J Cancer 2014; 110:286-96. [PMID: 24253501 PMCID: PMC3899758 DOI: 10.1038/bjc.2013.714] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/04/2013] [Accepted: 10/21/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Unlike malignant primary central nervous system (CNS) tumours outcome data on non-malignant CNS tumours are scarce. For patients diagnosed from 1996 to 2002 5-year relative survival of only 85.0% has been reported. We investigated this rate in a contemporary patient cohort to update information on survival. METHODS We followed a cohort of 3983 cases within the Austrian Brain Tumour Registry. All patients were newly diagnosed from 2005 to 2010 with a histologically confirmed non-malignant CNS tumour. Vital status, cause of death, and population life tables were obtained by 31 December 2011 to calculate relative survival. RESULTS Overall 5-year relative survival was 96.1% (95% CI 95.1-97.1%), being significantly lower in tumours of borderline (90.2%, 87.2-92.7%) than benign behaviour (97.4%, 96.3-98.3%). Benign tumour survival ranged from 86.8 for neurofibroma to 99.7% for Schwannoma; for borderline tumours survival rates varied from 83.2 for haemangiopericytoma to 98.4% for myxopapillary ependymoma. Cause of death was directly attributed to the CNS tumour in 39.6%, followed by other cancer (20.4%) and cardiovascular disease (15.8%). CONCLUSION The overall excess mortality in patients with non-malignant CNS tumours is 5.5%, indicating a significant improvement in survival over the last decade. Still, the remaining adverse impact on survival underpins the importance of systematic registration of these tumours.
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Affiliation(s)
- A Woehrer
- Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - M Hackl
- Austrian National Cancer Registry, Statistics Austria, Guglgasse 13, A-1110 Vienna, Austria
| | - T Waldhör
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - S Weis
- Department of Pathology and Neuropathology, State Neuropsychiatric Hospital Wagner-Jauregg, Linz, Wagner-Jauregg-Weg 15, A-4020 Linz, Austria
| | - J Pichler
- Internal Medicine and Neurooncology, State Neuropsychiatric Hospital Wagner-Jauregg, Wagner-Jauregg-Weg 15, A-4020 Linz, Austria
| | - A Olschowski
- Department of Neurosurgery, State Neuropsychiatric Hospital Wagner-Jauregg, Wagner-Jauregg-Weg 15, A-4020 Linz, Austria
| | - J Buchroithner
- Department of Neurosurgery, State Neuropsychiatric Hospital Wagner-Jauregg, Wagner-Jauregg-Weg 15, A-4020 Linz, Austria
| | - H Maier
- Department of Neuropathology, Institute of Pathology, Medical University of Innsbruck, Christoph-Probst-Platz Innrain 52, A-6020 Innsbruck, Austria
| | - G Stockhammer
- Department of Neurology, Medical University of Innsbruck, Christoph-Probst-Platz Innrain 52, A-6020 Innsbruck, Austria
| | - C Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Christoph-Probst-Platz Innrain 52, A-6020 Innsbruck, Austria
| | - J Haybaeck
- Department of Neuropathology, Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria
| | - F Payer
- Division of General Neurology and Division of Neuroradiology, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria
| | - G von Campe
- Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria
| | - A Kiefer
- Institute of Pathology, State Hospital Klagenfurt, St Veiter Strasse 47, A-9020 Klagenfurt, Austria
| | - F Würtz
- Institute of Pathology, State Hospital Klagenfurt, St Veiter Strasse 47, A-9020 Klagenfurt, Austria
| | - G H Vince
- Department of Neurosurgery, State Hospital Klagenfurt, St Veiter Strasse 47, A-9020 Klagenfurt, Austria
| | - R Sedivy
- Department of Clinical Pathology, General Hospital St Pölten, Probst-Führer-Strasse 4, A-3100 St Pölten, Austria
| | - S Oberndorfer
- Department of Neurology, General Hospital St Pölten, Probst-Führer-Strasse 4, A-3100 St Pölten, Austria
| | - F Marhold
- Department of Neurosurgery, General Hospital St Pölten, Probst-Führer-Strasse 4, A-3100 St Pölten, Austria
| | - K Bordihn
- Department of Neurosurgery, Christian Doppler Clinic, Paracelsus Private Medical University, Strubergasse 21, A-5020 Salzburg, Austria
| | - W Stiglbauer
- Institute of Pathology, General Hospital Wiener Neustadt, Corvinusring 3–5, A-2700 Wiener Neustadt, Austria
| | - U Gruber-Mösenbacher
- Department of Pathology, Feldkirch State Hospital, Carinagasse 47, A-6807 Feldkirch, Austria
| | - R Bauer
- Department of Neurosurgery, Feldkirch State Hospital, Carinagasse 47, A-6807 Feldkirch, Austria
| | - J Feichtinger
- Department of Pathology, Krankenanstalt Rudolfstiftung, Juchgasse 25, A-1030 Vienna, Austria
| | - A Reiner-Concin
- Institute of Pathology, Danube Hospital, Langobardenstrasse 122, A-1220 Vienna, Austria
| | - W Grisold
- Department of Neurology, KFJ-Hospital Vienna, Kundratstrasse 3, A-1100 Vienna, Austria
| | - C Marosi
- Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - M Preusser
- Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - K Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - I Slavc
- Department of Paediatrics, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - B Gatterbauer
- Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - G Widhalm
- Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - C Haberler
- Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
| | - J A Hainfellner
- Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18–20, A-1097 Vienna, Austria
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Thimm M, Weis S, Hausmann M, Sturm W. Menstrual cycle effects on selective attention and its underlying cortical networks. Neuroscience 2013; 258:307-17. [PMID: 24262802 DOI: 10.1016/j.neuroscience.2013.11.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 10/31/2013] [Accepted: 11/05/2013] [Indexed: 10/26/2022]
Abstract
It was the aim of the present study to investigate menstrual cycle effects on selective attention and its underlying functional cerebral networks. Twenty-one healthy, right-handed, normally cycling women were investigated by means of functional magnetic resonance imaging using a go/no-go paradigm during the menstrual, follicular and luteal phase. On the behavioral level there was a significant interaction between visual half field and cycle phase with reaction times to right-sided compared to left-sided stimuli being faster in the menstrual compared to the follicular phase. These results might argue for a more pronounced functional cerebral asymmetry toward the left hemisphere in selective attention during the menstrual phase with low estradiol and progesterone levels. Functional imaging, however, did not reveal clear-cut menstrual phase-related changes in activation pattern in parallel to these behavioral findings. A functional connectivity analysis identified differences between the menstrual and the luteal phase: During the menstrual phase, left inferior parietal cortex showed a stronger negative correlation with the right middle frontal gyrus while the left medial frontal cortex showed a stronger negative correlation with the left middle frontal gyrus. These results can serve as further evidence of a modulatory effect of steroid hormones on networks of lateralized cognitive functions not only by interhemispheric inhibition but also by affecting intrahemispheric functional connectivity.
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Affiliation(s)
- M Thimm
- Department of Neurology, Section Clinical Neuropsychology, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany.
| | - S Weis
- Department of Psychology, Durham University, Durham DH1 3LE, United Kingdom
| | - M Hausmann
- Department of Psychology, Durham University, Durham DH1 3LE, United Kingdom
| | - W Sturm
- Department of Neurology, Section Clinical Neuropsychology, University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
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Cheng L, Huang Z, Zhou W, Wu Q, Rich J, Bao S, Baxter P, Mao H, Zhao X, Liu Z, Huang Y, Voicu H, Gurusiddappa S, Su JM, Perlaky L, Dauser R, Leung HCE, Muraszko KM, Heth JA, Fan X, Lau CC, Man TK, Chintagumpala M, Li XN, Clark P, Zorniak M, Cho Y, Zhang X, Walden D, Shusta E, Kuo J, Sengupta S, Goel-Bhattacharya S, Kulkarni S, Cochran B, Cusulin C, Luchman A, Weiss S, Wu M, Fernandez N, Agnihotri S, Diaz R, Rutka J, Bredel M, Karamchandani J, Das S, Day B, Stringer B, Al-Ejeh F, Ting M, Wilson J, Ensbey K, Jamieson P, Bruce Z, Lim YC, Offenhauser C, Charmsaz S, Cooper L, Ellacott J, Harding A, Lickliter J, Inglis P, Reynolds B, Walker D, Lackmann M, Boyd A, Berezovsky A, Poisson L, Hasselbach L, Irtenkauf S, Transou A, Mikkelsen T, deCarvalho AC, Emlet D, Del Vecchio C, Gupta P, Li G, Skirboll S, Wong A, Figueroa J, Shahar T, Hossain A, Lang F, Fouse S, Nakamura J, James CD, Chang S, Costello J, Frerich JM, Rahimpour S, Zhuang Z, Heiss JD, Golebiewska A, Stieber D, Evers L, Lenkiewicz E, Brons NHC, Nicot N, Oudin A, Bougnaud S, Hertel F, Bjerkvig R, Barrett M, Vallar L, Niclou SP, Hao X, Rahn J, Ujack E, Lun X, Cairncross G, Weiss S, Senger D, Robbins S, Harness J, Lerner R, Ihara Y, Santos R, Torre JDL, Lu A, Ozawa T, Nicolaides T, James D, Petritsch C, Higgins D, Schroeder M, Ball B, Milligan B, Meyer F, Sarkaria J, Henley J, Flavahan W, Wu Q, Hitomi M, Rahim N, Kim Y, Sloan A, Weil R, Nakano I, Sarkaria J, Stringer B, Li M, Lathia J, Rich J, Hjelmeland A, Kaluzova M, Platt S, Kent M, Bouras A, Machaidze R, Hadjipanayis C, Kang SG, Kim SH, Huh YM, Kim EH, Park EK, Chang JH, Kim SH, Hong YK, Kim DS, Lee SJ, Kim EH, Kang SG, Hitomi M, Deleyrolle L, Sinyuk M, Li M, Goan W, Otvos B, Rohaus M, Oli M, Vedam-Mai V, Schonberg D, Wu Q, Rich J, Reynolds B, Lathia J, Lee ST, Chu K, Kim SH, Lee SK, Kim M, Roh JK, Lerner R, Griveau A, Ihara Y, Reichholf B, McMahon M, Rowitch D, James D, Petritsch C, Nitta R, Mitra S, Agarwal M, Bui T, Li G, Lin J, Adamson C, Martinez-Quintanilla J, Choi SH, Bhere D, Heidari P, He D, Mahmood U, Shah K, Mitra S, Gholamin S, Feroze A, Achrol A, Kahn S, Weissman I, Cheshier S, Nakano I, Sulman EP, Wang Q, Mostovenko E, Liu H, Lichti CF, Shavkunov A, Kroes RA, Moskal JR, Conrad CA, Lang FF, Emmett MR, Nilsson CL, Osuka S, Sampetrean O, Shimizu T, Saga I, Onishi N, Sugihara E, Okubo J, Fujita S, Takano S, Matsumura A, Saya H, Saito N, Fu J, Wang S, Yung WKA, Koul D, Schmid RS, Irvin DM, Vitucci M, Bash RE, Werneke AM, Miller CR, Shinojima N, Hossain A, Takezaki T, Fueyo J, Gumin J, Gao F, Nwajei F, Marini FC, Andreeff M, Kuratsu JI, Lang FF, Singh S, Burrell K, Koch E, Agnihotri S, Jalali S, Vartanian A, Gumin J, Sulman E, Lang F, Wouters B, Zadeh G, Spelat R, Singer E, Matlaf L, McAllister S, Soroceanu L, Spiegl-Kreinecker S, Loetsch D, Laaber M, Schrangl C, Wohrer A, Hainfellner J, Marosi C, Pichler J, Weis S, Wurm G, Widhalm G, Knosp E, Berger W, Takezaki T, Shinojima N, Kuratsu JI, Lang F, Tam Q, Tanaka S, Nakada M, Yamada D, Nakano I, Todo T, Hayashi Y, Hamada JI, Hirao A, Tilghman J, Ying M, Laterra J, Venere M, Chang C, Wu Q, Summers M, Rosenfeld S, Rich J, Tanaka S, Luk S, Chang C, Iafrate J, Cahill D, Martuza R, Rabkin S, Chi A, Wakimoto H, Wirsching HG, Krishnan S, Frei K, Krayenbuhl N, Reifenberger G, Weller M, Tabatabai G, Man J, Shoemake J, Venere M, Rich J, Yu J. STEM CELLS. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Agarwal M, Nitta R, Dovat S, Li G, Arita H, Narita Y, Fukushima S, Tateishi K, Matsushita Y, Yoshida A, Miyakita Y, Ohno M, Collins VP, Kawahara N, Shibui S, Ichimura K, Kahn SA, Gholamin S, Junier MP, Chneiweiss H, Weissman I, Mitra S, Cheshier S, Avril T, Hamlat A, Le Reste PJ, Mosser J, Quillien V, Carrato C, Munoz-Marmol A, Serrano L, Pijuan L, Hostalot C, Villa SL, Ariza A, Etxaniz O, Balana C, Benveniste ET, Zheng Y, McFarland B, Drygin D, Bellis S, Bredel M, Lotsch D, Engelmaier C, Allerstorfer S, Grusch M, Pichler J, Weis S, Hainfellner J, Marosi C, Spiegl-Kreinecker S, Berger W, Bronisz A, Nowicki MO, Wang Y, Ansari K, Chiocca EA, Godlewski J, Brown K, Kwatra M, Brown K, Kwatra M, Bui T, Nitta R, Li G, Zhu S, Kozono D, Li J, Kushwaha D, Carter B, Chen C, Schulte J, Srikanth M, Das S, Zhang J, Lathia J, Yin L, Rich J, Olson E, Kessler J, Chenn A, Cherry A, Haas B, Lin YH, Ong SE, Stella N, Cifarelli CP, Griffin RJ, Cong D, Zhu W, Shi Y, Clark P, Kuo J, Hu S, Sun D, Bookland M, Darbinian N, Dey A, Robitaille M, Remke M, Faury D, Maier C, Malhotra A, Jabado N, Taylor M, Angers S, Kenney A, Ren X, Zhou H, Schur M, Baweja A, Singh M, Erdreich-Epstein A, Fu J, Koul D, Yao J, Saito N, Zheng S, Verhaak R, Lu Z, Yung WKA, Gomez G, Volinia S, Croce C, Brennan C, Cavenee W, Furnari F, Lopez SG, Qu D, Petritsch C, Gonzalez-Huarriz M, Aldave G, Ravi D, Rubio A, Diez-Valle R, Marigil M, Jauregi P, Vera B, Rocha AADL, Tejada-Solis S, Alonso MM, Gopal U, Isaacs J, Gruber-Olipitz M, Dabral S, Ramkissoon S, Kung A, Pak E, Chung J, Theisen M, Sun Y, Monrose V, Franchetti Y, Sun Y, Shulman D, Redjal N, Tabak B, Beroukhim R, Zhao J, Buonamici S, Ligon K, Kelleher J, Segal R, Haas B, Canton D, Diaz P, Scott J, Stella N, Hara K, Kageji T, Mizobuchi Y, Kitazato K, Okazaki T, Fujihara T, Nakajima K, Mure H, Kuwayama K, Hara T, Nagahiro S, Hill L, Botfield H, Hossain-Ibrahim K, Logan A, Cruickshank G, Liu Y, Gilbert M, Kyprianou N, Rangnekar V, Horbinski C, Hu Y, Vo C, Li Z, Ke C, Ru N, Hess KR, Linskey ME, Zhou YAH, Hu F, Vinnakota K, Wolf S, Kettenmann H, Jackson PJ, Larson JD, Beckmann DA, Moriarity BS, Largaespada DA, Jalali S, Agnihotri S, Singh S, Burrell K, Croul S, Zadeh G, Kang SH, Yu MO, Song NH, Park KJ, Chi SG, Chung YG, Kim SK, Kim JW, Kim JY, Kim JE, Choi SH, Kim TM, Lee SH, Kim SK, Park SH, Kim IH, Park CK, Jung HW, Koldobskiy M, Ahmed I, Ho G, Snowman A, Raabe E, Eberhart C, Snyder S, Agnihotri S, Gugel I, Remke M, Bornemann A, Pantazis G, Mack S, Shih D, Sabha N, Taylor M, Tatagiba M, Zadeh G, Krischek B, Schulte A, Liffers K, Kathagen A, Riethdorf S, Westphal M, Lamszus K, Lee JS, Xiao J, Patel P, Schade J, Wang J, Deneen B, Erdreich-Epstein A, Song HR, Leiss L, Gjerde C, Saed H, Rahman A, Lellahi M, Enger PO, Leung R, Gil O, Lei L, Canoll P, Sun S, Lee D, Ho ASW, Pu JKS, Zhang XQ, Lee NP, Dat PJR, Leung GKK, Loetsch D, Steiner E, Holzmann K, Spiegl-Kreinecker S, Pirker C, Hlavaty J, Petznek H, Hegedus B, Garay T, Mohr T, Sommergruber W, Grusch M, Berger W, Lukiw WJ, Jones BM, Zhao Y, Bhattacharjee S, Culicchia F, Magnus N, Garnier D, Meehan B, McGraw S, Hashemi M, Lee TH, Milsom C, Gerges N, Jabado N, Trasler J, Pawlinski R, Mackman N, Rak J, Maherally Z, Thorne A, An Q, Barbu E, Fillmore H, Pilkington G, Maherally Z, Tan SL, Tan S, An Q, Fillmore H, Pilkington G, Malhotra A, Choi S, Potts C, Ford DA, Nahle Z, Kenney AM, Matlaf L, Khan S, Zider A, Singer E, Cobbs C, Soroceanu L, McFarland BC, Hong SW, Rajbhandari R, Twitty GB, Gray GK, Yu H, Benveniste EN, Nozell SE, Minata M, Kim S, Mao P, Kaushal J, Nakano I, Mizowaki T, Sasayama T, Tanaka K, Mizukawa K, Nishihara M, Nakamizo S, Tanaka H, Kohta M, Hosoda K, Kohmura E, Moeckel S, Meyer K, Leukel P, Bogdahn U, Riehmenschneider MJ, Bosserhoff AK, Spang R, Hau P, Mukasa A, Watanabe A, Ogiwara H, Saito N, Aburatani H, Mukherjee J, Obha S, See W, Pieper R, Nakajima K, Hara K, Kageji T, Mizobuchi Y, Kitazato K, Fujihara T, Otsuka R, Kung D, Nagahiro S, Rajbhandari R, Sinha T, Meares G, Benveniste EN, Nozell S, Ott M, Litzenburger U, Rauschenbach K, Bunse L, Pusch S, Ochs K, Sahm F, Opitz C, von Deimling A, Wick W, Platten M, Peruzzi P, Chiocca EA, Godlewski J, Read R, Fenton T, Gomez G, Wykosky J, Vandenberg S, Babic I, Iwanami A, Yang H, Cavenee W, Mischel P, Furnari F, Thomas J, Ronellenfitsch MW, Thiepold AL, Harter PN, Mittelbronn M, Steinbach JP, Rybakova Y, Kalen A, Sarsour E, Goswami P, Silber J, Harinath G, Aldaz B, Fabius AWM, Turcan S, Chan TA, Huse JT, Sonabend AM, Bansal M, Guarnieri P, Lei L, Soderquist C, Leung R, Yun J, Kennedy B, Sisti J, Bruce S, Bruce R, Shakya R, Ludwig T, Rosenfeld S, Sims PA, Bruce JN, Califano A, Canoll P, Stockhausen MT, Kristoffersen K, Olsen LS, Poulsen HS, Stringer B, Day B, Barry G, Piper M, Jamieson P, Ensbey K, Bruce Z, Richards L, Boyd A, Sufit A, Burleson T, Le JP, Keating AK, Sundstrom T, Varughese JK, Harter P, Prestegarden L, Petersen K, Azuaje F, Tepper C, Ingham E, Even L, Johnson S, Skaftnesmo KO, Lund-Johansen M, Bjerkvig R, Ferrara K, Thorsen F, Takeshima H, Yamashita S, Yokogami K, Mizuguchi S, Nakamura H, Kuratsu J, Fukushima T, Morishita K, Tanaka H, Sasayama T, Tanaka K, Nakamizo S, Mizukawa K, Kohmura E, Tang Y, Vaka D, Chen S, Ponnuswami A, Cho YJ, Monje M, Tateishi K, Narita Y, Nakamura T, Cahill D, Kawahara N, Ichimura K, Tiemann K, Hedman H, Niclou SP, Timmer M, Tjiong R, Rohn G, Goldbrunner R, Timmer M, Tjiong R, Stavrinou P, Rohn G, Perrech M, Goldbrunner R, Tokita M, Mikheev S, Sellers D, Mikheev A, Kosai Y, Rostomily R, Tritschler I, Seystahl K, Schroeder JJ, Weller M, Wade A, Robinson AE, Phillips JJ, Gong Y, Ma Y, Cheng Z, Thompson R, Wang J, Fan QW, Cheng C, Gustafson W, Charron E, Zipper P, Wong R, Chen J, Lau J, Knobbe-Thosen C, Weller M, Jura N, Reifenberger G, Shokat K, Weiss W, Wu S, Fu J, Zheng S, Koul D, Yung WKA, Wykosky J, Hu J, Taylor T, Villa GR, Gomez G, Mischel PS, Gonias SL, Cavenee W, Furnari F, Yamashita D, Kondo T, Takahashi H, Inoue A, Kohno S, Harada H, Ohue S, Ohnishi T, Li P, Ng J, Yuelling L, Du F, Curran T, Yang ZJ, Zhu D, Castellino RC, Van Meir EG, Zhu W, Begum G, Wang Q, Clark P, Yang SS, Lin SH, Kahle K, Kuo J, Sun D. CELL BIOLOGY AND SIGNALING. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not174] [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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Weis S, John E, Lippmann N, Mössner J, Lübbert C. [Clostridium difficile infection (CDI) in the course of time - an issue only for the internist?]. Zentralbl Chir 2013; 139:460-8. [PMID: 24132675 DOI: 10.1055/s-0032-1328623] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Toxigenic strains of Clostridium (C.) difficile are the most prevalent pathogens of antibiotic associated intestinal disease and nosocomial diarrhoea. During the last 10 years, incidences of C. difficile infection (CDI) have increased worldwide. MATERIALS AND METHODS With clinical and microbiological original data for 2002-2012 from the University Hospitals Leipzig and Halle (Saale), Germany, the authors illustrate the current situation regarding CDI in the states of Saxony and Saxony-Anhalt and exemplify the latest developments in terms of incidence, prevalence of resistance, diagnosis and treatment strategies regarding CDI with an emphasis on surgical options. RESULTS Following the general trend, at the University Hospitals of Leipzig and Halle (Saale) there was also an increase in incidence of CDI, especially of severe clinical courses. In primary and secondary care facilities, prevention of CDI is based on hygiene management and restricted usage of antibiotics, preferably as "Antibiotic Stewardship" programmes. In 2012, the new macrocyclic antibiotic Fidaxomicin was approved in the European Union for the treatment of CDI. The therapeutic armamentarium, previously based on metronidazole or vancomycin, has now been enriched by a substance that presumably will reduce the rate of recurrence of CDI. Moreover, early data from case series and controlled trials suggest that the re-establishment of eubiosis in the colon of patients with recurrent CDI by stool transplantation from healthy donors is an alternative to antibiotics. Standard surgical intervention for refractory CDI is subtotal colectomy with terminal ileostomy. In patients with adequate life expectancy and without organ dysfunction, a colon-saving surgical technique should be considered. CONCLUSION Taking antibiotics for most remains the main risk factor for suffering from symptomatic CDI. With the introduction of Fidaxomicin there is hope for an improvement in the conservative treatment of CDI. Stool transplants from healthy donors are now considered to be better than giving antibiotics for severe CDI, but this treatment has not found broad acceptance yet. In cases with a lack of early treatment success, the surgeon must be consulted. Here, the evidence for preferably colon-saving surgical procedures is so far unfortunately low.
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Affiliation(s)
- S Weis
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
| | - E John
- Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Deutschland
| | - N Lippmann
- Institut für Medizinische Mikrobiologie, Universität Leipzig, Leipzig, Deutschland
| | - J Mössner
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
| | - C Lübbert
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Gastroenterologie und Rheumatologie, Universität Leipzig, Leipzig, Deutschland
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Lübbert C, Johann C, Kekulé AS, Worlitzsch D, Weis S, Mössner J, Behl S, Seufferlein T. [Immunosuppressive treatment as a risk factor for the occurrence of clostridium difficile infection (CDI)]. Z Gastroenterol 2013; 51:1251-8. [PMID: 23696115 DOI: 10.1055/s-0033-1335505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Toxigenic Clostridium difficile strains are known as the most common infectious cause of antibiotic-associated intestinal disease and nosocomial diarrhoea. The increased incidence of hypervirulent strains gives rise to worldwide concern. In particular, courses with multiple recurrences are observed in the presence of immunosuppression. METHODS In this retrospective controlled observational study we aimed to determine immunosuppression as an independent risk factor for symptomatic CDI and to identify characteristics and differences of immunocompromised patients with respect to disease severity, disease progression, intestinal manifestations, recurrence rates and other factors. We compared symptoms and clinical features of 55 immunosuppressed patients with confirmed CDI with those of 50 patients without immunosuppressive medication (mean age 59.3 years ± 16.2 vs. 69.2 years ± 15.0) who were treated at the Departments of Internal Medicine I and IV of the University Hospital Halle (Saale), Germany, between 2006 and 2009. Multivariate analysis using binary logistic regression was performed for a control group of 105 patients without CDI. In this group, there were 62 patients without evidence of immunosuppression and 43 immunosuppressed patients (mean age 66.9 years ± 12.4 vs. 56.0 years ± 13.7). RESULTS The clinical courses of the two groups differed considerably. Immunosuppressed patients were significantly more frequently colonised with Clostridium difficile without clinically detectable manifestation or only mild clinical symptoms not requiring therapy (22 vs. 2 %, p = 0.003), while there were similar numbers of moderate (46 vs. 52 %, p = 0.503) but less severe CDI cases (27 vs. 40 %, p = 0.167). Relapses were observed more frequently in the group of immunosuppressed patients (15 vs. 6 %, p = 0.153). Multivariate analysis using logistic regression identified immunosuppression as an independent risk factor for CDI (OR = 2.75), in addition to prior antibiotic therapy (OR = 10.15) and PPI intake (OR = 2.93). CONCLUSION We conclude that immunosuppression has to be regarded as an independent risk factor for CDI. Immunosuppressive treatment increases the risk of colonisation and infection with Clostridium difficile and leads to a higher relapse rate in patients with CDI.
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Affiliation(s)
- C Lübbert
- Klinik für Innere Medizin I, Universitätsklinikum Halle, Halle (Saale)
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Alba-Ferrara L, de Erausquin GA, Hirnstein M, Weis S, Hausmann M. Emotional prosody modulates attention in schizophrenia patients with hallucinations. Front Hum Neurosci 2013; 7:59. [PMID: 23459397 PMCID: PMC3586698 DOI: 10.3389/fnhum.2013.00059] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 10/19/2012] [Accepted: 02/14/2013] [Indexed: 11/13/2022] Open
Abstract
Recent findings have demonstrated that emotional prosody (EP) attracts attention involuntarily (Grandjean et al., 2008). The automat shift of attention toward emotionally salient stimuli can be overcome by attentional control (Hahn et al., 2010). Attentional control is impaired in schizophrenia, especially in schizophrenic patients with hallucinations because the “voices” capture attention increasing the processing load and competing for top-down resources. The present study investigates how involuntary attention is driven by implicit EP in schizophrenia with auditory verbal hallucinations (AVH) and without (NAVH). Fifteen AVH patients, 12 NAVH patients and 16 healthy controls (HC) completed a dual-task dichotic listening paradigm, in which an emotional vocal outburst was paired with a neutral vocalization spoken in male and female voices. Participants were asked to report the speaker's gender while attending to either the left or right ear. NAVH patients and HC revealed shorter response times for stimuli presented to the attended left ear than the attended right ear. This laterality effect was not present in AVH patients. In addition, NAVH patients and HC showed faster responses when the EP stimulus was presented to the unattended ear, probably because of less interference between the attention-controlled gender voice identification task and involuntary EP processing. AVH patients did not benefit from presenting emotional stimuli to the unattended ear. The findings suggest that similar to HC, NAVH patients show a right hemispheric bias for EP processing. AVH patients seem to be less lateralized for EP and therefore might be more susceptible to interfering involuntary EP processing; regardless which ear/hemisphere receives the bottom up input.
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Affiliation(s)
- L Alba-Ferrara
- Department of Psychiatry and Neurosciences, Roskamp Laboratory of Brain Development, Modulation and Repair, Morsani College of Medicine, University of South Florida Tampa, FL, USA ; Department of Psychology, Durham University Durham, UK
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Haybaeck J, Llenos IC, Dulay RJ, Bettermann K, Miller CL, Wälchli T, Frei K, Virgintino D, Rizzi M, Weis S. Expression of nogo-a is decreased with increasing gestational age in the human fetal brain. Dev Neurosci 2012; 34:402-16. [PMID: 23146900 DOI: 10.1159/000343143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 09/04/2012] [Indexed: 12/16/2022] Open
Abstract
Nogo is a member of the reticulon family. Our understanding of the physiological functions of the Nogo-A protein has grown over the last few years, and this molecule is now recognized as one of the most important axonal regrowth inhibitors present in central nervous system (CNS) myelin. Nogo-A plays other important roles in nervous system development, epilepsy, vascular physiology, muscle pathology, stroke, inflammation, and CNS tumors. Since the exact role of Nogo-A protein in human brain development is still poorly understood, we studied its cellular and regional distribution by immunohistochemistry in the frontal lobe of 30 human fetal brains. Nogo-A was expressed in the following cortical zones: ependyma, ventricular zone, subventricular zone, intermediate zone, subplate, cortical plate, and marginal zone. The number of positive cells decreased significantly with increasing gestational age in the subplate and marginal zone. Using different antibodies, changes in isoform expression and dimerization states could be shown between various cortical zones. The results demonstrate a significant change in the expression of Nogo-A during the development of the human brain. The effects of its time- and region-specific regulation have to be further studied in detail.
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Affiliation(s)
- J Haybaeck
- Department of Neuropathology, Institute of Pathology, Medical University Graz, Graz, Austria
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Broussalis E, Hutterer M, Oppermann K, Wipfler P, Pilz G, Harrer A, Haschke-Becher E, Golaszewski S, Schönauer U, Weis S, Killer-Oberpfalzer M, Mc Coy M, Trinka E, Kraus J. Isolated leptomeningeal infiltration of a primary CNS B-cell lymphoma diagnosed by flow cytometry and confirmed by necropsy. Acta Neurol Scand 2012; 126:e11-6. [PMID: 22211863 DOI: 10.1111/j.1600-0404.2011.01630.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND The diagnosis of the isolated leptomeningeal involvement of a primary central nervous system B-cell lymphoma without parenchyma lesions may be difficult. Patients with leptomeningeal meningeosis lymphomatosa can present with various neurologic deficits. AIMS OF THE STUDY To demonstrate the impact of cerebrospinal fluid (CSF) flow cytometry in the diagnosis of an isolated leptomeningeal manifestation of B-cell lymphoma by presenting an interesting case report. METHODS Flow cytometric analysis of B-cell monoclonality of the CSF was performed as complementary diagnostic procedure in addition to CSF cytology. Final diagnosis was confirmed by necropsy. RESULTS We suspected isolated leptomeningeal manifestation of B-cell lymphoma with palsy of the VI and VII cranial nerves in a 79-year-old male, because of mononuclear pleocytosis in CSF. Interestingly, the decisive diagnostic hint was given by implementation of flow cytometry of the CSF. Diagnosis was confirmed by postmortem autopsy. CONCLUSION Our case shows that flow cytometry of the CSF in addition to conventional CSF cytology has the potential to accelerate diagnosis of lymphomeningeal infiltration of B-cell lymphoma.
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Affiliation(s)
- E. Broussalis
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - M. Hutterer
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - K. Oppermann
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - P. Wipfler
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - G. Pilz
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - A. Harrer
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - E. Haschke-Becher
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Central Laboratory; Paracelsus Medical University; Salzburg; Austria
| | - S. Golaszewski
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Central Laboratory; Paracelsus Medical University; Salzburg; Austria
| | - U. Schönauer
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Central Laboratory; Paracelsus Medical University; Salzburg; Austria
| | - S. Weis
- Institute of Pathology and Neuropathology; Wagner-JaureggHospital; Linz; Austria
| | - M. Killer-Oberpfalzer
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - M. Mc Coy
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Radiology; Paracelsus Medical University; Salzburg; Austria
| | - E. Trinka
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
| | - J. Kraus
- SalzburgerLandeskliniken; Christian-Doppler-Klinik; Department of Neurology; Paracelsus Medical University; Salzburg; Austria
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Spiegl-Kreinecker S, Wild M, Loetsch D, Ghanim B, Pirker C, Pichler J, Weis S, Wurm G, Berger W. 831 Telomerase Activity Has Prognostic Quality for Glioblastoma Patients Preferentially of Younger Age. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [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: 08/15/2023] Open
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Weis S, Grimm M. Erratum zu: Nosokomiale Diarrhö. Internist (Berl) 2011. [DOI: 10.1007/s00108-011-2872-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Weis S, Nuerk HC. TBS-TK Rezensionen. Psychologische Rundschau 2011. [DOI: 10.1026/0033-3042/a000063] [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: 11/04/2022]
Affiliation(s)
- S. Weis
- Methodenzentrum, Universität Koblenz-Landau
| | - H.-C. Nuerk
- Psychologisches Institut, Eberhard Karls Universität Tübingen Institut für Wissensmedien IWM-KMRC, Tübingen
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Abstract
Hospital acquired or nosocomial diarrhea affects up to one third of hospitalized patients. It increases mortality rates as well as length and costs of the hospital stay. Drug side effects are the predominant cause of nosocomial diarrhea whilst clostridium difficile is the most common infectious agent, whose development is closely linked to antibiotic usage. The causal therapy of mild clostridium difficile infections is controversially discussed. Nevertheless, the use of Metronidazol for mild cases and of vancomycin for severe forms of the disease is recommended. Diarrhea outbreaks might be caused by viruses and less often by Salmonella and Listeria. Norovirus infections are of outstanding importance. Rehydration and isolation to prevent the spread of this highly contagious virus are the only reasonable options as we still lack a proper therapy.
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Affiliation(s)
- S Weis
- Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Dermatologie und Neurologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
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Dinkelacker V, Grüter M, Klaver P, Grüter T, Specht K, Weis S, Kennerknecht I, Elger CE, Fernandez G. Congenital prosopagnosia: multistage anatomical and functional deficits in face processing circuitry. J Neurol 2010; 258:770-82. [PMID: 21120515 PMCID: PMC3090571 DOI: 10.1007/s00415-010-5828-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 10/30/2010] [Accepted: 11/03/2010] [Indexed: 11/27/2022]
Abstract
Face recognition is a primary social skill which depends on a distributed neural network. A pronounced face recognition deficit in the absence of any lesion is seen in congenital prosopagnosia. This study investigating 24 congenital prosopagnosic subjects and 25 control subjects aims at elucidating its neural basis with fMRI and voxel-based morphometry. We found a comprehensive behavioral pattern, an impairment in visual recognition for faces and buildings that spared long-term memory for faces with negative valence. Anatomical analysis revealed diminished gray matter density in the bilateral lingual gyrus, the right middle temporal gyrus, and the dorsolateral prefrontal cortex. In most of these areas, gray matter density correlated with memory success. Decreased functional activation was found in the left fusiform gyrus, a crucial area for face processing, and in the dorsolateral prefrontal cortex, whereas activation of the medial prefrontal cortex was enhanced. Hence, our data lend strength to the hypothesis that congenital prosopagnosia is explained by network dysfunction and suggest that anatomic curtailing of visual processing in the lingual gyrus plays a substantial role. The dysfunctional circuitry further encompasses the fusiform gyrus and the dorsolateral prefrontal cortex, which may contribute to their difficulties in long-term memory for complex visual information. Despite their deficits in face identity recognition, processing of emotion related information is preserved and possibly mediated by the medial prefrontal cortex. Congenital prosopagnosia may, therefore, be a blueprint of differential curtailing in networks of visual cognition.
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Buchroithner J, Nußbaumer K, Pichler R, Weis S. Anti-angiogenetic metronomic chemotherapy in an adult patient with recurrent medulloblastoma with spinal metastases: a case report. memo 2010. [DOI: 10.1007/s12254-010-0204-9] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Leitinger M, Novak H, McCoy M, Weis S, Ladurner G. Heparin induced thrombocytopenia causing acute paraplegia. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Weis S, Dietrich W, Erbguth F. Richtungsbestimmter rotatorischer Nystagmus nach rechts als klinische Manifestation eines rechtshirnigen Mediateilinfarktes. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Eggers C, Iglseder S, Weis S, Kubisch C, Schoser BGH. Wurmartige Muskelbewegungen bei elektrischer Stille – Rippling Muscle Disease. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schoppmeyer K, Weis S, Mossner J, Fleig WE. Systematic meta-analysis on percutaneous ethanol injection and percutaneous acid injection for the treatment of early HCC: A Cochrane analysis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15657 Background: Hepatocellular carcinoma (HCC) is the fifth most common global cancer with high geographical variability. When HCC is detected early, percutaneous approaches such as percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI), and radiofrequency thermal ablation (RFTA) have curative potential and represent low invasive alternatives to surgery. The role of percutaneous ethanol or acetic acid injection and other percutaneous interventions except RFTA has not been addressed in a systematic metaanalysis. The objective was to evaluate the effects of PEI and PAI for early HCC. Methods: A systematic search was performed in EMBASE, Cochrane Central, The Cochrane Hepato-Biliary Group Controlled Trials Register, Medline and Scopus as well as a handsearch of meeting abstracts. Only randomised controlled trials were included. RFTA studies were not considered. Primary endpoint was overall survival, secondary endpoints were cancer free survival, number and type of adverse events, duration of hospital stay, and quality of life. Results: 3 studies covering 261 patients were identified. Two studies compared PEI with PAI. 91 and 94 patients with one to three HCC-nodules ≤ 3cm underwent PEI and PAI, respectively. Overall survival (HR 1.47; 95% CI 0.68 to 3.19) and cancer free survival (HR 1.42; 95% CI 0.68 to 2.94) were not significantly different after treatment by PEI versus PAI. Both treatments were safe with no serious adverse events reported and modest pain being the most frequent adverse event. Data on the duration of hospital stay were inconclusive and data on quality of life not available. One study compared PEI with surgery. 38 patients were allocated to each treatment arm. There was no significant difference in survival (HR 1.57; 95% CI 0.53 to 4.61) and cancer free survival (HR 1.35; 95% CI 0.69 to 2.63). No serious adverse events were reported in the PEI group but 3 postoperative deaths occurred in the surgery arm. Conclusions: PEI and PAI are similarly effective and safe in patients with one to three small (≤ 3 cm) HCC nodules. Although the evidence is weaker, the beneficial effect of PEI is comparable to that of segmental liver resection and thus should be used preferentially due to its low morbidity and mortality. No significant financial relationships to disclose.
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Affiliation(s)
| | - S. Weis
- University of Leipzig, Leipzig, Germany
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Weis S, Stoffers B, Hausmann M, Sturm W. 194. Sex hormones affect interhemispheric connectivity during the menstrual cycle: An fMRI study. Clin Neurophysiol 2009. [DOI: 10.1016/j.clinph.2008.07.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weis S, Nückel M, Erbguth F. Hereditäres Vorhofmyxom im Rahmen eines Carney-Komplexes – eine seltene Ursache für kardiogene Hirnembolien. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weis S, Stoffers B, Hausmann M, Sturm W. Sex Hormones Affect Interhemispheric Connectivity during the Menstrual Cycle: An fMRI study. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Burman W, Weis S, Vernon A, Khan A, Benator D, Jones B, Silva C, King B, LaHart C, Mangura B, Weiner M, El-Sadr W. Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. Int J Tuberc Lung Dis 2007; 11:1282-1289. [PMID: 18229435] [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: 05/25/2023] Open
Abstract
SETTING Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS Of 169 patients, 25 (15%) developed immune reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION Immune reconstitution events were common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months.
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Affiliation(s)
- W Burman
- Denver Public Health and the University of Colorado Health Sciences Center, Denver, Colorado 80204, USA.
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Koethe D, Llenos IC, Dulay JR, Hoyer C, Torrey EF, Weis S, Leweke FM. Changes of CB1 cannabinoid receptor expression following Selective Serotonin Reuptake Inhibitors (SSRI) and First Generation Antipsychotics (FGA) in depression and bipolar disorder. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991705] [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: 10/21/2022]
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Weis S, Llenos IC, Dulay JR, Elashoff M, Martínez-Murillo F, Miller CL. Quality control for microarray analysis of human brain samples: The impact of postmortem factors, RNA characteristics, and histopathology. J Neurosci Methods 2007; 165:198-209. [PMID: 17628689 DOI: 10.1016/j.jneumeth.2007.06.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Revised: 06/01/2007] [Accepted: 06/04/2007] [Indexed: 11/29/2022]
Abstract
The quality of results from microarray studies depends on RNA quality, which can be significantly influenced by postmortem factors. The aim of this study was to determine which postmortem factors and/or RNA electropherogram characteristics best correspond to microarray output and can be used to prospectively screen RNA prior to microarray analysis. Total RNA was extracted (N=125) from gray and white matter of postmortem frontal and occipital lobe tissue, acquired from normal controls, and patients with schizophrenia, bipolar disorder or major depression. Electropherograms were generated by the Agilent BioAnalyzer 2100, allowing calculation of the 28S/18S ratio, the 18S/baseline peak ratio and the RNA Integrity Number (RIN). These values were compared to post-hybridization image analysis of Affymetrix microarrays. The postmortem variables correlated with some quality measures but could not be used as effective screening tools. Logistic regression demonstrated that all three electropherogram measures were predictive for microarray quality, and that the RIN threshold predictive of "good quality" (>35% present calls) was most consistent with that of prior studies. The optimal RIN must be determined by the investigator's specifications for false inclusion and false exclusion. In contrast to RIN, the quality threshold for the 28S/18S ratio has proven unacceptably variable, due to sensitivity to slight differences in protocol and/or tissue source. In conclusion, the measures we found useful as screening criteria do not replace the need to exclude samples after a microarray analysis is performed, as an acceptable percent call rate and other measures of microarray quality represent the desired endpoint.
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Affiliation(s)
- S Weis
- Stanley Laboratory for Brain Research and Neuropathology, Department of Psychiatry, Uniformed Services University of the Health Sciences, and Stanley Medical Research Institute, Bethesda, MD, USA
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Roy S, Barnes P, Garg A, Wu S, Weis S, Rajavelu P, Cosman D, Vankayalapati R. NK Cells Lyse T Regulatory Cells in Human Infection with An Intracellular Pathogen (B167). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.b167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Previously we found that regulatory T cells (CD4+CD25+Foxp3+ cells, Tregs) expand in response to M.tuberculosis (M. TB) through mechanism that depend on prostaglandin E2 production. In the current study, we determined the role of NK cells in regulating Tregs expansion in human M. TB infection. M. TB whole cell lysate (TB lysate) resulted in regulatory T cell expansion (15.33±1.02% vs 1.5±0.22%, P<0.001). Addition of monokine-activated NK cells (IL-12, IL-15 and IL-18) markedly inhibited Treg expansion (6.2±1.2% vs 15±1.5%, P<0.001) but freshly isolated NK cells had no effect. NK cells activated with TB lysate-stimulated monocytes also reduced Tregs expansion (13.2±0.3% to 3.4±1.4%, P<0.001) confirming the physiological relevance of this effect. Reduced Tregs expansion was not due to inhibition of PGE2 production or because of IFN γ. Monokine activated NK cells lysed TB lysate-expanded Tregs, but not freashly isolated Tregs (% specific lysis of 21±3% vs 1±1% P<0.001), nor T regs depleted T cells. Anti-NKG2D and anti-NKp46 reduced the % specific lysis of expanded Tregs from 22±3% to 7±3% and 8±3%, respectively (P<0.001) but abs to CD16, DNAM-1, and 2B4 had no effect. NKG2D ligand, ULBP1 expression was markedly upregulated on expanded T regs, compared to T regs depleted cells ( 31±5% vs 2.1 ±0.4%, P=0.002) and freshly isolated Tregs (4.6±1.1%). Anti -ULBP1 significantly inhibited the NK mediated lysis of expanded Tregs (specific lysis of 27±4% vs 9±2%, P<0.001) but abs to ULBP2, ULBP3 and MICA/B had no effect. These finding suggest that NK cells reduce the frequency of M.TB-expanded T regs by direct lysis.
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Affiliation(s)
- S Roy
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
| | - P Barnes
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
| | - A Garg
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
| | - S Wu
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
| | - S Weis
- 2UNT, health sciences Center, Fort worth, Texas, 76107,
| | - P Rajavelu
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
| | - D Cosman
- 3Amgen, 1201 amgen court west, Seattle, WA, 98101
| | - R Vankayalapati
- 1University of texas, health center at tyler, Tyler, Texas, 75708,
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Fliessbach K, Weis S, Trautner P, Elger C, Weber B. Determination of language lateralization with fMRI – Introduction of a new paradigm with auditory stimulation. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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