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Nadalin S, Zatković L, Peitl V, Karlović D, Vilibić M, Silić A, Dević Pavlić S, Buretić-Tomljanović A. An association between PPARα-L162V polymorphism and increased plasma LDL cholesterol levels after risperidone treatment. Prostaglandins Leukot Essent Fatty Acids 2024; 200:102604. [PMID: 38113727 DOI: 10.1016/j.plefa.2023.102604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Peroxisome proliferator-activated receptor alpha (PPARα) and antipsychotic medications both influence polyunsaturated fatty acids (PUFA) homeostasis, and thus PPARα polymorphism may be linked to antipsychotic treatment response. Here we investigated whether the functional leucine 162 valine (L162V) polymorphism in PPARα influenced antipsychotic treatment in a group of psychosis patients (N = 186), as well as in a patient subgroup with risperidone, paliperidone, or combination treatment (N = 65). Antipsychotic-naïve first-episode patients and nonadherent chronic individuals were genotyped by polymerase chain reaction analysis. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed the patients' Positive and Negative Syndrome Scale (PANSS) scores; PANSS factors; and metabolic syndrome-related parameters, including fasting plasma lipid and glucose levels, and body mass index. In the total patient group, PPARα polymorphism did not affect PANSS psychopathology or metabolic parameters. However, in the subgroup of patients with risperidone, paliperidone, or combination treatment, PPARα polymorphism influenced changes in plasma LDL cholesterol. Specifically, compared to PPARα-L162L homozygous patients, PPARα-L162V heterozygous individuals exhibited significantly higher increases of LDL cholesterol levels after antipsychotic treatment. The PPARα polymorphism had a strong effect size, but a relatively weak contribution to LDL cholesterol level variations (∼12.8 %).
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Affiliation(s)
- Sergej Nadalin
- Department of Psychiatry, General Hospital "Dr. Josip Benčević", Slavonski Brod, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
| | - Lena Zatković
- Hospital Pharmacy, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Vjekoslav Peitl
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Dalibor Karlović
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Maja Vilibić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ante Silić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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Carbone M, Della Penna A, Mazzarelli C, De Martin E, Villard C, Bergquist A, Line PD, Neuberger JM, Al-Shakhshir S, Trivedi PJ, Baumann U, Cristoferi L, Hov J, Fischler B, Hadzic NH, Debray D, D’Antiga L, Selzner N, Belli LS, Nadalin S. Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement. Transpl Int 2023; 36:11729. [PMID: 37841645 PMCID: PMC10570452 DOI: 10.3389/ti.2023.11729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023]
Abstract
Primary sclerosing cholangitis (PSC) is the classical hepatobiliary manifestation of inflammatory bowel disease (IBD) and a lead indication for liver transplantation (LT) in the western world. In this article, we present a Consensus Statement on LT practice, developed by a dedicated Guidelines' Taskforce of the European Society of Organ Transplantation (ESOT). The overarching goal is to provide practical guidance on commonly debated topics, including indications and timing of LT, management of bile duct stenosis in patients on the transplant waiting list, technical aspects of transplantation, immunosuppressive strategies post-transplant, timing and extension of intestinal resection and futility criteria for re-transplantation.
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Affiliation(s)
- M. Carbone
- Centre for Autoimmune Liver Diseases, Department of Medicina and Surgery, University of Milano-Bicocca, Milan, Italy
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS San Gerardo dei Tintori, Monza, Italy
| | - A. Della Penna
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - C. Mazzarelli
- Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy
| | - E. De Martin
- AP-HP Hôpital Paul-Brousse, Centre Hépato-Biliaire, Inserm Unité 1193, Université Paris-Saclay, FHU Hépatinov, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Villejuif, France
| | - C. Villard
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS San Gerardo dei Tintori, Monza, Italy
- Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - A. Bergquist
- Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - P. D. Line
- Norwegian PSC Research Center and Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - J. M. Neuberger
- Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - S. Al-Shakhshir
- National Institute for Health and Care Research (NIHR) Birmingham Liver Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - P. J. Trivedi
- National Institute for Health and Care Research (NIHR) Birmingham Liver Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - U. Baumann
- Division of Pediatric Gastroenterology, Hepatology and Liver Transplantation, Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - L. Cristoferi
- Centre for Autoimmune Liver Diseases, Department of Medicina and Surgery, University of Milano-Bicocca, Milan, Italy
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS San Gerardo dei Tintori, Monza, Italy
| | - J. Hov
- Norwegian PSC Research Center and Section of Gastroenterology, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - B. Fischler
- Department of Pediatrics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - N. H. Hadzic
- Paediatric Centre for Hepatology, Gastroenterology and Nutrition, King’s College, London, United Kingdom
| | - D. Debray
- Unité d’Hépatologie Pédiatrique, Hôpital Necker-Enfants Malades, Centre de Référence Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-Immunes, Filfoie, Paris, France
| | - L. D’Antiga
- Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - N. Selzner
- Multiorgan Transplant Program, University of Toronto, Toronto, ON, Canada
| | - L. S. Belli
- Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy
| | - S. Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
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Nadalin S, Zatković L, Peitl V, Karlović D, Vidrih B, Puljić A, Pavlić SD, Buretić-Tomljanović A. Association between PLA2 gene polymorphisms and treatment response to antipsychotic medications: A study of antipsychotic-naïve first-episode psychosis patients and nonadherent chronic psychosis patients. Prostaglandins Leukot Essent Fatty Acids 2023; 194:102578. [PMID: 37290257 DOI: 10.1016/j.plefa.2023.102578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Here we investigated whether antipsychotic treatment was influenced by three polymorphisms: rs10798059 (BanI) in the phospholipase A2 (PLA2)G4A gene, rs4375 in PLA2G6, and rs1549637 in PLA2G4C. A total of 186 antipsychotic-naïve first-episode psychosis patients or nonadherent chronic psychosis individuals (99 males and 87 females) were genotyped by polymerase chain reaction analysis/restriction fragment length polymorphism. At baseline, and after 8 weeks of treatment with various antipsychotic medications, we assessed patients' Positive and Negative Syndrome Scale (PANSS) scores, PANSS factors, and metabolic syndrome-related parameters (fasting plasma lipid and glucose levels, and body mass index). We found that PLA2G4A polymorphism influenced changes in PANSS psychopathology, and PLA2G6 polymorphism influenced changes in PANSS psychopathology and metabolic parameters. PLA2G4C polymorphism did not show any impact on PANSS psychopathology or metabolic parameters. The polymorphisms' effect sizes were estimated as moderate to strong, with contributions ranging from around 6.2-15.7%. Furthermore, the polymorphisms' effects manifested in a gender-specific manner.
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Affiliation(s)
- Sergej Nadalin
- Department of Psychiatry, General Hospital "Dr. Josip Benčević", Slavonski Brod, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, Croatia.
| | - Lena Zatković
- Hospital pharmacy, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Vjekoslav Peitl
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Dalibor Karlović
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Branka Vidrih
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Antonia Puljić
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia; Department of Psychiatry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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Peitl V, Puljić A, Škrobo M, Nadalin S, Fumić Dunkić L, Karlović D. Clozapine in Treatment-Resistant Schizophrenia and Its Augmentation with Electroconvulsive Therapy in Ultra-Treatment-Resistant Schizophrenia. Biomedicines 2023; 11:biomedicines11041072. [PMID: 37189691 DOI: 10.3390/biomedicines11041072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Clozapine is considered the gold standard for patients with treatment-resistant schizophrenia (TRS) who have previously tried other antipsychotics at adequate doses (two or more, with at least one being atypical). However, despite optimal treatment, a subgroup of TRS patients with what is known as ultra-treatment-resistant schizophrenia (UTRS) fails to respond to clozapine, which occurs in 40–70% of cases. The most common approach to manage UTRS involves augmenting clozapine with pharmacological or non-pharmacological interventions, with a growing body of evidence that supports the use of electroconvulsive therapy (ECT) as an augmenter. This prospective non-randomized 8-week study, which followed the TRIPP Working Group guidelines and is one of few that separate TRS from UTRS, aimed to evaluate the effectiveness of clozapine in TRS patients and the efficacy of ECT augmentation of clozapine in UTRS patients. Patients with TRS were assigned to receive clozapine alone (clozapine group), whereas UTRS patients received bilateral ECT in addition to their current medication regimen (ECT plus clozapine group). The severity of symptoms was evaluated using the Clinical Global Impression Scale (CGI) and Positive and Negative Syndrome Scale (PANSS) at baseline and at the end of the 8-week trial. Both treatment approaches resulted in improved CGI and PANSS scores. The results suggest that both clozapine and ECT are effective treatment options for patients with TRS and UTRS, respectively, and that adherence to guidelines should provide a better frame for future clinical studies.
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Affiliation(s)
- Vjekoslav Peitl
- Department of Psychiatry, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Antonia Puljić
- Department of Psychiatry, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Mislav Škrobo
- Department of Psychiatry, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Sergej Nadalin
- Department of Psychiatry, General Hospital “Dr. Josip Benčević”, 35000 Slavonski Brod, Croatia
| | - Lidija Fumić Dunkić
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
- Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Dalibor Karlović
- Department of Psychiatry, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
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Nadalin S, Peters M, Königsrainer A. [Liver metastases of neuroendocrine tumors]. Chirurgie (Heidelb) 2022; 93:659-666. [PMID: 35713676 DOI: 10.1007/s00104-022-01656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Neuroendocrine liver metastases (NELM) are very heterogeneous with respect to the clinical presentation and the prognosis. The treatment of NELMs requires a multidisciplinary approach and patients with NELM should be referred to a specialized center. When possible, the resection of NELMs provides the best long-term results. The general selection criteria for liver resection include an acceptable general physical condition for a large liver operation, tumors with a favorable differentiation grade 1 or 2, a lack of extrahepatic lesions, a sufficient residual liver volume and the possibility to resect at least 70% of the metastases. Supplementary treatment, including simultaneous liver ablation, are generally safe and can increase the number of patients who can be considered for surgery. For patients with resectable NELM, the resection of the primary tumor is recommended either in a 2-stage or combined procedure. In selected patients with nonresectable NELM a liver transplantation can be carried out, which can be associated with excellent long-term results.
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Affiliation(s)
- S Nadalin
- Klinik für Allgemeine, Viszeral- Und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
| | - M Peters
- Klinik für Allgemeine, Viszeral- Und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
| | - A Königsrainer
- Klinik für Allgemeine, Viszeral- Und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
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Nadalin S, Peitl V, Karlović D, Dević Pavlić S, Škrobo M, Uremović M, Zatković L, Buretić-Tomljanović A. Could the Type of Delivery Contribute to Clinical Features of Schizophrenia and Nicotine Dependence among Patients Who are not Under Antipsychotic Treatment? Arch Psychiatry Res 2022. [DOI: 10.20471/may.2022.58.01.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Linschoten M, Uijl A, Schut A, Jakob CEM, Romão LR, Bell RM, McFarlane E, Stecher M, Zondag AGM, van Iperen EPA, Hermans-van Ast W, Lea NC, Schaap J, Jewbali LS, Smits PC, Patel RS, Aujayeb A, van der Harst P, Siebelink HJ, van Smeden M, Williams S, Pilgram L, van Gilst WH, Tieleman RG, Williams B, Asselbergs FW, Al-Ali AK, Al-Muhanna FA, Al-Rubaish AM, Al-Windy NYY, Alkhalil M, Almubarak YA, Alnafie AN, Alshahrani M, Alshehri AM, Anning C, Anthonio RL, Badings EA, Ball C, van Beek EA, ten Berg JM, von Bergwelt-Baildon M, Bianco M, Blagova OV, Bleijendaal H, Bor WL, Borgmann S, van Boxem AJM, van den Brink FS, Bucciarelli-Ducci C, van Bussel BCT, Byrom-Goulthorp R, Captur G, Caputo M, Charlotte N, vom Dahl J, Dark P, De Sutter J, Degenhardt C, Delsing CE, Dolff S, Dorman HGR, Drost JT, Eberwein L, Emans ME, Er AG, Ferreira JB, Forner MJ, Friedrichs A, Gabriel L, Groenemeijer BE, Groenendijk AL, Grüner B, Guggemos W, Haerkens-Arends HE, Hanses F, Hedayat B, Heigener D, van der Heijden DJ, Hellou E, Hellwig K, Henkens MTHM, Hermanides RS, Hermans WRM, van Hessen MWJ, Heymans SRB, Hilt AD, van der Horst ICC, Hower M, van Ierssel SH, Isberner N, Jensen B, Kearney MT, van Kesteren HAM, Kielstein JT, Kietselaer BLJH, Kochanek M, Kolk MZH, Koning AMH, Kopylov PY, Kuijper AFM, Kwakkel-van Erp JM, Lanznaster J, van der Linden MMJM, van der Lingen ACJ, Linssen GCM, Lomas D, Maarse M, Macías Ruiz R, Magdelijns FJH, Magro M, Markart P, Martens FMAC, Mazzilli SG, McCann GP, van der Meer P, Meijs MFL, Merle U, Messiaen P, Milovanovic M, Monraats PS, Montagna L, Moriarty A, Moss AJ, Mosterd A, Nadalin S, Nattermann J, Neufang M, Nierop PR, Offerhaus JA, van Ofwegen-Hanekamp CEE, Parker E, Persoon AM, Piepel C, Pinto YM, Poorhosseini H, Prasad S, Raafs AG, Raichle C, Rauschning D, Redón J, Reidinga AC, Ribeiro MIA, Riedel C, Rieg S, Ripley DP, Römmele C, Rothfuss K, Rüddel J, Rüthrich MM, Salah R, Saneei E, Saxena M, Schellings DAAM, Scholte NTB, Schubert J, Seelig J, Shafiee A, Shore AC, Spinner C, Stieglitz S, Strauss R, Sturkenboom NH, Tessitore E, Thomson RJ, Timmermans P, Tio RA, Tjong FVY, Tometten L, Trauth J, den Uil CA, Van Craenenbroeck EM, van Veen HPAA, Vehreschild MJGT, Veldhuis LI, Veneman T, Verschure DO, Voigt I, de Vries JK, van de Wal RMA, Walter L, van de Watering DJ, Westendorp ICD, Westendorp PHM, Westhoff T, Weytjens C, Wierda E, Wille K, de With K, Worm M, Woudstra P, Wu KW, Zaal R, Zaman AG, van der Zee PM, Zijlstra LE, Alling TE, Ahmed R, van Aken K, Bayraktar-Verver ECE, Bermúdez Jiménes FJ, Biolé CA, den Boer-Penning P, Bontje M, Bos M, Bosch L, Broekman M, Broeyer FJF, de Bruijn EAW, Bruinsma S, Cardoso NM, Cosyns B, van Dalen DH, Dekimpe E, Domange J, van Doorn JL, van Doorn P, Dormal F, Drost IMJ, Dunnink A, van Eck JWM, Elshinawy K, Gevers RMM, Gognieva DG, van der Graaf M, Grangeon S, Guclu A, Habib A, Haenen NA, Hamilton K, Handgraaf S, Heidbuchel H, Hendriks-van Woerden M, Hessels-Linnemeijer BM, Hosseini K, Huisman J, Jacobs TC, Jansen SE, Janssen A, Jourdan K, ten Kate GL, van Kempen MJ, Kievit CM, Kleikers P, Knufman N, van der Kooi SE, Koole BAS, Koole MAC, Kui KK, Kuipers-Elferink L, Lemoine I, Lensink E, van Marrewijk V, van Meerbeeck JP, Meijer EJ, Melein AJ, Mesitskaya DF, van Nes CPM, Paris FMA, Perrelli MG, Pieterse-Rots A, Pisters R, Pölkerman BC, van Poppel A, Reinders S, Reitsma MJ, Ruiter AH, Selder JL, van der Sluis A, Sousa AIC, Tajdini M, Tercedor Sánchez L, Van De Heyning CM, Vial H, Vlieghe E, Vonkeman HE, Vreugdenhil P, de Vries TAC, Willems AM, Wils AM, Zoet-Nugteren SK. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries. Eur Heart J 2022; 43:1104-1120. [PMID: 34734634 DOI: 10.1093/eurheartj/ehab656] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. METHODS AND RESULTS We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. CONCLUSION Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
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Bitzer M, Voesch S, Albert J, Bartenstein P, Bechstein W, Blödt S, Brunner T, Dombrowski F, Evert M, Follmann M, La Fougère C, Freudenberger P, Geier A, Gkika E, Götz M, Hammes E, Helmberger T, Hoffmann RT, Hofmann WP, Huppert P, Kautz A, Knötgen G, Körber J, Krug D, Lammert F, Lang H, Langer T, Lenz P, Mahnken A, Meining A, Micke O, Nadalin S, Nguyen HP, Ockenga J, Oldhafer K, Paprottka P, Paradies K, Pereira P, Persigehl T, Plauth M, Plentz R, Pohl J, Riemer J, Reimer P, Ringwald J, Ritterbusch U, Roeb E, Schellhaas B, Schirmacher P, Schmid I, Schuler A, von Schweinitz D, Seehofer D, Sinn M, Stein A, Stengel A, Steubesand N, Stoll C, Tannapfel A, Taubert A, Trojan J, van Thiel I, Tholen R, Vogel A, Vogl T, Vorwerk H, Wacker F, Waidmann O, Wedemeyer H, Wege H, Wildner D, Wittekind C, Wörns MA, Galle P, Malek N. S3-Leitlinie: Diagnostik und Therapie biliärer Karzinome. Z Gastroenterol 2022; 60:219-238. [PMID: 35148562 DOI: 10.1055/a-1589-7638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Bitzer
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - S Voesch
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - J Albert
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart
| | - P Bartenstein
- Klinik und Poliklinik für Nuklearmedizin, LMU Klinikum, München
| | - W Bechstein
- Klinik für Allgemein-, Viszeral-, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt
| | - S Blödt
- AWMF-Geschäftsstelle, Berlin
| | - T Brunner
- Klinik für Strahlentherapie, Universitätsklinikum Magdeburg
| | - F Dombrowski
- Institut für Pathologie, Universitätsmedizin Greifswald
| | - M Evert
- Institut für Pathologie, Regensburg
| | - M Follmann
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - C La Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Tübingen
| | | | - A Geier
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg
| | - E Gkika
- Klinik für Strahlenheilkunde, Department für Radiologische Diagnostik und Therapie, Universitätsklinikum Freiburg
| | | | - E Hammes
- Lebertransplantierte Deutschland e. V., Ansbach
| | - T Helmberger
- Institut für Radiologie, Neuroradiologie und minimal-invasive Therapie, München Klinik Bogenhausen, München
| | - R T Hoffmann
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Dresden
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz, medizinisches Versorgungszentrum, Berlin
| | - P Huppert
- Radiologisches Zentrum, Max Grundig Klinik, Bühl
| | - A Kautz
- Deutsche Leberhilfe e.V., Köln
| | - G Knötgen
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - J Körber
- Klinik Nahetal, Fachklinik für onkologische Rehabilitation und Anschlussrehabilitation, Bad Kreuznach
| | - D Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel
| | | | - H Lang
- Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - T Langer
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - P Lenz
- Universitätsklinikum Münster, Zentrale Einrichtung Palliativmedizin, Münster
| | - A Mahnken
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - A Meining
- Medizinische Klinik und Poliklinik II des Universitätsklinikums Würzburg
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital Bielefeld
| | - S Nadalin
- Universitätsklinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | | | - J Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen
| | - K Oldhafer
- Klinik für Leber-, Gallenwegs- und Pankreaschirurgie, Semmelweis Universität, Asklepios Campus Hamburg
| | - P Paprottka
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - K Paradies
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - P Pereira
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln
| | | | - R Plentz
- Klinikum Bremen-Nord, Innere Medizin, Bremen
| | - J Pohl
- Interventionelles Endoskopiezentrum und Schwerpunkt Gastrointestinale Onkologie, Asklepios Klinik Altona, Hamburg
| | - J Riemer
- Lebertransplantierte Deutschland e. V., Bretzfeld
| | - P Reimer
- Institut für diagnostische und interventionelle Radiologie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe
| | - J Ringwald
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - E Roeb
- Medizinische Klinik II, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - B Schellhaas
- Medizinische Klinik I, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg
| | - I Schmid
- Zentrum Pädiatrische Hämatologie und Onkologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München
| | - A Schuler
- Medizinische Klinik, Alb Fils Kliniken GmbH, Göppingen
| | | | - D Seehofer
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig
| | - M Sinn
- Medizinische Klinik II, Universitätsklinikum Hamburg-Eppendorf
| | - A Stein
- Hämatologisch-Onkologischen Praxis Eppendorf, Hamburg
| | - A Stengel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - C Stoll
- Klinik Herzoghöhe Bayreuth, Bayreuth
| | - A Tannapfel
- Institut für Pathologie der Ruhr-Universität Bochum am Berufsgenossenschaftlichen Universitätsklinikum Bergmannsheil, Bochum
| | - A Taubert
- Kliniksozialdienst, Universitätsklinikum Heidelberg, Bochum
| | - J Trojan
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | | | - R Tholen
- Deutscher Verband für Physiotherapie e. V., Köln
| | - A Vogel
- Klinik für Gastroenterologie, Hepatologie, Endokrinologie der Medizinischen Hochschule Hannover, Hannover
| | - T Vogl
- Universitätsklinikum Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - H Vorwerk
- Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - F Wacker
- Institut für Diagnostische und Interventionelle Radiologie der Medizinischen Hochschule Hannover, Hannover
| | - O Waidmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie Medizinische Hochschule Hannover, Hannover
| | - H Wege
- Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - D Wildner
- Innere Medizin, Krankenhäuser Nürnberger Land GmbH, Lauf an der Pegnitz
| | - C Wittekind
- Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig
| | - M A Wörns
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - P Galle
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - N Malek
- Medizinische Klinik I, Universitätsklinikum Tübingen, Tübingen
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9
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Bitzer M, Voesch S, Albert J, Bartenstein P, Bechstein W, Blödt S, Brunner T, Dombrowski F, Evert M, Follmann M, La Fougère C, Freudenberger P, Geier A, Gkika E, Götz M, Hammes E, Helmberger T, Hoffmann RT, Hofmann WP, Huppert P, Kautz A, Knötgen G, Körber J, Krug D, Lammert F, Lang H, Langer T, Lenz P, Mahnken A, Meining A, Micke O, Nadalin S, Nguyen HP, Ockenga J, Oldhafer K, Paprottka P, Paradies K, Pereira P, Persigehl T, Plauth M, Plentz R, Pohl J, Riemer J, Reimer P, Ringwald J, Ritterbusch U, Roeb E, Schellhaas B, Schirmacher P, Schmid I, Schuler A, von Schweinitz D, Seehofer D, Sinn M, Stein A, Stengel A, Steubesand N, Stoll C, Tannapfel A, Taubert A, Trojan J, van Thiel I, Tholen R, Vogel A, Vogl T, Vorwerk H, Wacker F, Waidmann O, Wedemeyer H, Wege H, Wildner D, Wittekind C, Wörns MA, Galle P, Malek N. S3-Leitlinie – Diagnostik und Therapie biliärer Karzinome. Z Gastroenterol 2022; 60:e186-e227. [PMID: 35148560 DOI: 10.1055/a-1589-7854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Bitzer
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - S Voesch
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - J Albert
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart
| | - P Bartenstein
- Klinik und Poliklinik für Nuklearmedizin, LMU Klinikum, München
| | - W Bechstein
- Klinik für Allgemein-, Viszeral-, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt
| | - S Blödt
- AWMF-Geschäftsstelle, Berlin
| | - T Brunner
- Klinik für Strahlentherapie, Universitätsklinikum Magdeburg
| | - F Dombrowski
- Institut für Pathologie, Universitätsmedizin Greifswald
| | - M Evert
- Institut für Pathologie, Regensburg
| | - M Follmann
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - C La Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Tübingen
| | | | - A Geier
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg
| | - E Gkika
- Klinik für Strahlenheilkunde, Department für Radiologische Diagnostik und Therapie, Universitätsklinikum Freiburg
| | | | - E Hammes
- Lebertransplantierte Deutschland e. V., Ansbach
| | - T Helmberger
- Institut für Radiologie, Neuroradiologie und minimal-invasive Therapie, München Klinik Bogenhausen, München
| | - R T Hoffmann
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Dresden
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz, medizinisches Versorgungszentrum, Berlin
| | - P Huppert
- Radiologisches Zentrum, Max Grundig Klinik, Bühl
| | - A Kautz
- Deutsche Leberhilfe e.V., Köln
| | - G Knötgen
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - J Körber
- Klinik Nahetal, Fachklinik für onkologische Rehabilitation und Anschlussrehabilitation, Bad Kreuznach
| | - D Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel
| | | | - H Lang
- Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - T Langer
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - P Lenz
- Universitätsklinikum Münster, Zentrale Einrichtung Palliativmedizin, Münster
| | - A Mahnken
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - A Meining
- Medizinische Klinik und Poliklinik II des Universitätsklinikums Würzburg
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital Bielefeld
| | - S Nadalin
- Universitätsklinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | | | - J Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen
| | - K Oldhafer
- Klinik für Leber-, Gallenwegs- und Pankreaschirurgie, Semmelweis Universität, Asklepios Campus Hamburg
| | - P Paprottka
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - K Paradies
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - P Pereira
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln
| | | | - R Plentz
- Klinikum Bremen-Nord, Innere Medizin, Bremen
| | - J Pohl
- Interventionelles Endoskopiezentrum und Schwerpunkt Gastrointestinale Onkologie, Asklepios Klinik Altona, Hamburg
| | - J Riemer
- Lebertransplantierte Deutschland e. V., Bretzfeld
| | - P Reimer
- Institut für diagnostische und interventionelle Radiologie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe
| | - J Ringwald
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - E Roeb
- Medizinische Klinik II, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - B Schellhaas
- Medizinische Klinik I, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg
| | - I Schmid
- Zentrum Pädiatrische Hämatologie und Onkologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München
| | - A Schuler
- Medizinische Klinik, Alb Fils Kliniken GmbH, Göppingen
| | | | - D Seehofer
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig
| | - M Sinn
- Medizinische Klinik II, Universitätsklinikum Hamburg-Eppendorf
| | - A Stein
- Hämatologisch-Onkologischen Praxis Eppendorf, Hamburg
| | - A Stengel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - C Stoll
- Klinik Herzoghöhe Bayreuth, Bayreuth
| | - A Tannapfel
- Institut für Pathologie der Ruhr-Universität Bochum am Berufsgenossenschaftlichen Universitätsklinikum Bergmannsheil, Bochum
| | - A Taubert
- Kliniksozialdienst, Universitätsklinikum Heidelberg, Bochum
| | - J Trojan
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | | | - R Tholen
- Deutscher Verband für Physiotherapie e. V., Köln
| | - A Vogel
- Klinik für Gastroenterologie, Hepatologie, Endokrinologie der Medizinischen Hochschule Hannover, Hannover
| | - T Vogl
- Universitätsklinikum Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - H Vorwerk
- Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - F Wacker
- Institut für Diagnostische und Interventionelle Radiologie der Medizinischen Hochschule Hannover, Hannover
| | - O Waidmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie Medizinische Hochschule Hannover, Hannover
| | - H Wege
- Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - D Wildner
- Innere Medizin, Krankenhäuser Nürnberger Land GmbH, Lauf an der Pegnitz
| | - C Wittekind
- Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig
| | - M A Wörns
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - P Galle
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - N Malek
- Medizinische Klinik I, Universitätsklinikum Tübingen, Tübingen
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10
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Gohla G, Archid R, Hoffmann R, Kübler J, Munzel M, Königsrainer A, Nadalin S, Nikolaou K, Winkelmann MT. MRI-guided percutaneous thermoablation as first-line treatment of recurrent hepatic malignancies following hepatic resection: single center long-term experience. Int J Hyperthermia 2021; 38:1401-1408. [PMID: 34542009 DOI: 10.1080/02656736.2021.1979257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Hepatic recurrence of liver malignancies is a leading problem in patients after liver resection with curative intention. Thermoablation is a promising treatment approach for patients after hepatic resection, especially in liver-limited conditions. This study aimed to investigate safety, survival, and local tumor control rates of MRI-guided percutaneous thermoablation of recurrent hepatic malignancies following hepatic resection. MATERIAL AND METHODS Data from patients with primary or secondary hepatic malignancies treated between 2004 and 2018 with MRI-guided percutaneous thermoablation of hepatic recurrence after prior hepatic resection were retrospectively analyzed. Disease-free survival and overall survival rates were calculated using the Kaplan-Meier method. RESULTS A total of 57 patients with hepatic recurrence (mean tumor size = 18.9 ± 9.1 mm) of colorectal cancer liver metastases (n = 27), hepatocellular carcinoma (n = 17), intrahepatic recurrence of cholangiocellular carcinoma (n = 9), or other primary malignant tumor entities (n = 4) were treated once or several times with MR-guided percutaneous radiofrequency (n = 52) or microwave ablation (n = 5) (range: 1-4 times). Disease progression occurred due to local recurrence at the ablation site in nine patients (15.8%), non-local hepatic recurrence in 33 patients (57.9%), and distant malignancy in 18 patients (31.6%). The median overall survival for the total cohort was 40 months and 49 months for the colorectal cancer group, with a 5-year overall survival rate of 40.7 and 42.5%, respectively. The median disease-free survival was 10 months for both the total cohort and the colorectal cancer group with a 5-year disease-free survival rate of 15.1 and 14.8%, respectively. The mean follow-up time was 39.6 ± 35.7 months. CONCLUSION MR-guided thermoablation is an effective and safe approach in the treatment of hepatic recurrences in liver-limited conditions and can achieve long-term survival.
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Affiliation(s)
- G Gohla
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - R Archid
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - R Hoffmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - J Kübler
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - M Munzel
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - K Nikolaou
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
| | - M T Winkelmann
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany
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11
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Nadalin S, Jakovac H, Peitl V, Karlović D, Buretić-Tomljanović A. Dysregulated inflammation may predispose patients with serious mental illnesses to severe COVID‑19 (Review). Mol Med Rep 2021; 24:611. [PMID: 34184073 PMCID: PMC8258463 DOI: 10.3892/mmr.2021.12250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
Genetic and nongenetic factors associated with an increased inflammatory response may mediate a link between severe coronavirus disease 2019 (COVID‑19) and serious mental illness (SMI). However, systematic assessment of inflammatory response‑related factors associated with SMI that could influence COVID‑19 outcomes is lacking. In the present review, dietary patterns, smoking and the use of psychotropic medications are discussed as potential extrinsic risk factors and angiotensin‑converting enzyme (ACE) insertion/deletion (I/D) gene polymorphisms are considered as potential intrinsic risk factors. A genetics‑based prediction model for SMI using ACE‑I/D genotyping is also proposed for use in patients experiencing severe COVID‑19. Furthermore, the literature suggests that ACE inhibitors may have protective effects against SMI or severe COVID‑19, which is often linked to hypertension and other cardiovascular comorbidities. For this reason, we hypothesize that using these medications to treat patients with severe COVID‑19 might yield improved outcomes, including in the context of SMI associated with COVID‑19.
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Affiliation(s)
- Sergej Nadalin
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Hrvoje Jakovac
- Department of Physiology and Immunology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Vjekoslav Peitl
- Department of Psychiatry, Sestre Milosrdnice University Hospital Center and Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Dalibor Karlović
- Department of Psychiatry, Sestre Milosrdnice University Hospital Center and Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
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12
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Ristić S, Pavlić SD, Nadalin S, Čizmarević NS. ACE I/D polymorphism and epidemiological findings for COVID-19: One year after the pandemic outbreak in Europe. J Infect 2021; 83:381-412. [PMID: 34097930 PMCID: PMC8205561 DOI: 10.1016/j.jinf.2021.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Smiljana Ristić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Sergej Nadalin
- Department of Psychiatry, General Hospital "Dr. Josip Benčević", Slavonski Brod, Croatia.
| | - Nada Starčević Čizmarević
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
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13
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Steinke J, Nadalin S, Horger MS, Fend F, Frauenfeld L. [Rosai-Dorfman disease as a rare cause of a pancreatic mass]. Pathologe 2020; 42:231-234. [PMID: 33306139 DOI: 10.1007/s00292-020-00877-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
The CT and MRI scans of a 70-year-old male patient revealed a mass in the pancreatic head and a 2.8-cm peripancreatic lymph node. Under steroid therapy the mass did not show regression. Finally, a pancreatoduodenectomy was performed. Histologically, Rosai-Dorfman disease (RDD) was diagnosed. RDD is a rare histiocytic disorder with usually nodal but sometimes also extranodal involvement. Herein we report a rare case of extranodal RDD with intrapancreatic localization.
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Affiliation(s)
- J Steinke
- Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Universitätsklinikum Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland
| | - S Nadalin
- Klinik für Allgemein‑, Viszeral und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - M S Horger
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - F Fend
- Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Universitätsklinikum Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland.
| | - L Frauenfeld
- Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Universitätsklinikum Tübingen, Liebermeisterstraße 8, 72076, Tübingen, Deutschland
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14
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Rüthrich MM, Giessen-Jung C, Borgmann S, Classen AY, Dolff S, Grüner B, Hanses F, Isberner N, Köhler P, Lanznaster J, Merle U, Nadalin S, Piepel C, Schneider J, Schons M, Strauss R, Tometten L, Vehreschild JJ, von Lilienfeld-Toal M, Beutel G, Wille K. COVID-19 in cancer patients: clinical characteristics and outcome-an analysis of the LEOSS registry. Ann Hematol 2020; 100:383-393. [PMID: 33159569 PMCID: PMC7648543 DOI: 10.1007/s00277-020-04328-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [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: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Introduction Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk. Patients and methods We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality. Results In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%, p value < 0.001). After adjustments for other risk factors, mortality was comparable. Conclusion Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions. Supplementary Information The online version contains supplementary material available at 10.1007/s00277-020-04328-4.
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Affiliation(s)
- Maria Madeleine Rüthrich
- Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany. .,Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institute, Jena, Germany.
| | - C Giessen-Jung
- Department of Internal Medicine III, Ludwig Maximilian University, Munich, Germany
| | - S Borgmann
- Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
| | - A Y Classen
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany
| | - S Dolff
- Department of Infectious Diseases, University Hospital Essen, University Duisburg Essen, Essen, Germany
| | - B Grüner
- Section Clinical Infectiology, University Hospital Ulm, Ulm, Germany
| | - F Hanses
- Emergency Department, University Hospital Regensburg, Regensburg, Germany
| | - N Isberner
- Department of Internal Medicine II, Division of Infectious Diseases, University Hospital Würzburg, Würzburg, Germany
| | - P Köhler
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - J Lanznaster
- Department of Internal Medicine II, Passau Hospital, Passau, Germany
| | - U Merle
- Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - C Piepel
- Hospital Bremen-Center, Bremen, Germany
| | - J Schneider
- Department of Internal Medicine II, Technical University of Munich, School of Medicine, University hospital rechts der Isar, Munich, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - M Schons
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - R Strauss
- Medical Clinic I, University Hospital Erlangen, Erlangen, Germany
| | - L Tometten
- Department of Gastroenterology and Infectiology, Hospital Ernst-von-Bergmann, Potsdam, Germany
| | - J J Vehreschild
- Department I for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany.,Department of Internal Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - M von Lilienfeld-Toal
- Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.,Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institute, Jena, Germany
| | - G Beutel
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - K Wille
- University of Bochum, University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Minden, Germany
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15
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Nadalin S, Flego V, Pavlić SD, Volarić D, Radojčić Badovinac A, Kapović M, Ristić S. Association between the ACE-I/D polymorphism and nicotine dependence amongst patients with lung cancer. Biomed Rep 2020; 13:58. [PMID: 33123372 DOI: 10.3892/br.2020.1365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/14/2020] [Indexed: 11/06/2022] Open
Abstract
The biologically active peptide angiotensin II is cleaved from angiotensinogen by the renin and the angiotensin-converting enzyme (ACE), an enzymatic cascade known as the renin-angiotensin system (RAS). RAS may be important in the etiology of nicotine dependence by influencing dopaminergic signaling. In the present study, the association between an insertion/deletion (I/D) polymorphism of ACE and nicotine dependence amongst patients with lung cancer was assessed. To date, several studies have shown the relevance of this polymorphic variant in both nicotine dependence and lung cancer. However, the present study is the first to address the potential role of the ACE-I/D polymorphism in nicotine dependence among patients with lung cancer. Genotyping was performed in 305 patients with lung cancer (males/females, 214/91). Significantly more male smokers had the ACE-I allele compared with male non-smokers (44.9 vs. 20.0%; P<0.05). The risk of smoking was ~5-fold higher for males with the ACE-I allele (ACE-II homozygous and ACE-ID heterozygous) vs. ACE-DD homozygous (odds ratio, 5.47; 95% confidence interval, 1.4-21.9; P=0.016). The pack-year smoking history in a subgroup of females with squamous cell carcinoma carrying the ACE-I allele was significantly lower compared with ACE-DD (37.1±14.1 vs. 57.0±29.1; F=4.5; P=0.046). The ACE-I/D polymorphism accounted for 17.6% of the smoking severity in this patient group (β, -0.42; multiple R2 change, 0.176; P=0.046). These results suggest that the ACE-I/D polymorphism contributes to the risk of nicotine dependence and smoking severity in lung cancer patients in a sex-specific manner.
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Affiliation(s)
- Sergej Nadalin
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Veljko Flego
- Department of Pulmonology, Clinical Hospital Center Rijeka, University of Rijeka, 51000 Rijeka, Croatia
| | - Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Darian Volarić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Anđelka Radojčić Badovinac
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.,Department of Biotechnology, University of Rijeka, 51000 Rijeka, Croatia
| | - Miljenko Kapović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Smiljana Ristić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
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16
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Dević Pavlić S, Nadalin S, Starčević Čizmarević N, Buretić-Tomljanović A, Radojčić Badovinac A, Ristić S. Could angiotensin-converting enzyme 1 I/D polymorphism be a modificator of COVID-19 response in different populations, diseases, and/or conditions? J Renin Angiotensin Aldosterone Syst 2020; 21:1470320320957157. [PMID: 32928023 PMCID: PMC7495939 DOI: 10.1177/1470320320957157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sanja Dević Pavlić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Croatia
| | - Sergej Nadalin
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Croatia
| | | | | | - Anđelka Radojčić Badovinac
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Croatia.,Department of Biotechnology, University of Rijeka, Croatia
| | - Smiljana Ristić
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Croatia
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17
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Nadalin S, Jonovska S, Šendula Jengić V, Buretić-Tomljanović A. An association between niacin skin flush response and plasma triglyceride levels in patients with schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2020; 155:102084. [PMID: 32126479 DOI: 10.1016/j.plefa.2020.102084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/03/2020] [Accepted: 02/18/2020] [Indexed: 01/31/2023]
Abstract
The available data suggest that abnormalities of arachidonic acid-related signaling may be of relevance in attenuated niacin-induced flush responses and lipid and glucose metabolism disturbances, which are all common among individuals with schizophrenia. We previously demonstrated attenuated skin flush responses to niacin in patients with schizophrenia. Here we investigated whether these niacin responses might be associated with elevated plasma lipid and glucose concentrations in this patient group. We found that higher plasma triglyceride levels were associated with higher total volumetric niacin response (VNR) values and that the VNR accounted for ~14.2% of the variability in triglyceride levels. Triglyceride levels were significantly higher in patients with a positive niacin skin flush response compared to those with absent niacin skin flushing at the 5-minute interval with niacin concentrations of 0.1 and 0.01 M, and at the 10- and 15-minute intervals with a niacin concentration of 0.001 M.
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Affiliation(s)
- Sergej Nadalin
- Department of Medical Biology and Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
| | | | | | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
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18
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Abstract
Posthepatectomy liver failure (PHLF) still represents a severe complication after major liver resection associated with a high mortality. In addition to an insufficient residual liver volume various factors play an important role in the pathophysiology of PHLF. These include the quality of the parenchyma, liver function, perfusion, i.e. maintenance of adequate inflow and outflow, as well as the condition of the patient and comorbidities. While the liver volume is relatively easy to evaluate using modern imaging techniques, the evaluation of liver function and liver quality require a differentiated approach. Both factors can be influenced by the constitutional status of the patient, medical history and previous treatment and must be given sufficient consideration in the risk evaluation. An adequate perfusion, e.g. portal and arterial circulation and adequate outflow by at least one hepatic vein as well an adequate biliary drainage should be always guaranteed in order to allow regeneration of the residual liver tissue. Only the understanding of all these aspects will support the surgeon in a correct and safe evaluation of the resectability. Additionally, the liver surgeon should be aware of all available perioperative and postoperative options to treat and to prevent PHLF. In this review article the most important questions regarding the risk factors related to PHLF are presented and the potential therapeutic and prophylactic management is described. The main goal is to ensure functional operability of the patient if oncological resectability is possible. In other words: in the case of correct oncological indication, the liver surgeon should be able to resect what is resectable or, alternatively, make resectable what primarily was not resectable.
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Affiliation(s)
- I Capobianco
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland
| | - J Strohäker
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland
| | - A Della Penna
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland
| | - S Nadalin
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland
| | - A Königsrainer
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland.
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19
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Nadalin S, Rebić J, Šendula Jengić V, Peitl V, Karlović D, Buretić-Tomljanović A. Association between PLA2G6 gene polymorphism for calcium-independent phospholipase A2 and nicotine dependence among males with schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2019; 148:9-15. [PMID: 31492433 DOI: 10.1016/j.plefa.2019.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/03/2019] [Accepted: 07/02/2019] [Indexed: 01/08/2023]
Abstract
We investigated the relationship between the rs10798059 (BanI) and rs4375 polymorphisms in the phospholipase A2 (PLA2)G4A and PLA2G6 genes and the risk of nicotine dependence in 263 Croatian patients with schizophrenia. We also examined whether interactions between these polymorphisms and smoking contributed to schizophrenia onset and Positive and Negative Syndrome Scale (PANSS) psychopathology. We found no significant differences in the distribution of PLA2G4A genotypes and alleles according to smoking status, and no effect of the PLA2G4A genotype-smoking interaction on disease onset or PANSS. The PLA2G6-TT homozygous genotype was significantly overrepresented in male smokers compared to nonsmokers (34.7% vs. 17.1%, p < 0.05). These patients had ∼2.6-fold higher risk of becoming smokers than males with heterozygous PLA2G6-CT and homozygous PLA2G6-CC genotypes. In addition, male smokers without the PLA2G6-C allele (PLA2G6-TT homozygous) experienced earlier onset than nonsmoking homozygous PLA2G6-TT males. Thus, the PLA2G6 polymorphism affected the risk of nicotine dependence in male patients and the PLA2G6 genotype-smoking interaction was linked to the age of disease onset.
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Affiliation(s)
- Sergej Nadalin
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000, Rijeka, Croatia.
| | - Jelena Rebić
- Psychiatry Clinic, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | - Vjekoslav Peitl
- Department of Psychiatry, Sestre Milosrdnice University Hospital Center and Catholic University of Croatia, Zagreb, Croatia
| | - Dalibor Karlović
- Department of Psychiatry, Sestre Milosrdnice University Hospital Center and Catholic University of Croatia, Zagreb, Croatia
| | - Alena Buretić-Tomljanović
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000, Rijeka, Croatia
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20
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Abstract
INTRODUCTION Cystic and alveolar echinococcosis are two potentially life-threatening diseases caused by the helminthic parasites Echinococcus granulosus or Echinococcus multilocularis, respectively. In central Europe a marked increase in incidence of both forms of echinococcosis has recently been observed. OBJECTIVE There is widespread uncertainty with diagnostic and treatment algorithms due to the close genetic relationship of both parasites and the similar presentation; however, since the treatment and prognosis significantly differ between the two diseases, a correct diagnosis is essential. This review summarizes the similarities and differences in the diagnostics and surgical treatment of these two parasites. RESULTS The correct diagnosis is mainly based on patient history, radiological imaging and serological testing. In cystic echinococcosis cyst viability and stage determine whether treatment is medicinal, interventional, surgical or a watch and wait strategy. For alveolar echinococcosis surgical resection in combination with perioperative or adjuvant medicinal treatment is the gold standard and the only therapeutic option. As identification of the disease is often delayed due to the oligosymptomatic manifestation, complex resections are frequently necessary that need to be treated by a multidisciplinary team of experts. CONCLUSION Echinococcosis is still a neglected disease due to the rarity and thus should be referred to experts in a tertiary hospital to avoid mistreatment or overtreatment. Due to a timely surgical, infectiological and interventional treatment in an interdisciplinary work-up, the prognosis of echinococcosis has significantly improved in recent years.
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Affiliation(s)
- J Strohäker
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland
| | - S Nadalin
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
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21
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Horvath P, Beckert S, Königsrainer A, Nadalin S, Königsrainer I. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy combined with liver resection for concurrent peritoneal and hepatic metastases of gastrointestinal and gynecological primary tumors. J Visc Surg 2019; 156:475-484. [PMID: 31324533 DOI: 10.1016/j.jviscsurg.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
AIM OF THE STUDY Cytoreductive surgery including liver resection and hyperthermic intraperitoneal chemotherapy provide survival benefit to selected patients but is associated with relevant morbidity and mortality rates. We aimed to report morbidity and mortality rates and parameters linked to increased morbidity. PATIENTS AND METHODS Retrospective analysis of 37 patients who underwent liver resection and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy between 2006 and 2016. From a prospectively collected database the morbidity and mortality rates and survival data were analyzed. RESULTS The mortality rate was 0% and grade III-IV morbidity was 42%. Re-operation rate was 27%. Patients with complications tended to have a higher peritoneal cancer index (16 vs. 13; P=0.23). The performance of rectal resections was statistically significantly associated with morbidity (P=0.02). Neither performance of other type of resections nor the hyperthermic intraperitoneal chemotherapy compound nor the completeness of cytoreduction score was associated with elevated morbidity. No complications related to liver resections were observed. Furthermore, origin of peritoneal metastases did not impact on occurrence of complications. Median overall survival for colorectal primaries was 22 months (range, 9-60 months) and 30 months (range, 12-58 months) for ovarian cancer. CONCLUSION Simultaneous resection of hepatic and peritoneal metastases seems to provide a survival benefit for selected patients and is associated with acceptable morbidity and mortality rates. Knowledge of patients and operative factors linked to morbidity will help to provide a strict selection process and a safer surgical procedure.
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Affiliation(s)
- P Horvath
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany.
| | - S Beckert
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany.
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany.
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany.
| | - I Königsrainer
- Department of General, Visceral and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807 Feldkirch, Austria.
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22
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Brucker SY, Taran FA, Rall K, Schöller D, Dahm-Kâhler P, Kvarnström N, Järvholm S, Nadalin S, Königsrainer A, Wallwiener D, Brännström M. Experiences of a multistep process with medical and psychological interventions for patients with congenital uterine aplasia to achieve motherhood: the Gothenburg-Tübingen collaboration. Facts Views Vis Obgyn 2019; 11:121-126. [PMID: 31824633 PMCID: PMC6897517] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Congenital uterine aplasia, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a condition associated to a non-functional uterus in the presence of functional ovaries. In a setting where surrogacy is illegal (or not accepted) and adoption is the only alternative, neovaginoplasty and subsequent uterus transplantation (UTx) can provide a route to motherhood for women with MRKHS. This review article describes a multistep process by which patients with MRKHS can achieve motherhood with their own biological child. This process involving a careful clinical diagnosis, psychological counselling, assessment of eligibility for neovagina creation and UTx, the surgical treatment, fertility treatment, and long-term follow-up was developed at the Tübingen University Hospital and in close collaboration with Sahlgrenska Academy, University of Gothenburg, Sweden, where the basic experimental and clinical groundwork for UTx was laid and the first-ever UTx procedure was performed.
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Affiliation(s)
- SY Brucker
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - F-A Taran
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - K Rall
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - D Schöller
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - P Dahm-Kâhler
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - N Kvarnström
- Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - S Järvholm
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Tübingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Tübingen, Germany
| | - D Wallwiener
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - M Brännström
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden,Stockholm IVF, Stockholm, Sweden
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23
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Nadalin S, Rebić J, Ružić K, Buretić-Tomljanović A. The relationship between components of metabolic syndrome and disease onset in patients with schizophrenia. Schizophr Res 2018; 201:420-421. [PMID: 29880450 DOI: 10.1016/j.schres.2018.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 05/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
| | - Jelena Rebić
- Psychiatry Clinic, Clinical Hospital Centre, Krešimirova 42, 51000 Rijeka, Croatia
| | - Klementina Ružić
- Psychiatry Clinic, Clinical Hospital Centre, Krešimirova 42, 51000 Rijeka, Croatia
| | - Alena Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
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24
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Nadalin S, Buretić-Tomljanović A. An association between the BanI polymorphism of the PLA2G4A gene for calcium-dependent phospholipase A2 and plasma glucose levels among females with schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2018; 135:39-41. [PMID: 30103930 DOI: 10.1016/j.plefa.2018.06.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/21/2022]
Abstract
Abnormal glucose and lipid metabolism may be associated with altered cytosolic Ca2+-dependent phospholipase A2 (cPLA2) signaling in patients with schizophrenia. The relationship between schizophrenia and the functional BanI polymorphism (rs10798059 variant, A/G polymorphism) of the PLA2G4A gene for cPLA2 has been extensively investigated. We previously reported that it can influence several clinical features of schizophrenia, and it was shown to contribute to schizophrenia risk in several population studies. We performed PCR/RFLP genotyping of 263 Croatian patients (males/females: 139/124) to investigate the relationship between the BanI polymorphism and fasting plasma glucose and lipid levels in patients with schizophrenia. Our results indicate that the BanI polymorphic variant contributes significantly to plasma glucose levels in female patients. Females carrying the PLA2G4A-G allele (PLA2G4A-GG homozygous and PLA2G4A-AG heterozygous) presented with lower glucose levels than PLA2G4A-AA homozygous carriers, and the PLA2G4A genotype contributed approximately 6% of plasma glucose level variability in this group of patients.
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Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia.
| | - Alena Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia
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25
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Siegel-Axel D, Jaghutriz BA, Peter A, Machann J, Kovarova M, Ullrich S, Gerst F, Nadalin S, Sipos B, Königsrainer A, Schick F, Stefan N, Fend F, Haen S, Häring HU, Wagner R, Schleicher E. Human fat depots show distinct quantitative, qualitative and functional inter-individual differences. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Siegel-Axel
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - BA Jaghutriz
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - A Peter
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - J Machann
- Sektion für Experimentelle Radiologie, Abteilung für Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Tübingen, Germany
- Institut für Diabetes-Forschung und Metabolische Erkrankungen (IDM) – Metabolic Imaging des Helmholtz-Zentrums München an der Universität Tübingen, Neuherberg, Germany
| | - M Kovarova
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - S Ullrich
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - F Gerst
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - S Nadalin
- Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum (UKT), Tübingen, Germany
| | - B Sipos
- Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum (UKT), Tübingen, Germany
| | - A Königsrainer
- Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum (UKT), Tübingen, Germany
| | - F Schick
- Sektion für Experimentelle Radiologie, Abteilung für Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Tübingen, Germany
| | - N Stefan
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - F Fend
- Institut für Pathologie und Neuropathologie, Abt. für Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Tübingen, Germany
| | - S Haen
- Institut für Pathologie und Neuropathologie, Abt. für Allgemeine und Molekulare Pathologie und Pathologische Anatomie, Tübingen, Germany
| | - HU Häring
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - R Wagner
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
| | - E Schleicher
- Universitätsklinikum Tübingen (UKT), Medizinische Klinik IV, Abt. Endokrinologie, Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Neuherberg, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), Tübingen, Germany
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Benkö T, Sgourakis G, Molmenti EP, Peitgen HO, Paul A, Nadalin S, Schroeder T, Radtke A. Portal Supply and Venous Drainage of the Caudate Lobe in the Healthy Human Liver: Virtual Three-Dimensional Computed Tomography Volume Study. World J Surg 2017; 41:817-824. [PMID: 27822720 DOI: 10.1007/s00268-016-3791-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe. METHODS Extrahepatic (provided by the first-order branches) versus intrahepatic (provided by the second- to third-order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3-D liver maps in 140 potential live liver donors. RESULTS The caudate lobe has a greater intrahepatic than extrahepatic portal inflow volume (mean 55 ± 26 vs. 45 ± 26%: p = 0.0763), and a greater extrahepatic than intrahepatic venous drainage (mean 54-61 vs. 39-46%). Intrahepatic drainage based on mean estimated values showed the following distribution: middle > inferior (accessory) > right > left hepatic vein. CONCLUSIONS Sacrifice of extrahepatic caudate portal branches can be compensated by the intrahepatic portal supply. The dominant outflow via Spieghel veins and the negligible role of left hepatic vein in caudate venous drainage may suggest reconstruction of caudate outflow via Spieghel veins in instances of extended left hemiliver live donation not inclusive of the middle hepatic vein. The anatomical data and the real implication for living donors must be further verified by clinical studies.
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Affiliation(s)
- T Benkö
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
| | - G Sgourakis
- Department of Surgery, Furness General Hospital, Dalton Ln, Barrow-in-Furness, Cumbria, LA14 4LF, UK.
| | - E P Molmenti
- Department of Surgery, North Shore University Hospital, Manhasset, NY, USA
| | - H O Peitgen
- MeVis Center for Medical Diagnostic Systems and Visualization, University of Bremen, Bremen, Germany
| | - A Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
| | - S Nadalin
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
- Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Tubingen, Germany
| | - T Schroeder
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany
| | - A Radtke
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany
- Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Tubingen, Germany
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Nadalin S, Buretić-Tomljanović A. An association between PLA2G6 and PLA2G4C gene polymorphisms and schizophrenia risk and illness severity in a Croatian population. Prostaglandins Leukot Essent Fatty Acids 2017; 121:57-59. [PMID: 28651698 DOI: 10.1016/j.plefa.2017.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/30/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
Abstract
We investigated the allele and genotype frequency of the rs4375 and rs1549637 polymorphisms in phospholipase A2 (PLA2)G6 and PLA2G4C genes in 203 patients with schizophrenia and 191 controls in a Croatian population. We hypothesized that these polymorphic variations might influence the age of schizophrenia onset and Positive and Negative Syndrome Scale psychopathology (PANSS) data. We detected a significant overrepresentation of the PLA2G6-CT and PLA2G4C-AT genotype combination in patients compared with controls (14.7% vs. 7.3%, P < 0.05). The combined PLA2G6/PLA2G4C heterozygosity was associated with about a two-fold higher schizophrenia risk. We found no significant influence of the PLA2G6 and PLA2G4C polymorphisms on mean age at first hospital admission (P > 0.05) and that the investigated polymorphisms significantly influenced the clinical psychopathology only in male patients. The PLA2G4C polymorphism accounted for approximately 12% of negative symptom severity; whereas, the PLA2G6/PLA2G4C interaction contributed to a similar extent to total PANSS symptom variations.
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Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Alena Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
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Wagner R, Machann J, Guthoff M, Nawroth PP, Nadalin S, Saleem MA, Heyne N, Königsrainer A, Fend F, Schick F, Fritsche A, Stefan N, Häring HU, Schleicher E, Siegel-Axel DI. The protective effect of human renal sinus fat on glomerular cells is reversed by the hepatokine fetuin-A. Sci Rep 2017; 7:2261. [PMID: 28536464 PMCID: PMC5442123 DOI: 10.1038/s41598-017-02210-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 01/19/2017] [Accepted: 04/06/2017] [Indexed: 02/06/2023] Open
Abstract
Renal sinus fat (RSF) is a perivascular fat compartment located around renal arteries. In this in vitro and in vivo study we hypothesized that the hepatokine fetuin-A may impair renal function in non alcoholic fatty liver disease (NAFLD) by altering inflammatory signalling in RSF. To study effects of the crosstalk between fetuin-A, RSF and kidney, human renal sinus fat cells (RSFC) were isolated and cocultured with human endothelial cells (EC) or podocytes (PO). RSFC caused downregulation of proinflammatory and upregulation of regenerative factors in cocultured EC and PO, indicating a protective influence of RFSC. However, fetuin-A inverted these benign effects of RSFC from an anti- to a proinflammatory status. RSF was quantified by magnetic resonance imaging and liver fat content by 1H-MR spectroscopy in 449 individuals at risk for type 2 diabetes. Impaired renal function was determined via urinary albumin/creatinine-ratio (uACR). RSF did not correlate with uACR in subjects without NAFLD (n = 212, p = 0.94), but correlated positively in subjects with NAFLD (n = 105, p = 0.0005). Estimated glomerular filtration rate (eGRF) was inversely correlated with RSF, suggesting lower eGFR for subjects with higher RSF (r = 0.24, p < 0.0001). In conclusion, our data suggest that in the presence of NAFLD elevated fetuin-A levels may impair renal function by RSF-induced proinflammatory signalling in glomerular cells.
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Affiliation(s)
- R Wagner
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - J Machann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany
| | - M Guthoff
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | - P P Nawroth
- German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany
| | - M A Saleem
- Bristol Renal and Children's Renal Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - N Heyne
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany
| | - A Königsrainer
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Tübingen, Germany
| | - F Fend
- Institute of Pathology and Neuropathology, University of Tübingen, Tübingen, Germany
| | - F Schick
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany.,Department of Diagnostic and Interventional Radiology, Section on Experimental Radiology, University Hospital Tübingen, Tübingen, Germany
| | - A Fritsche
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - N Stefan
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - H-U Häring
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - E Schleicher
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - D I Siegel-Axel
- Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine IV, University Hospital Tübingen, Tübingen, Germany. .,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Tübingen, Germany. .,German Center for Diabetes Research (DZD), Neuherberg, Germany.
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Wagner R, Machann J, Guthoff M, Nadalin S, Nawroth P, Saleem MA, Stefan N, Schick F, Fend F, Fritsche A, Königsrainer A, Heyne N, Häring HU, Schleicher E, Siegel-Axel DI. Die ‚fettige Niere‘: Interaktionen von renalem Sinusfett mit der Fettleber beeinflussen die Zytokinexpression glomerulärer Zellen in vitro und die renale Funktion in Prädiabetikern. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Wagner
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - J Machann
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - M Guthoff
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - S Nadalin
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie (AVT), Tübingen, Germany
| | - P Nawroth
- Deutsches Zentrum für Diabetesforschung (DZD e.V.), Neuherberg/München, Germany
| | - MA Saleem
- Bristol Royal Hospital for Children, Paediatric Renal Medicine, University of Bristol, Bristol, Germany
| | - N Stefan
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - F Schick
- Institut für Diabetesforschung und Metabolische Erkrankungen des Helmholtz-Zentrums München an der Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - F Fend
- Institut für Pathologie und Neuropathologie (Department), Allgemeine Pathologie und Pathologische Anatomie, Tübingen, Germany
| | - A Fritsche
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - A Königsrainer
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie (AVT), Tübingen, Germany
| | - N Heyne
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - HU Häring
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - E Schleicher
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - DI Siegel-Axel
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
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Siegel-Axel DI, Gerst F, Wagner R, Nadalin S, Sipos B, Königsrainer A, Häring HU, Ullrich S. Sind pankreatische Fettzellen anders? Vergleich der Expression inflammatorischer, regenerativer, profibrotischer und Makrophagen-anlockender Faktoren zu Fettzellen verschiedener anderer Lokalisationen im Körper. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- DI Siegel-Axel
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - F Gerst
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - R Wagner
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - S Nadalin
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie (AVT), Tübingen, Germany
| | - B Sipos
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie (AVT), Tübingen, Germany
| | - A Königsrainer
- Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie (AVT), Tübingen, Germany
| | - HU Häring
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
| | - S Ullrich
- Medizinische Klinik IV, UKT, Abteilung Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Tübingen, Germany
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Nadalin S, Buretić-Tomljanović A, Lavtar P, Starčević Čizmarević N, Hodžić A, Sepčić J, Kapović M, Peterlin B, Ristić S. The lack of association between angiotensin-converting enzyme gene insertion/deletion polymorphism and nicotine dependence in multiple sclerosis. Brain Behav 2017; 7:e00600. [PMID: 28127518 PMCID: PMC5256183 DOI: 10.1002/brb3.600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/14/2016] [Accepted: 10/03/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Blood-borne angiotensin II is generated from angiotensinogen via cleavage by renin and angiotensin-converting enzyme (ACE), an enzymatic cascade known as the renin-angiotensin system (RAS). Several lines of evidence indicate that ACE, beyond its classical role of mediating blood pressure regulation, might contribute to the etiology of substance addictions by influencing dopaminergic signaling. A functional insertion/deletion (I/D) polymorphism of the ACE gene was associated with risk for being a smoker among individuals with depression and with smoking severity in studies comprising patients with depression and healthy controls. Several reports have described significantly increased ACE activity in cerebrospinal fluid and serum among MS patients. Furthermore, in our previous work with MS patients from Croatian and Slovenian populations, we demonstrated that the ACE-I/D polymorphism contributes to an elevated MS risk among male patients. Here we investigated whether the ACE-I/D polymorphism might influence smoking behavior among patients with MS. PATIENTS AND METHODS Genotyping was performed in 521 patients (males/females: 139/382) using polymerase chain reaction. RESULTS We revealed no significant differences in ACE genotype and allele frequencies between smokers and nonsmokers and no significant association between the ACE-I/D polymorphism and either pack-year smoking history or number of cigarettes smoked daily (p > .05, respectively). CONCLUSION The ACE-I/D polymorphism does not contribute either to risk for nicotine dependence or to smoking severity among MS patients. In the context of reports on the ACE-I/D polymorphism and nicotine dependence among healthy controls and patients with depression, we may speculate that the mechanism by which this polymorphism influences nicotine dependence risk differs in MS compared to depression, although not compared to a healthy population. In addition to angiotensin II, other potential ACE substrates, such as substance P and neurotensin, which also influence dopaminergic neurotransmission (and are proposed to be associated with MS), may deserve study in future.
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Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
| | | | - Polona Lavtar
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | | | - Alenka Hodžić
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | - Juraj Sepčić
- Postgraduate Studies School of Medicine University of Rijeka Rijeka Croatia
| | - Miljenko Kapović
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics University Medical Centre Ljubljana Slovenia
| | - Smiljana Ristić
- Department of Biology and Medical Genetics School of Medicine University of Rijeka Rijeka Croatia
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Nadalin S, Ristić S, Rebić J, Šendula Jengić V, Kapović M, Buretić-Tomljanović A. The insertion/deletion polymorphism in the angiotensin-converting enzyme gene and nicotine dependence in schizophrenia patients. J Neural Transm (Vienna) 2016; 124:511-518. [DOI: 10.1007/s00702-016-1670-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 12/18/2016] [Indexed: 11/29/2022]
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Nadalin S, Buretić-Tomljanović A, Rebić J, Pleša I, Šendula Jengić V. An association between the PPARα-L162V polymorphism and nicotine dependency among patients with schizophrenia. Compr Psychiatry 2016; 70:118-24. [PMID: 27624431 DOI: 10.1016/j.comppsych.2016.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/25/2016] [Accepted: 07/06/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Patients with schizophrenia are more likely to be smokers than the general population, which makes them an interesting group with which to study the etiology of nicotine dependency. We studied the prevalence of a gene variant of peroxisome proliferator-activated receptor alpha (PPARα) in schizophrenia, together with nicotine dependency, to investigate whether the PPARα-L162V polymorphism (rs1800206) influences nicotine dependency in schizophrenia. Given evidence suggesting that smoking influences the severity of schizophrenia, together with our recent data linking the PPARα-L162V polymorphism to clinical manifestations of schizophrenia (in the Croatian population), we hypothesized that interactions between the two (smoking and the PPARα-L162V polymorphism) might contribute to disease onset and scores for the Positive and Negative Syndrome Scale. To the best of our knowledge, this is the first study to investigate the possible associations between the PPARα gene and nicotine dependency. PATIENTS AND METHODS Genotyping was performed for 267 chronically ill schizophrenia patients (males/females: 140/127) by polymerase chain reaction. RESULTS A significant excess of PPARα-L162V genotypes and PPARα-162V alleles were detected among female smokers in comparison to female nonsmokers (18.2% vs. 2.0%, and 9.1% vs. 1.0%, p<0.01, respectively). We also revealed a significant PPARα genotype-smoking interaction that predicted positive symptom severity among male patients (F=4.43, p<0.05). These data indicated that the PPARα-L162V heterozygous genotype, depending on smoking status, might be of relevance as either protective, or a risk factor, for the severity of positive symptoms. No interaction between the PPARα-L162V polymorphism and smoking for the time of onset of schizophrenia was detected (p>0.05, respectively). CONCLUSION We demonstrated two significant yet weak effects. The first showed an effect of the PPARα-L162V polymorphism on the risk of nicotine dependency. The second linked the PPARα genotype-smoking interaction to positive symptoms severity among schizophrenia patients; both effects manifested in a gender-specific fashion.
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Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
| | - Alena Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
| | - Jelena Rebić
- Psychiatry Clinic, Clinical Hospital Center Rijeka, Cambierieva 15, 51000 Rijeka, Croatia
| | - Ivana Pleša
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
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Gerst F, Wagner R, Panse M, Siegel-Axel D, Ordelheide A, Stefan N, Sipos B, Fend F, Nadalin S, Königsrainer A, Häring HU, Ullrich S. Charakterisierung des „fettigen“ Pankreas: Beeinflussen Adipozyten und Immunzellen die Insel? DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580810] [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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Siegel-Axel DI, Gerst F, Panse M, Wagner R, Machann J, Stefan N, Schmidt U, Schreiner B, Sipos B, Fend F, Nadalin S, Königsrainer A, Häring HU, Ullrich S. Interaktionen des „fettigen“ Pankreas mit der Fettleber: Unterschiedliche Effekte von Fetuin-A auf die durch Prädipozyten und Adipozyten vermittelte pankreatische Inflammation. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580756] [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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Horvath P, Beckert S, Nadalin S, Königsrainer A, Königsrainer I. Pancreas-preserving surgical management of grade-C pancreatic fistulas after pancreatic head resection by external wirsungostomy. Langenbecks Arch Surg 2016; 401:457-62. [DOI: 10.1007/s00423-016-1423-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/01/2016] [Indexed: 12/30/2022]
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Reiner J, Hsieh CJ, Straarup C, Bodammer P, Schäffler H, Graepler F, Stüker D, Kratt T, Linnebacher M, Nadalin S, Witte M, Königsrainer A, Lamprecht G. After Intestinal Transplantation Kidney Function Is Impaired by Downregulation of Epithelial Ion Transporters in the Ileum. Transplant Proc 2016; 48:499-506. [DOI: 10.1016/j.transproceed.2015.12.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/29/2015] [Indexed: 12/18/2022]
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Abstract
The vascular management in anatomical liver resection plays a pivotal role in maintaining an adequately functional residual liver volume. In this respect it is essential to guarantee an adequate portal and arterial inflow as well venous outflow for the whole residual liver (lobe or segments). To achieve this, the liver surgeon should have excellent perioperative imaging, surgical expertise based on knowledge of vascular anatomy, physiology and hemodynamics of the liver and a well-designed and cautious operative strategy. The use of intraoperative ultrasonography (with or without contrast enhancement) and modern parenchymal dissectors (e.g. ultrasound or water jet dissectors) are strongly recommended.
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Affiliation(s)
- S Nadalin
- Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe Seyler Str. 3, 72076, Tübingen, Deutschland
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Capobianco I, Frank M, Königsrainer A, Sipos B, Menzel M, Sturm E, Nadalin S. Liver fluke-infested graft used for living-donor liver transplantation: case report and review of the literature. Transpl Infect Dis 2015; 17:880-5. [DOI: 10.1111/tid.12463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 08/06/2015] [Accepted: 09/06/2015] [Indexed: 11/30/2022]
Affiliation(s)
- I. Capobianco
- General, Visceral and Transplant Surgery; University Hospital Tuebingen; Tuebingen Germany
| | - M. Frank
- Institute of Tropical Medicine, Travel Medicine, Human Parasitology; University Hospital Tuebingen; Tuebingen Germany
| | - A. Königsrainer
- General, Visceral and Transplant Surgery; University Hospital Tuebingen; Tuebingen Germany
| | - B. Sipos
- Institute of Pathology; University Hospital Tuebingen; Tuebingen Germany
| | - M. Menzel
- General, Visceral and Transplant Surgery; University Hospital Tuebingen; Tuebingen Germany
| | - E. Sturm
- Department of Pediatric Gastroenterology and Hepatology; University Hospital Tuebingen; Tuebingen Germany
| | - S. Nadalin
- General, Visceral and Transplant Surgery; University Hospital Tuebingen; Tuebingen Germany
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Nadalin S, Radović I, Buretić-Tomljanović A. Polymorphisms in PLA2G6 and PLA2G4C genes for calcium-independent phospholipase A2 do not contribute to attenuated niacin skin flush response in schizophrenia patients. Prostaglandins Leukot Essent Fatty Acids 2015; 100:29-32. [PMID: 26160611 DOI: 10.1016/j.plefa.2015.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 05/11/2015] [Accepted: 06/18/2015] [Indexed: 11/18/2022]
Abstract
We hypothesized that attenuated niacin skin flushing in schizophrenia patients might be associated with polymorphic variants in PLA2G6 and PLA2G4C genes (rs4375 and rs1549637 variations) which encode calcium-independent phospholipase A2 beta (iPLA2β) and cytosolic phospholipase A2 gamma (cPLA2γ) enzymes. The iPLA2β and cPLA2γ may play an important role in niacin-mediated signaling; in addition to their major role - mediating phospholipids remodeling, which alters membrane receptors and signal transduction, they regulate the reservoir of arachidonic acid for prostaglandins synthesis. Skin response to topical niacin of 0.1M, 0.01M, 0.001M and 0.0001M concentrations in 75 schizophrenia patients was rated using the method of volumetric niacin response (VNR). Neither PLA2G6 nor PLA2G4C gene polymorphisms were significantly associated with VNR values. Furthermore, polymorphisms׳ synergy on niacin skin flushing was also not detected.
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Affiliation(s)
- S Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia.
| | - I Radović
- School of Medicine, University of Rijeka, Rijeka, Croatia
| | - A Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
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Wiegand G, Sturm E, Haber P, Königsrainer A, Nadalin S, Sieverding L, Hofbeck M. Ballondilatation von Lebervenenobstruktionen nach Lebertransplantation im Kindesalter. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556029] [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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Nadalin S, Monti L, Grimaldi C, di Francesco F, Tozzi AE, de Ville de Goyet J. Roux-en-Y hepatico-jejunostomy for a left segmental graft: Do not twist the loop, stick it! Pediatr Transplant 2015; 19:358-65. [PMID: 25879299 DOI: 10.1111/petr.12474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 12/31/2022]
Abstract
Biliary complications remain a major challenge for long-term success after LT, as it is, as a rule, the most common technical - early and late - complication that occurs, and because these complications contribute to a significant number of late graft losses and retransplantations. In the pediatric age group, both biliary atresia, as the patient's condition, and the use of a left liver graft, obtained by a liver division technique, make it necessary for the use of a Roux-en-Y jejunal loop for the biliary reconstruction in the majority of cases. A slight modification of the technique is presented, consisting of a straight positioning along the cut surface (rather than the conventional position that results in a harpoon shape). A favorable outcome in terms of a technical complication and graft survival was observed. This way of doing this is an interesting variation and adds to the surgical armamentarium.
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Affiliation(s)
- S Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
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Nadalin S, Buretić-Tomljanović A, Ristić S, Jonovska S, Tomljanović D. The impact of ACE gene I/D polymorphism on plasma glucose and lipid concentrations in schizophrenia patients. Psychiatry Res 2015; 227:71-2. [PMID: 25817701 DOI: 10.1016/j.psychres.2015.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/04/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Sergej Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia.
| | - Alena Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Smiljana Ristić
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
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Siegel-Axel DI, Guthoff M, Nadalin S, Schmidt U, Schreiner B, Wagner R, Königsrainer A, Nawroth P, Heyne N, Schleicher E, Häring HU. Humane perihiläre Fettzellen und das Hepatokin Fetuin-A beeinflussen die Expression von Adhäsionsmolekülen, Zyokinen und Chemokinen in co-kultivierten Endothelzellen: Ein Mechanismus zur Anlockung von Makrophagen in der Pathogenese der Niere? DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549596] [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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Blank G, Welker C, Haarer J, Sterk M, Nadalin S, Yañez VAC, Joos TO, Menrad A, Snell D, LaCorcia G, Königsrainer A, Handgretinger R, Schilbach K. Selective, efficient modulation of activated CD4+ αβT cells by the novel humanized antibody GZ-αβTCR targeting human αβTCR. Bone Marrow Transplant 2014; 50:390-401. [DOI: 10.1038/bmt.2014.263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 11/09/2022]
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Nadalin S, Giacometti J, Buretić-Tomljanović A. PPARα-L162V polymorphism is not associated with schizophrenia risk in a Croatian population. Prostaglandins Leukot Essent Fatty Acids 2014; 91:221-5. [PMID: 25087592 DOI: 10.1016/j.plefa.2014.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/18/2014] [Accepted: 07/04/2014] [Indexed: 12/24/2022]
Abstract
Disturbances of lipid and glucose metabolism have been repeatedly reported in schizophrenia. A functional L162V polymorphism in peroxisome proliferator-activated receptor alpha (PPARα) gene has been extensively investigated in etiology of abnormal lipid and glucose metabolism, yet not in schizophrenia. We determined whether the schizophrenia risk was associated with L162V polymorphism and we examined the impact of L162V variant on age of onset, and data of psychopathology scores. We also hypothesized that plasma glucose and lipid concentrations in patients may be influenced by L162V polymorphism. Genotype and allele frequencies between 203 patients and 191 controls did not differ significantly. Females heterozygous for the PPARα genotype (L162V) manifested significantly lower negative symptom scores, tended toward an earlier onset, and had significantly greater triglyceride levels. The PPARα-L162V polymorphism is not associated with schizophrenia risk in Croatian population, but it impacts clinical expression of the illness and plasma lipid concentrations in female patients.
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Affiliation(s)
- S Nadalin
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
| | - J Giacometti
- Department of Biotechnology, University of Rijeka, Slavka Krautzeka bb, 51000 Rijeka, Croatia
| | - A Buretić-Tomljanović
- Department of Biology and Medical Genetics, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
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Guthoff M, Schnaidt M, Nadalin S, Koenigsrainer A, Heyne N. Eculizumab Bridging and Plasma Cell-Directed Therapy - A Novel Concept in Severe Antibody Mediated Rejection in Kidney Transplantation. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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48
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Siegel-Axel D, Guthoff M, Nadalin S, Rittig K, Schaller HE, Königsrainer A, Heyne N, Häring HU. Perihiläres Fett: ein weiteres funktionell aktives, perivaskuläres Fettgewebe mit hohem angiogenetischem Potential, das sich von anderen Fettgeweben unterscheidet. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374884] [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: 10/25/2022]
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Sterneck M, Kaiser GM, Heyne N, Richter N, Rauchfuss F, Pascher A, Schemmer P, Fischer L, Klein CG, Nadalin S, Lehner F, Settmacher U, Neuhaus P, Gotthardt D, Loss M, Ladenburger S, Paulus EM, Mertens M, Schlitt HJ. Everolimus and early calcineurin inhibitor withdrawal: 3-year results from a randomized trial in liver transplantation. Am J Transplant 2014; 14:701-10. [PMID: 24502384 PMCID: PMC4285226 DOI: 10.1111/ajt.12615] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [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: 07/19/2013] [Revised: 11/27/2013] [Accepted: 11/27/2013] [Indexed: 01/25/2023]
Abstract
The feasibility of de novo everolimus without calcineurin inhibitor (CNI) therapy following liver transplantation was assessed in a multicenter, prospective, open-label trial. Liver transplant patients were randomized at 4 weeks to start everolimus and discontinue CNI, or continue their current CNI-based regimen. The primary endpoint was adjusted estimated GFR (eGFR; Cockcroft-Gault) at month 11 post randomization. A 24-month extension phase followed 81/114 (71.1%) of eligible patients to month 35 post randomization. The adjusted mean eGFR benefit from randomization to month 35 was 10.1 mL/min (95% confidence interval [CI] -1.3, 21.5 mL/min, p = 0.082) in favor of CNI-free versus CNI using Cockcroft-Gault, 9.4 mL/min/1.73 m(2) (95% CI -0.4, 18.9, p = 0.053) with Modification of Diet in Renal Disease (four-variable) and 9.5 mL/min/1.73 m(2) (95% CI -1.1, 17.9, p = 0.028) using Nankivell. The difference in favor of the CNI-free regimen increased gradually over time due to a small progressive decline in eGFR in the CNI cohort despite a reduction in CNI exposure. Biopsy-proven acute rejection, graft loss and death were similar between groups. Adverse events led to study drug discontinuation in five CNI-free patients and five CNI patients (12.2% vs. 12.5%, p = 1.000) during the extension phase. Everolimus-based CNI-free immunosuppression is feasible following liver transplantation and patients benefit from sustained preservation of renal function versus patients on CNI for at least 3 years.
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Affiliation(s)
- M Sterneck
- Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-EppendorfHamburg, Germany
| | - G M Kaiser
- Department of General, Visceral and Transplantation Surgery, Essen University HospitalEssen, Germany
| | - N Heyne
- Department of General, Visceral and Transplant Surgery, University Hospital TuebingenTuebingen, Germany
| | - N Richter
- Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School (MHH)Hannover, Germany
| | - F Rauchfuss
- Department of General, Abdominal and Vascular Surgery, Jena University HospitalJena, Germany
| | - A Pascher
- Clinic for General, Abdominal and Transplant Surgery, Charité University Medical Center BerlinBerlin, Germany
| | - P Schemmer
- Department of General, Visceral and Transplant Surgery, University Hospital HeidelbergHeidelberg, Germany
| | - L Fischer
- Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-EppendorfHamburg, Germany
| | - C G Klein
- Department of General, Visceral and Transplantation Surgery, Essen University HospitalEssen, Germany
| | - S Nadalin
- Department of General, Visceral and Transplant Surgery, University Hospital TuebingenTuebingen, Germany
| | - F Lehner
- Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School (MHH)Hannover, Germany
| | - U Settmacher
- Department of General, Abdominal and Vascular Surgery, Jena University HospitalJena, Germany
| | - P Neuhaus
- Clinic for General, Abdominal and Transplant Surgery, Charité University Medical Center BerlinBerlin, Germany
| | - D Gotthardt
- Department of General, Visceral and Transplant Surgery, University Hospital HeidelbergHeidelberg, Germany
| | - M Loss
- Department of Surgery, University Hospital RegensburgRegensburg, Germany
| | | | | | - M Mertens
- Novartis Pharma GmbHNürnberg, Germany
| | - H J Schlitt
- Department of Surgery, University Hospital RegensburgRegensburg, Germany,
* Corresponding author: Hans J. Schlitt,
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Nadalin S, Capobianco I, Li J, Girotti P, Königsrainer I, Königsrainer A. Indications and limits for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Lessons Learned from 15 cases at a single centre. Z Gastroenterol 2014; 52:35-42. [PMID: 24420797 DOI: 10.1055/s-0033-1356364] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The ALPSS procedure has been recently introduced as an alternative to PVE for liver volume augmentation in cases of planned right trisectionectomy with small future RLV and high risk of PHLF. We retrospectively analysed our single centre experience with 15 ALPPS procedures in order to better assess the limits and indications of the procedure. PATIENTS AND METHODS The following volumetric parameters were evaluated: total liver volume (TLV), remnant liver volume (RLV), remnant liver volume to total liver volume ratio (RLV/TLV), remnant liver volume to body weight ratio (RLV/BWR) and median volume gain. The ALPPS procedure was usually considered when RLV/TLV < 25 % or RLV/BWR < 0.5. The ALPPS procedure consisted of phase 1 (in situ splitting of the liver), interphase (waiting for liver regeneration) and phase 2 (completion of right trisectionectomy). Postoperative complications were reported according to the Dindo-Clavien classification. Patient survival, late complications and tumour recurrence were analysed. RESULTS Between November 2010 and September 2013, we performed 15 ALPPS procedures in 10 patients with primary liver tumours (5 h-CCA, 4 i-CCA and 1 HCC) and in 5 with CRLM. The preoperative RLV/TLV ratio was 22.6 % (15.7 - 29.2) and the RLV/BWR 0.46 (0.22 - 0.66). After 10 days (range 8 - 16) the RLV/TLV ratio and RLV/BWR increased up to 36.3 % (30 - 59.2 %) and 0.67 (0.5 - 1.2) respectively, with a median volume gain of 87.2 % (23.8 - 161 %). The time interval between phases 1 and 2 was 13 days (9 - 18). An R0 status was reached in 13 patients and R1 in 2. The overall postoperative morbidity was 66.7 %. After phase 1, 8 patients experienced 19 complications and 7 none. After phase 2, 11 patients experienced 36 complications and 4 none. Four patients died postoperatively after 22 days (9 - 36 days) resulting in a postoperative mortality of 28.7 %. After a median follow-up of 17 months (1 - 33), 10 out of 15 patients are still alive (survival rate 66.6 %). Four patients (2 i-CCA, 1 CRLM, 1 HCC) developed tumour recurrences (2 intrahepatic and 2 extrahepatic). One patient with i-CCA died at POM 4 secondary to peritoneal carcinosis. DISCUSSION The actual high morbidity and mortality rates related to the ALPPS procedure should lead us to a more cautious selection of the candidates for this operation and restriction of the indications through an accurate work-up based on interdisciplinary cooperation among hepatologists, oncologists, radiologists and surgeons.
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Affiliation(s)
- S Nadalin
- General, Visceral and Transplant Surgery, University Hospital Tübingen
| | - I Capobianco
- General, Visceral and Transplant Surgery, University Hospital Tübingen
| | - J Li
- Hepatobiliary and Transplant Surgery, University Hospital Hamburg-Eppendorf, Hamburg
| | - P Girotti
- General, Visceral and Transplant Surgery, University Hospital Tübingen
| | - I Königsrainer
- General, Visceral and Transplant Surgery, University Hospital Tübingen
| | - A Königsrainer
- General, Visceral and Transplant Surgery, University Hospital Tübingen
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