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Schöbel T, Schuschke L, Youssef Y, Rotzoll D, Theopold J, Osterhoff G. Immersive virtual reality in orthopedic surgery as elective subject for medical students : First experiences in curricular teaching. Orthopadie (Heidelb) 2024; 53:369-378. [PMID: 38575780 PMCID: PMC11052777 DOI: 10.1007/s00132-024-04491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Virtual reality (VR) simulators have been introduced for skills training in various medical disciplines to create an approximately realistic environment without the risk of patient harm and have improved to more immersive VR (iVR) simulators at affordable costs. There is evidence that training on VR simulators improves technical skills but its use in orthopedic training programs and especially in curricular teaching sessions for medical students are currently not well established. The aim of this study was to describe the implementation of a VR operating theater as an elective course for undergraduate medical students and to evaluate its effect on student learning. METHODS An elective course for 12 students was implemented during the summer semester of 2023. Using Oculus Quest 2 headsets (Reality Labs, Meta Platforms, USA) and controllers and the PrecisionOS platform, they were able to train five different surgical procedures. The courses were accompanied by weekly topic discussions and instructional videos. Students were assigned to two groups: group VR vs. group non-VR. The groups were switched after 5 weeks. User feedback and performance development (theoretical and procedural surgical knowledge) after VR training were assessed using three questionnaires. RESULTS The students highly appreciated the implementation of VR training into their curriculum and 91% stated that they would opt for further VR training. All students stated that VR training improved their understanding of surgical procedures and that it should be obligatory in surgical training for undergraduate medical students. After 5 weeks of training, students in the VR group achieved significantly better results (100 out of maximum 180 points) than the non-VR group (70 points, p = 0.0495) in procedural surgical knowledge. After completion of the VR training the VR group achieved 106 points and the non-VR group 104 points (p = 0.8564). The procedural knowledge for non-VR group after 5 weeks significantly improved after VR training from 70 to 106 points (p = 0.0087). CONCLUSION The iVR can be easily integrated into the curriculum of medical students and is highly appreciated by the participants. The iVR statistically improves the procedural knowledge of surgical steps compared to conventional teaching methods. Further implementation of iVR training in curricular teaching of medical students should be considered.
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Affiliation(s)
- Tobias Schöbel
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
| | - Leonard Schuschke
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Yasmin Youssef
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Daisy Rotzoll
- Skills and Simulation Centre LernKlinik Leipzig, Faculty of Medicine, University of Leipzig, Liebigstraße 23/25, 04103, Leipzig, Germany
| | - Jan Theopold
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Georg Osterhoff
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
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Franke GN, Loewe G, Reiser M, Linde H, Josting A, von der Heyde E, Platzbecker U, Weide R, Tesch H, Nusch A, Dengler J, Jentsch-Ullrich K. Spotlight on the real-world treatment of CML pts in Germany: a retrospective survey in private oncology practices. Ann Hematol 2024; 103:1569-1575. [PMID: 38472361 PMCID: PMC11009736 DOI: 10.1007/s00277-024-05702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Abstract
Clinical trials in chronic myeloid leukemia (CML) are usually carried out in specialized centers whereas primary care for patients (pts) with CML is mainly provided by local oncology practices. The aim of this study was to assess treatment practices in pts with CML in the setting of private oncology practices in Germany. We collected data of 819 pts with a confirmed diagnosis (dx) of CML in 2013 or later from 43 practices. At dx, 84.2% (n=690) and 9.4% (n=77) of pts were in chronic or accelerated phase, 0.7% (n=6) had a blast crisis. Molecular monitoring was provided by EUTOS certified laboratories in 87.7% of pts. Typical BCR::ABL1 transcripts were detected in 86.6% (n=709). Molecular response was assessed after 2.8, 6.0, 9.4 and 12.9 m (mean) after start of treatment. Of the pts with available data, 11.1% did not achieve early molecular response and at 18 m, 83.7% had at least a major molecular response. 288 (35.2%) of pts switched to 2nd line (2L) treatment after a mean of 21.0 months. Reasons for 2L treatment were side effects in 43.4% and suboptimal response or failure in 31.4% of pts. 106 pts went on to third line (3L) treatment. 36.8 % of pts switched to and 92.8 % of pts still on 3L treatment achieved BCR::ABL1IS ≤1% at 12 m. In conclusion, in Germany pts with CML are routinely monitored by qPCR and good responses are achieved in the majority. Treatment changes are mainly due to adverse events rather than suboptimal responses.
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Affiliation(s)
- Georg-Nikolaus Franke
- Department for Hematology, Cellular Therapies, Hemostaseology and Infectious Diseases, University of Leipzig Medical Center, Leipzig, Germany.
| | | | - Marcel Reiser
- PIOH-Zentrum Praxis Internistischer Onkologie und Hämatologie, Cologne, Germany
| | - Hartmut Linde
- MVZ für Blut- und Krebserkrankungen, Potsdam, Germany
| | - Andreas Josting
- Schwerpunktpraxis für Onkologie, Gastroenterologie, Hämatologie und Palliativmedizin, Berlin, Germany
| | | | - Uwe Platzbecker
- Department for Hematology, Cellular Therapies, Hemostaseology and Infectious Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Rudolf Weide
- Praxis für Hämatologie und Onkologie, Koblenz, Germany
| | - Hans Tesch
- Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany
| | - Arndt Nusch
- MVZ-Onkologie Velbert/Ratingen GbR, Velbert, Germany
| | - Jolanta Dengler
- Onkologische Schwerpunktpraxis Heilbronn, Heilbronn, Germany
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Eichholz HM, Cornelis A, Wolf B, Grubitzsch H, Friedrich P, Makky A, Aktas B, Käs JA, Stepan H. Anatomy of the fetal membranes: insights from spinning disk confocal microscopy. Arch Gynecol Obstet 2024; 309:1919-1923. [PMID: 37184578 PMCID: PMC11018647 DOI: 10.1007/s00404-023-07070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE The fetal membranes are essential for the maintenance of pregnancy, and their integrity until parturition is critical for both fetal and maternal health. Preterm premature rupture of the membranes (pPROM) is known to be an indicator of preterm birth, but the underlying architectural and mechanical changes that lead to fetal membrane failure are not yet fully understood. The aim of this study was to gain new insights into the anatomy of the fetal membrane and to establish a tissue processing and staining protocol suitable for future prospective cohort studies. METHODS In this proof of principle study, we collected fetal membranes from women undergoing vaginal delivery or cesarean section. Small membrane sections were then fixed, stained for nucleic acids, actin, and collagen using fluorescent probes, and subsequently imaged in three dimensions using a spinning disk confocal microscope. RESULTS Four fetal membranes of different types were successfully processed and imaged after establishing a suitable protocol. Cellular and nuclear outlines are clearly visible in all cases, especially in the uppermost membrane layer. Focal membrane (micro) fractures could be identified in several samples. CONCLUSION The presented method proves to be well suited to determine whether and how the occurrence of membrane (micro) fractures and cellular jamming correlate with the timing of membrane rupture and the mode of delivery. In future measurements, this method could be combined with mechanical probing techniques to compare optical and mechanical sample information.
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Affiliation(s)
- Hannah Marie Eichholz
- Leipzig Institute for Meteorology, Leipzig University, 04103, Leipzig, Germany
- Center for Scalable Data Analytics and Artificial Intelligence, Leipzig University, 04105, Leipzig, Germany
| | - Alissa Cornelis
- Department of Obstetrics, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Benjamin Wolf
- Department of Gynecology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Hanna Grubitzsch
- Department of Obstetrics, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Philip Friedrich
- Peter Debye Institute for Soft Matter Physics, Leipzig University, 04103, Leipzig, Germany
| | - Ahmad Makky
- Department of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, 72076, Tübingen, Germany
| | - Bahriye Aktas
- Department of Gynecology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Josef Alfons Käs
- Peter Debye Institute for Soft Matter Physics, Leipzig University, 04103, Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University Hospital Leipzig, 04103, Leipzig, Germany.
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Tönjes A, Würfel M, Quinkler M, Knappe UJ, Honegger J, Krause-Joppig N, Bacher K, Deutschbein T, Störmann S, Schopohl J, Meyhöfer SM. Pregnancy and acromegaly: clinical outcomes of retrospectively analysed data from the German acromegaly registry. Reprod Biol Endocrinol 2024; 22:48. [PMID: 38650041 PMCID: PMC11034139 DOI: 10.1186/s12958-024-01207-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/16/2024] [Indexed: 04/25/2024] Open
Abstract
CONTEXT Acromegaly is a rare disease caused by excessive growth hormone (GH) secretion, mostly induced by pituitary adenomas. The care of pregnant women with acromegaly is challenging, in part due to existing clinical data being limited and not entirely consistent with regard to potential risks for mother and child. OBJECTIVE To retrospectively examine data on pregnancy and maternal as well as neonatal outcomes in patients with acromegaly. DESIGN & METHODS Retrospective data analysis from 47 pregnancies of 31 women treated in centers of the German Acromegaly Registry. RESULTS 87.1% of the studied women underwent transsphenoidal surgery before pregnancy. In 51.1% a combination of dopamine agonists and somatostatin analogs were used before pregnancy. Three women did not receive any therapy for acromegaly. During pregnancy only 6.4% received either somatostatin analogs or dopamine agonists. In total, 70.2% of all documented pregnancies emerged spontaneously. Gestational diabetes was diagnosed in 10.6% and gravid hypertension in 6.4%. Overall, no preterm birth was detected. Indeed, 87% of acromegalic women experienced a delivery without complications. CONCLUSION Pregnancies in women with acromegaly are possible and the course of pregnancy is in general safe for mother and child both with and without specific treatment for acromegaly. The prevalence of concomitant metabolic diseases such as gestational diabetes is comparable to the prevalence in healthy pregnant women. Nevertheless, larger studies with more data in pregnant patients with acromegaly are needed to provide safe and effective care for pregnant women with this condition.
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Affiliation(s)
- Anke Tönjes
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Liebigstraße 20, 04103, Leipzig, Germany.
| | - Marleen Würfel
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Liebigstraße 20, 04103, Leipzig, Germany
| | | | - Ulrich J Knappe
- Department of Neurosurgery, Johannes Wesling Hospital, Minden, Germany
| | - Jürgen Honegger
- Department of Neurosurgery, University of Tübingen, Tübingen, Germany
| | | | - Konrad Bacher
- Practice for Endocrinology and Diabetes, Stuttgart, Germany
| | - Timo Deutschbein
- Medicover Oldenburg MVZ, Oldenburg, Germany
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Sylvère Störmann
- Medizinische Klinik Und Poliklinik IV, LMU Klinikum, Munich, Germany
| | - Jochen Schopohl
- Medizinische Klinik Und Poliklinik IV, LMU Klinikum, Munich, Germany
- Medicover Neuroendocrinology, Munich, Germany
| | - Sebastian M Meyhöfer
- Institute of Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
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Jahnke C, Darma A, Lindemann F, Oebel S, Hilbert S, Bode K, Stehning C, Smink J, Paetsch I. Electrophysiological cardiovascular MR: procedure-ready mesh model generation for interventional guidance based on non-selective excitation compressed sensing whole heart imaging. Sci Rep 2024; 14:8974. [PMID: 38637577 PMCID: PMC11026457 DOI: 10.1038/s41598-024-59230-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
Fully CMR-guided electrophysiological interventions (EP-CMR) have recently been introduced but data on the optimal CMR imaging protocol are scarce. This study determined the clinical utility of 3D non-selective whole heart steady-state free precession imaging using compressed SENSE (nsWHcs) for automatic segmentation of cardiac cavities as the basis for targeted catheter navigation during EP-CMR cavo-tricuspid isthmus ablation. Fourty-two consecutive patients with isthmus-dependent right atrial flutter underwent EP-CMR radiofrequency ablations. nsWHcs succeeded in all patients (nominal scan duration, 98 ± 10 s); automatic segmentation/generation of surface meshes of right-sided cavities exhibited short computation times (16 ± 3 s) with correct delineation of right atrium, right ventricle, tricuspid annulus and coronary sinus ostium in 100%, 100%, 100% and 95%, respectively. Point-by-point ablation adhered to the predefined isthmus line in 62% of patients (26/42); activation mapping confirmed complete bidirectional isthmus block (conduction time difference, 136 ± 28 ms). nsWHcs ensured automatic and reliable 3D segmentation of targeted endoluminal cavities, multiplanar reformatting and image fusion (e.g. activation time measurements) and represented the basis for precise real-time active catheter navigation during EP-CMR ablations of isthmus-dependent right atrial flutter. Hence, nsWHcs can be considered a key component in order to advance EP-CMR towards the ultimate goal of targeted substrate-based ablation procedures.
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Affiliation(s)
- Cosima Jahnke
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Angeliki Darma
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Frank Lindemann
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Sabrina Oebel
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Sebastian Hilbert
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Kerstin Bode
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | | | - Jouke Smink
- Philips Research Laboratories, Best, The Netherlands
| | - Ingo Paetsch
- Department of Electrophysiology, HELIOS Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany.
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Landmann M, Scheibner D, Gischke M, Abdelwhab EM, Ulrich R. Automated quantification of avian influenza virus antigen in different organs. Sci Rep 2024; 14:8766. [PMID: 38627481 PMCID: PMC11021523 DOI: 10.1038/s41598-024-59239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
As immunohistochemistry is valuable for determining tissue and cell tropism of avian influenza viruses (AIV), but time-consuming, an artificial intelligence-based workflow was developed to automate the AIV antigen quantification. Organ samples from experimental AIV infections including brain, heart, lung and spleen on one slide, and liver and kidney on another slide were stained for influenza A-matrixprotein and analyzed with QuPath: Random trees algorithms were trained to identify the organs on each slide, followed by threshold-based quantification of the immunoreactive area. The algorithms were trained and tested on two different slide sets, then retrained on both and validated on a third set. Except for the kidney, the best algorithms for organ selection correctly identified the largest proportion of the organ area. For most organs, the immunoreactive area assessed following organ selection was significantly and positively correlated to a manually assessed semiquantitative score. In the validation set, intravenously infected chickens showed a generally higher percentage of immunoreactive area than chickens infected oculonasally. Variability between the slide sets and a similar tissue texture of some organs limited the ability of the algorithms to select certain organs. Generally, suitable correlations of the immunoreactivity data results were achieved, facilitating high-throughput analysis of AIV tissue tropism.
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Affiliation(s)
- Maria Landmann
- Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany
| | - David Scheibner
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | - Marcel Gischke
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | - Elsayed M Abdelwhab
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany
| | - Reiner Ulrich
- Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany.
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Gothe J, Pfetzing S, Ulrich R, Schrödl W, Baums CG, Heilmann RM. Brachyspira in dogs: risk factors of shedding in central Germany and longitudinal study of an infected kennel. BMC Vet Res 2024; 20:136. [PMID: 38575983 PMCID: PMC10993570 DOI: 10.1186/s12917-024-03989-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Brachyspira (B.) pilosicoli is a zoonotic pathogen, able to infect different animal species such as pigs, poultry, and rodents, causing intestinal spirochetosis. An association of gastrointestinal clinical signs, such as diarrhea, with the isolation of B. pilosicoli from fecal samples or rectal swabs has not been proven in dogs. Other Brachyspira species commonly isolated from dogs, such as "B. canis" and "B. pulli", are considered commensals. This study investigated the occurrence of different Brachyspira species in rectal swabs and fecal samples in an independent canine cohort in central Germany. These included samples from shelter dogs, hunting dogs, and dogs presenting at regional small animal practices with various clinical signs. Data about the dogs, including potential risk factors for Brachyspira isolation, were obtained using a standardized questionnaire. The study also longitudinally investigated a colony of Beagle dogs for Brachyspira over 5 years. RESULTS The rate of Brachyspira spp. isolation was 11% and included different Brachyspira species ("B. canis", "B. pulli", and B. pilosicoli). "B. canis" was detected in 18 dogs, whereas B. pilosicoli was only isolated from 1 dog in the independent cohort (not including the Beagle colony). Risk factors for shedding Brachyspira and "B. canis" were being less than 1 year of age and shelter origin. Gastrointestinal signs were not associated with the shedding of Brachyspira. B. pilosicoli and "B. canis" were isolated from several dogs of the same Beagle colony in 2017 and again in 2022, while Brachyspira was not isolated at multiple sampling time points in 2021. CONCLUSIONS Shedding of B. pilosicoli in dogs appears to be uncommon in central Germany, suggesting a low risk of zoonotic transmission from dogs. Commensal status of "B. canis" and "B. pulli" is supported by the results of this study. Findings from the longitudinal investigation of the Beagle colony agree with an asymptomatic long-term colonization of dogs with "B. canis" and B. pilosicoli and suggest that introducing new animals in a pack can trigger an increased shedding of B. pilosicoli.
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Affiliation(s)
- Julia Gothe
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
| | - Sarah Pfetzing
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
| | - Reiner Ulrich
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
| | - Wieland Schrödl
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
| | - Christoph G Baums
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany
| | - Romy M Heilmann
- Department for Small Animals, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 23, 04103, Leipzig, Germany.
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Fenske F, Kujat B, Krause L, Meyer S, Sander AK, Repmann J, Neuhaus M, Haak R, Roth A, Lethaus B, Ziebolz D, Schmalz G. Preoperative dental screening can reduce periprosthetic infections of hip and knee endoprostheses in the first month after surgery: results of a cohort study. Infection 2024; 52:535-543. [PMID: 38060067 PMCID: PMC10954939 DOI: 10.1007/s15010-023-02128-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE The oral cavity and, in particular, potential oral foci might pose a risk of periprosthetic joint infection (PJI). The aim of this cohort study was to determine whether practical preoperative dental screening would reduce the prevalence of early PJI in the first month after surgery. METHODS Patients attending a specialized endoprosthesis implantation clinic between 2018 and 2022 were recruited. Two groups were examined. The test group consisted of patients attending the clinic between 2020 and 2022 and who were referred to their family dentist using a standardized form. The comparison group consisted of patients who were treated in the clinic between 2018 and 2020. They were not referred to their family dentist. The two groups were compared for the prevalence of PJI. Univariate analysis followed by multiple logistic regression was performed to confirm risk factors for PJI in this cohort. RESULTS 2560 individuals (test group: 1227, comparison group: 1333) were included. The prevalence of PJI was significantly lower in the test group (0.8% vs. 1.8%, p = 0.04). Multiple logistic regression with PJI as the dependent variable showed that a dental referral was a strong predictor of a lower prevalence of PJI (OR: 0.43, CI95 0.205-0.917, p = 0.03). Male gender was also strongly associated with a higher frequency of PJI (OR: 2.68, CI95 1.32-5.42, p = 0.01). Age (OR: 1.06, CI95 1.01-1.10, p = 0.01) and BMI (OR: 1.11, CI95 1.05-1.17, p < 0.01) had little effect on the risk of PJI. CONCLUSION Dental referral using a standardized form can reduce the prevalence of early PJI. Accordingly, orthopedists and dentists should collaborate in this practical way.
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Affiliation(s)
- Fabian Fenske
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Benjamin Kujat
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Leah Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Stephan Meyer
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Anna-Katharina Sander
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Jaqueline Repmann
- Specialized Clinic for Orthopedics, Mediclin Waldkrankenhaus Bad Düben, 04848, Bad Düben, Germany
| | - Michael Neuhaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Andreas Roth
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
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Nitschke I, Krüger K, Jockusch J. Age-related knowledge deficit and attitudes towards oral implants: Survey-based examination of the correlation between patient age and implant therapy awareness. BMC Oral Health 2024; 24:403. [PMID: 38553697 PMCID: PMC10981345 DOI: 10.1186/s12903-024-04134-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/11/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Implantology, as a recognized therapeutic approach, is gaining prominence. The decision-making process and success of implant therapy are closely linked to patient knowledge and expectations. This study aims to explore the association between age and knowledge regarding oral implants. METHODS Participants were categorized into three age groups (ag): ag 1 (35-44 years), ag 2 (65-74 years), and ag 3 (75 years and older). A total of 400 participants per age group were randomly selected using data from the residents' registration office of Berlin, Germany. Structured telephone interviews were conducted between 2016 and 2017, employing a 67-item questionnaire covering awareness, information level, cost estimation, attitudes, and experiences with oral implants. RESULTS Despite a low overall knowledge level across all age groups, there was no significant correlation between age and knowledge about oral implants. Awareness increased with age. Information sources varied, with friends, acquaintances, and dentists playing key roles. Participants expressed diverse opinions on implants, with durability and stability identified as crucial characteristics. Significant differences in knowledge were observed between age groups regarding awareness, information sources, and perceptions of dentists offering implants. CONCLUSIONS The study suggests a need for targeted educational programs, emphasizing age-appropriate information sources to enhance health literacy in oral implantology, particularly among older individuals. Educating physicians on oral implant basics is also crucial. Implementing these measures could empower individuals to make informed decisions about oral implant treatment, thereby contributing to improved oral health outcomes.
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Affiliation(s)
- Ina Nitschke
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, 8032, Switzerland
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103, Leipzig, Germany
| | - Kristina Krüger
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103, Leipzig, Germany
| | - Julia Jockusch
- Department of Prosthodontics and Materials Science, Gerodontology Section, University of Leipzig, 04103, Leipzig, Germany.
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Stampfenbachstrasse, Zurich, CH-8006, Switzerland.
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10
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Wagner H, Schad A, Höhmann S, Briol TA, Wilhelm C. Carbon and energy balance of biotechnological glycolate production from microalgae in a pre-industrial scale flat panel photobioreactor. Biotechnol Biofuels Bioprod 2024; 17:42. [PMID: 38486283 PMCID: PMC10941469 DOI: 10.1186/s13068-024-02479-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/15/2024] [Indexed: 03/17/2024]
Abstract
Glycolate is produced by microalgae under photorespiratory conditions and has the potential for sustainable organic carbon production in biotechnology. This study explores the glycolate production balance in Chlamydomonas reinhardtii, using a custom-built 10-L flat panel bioreactor with sophisticated measurements of process factors such as nutrient supply, gassing, light absorption and mass balances. As a result, detailed information regarding carbon and energy balance is obtained to support techno-economic analyses. It is shown how nitrogen is a crucial element in the biotechnological process and monitoring nitrogen content is vital for optimum performance. Moreover, the suitable reactor design is advantageous to efficiently adjust the gas composition. The oxygen content has to be slightly above 30% to induce photorespiration while maintaining photosynthetic efficiency. The final volume productivity reached 27.7 mg of glycolate per litre per hour, thus, the total process capacity can be calculated to 13 tonnes of glycolate per hectare per annum. The exceptional volume productivity of both biomass and glycolate production is demonstrated, and consequently can achieve a yearly CO2 sequestration rate of 35 tonnes per hectare. Although the system shows such high productivity, there are still opportunities to enhance the achieved volume productivity and thus exploit the biotechnological potential of glycolate production from microalgae.
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Affiliation(s)
- Heiko Wagner
- Department of Algal Biotechnology, Institute for Biology, University of Leipzig, Permoserstrasse 15, 04318, Leipzig, Germany.
| | - Antonia Schad
- Department of Algal Biotechnology, Institute for Biology, University of Leipzig, Permoserstrasse 15, 04318, Leipzig, Germany
| | - Sonja Höhmann
- Department of Solar Materials, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, 04318, Leipzig, Germany
| | - Tim Arik Briol
- Department of Solar Materials, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, 04318, Leipzig, Germany
| | - Christian Wilhelm
- Department of Algal Biotechnology, Institute for Biology, University of Leipzig, Permoserstrasse 15, 04318, Leipzig, Germany
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11
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Jung FU, Pabst A, Löbner M, Luppa M, Riedel-Heller SG. Behind the times? Associations of working-time autonomy with health-related and occupational outcomes in health care personnel- a latent profile analysis. BMC Public Health 2024; 24:825. [PMID: 38491458 PMCID: PMC10943857 DOI: 10.1186/s12889-024-18289-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND In the light of personnel shortage, the health care sector is facing the challenge to combine increasing employees' as well as patients' needs. The aim of this study was to investigate the association between working-time autonomy and health-related (fatigue, psychosomatic complaints and work ability), as well as occupational outcomes (job satisfaction and turnover intention) in a large sample of health care employees. METHOD Based on data of the BauA-Working Time survey, a sample of n = 1,093 employees working in the health care sector was analysed. Outcomes were assessed by the German Fatigue Scale, the Work Ability-Index and single-item measurements. Besides descriptive analyses, latent profile analysis (LPA) was used to determine clusters of employees based on working-time autonomy. Subsequently, regression analyses have been conducted to examine the association between autonomy clusters with health-related and occupational outcomes, controlling for sociodemographic characteristics and employment status. RESULTS LPA revealed that a three-cluster model was most suitable: high autonomy (cluster 1), medium autonomy (cluster 2) and low autonomy (cluster 3). The extracted profiles of working-time autonomy differed significantly in terms of sociodemographic and occupational characteristics, but not in terms of average working hours per week or monthly household income. The multivariate regression analysis revealed that being in the low-autonomy cluster was associated with more psychosomatic health complaints (IRR: 1.427, p = 0.008), lower work ability (OR 0.339, p < 0.001), as well as less job satisfaction (OR 0.216, p < 0.001). DISCUSSION Overall, the analyses indicate that it is crucial to prospectively consider working-time autonomy as an important factor of satisfaction, well-being and turnover intention in health care employees.
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Affiliation(s)
- Franziska U Jung
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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12
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Zacher H, Rudolph CW. Workplace digitalization and workload: changes and reciprocal relations across 3 years. Sci Rep 2024; 14:5924. [PMID: 38467758 PMCID: PMC10928114 DOI: 10.1038/s41598-024-56537-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/07/2024] [Indexed: 03/13/2024] Open
Abstract
This article reports the results of a 33-wave longitudinal study of changes in, and reciprocal relations between, workplace digitalization and workload. Monthly data were collected between April 2020 and December 2022 from n = 1661 employees in Germany. Based on theoretical models of workplace information and communication technology use, stress, and coping, we hypothesized both positive and negative within-person effects of digitalization on workload, and vice versa. Results of an autoregressive latent trajectory model with structured residuals (ALT-SR) showed on-average positive linear trajectories in digitalization, but not in workload over time. Moreover, higher digitalization was associated with subsequently higher levels of workload, and vice versa. This pattern of results suggests a dynamic, reciprocal process wherein positive deviations from one's average trajectory of digitalization (workload) are associated with subsequently higher levels of workload (digitalization). We additionally find evidence for linear trends in these within-person processes, suggesting that the strength of the within-person effects of digitalization on workload, and of workload on digitalization, becomes more strongly positive over time. Practitioners developing work design interventions could focus on ways to reduce the detrimental impact of digitalization on increased workload, while simultaneously encouraging the potential of digitalization to help employees cope effectively with their workload.
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Affiliation(s)
- Hannes Zacher
- Wilhelm Wundt Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany.
| | - Cort W Rudolph
- Department of Psychology, Wayne State University, Detroit, USA
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13
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Pfetzing S, Bernhard A, Bauer C, Hansmann F. Cerebral baylisascariosis in a rainbow lorikeet (Trichoglossus moluccanus) in a German Zoo. BMC Vet Res 2024; 20:86. [PMID: 38459577 PMCID: PMC10921659 DOI: 10.1186/s12917-024-03946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/20/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The raccoon roundworm, Baylisascaris procyonis, can cause a meningoencephalitis as neural larva migrans which is known in avian species, including rainbow lorikeets in North America, but has not been described in Old World parrots in Germany yet. CASE PRESENTATION A 2-month-old, male rainbow lorikeet from a zoo in Germany was submitted for necropsy. Prior to death the animal had progressive neurological signs like apathy and torticollis. In the cerebrum a focally extensive severe granulomatous to necrotizing encephalitis with an intralesional larval nematode was diagnosed. Based on the clinical and pathological findings, the larval morphology and the epidemiological background, the larva was identified as Baylisascaris procyonis. CONCLUSIONS Cerebral baylisascariosis should be considered as a differential diagnosis in zoo and pet birds with neurological signs having contact to racoons or rather racoon faeces in Germany due to the high prevalence of Baylisascaris procyonis in the German raccoon population.
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Affiliation(s)
- Sarah Pfetzing
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103, Leipzig, Germany
| | - Andreas Bernhard
- Zoo Leipzig GmbH, Pfaffendorfer Straße 29, 04105, Leipzig, Germany
| | - Christian Bauer
- Institute of Parasitology, Justus Liebig University Giessen, Schubertstraße 81, 35392, Giessen, Germany
| | - Florian Hansmann
- Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103, Leipzig, Germany.
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14
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Suslow T, Hoepfel D, Kersting A, Bodenschatz CM. Depressive symptoms and visual attention to others' eyes in healthy individuals. BMC Psychiatry 2024; 24:184. [PMID: 38448877 PMCID: PMC10916197 DOI: 10.1186/s12888-024-05633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Eye contact is a fundamental part of social interaction. In clinical studies, it has been observed that patients suffering from depression make less eye contact during interviews than healthy individuals, which could be a factor contributing to their social functioning impairments. Similarly, results from mood induction studies with healthy persons indicate that attention to the eyes diminishes as a function of sad mood. The present screen-based eye-tracking study examined whether depressive symptoms in healthy individuals are associated with reduced visual attention to other persons' direct gaze during free viewing. METHODS Gaze behavior of 44 individuals with depressive symptoms and 49 individuals with no depressive symptoms was analyzed in a free viewing task. Grouping was based on the Beck Depression Inventory using the cut-off proposed by Hautzinger et al. (2006). Participants saw pairs of faces with direct gaze showing emotional or neutral expressions. One-half of the face pairs was shown without face masks, whereas the other half was presented with face masks. Participants' dwell times and first fixation durations were analyzed. RESULTS In case of unmasked facial expressions, participants with depressive symptoms looked shorter at the eyes compared to individuals without symptoms across all expression conditions. No group difference in first fixation duration on the eyes of masked and unmasked faces was observed. Individuals with depressive symptoms dwelled longer on the mouth region of unmasked faces. For masked faces, no significant group differences in dwell time on the eyes were found. Moreover, when specifically examining dwell time on the eyes of faces with an emotional expression there were also no significant differences between groups. Overall, participants gazed significantly longer at the eyes in masked compared to unmasked faces. CONCLUSIONS For faces without mask, our results suggest that depressiveness in healthy individuals goes along with less visual attention to other persons' eyes but not with less visual attention to others' faces. When factors come into play that generally amplify the attention directed to the eyes such as face masks or emotions then no relationship between depressiveness and visual attention to the eyes can be established.
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Affiliation(s)
- Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany.
| | - Dennis Hoepfel
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Charlott Maria Bodenschatz
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany
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Blüher M, Rosenstock J, Hoefler J, Manuel R, Hennige AM. Dose-response effects on HbA 1c and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial. Diabetologia 2024; 67:470-482. [PMID: 38095657 PMCID: PMC10844353 DOI: 10.1007/s00125-023-06053-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/17/2023] [Indexed: 01/25/2024]
Abstract
AIMS/HYPOTHESIS The aim of this study was to assess the dose-response effects of the subcutaneous glucagon receptor/glucagon-like peptide-1 receptor dual agonist survodutide (BI 456906) on HbA1c levels and bodyweight reduction. METHODS This Phase II, multicentre, randomised, double-blind, parallel-group, placebo-controlled study, conducted in clinical research centres, assessed survodutide in participants aged 18-75 years with type 2 diabetes, an HbA1c level of 53-86 mmol/mol (7.0-10.0%) and a BMI of 25-50 kg/m2 on a background of metformin therapy. Participants were randomised via interactive response technology to receive survodutide (up to 0.3, 0.9, 1.8 or 2.7 mg once weekly [qw; dose group (DG) 1-4, respectively] or 1.2 or 1.8 mg twice weekly [DG 5 and 6, respectively]), placebo or semaglutide (up to 1.0 mg qw). Participants and all those involved in the trial conduct/analysis were blinded; the semaglutide arm was open-label. The primary endpoint was absolute change from baseline in HbA1c after 16 weeks' treatment. The key secondary endpoint was relative change from baseline in bodyweight after 16 weeks' treatment. RESULTS A total of 413 participants were randomised (DG1, n=50; DG2, n=50; DG3, n=52; DG4, n=50; DG5, n=51; DG6, n=50; semaglutide, n=50; placebo, n=60). The full analysis set comprised 411 treated participants (DG6, n=49; placebo, n=59). Adjusted mean (95% CI) HbA1c decreased from baseline (mean ± SD 64.7±9.2 mmol/mol [8.07±0.84%] after 16 weeks' treatment: DG1 (n=41), -9.92 mmol/mol (-12.27, -7.56; -0.91% [-1.12, -0.69]); DG2 (n=46), -15.95 mmol/mol (-18.27, -13.63; -1.46% [-1.67, -1.25]); DG3 (n=36), -18.72 mmol/mol (-21.15, -16.29; -1.71% [-1.94, -1.49]); DG4 (n=33), -17.01 mmol/mol (-19.59, -14.43; -1.56% [-1.79, -1.32]); DG5 (n=44), -17.84 mmol/mol (-20.18, -15.51; -1.63% [-1.85, -1.42]); DG6 (n=36), -18.38 mmol/mol (-20.90, -15.87; -1.68% [-1.91, -1.45]). The mean reduction in HbA1c was similar with low-dose survodutide (DG2: -15.95 mmol/mol [-1.46%]; n=46) and semaglutide (-16.07 mmol/mol [-1.47%]; n=45). Mean (95% CI) bodyweight decreased dose-dependently up to -8.7% (-10.1, -7.3; DG6, n=37); survodutide ≥1.8 mg qw produced greater bodyweight reductions than semaglutide (-5.3% [-6.6, -4.1]; n=45). Adverse events (AEs) were reported for 77.8% of survodutide-treated participants (mainly gastrointestinal), 52.5% receiving placebo and 52.0% receiving semaglutide. CONCLUSIONS/INTERPRETATION Survodutide reduced HbA1c levels and bodyweight after 16 weeks' treatment in participants with type 2 diabetes. Dose-related gastrointestinal AEs could be mitigated with slower dose escalations. TRIAL REGISTRATION ClinicalTrials.gov NCT04153929 and EudraCT 2019-002390-60. FUNDING Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.
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Affiliation(s)
- Matthias Blüher
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München, University of Leipzig and University Hospital Leipzig, Leipzig, Germany.
| | | | - Josef Hoefler
- Staburo GmbH, Munich, Germany, on behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Germany
| | - Raymond Manuel
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | - Anita M Hennige
- Boehringer Ingelheim International GmbH, Biberach an der Riß, Germany.
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16
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Schönfeld T, Seitz P, Krieghoff C, Ponorac S, Wötzel A, Olthoff S, Schaudt S, Steglich J, Gutberlet M, Gohmann RF. High-pitch CT pulmonary angiography (CTPA) with ultra-low contrast medium volume for the detection of pulmonary embolism: a comparison with standard CTPA. Eur Radiol 2024; 34:1921-1931. [PMID: 37656178 PMCID: PMC10873234 DOI: 10.1007/s00330-023-10101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To investigate the feasibility and image quality of high-pitch CT pulmonary angiography (CTPA) with reduced iodine volume in normal weight patients. METHODS In total, 81 normal weight patients undergoing CTPA for suspected pulmonary arterial embolism were retrospectively included: 41 in high-pitch mode with 20 mL of contrast medium (CM); and 40 with normal pitch and 50 mL of CM. Subjective image quality was assessed and rated on a 3-point scale. For objective image quality, attenuation and noise values were measured in all pulmonary arteries from the trunk to segmental level. Contrast-to-noise ratio (CNR) was calculated. Radiation dose estimations were recorded. RESULTS There were no statistically significant differences in patient and scan demographics between high-pitch and standard CTPA. Subjective image quality was rated good to excellent in over 90% of all exams with no significant group differences (p = 0.32). Median contrast opacification was lower in high-pitch CTPA (283.18 [216.06-368.67] HU, 386.81 [320.57-526.12] HU; p = 0.0001). CNR reached a minimum of eight in all segmented arteries, but was lower in high-pitch CTPA (8.79 [5.82-12.42], 11.01 [9.19-17.90]; p = 0.005). Median effective dose of high-pitch CTPA was lower (1.04 [0.72-1.27] mSv/mGy·cm; 1.49 [1.07-2.05] mSv/mGy·cm; p < 0.0001). CONCLUSION High-pitch CTPA using ultra-low contrast volume (20 mL) rendered diagnostic images for the detection of pulmonary arterial embolism in most instances. Compared to standard CTPA, the high-pitch CTPA exams with drastically reduced contrast medium volume had also concomitantly reduced radiation exposure. However, objective image quality of high-pitch CTPA was worse, though likely still within acceptable limits for confident diagnosis. CLINICAL RELEVANCE This study provides valuable insights on the performance of a high-pitch dual-source CTPA protocol, offering potential benefits in reducing contrast medium and radiation dose while maintaining sufficient image quality for accurate diagnosis in patients suspected of pulmonary embolism. KEY POINTS • High-pitch CT pulmonary angiography (CTPA) with ultra-low volume of contrast medium and reduced radiation dose renders diagnostic examinations with comparable subjective image quality to standard CTPA in most patients. • Objective image quality of high-pitch CTPA is reduced compared to standard CTPA, but contrast opacification and contrast-to-noise ratio remain above diagnostic thresholds. • Challenges of high-pitch CTPA may potentially be encountered in patients with severe heart failure or when performing a Valsalva maneuver during the examination.
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Affiliation(s)
- Tobias Schönfeld
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
- Department of General and Geriatric Medicine, St. Elisabeth-Hospital Leipzig, Biedermannstr. 84, 04277, Leipzig, Germany
- Medical Faculty, University of Leipzig, Liebigstr. 27, 04103, Leipzig, Germany
| | - Patrick Seitz
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Christian Krieghoff
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Slavica Ponorac
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
- Institute of Radiology, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000, Ljubljana, Slovenia
| | - Alexander Wötzel
- Emergency Department, Helios Park-Clinic Leipzig, Strümpellstr. 41, 04289, Leipzig, Germany
| | - Stefan Olthoff
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Sebastian Schaudt
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
- Medical Faculty, University of Leipzig, Liebigstr. 27, 04103, Leipzig, Germany
| | - Jonas Steglich
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany
- Medical Faculty, University of Leipzig, Liebigstr. 27, 04103, Leipzig, Germany
- Leipzig Heart Institute, Russenstr. 69a, 04289, Leipzig, Germany
| | - Robin F Gohmann
- Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
- Medical Faculty, University of Leipzig, Liebigstr. 27, 04103, Leipzig, Germany.
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Herbst C, Bothe V, Wegler M, Axer-Schaefer S, Audebert-Bellanger S, Gecz J, Cogne B, Feldman HB, Horn AHC, Hurst ACE, Kelly MA, Kruer MC, Kurolap A, Laquerriere A, Li M, Mark PR, Morawski M, Nizon M, Pastinen T, Polster T, Saugier-Veber P, SeSong J, Sticht H, Stieler JT, Thifffault I, van Eyk CL, Marcorelles P, Vezain-Mouchard M, Abou Jamra R, Oppermann H. Heterozygous loss-of-function variants in DOCK4 cause neurodevelopmental delay and microcephaly. Hum Genet 2024; 143:455-469. [PMID: 38526744 PMCID: PMC11043173 DOI: 10.1007/s00439-024-02655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/09/2024] [Indexed: 03/27/2024]
Abstract
Neurons form the basic anatomical and functional structure of the nervous system, and defects in neuronal differentiation or formation of neurites are associated with various psychiatric and neurodevelopmental disorders. Dynamic changes in the cytoskeleton are essential for this process, which is, inter alia, controlled by the dedicator of cytokinesis 4 (DOCK4) through the activation of RAC1. Here, we clinically describe 7 individuals (6 males and one female) with variants in DOCK4 and overlapping phenotype of mild to severe global developmental delay. Additional symptoms include coordination or gait abnormalities, microcephaly, nonspecific brain malformations, hypotonia and seizures. Four individuals carry missense variants (three of them detected de novo) and three individuals carry null variants (two of them maternally inherited). Molecular modeling of the heterozygous missense variants suggests that the majority of them affect the globular structure of DOCK4. In vitro functional expression studies in transfected Neuro-2A cells showed that all missense variants impaired neurite outgrowth. Furthermore, Dock4 knockout Neuro-2A cells also exhibited defects in promoting neurite outgrowth. Our results, including clinical, molecular and functional data, suggest that loss-of-function variants in DOCK4 probable cause a variable spectrum of a novel neurodevelopmental disorder with microcephaly.
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Affiliation(s)
- Charlotte Herbst
- Institute of Human Genetics, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Viktoria Bothe
- Institute of Human Genetics, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Meret Wegler
- Institute of Human Genetics, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Susanne Axer-Schaefer
- Department of Epileptology, Krankenhaus Mara Bethel Epilepsy Center Medical School OWL, Bielefeld University, Campus Bethel, Bielefeld, Germany
| | | | - Jozef Gecz
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Benjamin Cogne
- Service de Génétique Médicale, CHU Nantes, 44000, Nantes, France
- l'institut du Thorax, Nantes Université, CHU Nantes, CNRS, INSERM, 44000, Nantes, France
| | - Hagit Baris Feldman
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anselm H C Horn
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Erlangen National High Performance Computing Center, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anna C E Hurst
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Melissa A Kelly
- HudsonAlpha Clinical Services Lab, HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Michael C Kruer
- Barrow Neurological Institute, Phoenix Children's Hospital University of Arizona College of Medicine, Phoenix, USA
| | - Alina Kurolap
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Annie Laquerriere
- Department of Anatomy, Inserm U1245 and CHU Rouen, Univ Rouen Normandie, 76000, Rouen, France
| | - Megan Li
- Invitae Corp, San Francisco, CA, USA
| | - Paul R Mark
- Division of Medical Genetics, Helen DeVos Children's Hospital, Corewell Health, Grand Rapids, MI, USA
| | - Markus Morawski
- Center of Neuropathology and Brain Research, Medical Faculty, Paul Flechsig Institute, University of Leipzig, Leipzig, Germany
| | - Mathilde Nizon
- Service de Génétique Médicale, CHU Nantes, 44000, Nantes, France
- l'institut du Thorax, Nantes Université, CHU Nantes, CNRS, INSERM, 44000, Nantes, France
| | - Tomi Pastinen
- Genomic Medicine Center, Children's Mercy Hospital, Kansas City, USA
- University of Missouri Kansas City School of Medicine, Kansas City, USA
| | - Tilman Polster
- Department of Epileptology, Krankenhaus Mara Bethel Epilepsy Center Medical School OWL, Bielefeld University, Campus Bethel, Bielefeld, Germany
| | - Pascale Saugier-Veber
- Department of Genetics and Reference Center for Developmental Disorders, Inserm U1245 and CHU Rouen, Univ Rouen Normandie, 76000, Rouen, France
| | - Jang SeSong
- Genomic Medicine Institute, Seoul National University, Seoul, Republic of Korea
| | - Heinrich Sticht
- Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jens T Stieler
- Center of Neuropathology and Brain Research, Medical Faculty, Paul Flechsig Institute, University of Leipzig, Leipzig, Germany
| | - Isabelle Thifffault
- Genomic Medicine Center, Children's Mercy Hospital, Kansas City, USA
- University of Missouri Kansas City School of Medicine, Kansas City, USA
| | - Clare L van Eyk
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | | | - Myriam Vezain-Mouchard
- Department of Genetics and Reference Center for Developmental Disorders, Inserm U1245 and CHU Rouen, Univ Rouen Normandie, 76000, Rouen, France
| | - Rami Abou Jamra
- Institute of Human Genetics, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Henry Oppermann
- Institute of Human Genetics, University of Leipzig Medical Center, 04103, Leipzig, Germany.
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Valerius K, von Eitzen L, Göbel M, Ohlbrecht H, van den Berg N, Völzke H, Grabe HJ, Schomerus G, Speerforck S. Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience. BMC Psychiatry 2024; 24:153. [PMID: 38388350 PMCID: PMC10885433 DOI: 10.1186/s12888-024-05521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We aimed to investigate narratives of socialization, value systems, and barriers of help-seeking to better understand social milieus at increased risk for underuse of psychiatric-psychotherapeutic services in a rural area in East Germany. This could complement the explanatory power of classical socio-demographic determinants and provide guidance for possible interventions. METHOD Based on results of an analysis of a population-based German cohort study (SHIP-TREND-1), 20 individual semi-structured interviews were conducted with participants who met criteria for having been moderately or severely depressed at least once in their life. Qualitative analyses of interview data were guided by grounded theory methodology. RESULTS Participants with severe symptoms of depression were more frequent among non-responders of this study. We identified key aspects that influence help-seeking for mental health problems and seem to be characteristic for rural regions: family doctors serve as initial contact points for mental health problems and are considered as alternatives for mental health professionals; norms of traditional masculinity such as being more rational than emotional, needing to endure hardships, embodying strength, and being independent were frequently mentioned as inhibiting help-seeking by middle-aged men; anticipated adverse side-effects of therapy such as worsening of symptoms; a frequently expressed desire for less pathologically perceived treatment options. CONCLUSIONS Our results suggest that barriers regarding help-seeking in rural regions are multifaceted and seem to be influenced by traditional norms of masculinity. We believe it is critical to strengthen existing and already utilized services such as family doctors and to implement and evaluate tailored interventions targeting the needs of the rural milieu.
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Affiliation(s)
- Karsten Valerius
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
| | - Linnéa von Eitzen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Mirjam Göbel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Heike Ohlbrecht
- Department for Social Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sven Speerforck
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
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Böttner J, Fischer-Schaepmann T, Werner S, Knauth S, Jahnke HG, Thiele H, Büttner P. Amphetamine increases vascular permeability by modulating endothelial actin cytoskeleton and NO synthase via PAR-1 and VEGF-R. Sci Rep 2024; 14:3596. [PMID: 38351286 PMCID: PMC10864289 DOI: 10.1038/s41598-024-53470-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024] Open
Abstract
Abuse of amphetamine-type stimulants is linked to cardiovascular adverse effects like arrhythmias, accelerated atherosclerosis, acute coronary syndromes and sudden cardiac death. Excessive catecholamine release following amphetamine use causes vasoconstriction and vasospasms, over time leading to hypertension, endothelial dysfunction or even cardiotoxicity. However, immediate vascular pathomechanisms related to amphetamine exposure, especially endothelial function, remain incompletely understood and were analyzed in this study. Pharmaco-pathological effects of acute d-amphetamine-sulfate (DAM) were investigated ex vivo using contraction-force measurements of rat carotid artery rings and in vitro using label-free, real-time electrochemical impedance spectroscopy (EIS) on endothelial and smooth muscle cells. Specific receptor and target blocking was used to identify molecular targets and to characterize intracellular signaling. DAM induced vasodilation represented by 29.3±2.5% decrease in vascular tone (p<0.001) involving vascular endothelial growth factor receptor (VEGF-R) and protease activated receptor 1 (PAR-1). EIS revealed that DAM induces endothelial barrier disruption (-75.9±1.1% of initial cellular impedance, p<0.001) also involving VEGF-R and PAR-1. Further, in response to DAM, Rho-associated protein kinase (ROCK) mediated reversible contraction of actin cytoskeleton resulting in endothelial barrier disruption. Dephosphorylation of Serine1177 (-50.8±3.7%, p<0.001) and Threonine495 (-44.8±6.5%, p=0.0103) of the endothelial NO synthase (eNOS) were also observed. Blocking of VEGF-R and PAR-1 restored baseline eNOS Threonine495 phosphorylation. DAM induced vasodilation, enhanced vascular permeability and actin cytoskeleton contraction and induced eNOS hypophosphorylation involving VEGF-R, PAR-1 and ROCK. These results may contribute to a better understanding of severe adverse cardiovascular effects in amphetamine abuse.
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Affiliation(s)
- Julia Böttner
- Department of Cardiology, Heart Center Leipzig at Leipzig University, Strümpellstr. 39, 04289, Leipzig, Germany.
| | - Tina Fischer-Schaepmann
- Department of Cardiology, Heart Center Leipzig at Leipzig University, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Sarah Werner
- Department of Cardiology, Heart Center Leipzig at Leipzig University, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Sarah Knauth
- Institute for Orthodontics, Leipzig University, Liebigstr. 21, 04103, Leipzig, Germany
| | - Heinz-Georg Jahnke
- Center for Biotechnology and Biomedicine at Leipzig University, Deutscher Platz 5, 04103, Leipzig, Germany
| | - Holger Thiele
- Department of Cardiology, Heart Center Leipzig at Leipzig University, Strümpellstr. 39, 04289, Leipzig, Germany
| | - Petra Büttner
- Department of Cardiology, Heart Center Leipzig at Leipzig University, Strümpellstr. 39, 04289, Leipzig, Germany
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Olbrich A, Niemeyer J, Seiffert H, Ebel S, Gros O, Lordick F, Forstmeyer D, Seehofer D, Rademacher S, Denecke T, Matz-Soja M, Berg T, van Bömmel F. The GALAD score and the BALAD-2 score correlate with transarterial and systemic treatment response and survival in patients with hepatocellular carcinoma. J Cancer Res Clin Oncol 2024; 150:81. [PMID: 38319485 PMCID: PMC10847183 DOI: 10.1007/s00432-023-05526-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/09/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The GALAD score and the BALAD-2 score are biomarker-based scoring systems used to detect hepatocellular carcinoma (HCC). Both incorporate levels of alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). Our objective was to examine the relationship between the GALAD score as well as the BALAD-2 score and treatment response to transarterial or systemic treatments in patients with HCC. METHODS A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria. RESULTS The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP. CONCLUSION The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.
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Affiliation(s)
- Anne Olbrich
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Johannes Niemeyer
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Hendrik Seiffert
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Sebastian Ebel
- Department of Diagnostic and Interventional Radiology, Leipzig University Medical Center, Leipzig, Germany
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany
| | - Olga Gros
- Department of Anesthesia and Intensive Care, Helios Clinic Köthen, Köthen, Germany
| | - Florian Lordick
- University Cancer Center Leipzig (UCCL) and Division of Oncology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Dirk Forstmeyer
- University Cancer Center Leipzig (UCCL) and Division of Oncology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Daniel Seehofer
- Department of Visceral, Vascular, Thoracic and Transplant Surgery, Leipzig University Medical Center, Leipzig, Germany
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany
| | - Sebastian Rademacher
- Department of Visceral, Vascular, Thoracic and Transplant Surgery, Leipzig University Medical Center, Leipzig, Germany
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, Leipzig University Medical Center, Leipzig, Germany
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany
| | - Madlen Matz-Soja
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
- Rudolf-Schönheimer-Institute for Biochemistry, University of Leipzig, Leipzig, Germany
| | - Thomas Berg
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Florian van Bömmel
- Laboratory for Clinical and Experimental Hepatology (LCEHep), Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
- University Liver Tumor Center (ULTC), Leipzig University Medical Center, Leipzig, Germany.
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
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Zhu H, Müller U, Baums CG, Öhlmann S. Comparative analysis of the interactions of different Streptococcus suis strains with monocytes, granulocytes and the complement system in porcine blood. Vet Res 2024; 55:14. [PMID: 38317258 PMCID: PMC10845567 DOI: 10.1186/s13567-024-01268-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
Streptococcus suis (S. suis) is an important porcine pathogen causing meningitis, arthritis, and septicemia. Serotypes 2 and 14 are the most common zoonotic ones worldwide, whereas serotypes 2, 9, and 7 are very important in pigs in Europe. To cause invasive infections S. suis needs to enter the bloodstream. Consequently, the immune response in blood represents an important line of defense and bacteremia plays a key role in the pathogenesis of invasive S. suis infections. We investigated the working hypothesis that S. suis strains of the same serotype but different clonal complex (CC) might exhibit substantial differences in the interaction with components of the immune system in porcine blood. The experimental design of this study includes comparative analysis of 8 virulent strains belonging to 4 serotypes with strains of the same serotype being genetically not closely related. Significant differences between two strains of the same serotype but different clonal complex were recorded in the flow cytometric analysis of association with different leukocytes for serotype 9 and 14. Our results demonstrate that the serotype 9 strain of CC94 shows significantly increased association with monocytes and survival in porcine blood of conventional piglets as well as a tendency towards decreased composition of C3 in plasma of these piglets in comparison to the serotype 9 strain of CC16. Correlation analysis of C3 deposition on the bacterial surface and survival in respective blood samples of 8-week-old piglets demonstrated a negative correlation indicating that C3 deposition is a crucial step to limit bacterial survival and proliferation of different S. suis pathotypes in the blood of these piglets. In summary, our results indicate that the capsule composition of a S. suis strain is not alone sufficient to determine association with leukocytes, activation of complement, induction of proinflammatory cytokines, oxidative burst, and bacterial survival in porcine blood. In this study, substantial differences in these host-pathogen interactions were observed between strains of the same serotype. Therefore, a more comprehensive characterization of the field isolates, including at least MLST analysis to determine the sequence type/clonal complex, is recommended.
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Affiliation(s)
- Haodan Zhu
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
- Institute of Veterinary Medicine, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Uwe Müller
- Institute of Immunology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Christoph Georg Baums
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany.
| | - Sophie Öhlmann
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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Rösch S, Woitas J, Neumann S, Alef M, Kiefer I, Oechtering G. Diagnostic benefits of platelet-to-lymphocyte, neutrophil-to-lymphocyte, and albumin-to-globulin ratios in dogs with nasal cavity diseases. BMC Vet Res 2024; 20:44. [PMID: 38310231 PMCID: PMC10837884 DOI: 10.1186/s12917-024-03876-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/01/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND A multimodal approach for diagnostic tests under anesthesia is required to diagnose nasal cavity pathology (NP) reliably in dogs. Blood test results may provide clues to the suspected NP. METHODS This prospective blinded study assessed 72 dogs with chronic nasal discharge due to NPs, and 10 healthy dogs as the control group (CG). NPs were diagnosed using whole-body computed tomography (CT), upper airway endoscopy, examination of nasal mucosal swabs by bacterial and fungal culture, and histopathological examination of nasal mucosa biopsies. The exclusion criteria were the presence of any additional diseases or corticosteroid pre-treatment. In consideration of these exclusion criteria, 55 dogs entered the study. Dogs were classified into benign (benign tumors, idiopathic rhinitis (IR), and others) and malignant (carcinomas and sarcomas) NP groups. Blood count and blood chemistry tests were performed. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and albumin-to-globulin ratio (AGR) were calculated and compared. RESULTS 25 dogs with malignant NP (13 and 12 with carcinomas and sarcomas, respectively) and 30 dogs with benign NP (seven with benign tumors,13 with IR, and 10 others) were included. In general, in dogs with NP there were only slight abnormalities in complete blood count. However, PLR was significantly higher in dogs with malignant NP (carcinoma and sarcoma) than in those with benign NP and in the CG. Compared with the CG, the NLR was significantly increased in all dogs with NP, and the AGR was mild but significantly lower, except in dogs with sarcomas and benign tumors. CONCLUSIONS In dogs with nasal disease alone, there are usually no marked abnormalities in blood count. However, while mildly increased NLR and decreased AGR can be observed in almost all NPs, an increased PLR may indicate a malignant NP and can be used as an additional screening tool in dogs with nasal discharge due to nasal cavity pathology.
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Affiliation(s)
- Sarah Rösch
- Small Animal Department, ENT-Unit, University of Leipzig, An den Tierkliniken 23, Leipzig, SN, DE- 04103, Germany.
- Current affiliation: Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, Hannover, NI, DE-30559, Germany.
| | - Julia Woitas
- Small Animal Department, ENT-Unit, University of Leipzig, An den Tierkliniken 23, Leipzig, SN, DE- 04103, Germany
| | - Stephan Neumann
- Institute of Veterinary Medicine, University of Goettingen, Burckhardtweg 2, Goettingen, NI, DE-37077, Germany
| | - Michaele Alef
- Small Animal Department, University of Leipzig, An den Tierkliniken 23, Leipzig, SN, DE-04103, Germany
| | - Ingmar Kiefer
- Small Animal Department, University of Leipzig, An den Tierkliniken 23, Leipzig, SN, DE-04103, Germany
| | - Gerhard Oechtering
- Small Animal Department, ENT-Unit, University of Leipzig, An den Tierkliniken 23, Leipzig, SN, DE- 04103, Germany.
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Thalheim T, Schneider MR. Skin single-cell transcriptomics reveals a core of sebaceous gland-relevant genes shared by mice and humans. BMC Genomics 2024; 25:137. [PMID: 38310227 PMCID: PMC10837983 DOI: 10.1186/s12864-024-10008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/11/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Single-cell RNA sequencing (scRNA-seq) has been widely applied to dissect cellular heterogeneity in normal and diseased skin. Sebaceous glands, essential skin components with established functions in maintaining skin integrity and emerging roles in systemic energy metabolism, have been largely neglected in scRNA-seq studies. METHODS Departing from mouse and human skin scRNA-seq datasets, we identified gene sets expressed especially in sebaceous glands with the open-source R-package oposSOM. RESULTS The identified gene sets included sebaceous gland-typical genes as Scd3, Mgst1, Cidea, Awat2 and KRT7. Surprisingly, however, there was not a single overlap among the 100 highest, exclusively in sebaceous glands expressed transcripts in mouse and human samples. Notably, both species share a common core of only 25 transcripts, including mitochondrial and peroxisomal genes involved in fatty acid, amino acid, and glucose processing, thus highlighting the intense metabolic rate of this gland. CONCLUSIONS This study highlights intrinsic differences in sebaceous lipid synthesis between mice and humans, and indicates an important role for peroxisomal processes in this context. Our data also provides attractive starting points for experimentally addressing novel candidates regulating sebaceous gland homeostasis.
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Affiliation(s)
- Torsten Thalheim
- Interdisciplinary Institute for Bioinformatics (IZBI), University of Leipzig, Härtelstr. 16-18, 04107, Leipzig, Germany
- Present Address: Deutsches Biomasseforschungszentrum gGmbH, Torgauer Str. 116, 04347, Leipzig, Germany
| | - Marlon R Schneider
- Institute of Veterinary Physiology, University of Leipzig, An den Tierkliniken 7, Leipzig, 04103, Germany.
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Schiek S, Hintzer K, Dahley C, Wernecke K, Feindt B, Baerwald C, Spiegl UJA, Bertsche T. Symptoms of older orthopedic and rheumatic patients : A telephone survey about symptoms, symptom communication, treatment and further support after hospital discharge. Z Gerontol Geriatr 2024; 57:50-58. [PMID: 36692537 PMCID: PMC10827833 DOI: 10.1007/s00391-022-02155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/13/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND In older multimorbid orthopedic and rheumatic patients, data on symptoms besides pain or reduced mobility are rarely published. OBJECTIVE We investigated patients' perspectives on their symptoms after hospital discharge. MATERIAL AND METHODS Orthopedic and rheumatic patients aged over 70 years were asked via telephone interviews about (i) their symptoms, (ii) communication, (iii) treatment, and (iv) support. RESULTS (i) The 60 participants (35 women and 25 men) reported a median of 6 (min-max: 1-14) different symptoms, of which 86% (356 of 415) had existed before hospitalization, (ii) patients did not communicate 28% (117) of symptoms to either healthcare professionals, family or friends and (iii) 52 (87%) patients desired improvement. Of the 280 most impairing symptoms, 19% (52) were not treated at all. (iv) Almost all patients (59; 98%) considered it easy to obtain support. CONCLUSION Remarkably, many symptoms were not communicated or treated despite the patients having been hospitalized.
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Affiliation(s)
- Susanne Schiek
- Department of Clinical Pharmacy, Institute of Pharmacy, Leipzig University, Bruederstraße 32, 04103, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Katharina Hintzer
- Department of Clinical Pharmacy, Institute of Pharmacy, Leipzig University, Bruederstraße 32, 04103, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Carolin Dahley
- Department of Clinical Pharmacy, Institute of Pharmacy, Leipzig University, Bruederstraße 32, 04103, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Kathrin Wernecke
- Department of Clinical Pharmacy, Institute of Pharmacy, Leipzig University, Bruederstraße 32, 04103, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Birgit Feindt
- Central Patient Management, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Baerwald
- Department of Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich J A Spiegl
- Department of Orthopaedics, Trauma Surgery and Reconstructive Surgery, University of Leipzig, Leipzig, Germany
| | - Thilo Bertsche
- Department of Clinical Pharmacy, Institute of Pharmacy, Leipzig University, Bruederstraße 32, 04103, Leipzig, Germany.
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany.
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Liegert P, Pabst A, Conrad I, van den Bussche H, Eisele M, Hajek A, Heser K, Kleineidam L, Weyerer S, Werle J, Pentzek M, Weeg D, Mösch E, Wiese B, Oey A, Wagner M, Maier W, König HH, Riedel-Heller SG, Scherer M, Luppa M. The effect of depressive symptoms on quality of life and its different facets in the oldest age population: evidence from the AgeQualiDe prospective cohort study. Qual Life Res 2024; 33:387-398. [PMID: 37897642 PMCID: PMC10850022 DOI: 10.1007/s11136-023-03526-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE The present study aims to investigate the prospective effect of depressive symptoms on overall QoL in the oldest age group, taking into account its different facets. METHODS Data were derived from the multicenter prospective AgeCoDe/AgeQualiDe cohort study, including data from follow-up 7-9 and n = 580 individuals 85 years of age and older. Overall QoL and its facets were assessed using the WHOQOL-OLD instrument. The short form of the geriatric depression scale (GDS-15) was applied to assess depressive symptoms. Cognitively impaired individuals were excluded. Linear mixed-effects models were used to assess the effect of depressive symptoms on QoL. RESULTS Depressive symptoms were significantly associated with overall QoL and each of the different facets of WHOQOL-OLD, also after adjustment for time and sociodemographic characteristics such as age, gender, education, marital status, living situation, and cognitive status. Higher age and single as well as divorced marital status were also associated with a lower QoL. CONCLUSION This work provides comprehensive longitudinal results on the relationship between depressive symptoms and QoL in the oldest age population. The results underscore the relevance of tailored and targeted care planning and the development of customized interventions.
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Affiliation(s)
- Paula Liegert
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
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Weise C, Westphal H, Warias R, Belder D. High-temperature ultrafast ChipHPLC-MS. Anal Bioanal Chem 2024; 416:1023-1031. [PMID: 38112789 PMCID: PMC10800301 DOI: 10.1007/s00216-023-05092-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
Herein, we present a miniaturized chip-based HPLC approach coupled to electrospray ionization mass spectrometry utilizing temperature to achieve high-speed separations. The approach benefits from the low thermal mass of the microfluidic chip and can form an electrospray from the pre-heated mobile phase. With the help of this technology, isothermal and temperature-programmable operations up to 130°C were pursued to perform reversed-phase separations of pesticides in methanol and ethanol-containing eluents in less than 20 s.
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Affiliation(s)
- Chris Weise
- Institute of Analytical Chemistry, University Leipzig, Linnéstrasse 3, 04103, Leipzig, Germany
| | - Hannes Westphal
- Institute of Analytical Chemistry, University Leipzig, Linnéstrasse 3, 04103, Leipzig, Germany
| | - Rico Warias
- Institute of Analytical Chemistry, University Leipzig, Linnéstrasse 3, 04103, Leipzig, Germany
| | - Detlev Belder
- Institute of Analytical Chemistry, University Leipzig, Linnéstrasse 3, 04103, Leipzig, Germany.
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Lidle LR, Schmitz J. Assessing Visual Avoidance of Faces During Real-Life Social Stress in Children with Social Anxiety Disorder: A Mobile Eye-Tracking Study. Child Psychiatry Hum Dev 2024; 55:24-35. [PMID: 35708796 PMCID: PMC10796484 DOI: 10.1007/s10578-022-01383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/01/2022]
Abstract
This study measured visual attention (fixation count, dwell time) during two real-life social stress tasks using mobile eye-tracking glasses in children (9-13 years) diagnosed with social anxiety disorder (SAD; n = 25) and a healthy control group (HC; n = 30). The influence of state anxiety on attention allocation and negative self-evaluation biases regarding gaze behavior were also examined. Compared to the HC group, children with SAD showed visual avoidance (i.e., fewer fixations) of the faces of interaction partners during the second social stress task. While visual avoidance in HC children decreased with declining state anxiety from the first to the second social stress task, no such effect was found in children with SAD. A negative self-evaluation bias regarding gaze behavior in children with SAD was not found. In sum, measuring visual attention during real-life social situations may help enhance our understanding of social attention in childhood SAD.
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Affiliation(s)
- Leonie Rabea Lidle
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany.
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany.
| | - Julian Schmitz
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany
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Hillig N, Schumann-Muck F, Hamedy A, Braun PG, Koethe M. Impact of nanoscale silicon dioxide coating of stainless-steel surfaces on Listeria monocytogenes. Folia Microbiol (Praha) 2024; 69:173-180. [PMID: 37688746 PMCID: PMC10876764 DOI: 10.1007/s12223-023-01089-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/24/2023] [Indexed: 09/11/2023]
Abstract
High resistance to environmental factors as well as the ability to form biofilms allow Listeria monocytogenes to persist for a long time in difficult-to-reach places in food-producing plants. L. monocytogenes enters final products from contaminated surfaces in different areas of plants and poses a health risk to consumer. Modified surfaces are already used in the food industry to prevent cross-contamination. In this study, stainless-steel surfaces were coated with nanoscale silicon dioxide and the effects on attachment, bacterial growth and detachment of L. monocytogenes were evaluated. Attachment was considered for three different ways of application to simulate different scenarios of contamination. Bacterial growth of L. monocytogenes on the surface was recorded over a period of up to 8 h. Detachment was tested after cleaning inoculated stainless-steel surfaces with heated distilled water or detergent. Coating stainless-steel surfaces with nanoscale silica tends to reduce adherence and increased detachment and does not influence the bacterial growth of L. monocytogenes. Further modifications of the coating are necessary for a targeted use in the reduction of L. monocytogenes in food-processing plants.
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Affiliation(s)
- Nadja Hillig
- Institute of Food Hygiene, Faculty of Veterinary Medicine , Leipzig University, An den Tierkliniken 1, 04103, Leipzig, Germany.
| | - Felicitas Schumann-Muck
- Institute of Food Hygiene, Faculty of Veterinary Medicine , Leipzig University, An den Tierkliniken 1, 04103, Leipzig, Germany
| | - Ahmad Hamedy
- Institute of Food Hygiene, Faculty of Veterinary Medicine , Leipzig University, An den Tierkliniken 1, 04103, Leipzig, Germany
| | - Peggy G Braun
- Institute of Food Hygiene, Faculty of Veterinary Medicine , Leipzig University, An den Tierkliniken 1, 04103, Leipzig, Germany
| | - Martin Koethe
- Institute of Food Hygiene, Faculty of Veterinary Medicine , Leipzig University, An den Tierkliniken 1, 04103, Leipzig, Germany
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Holze S, Kuntze AS, Mende M, Neuhaus P, Truss MC, Do HM, Dietel A, Franz T, Stolzenburg JU. Assessment of different continence definitions in the context of the randomized multicenter prospective LAP-01 trial-Does the best definition change over time? Eur J Med Res 2024; 29:58. [PMID: 38238789 PMCID: PMC10795395 DOI: 10.1186/s40001-024-01662-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND A uniform definition of continence is urgently needed to allow the comparison of study results and to estimate patient outcomes after radical prostatectomy (RP). To identify a practical definition that includes both objective and subjective aspects in a tangible way, we assessed different continence definitions and evaluated which best reflects the patients' subjective perception of continence. METHODS Our analyses included 718 patients that underwent either robot-assisted radical prostatectomy (RARP) or laparoscopic radical prostatectomy (LRP) in a multicenter randomized patient-blinded trial. Continence was assessed through patient questionnaires prior to and at 3, 6 and 12 months after surgery which included the number of pads used per day, the ICIQ-SF and the question "Do you suffer from incontinence? (yes/no)" to assess subjective continence. We used Krippendorff's Alpha to calculate the agreement of different continence definitions with the subjective perception. RESULTS At 3 months, the "0/safety pad" definition shows the highest agreement by alpha = 0.70 (vs. 0.63 for "0 pads" and 0.37 for "0-1 pad"). At 6 and 12 months "0 pads" is the better match, with alpha values of 0.69 (vs. 0.62 and 0.31) after 6 months and 0.70 (vs. 0.65 and 0.32) after 12 months. The ICIQ-SF score shows good correlation with the subjective continence at 3 months (alpha = - 0.79), the coefficient then decreasing to - 0.69 and - 0.59 at 6 and 12 months. CONCLUSION The best continence definition according to the patients' perspective changes over time, "0 pads" being the superior criterion in the long-term. We recommend using the 0-pad definition for standardized continence reporting, as it is simple yet as accurate as possible given the inevitably high subjectivity of continence perception. Trial registration The LAP-01 trial was registered with the U.S. National Library of Medicine clinical trial registry (clinicaltrials.gov), NCT number: NCT03682146, and with the German Clinical Trial registry (Deutsches Register Klinischer Studien), DRKS ID number: DRKS00007138.
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Affiliation(s)
- Sigrun Holze
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
| | - Anna Sophie Kuntze
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Meinhard Mende
- Clinical Trial Centre Leipzig, University of Leipzig, Härtelstraße 16-18, 04107, Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstraße 16-18, 04107, Leipzig, Germany
| | - Petra Neuhaus
- Clinical Trial Centre Leipzig, University of Leipzig, Härtelstraße 16-18, 04107, Leipzig, Germany
| | - Michael C Truss
- Department of Urology, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Germany
| | - Hoang Minh Do
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Anja Dietel
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Toni Franz
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - Jens-Uwe Stolzenburg
- Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
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Fulfs T, Poulain T, Vogel M, Nenoff K, Kiess W. Associations between sleep problems and emotional/behavioural difficulties in healthy children and adolescents. BMC Pediatr 2024; 24:15. [PMID: 38183087 PMCID: PMC10768421 DOI: 10.1186/s12887-023-04487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to (1) characterise sleep disturbances and emotional/behavioural difficulties among healthy German children and adolescents aged 3 to 13 years, (2) examine the association between parent-reported sleep problems and emotional/behavioural difficulties, (3) point out possible relations between specific kinds of sleep disturbances and different behavioural difficulties. METHODS Data were collected between 2011 and 2015 within the LIFE Child study in Germany. The sample included 1101 3- to 13-year-old children and adolescents. Information on sleep disturbances-assessed via the Children's Sleep Habits Questionnaire (CSHQ), emotional/behavioural difficulties-assessed via the Strengths and Difficulties Questionnaire (SDQ), and socioeconomic status was provided by participants' parents. Multiple regressions were applied to analyse the associations between general and specific sleep disturbances (independent variables) and emotional/behavioural difficulties (dependent variables). RESULTS The total CSHQ score was positively associated with the total SDQ score and all SDQ subscales (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems). Most of the CSHQ subscales were related to SDQ subscale scores, except for a few non-significant relations with hyperactivity/inattention and conduct problems. The CSHQ total score, daytime sleepiness, sleep duration and parasomnias showed the strongest associations with the SDQ total score. CONCLUSION This study confirms an association between children's and adolescents' sleep habits and psychological health. We were able to demonstrate the association between sleep problems and emotional/behavioural difficulties in a large sample of healthy participants. In particular, we observed a significant relation between parasomnias and hyperactive/inattentive behaviour as well as a significant association between emotional problems and sleep problems, especially daytime sleepiness, sleep anxiety and parasomnias.
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Affiliation(s)
- Theresa Fulfs
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Kolja Nenoff
- Medical Department for Hematology, Cell Therapy and Hemostaseology, Leipzig University, Liebigstrasse. 20/22, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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Carius D, Kaminski E, Clauß M, Schewe Y, Ryk L, Ragert P. Quantifying motor adaptation in a sport-specific table tennis setting. Sci Rep 2024; 14:601. [PMID: 38182640 PMCID: PMC10770152 DOI: 10.1038/s41598-023-50927-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024] Open
Abstract
Studies on motor adaptation aim to better understand the remarkable, largely implicit capacity of humans to adjust to changing environmental conditions. So far, this phenomenon has mainly been investigated in highly controlled laboratory setting, allowing only limited conclusions and consequences for everyday life scenarios. Natural movement tasks performed under externally valid conditions would provide important support on the transferability of recent laboratory findings. Therefore, one major goal of the current study was to create and assess a new table tennis paradigm mapping motor adaptation in a more natural and sport-specific setting. High-speed cinematographic measurements were used to determine target accuracy in a motor adaptation table tennis paradigm in 30 right-handed participants. In addition, we investigated if motor adaptation was affected by temporal order of perturbations (serial vs. random practice). In summary, we were able to confirm and reproduce typical motor adaptation effects in a sport-specific setting. We found, according to previous findings, an increase in target errors with perturbation onset that decreased during motor adaptation. Furthermore, we observed an increase in target errors with perturbation offset (after-effect) that decrease subsequently during washout phase. More importantly, this motor adaptation phenomenon did not differ when comparing serial vs. random perturbation conditions.
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Affiliation(s)
- Daniel Carius
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany.
| | - Elisabeth Kaminski
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany
| | - Martina Clauß
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany
| | - Yannick Schewe
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany
| | - Lenja Ryk
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany
| | - Patrick Ragert
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, 04109, Leipzig, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany
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Lordick F, Wörmann B. National guidelines for gastric cancer: redundant or needed? Gastric Cancer 2024; 27:3-5. [PMID: 37847332 PMCID: PMC10761429 DOI: 10.1007/s10120-023-01430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/29/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Florian Lordick
- University Cancer Center Leipzig and Department of Medicine II (Oncology, Gastroenterology, Hepatology, and Pulmonology, University of Leipzig Medical Center, Liebigstr. 22, 04103, Leipzig, Germany.
| | - Bernhard Wörmann
- Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie, Charité Universitätsmedizin Berlin, Berlin, Germany
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Höppner J, Krohn S, van den Munckhof EHA, Kallies R, Herber A, Zeller K, Tünnemann J, Matz-Soja M, Chatzinotas A, Böhm S, Hoffmeister A, Berg T, Engelmann C. Changes of the bacterial composition in duodenal fluid from patients with liver cirrhosis and molecular bacterascites. Sci Rep 2023; 13:23001. [PMID: 38155157 PMCID: PMC10754895 DOI: 10.1038/s41598-023-49505-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/08/2023] [Indexed: 12/30/2023] Open
Abstract
Small intestinal bacterial overgrowth and compositional changes of intestinal microbiota are pathomechanistic factors in liver cirrhosis leading to bacterial translocation and infectious complications. We analyzed the quantity and composition of duodenal bacterial DNA (bactDNA) in relation to bactDNA in blood and ascites of patients with liver cirrhosis. Duodenal fluid and corresponding blood and ascites samples from 103 patients with liver cirrhosis were collected. Non-liver disease patients (n = 22) served as controls. BactDNA was quantified by 16S-rRNA gene-based PCR. T-RFLP and 16S-rRNA amplicon sequencing were used to analyze bacterial composition. Duodenal bacterial diversity in cirrhosis was distinct to controls showing significantly higher abundances of Streptococcus, Enterococcus and Veillonella. Patients with bactDNA positive ascites revealed reduced spectrum of core microbiota with Streptococcus as key player of duodenal community and higher prevalence of Granulicatella proving presence of cirrhosis related intestinal dysbiosis. Regarding duodenal fluid bactDNA quantification, no significant differences were found between patients with cirrhosis and controls. Additionally, percentage of subjects with detectable bactDNA in blood did not differ between patients and controls. This study evaluated the diversity of bacterial DNA in different body specimens with potential implications on understanding how intestinal bacterial translocation may affect infectious complications in cirrhosis.
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Affiliation(s)
- Jim Höppner
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Sandra Krohn
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | | | - René Kallies
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Adam Herber
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Katharina Zeller
- Endocrinology and Nephrology, University Hospital Leipzig, Leipzig, Germany
| | - Jan Tünnemann
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Madlen Matz-Soja
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Antonis Chatzinotas
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Stephan Böhm
- Max von Pettenkofer-Institute for Hygiene and Clinical Microbiology, Ludwig Maximilians-University, Munich, Germany
| | - Albrecht Hoffmeister
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
| | - Cornelius Engelmann
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany
- Institute for Liver and Digestive Health, Royal Free Campus, University College London, London, UK
- Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité - Universitaetsmedizin Berlin, Berlin, Germany
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Siess M, Steinke H, Zwirner J, Hammer N. On a potential morpho-mechanical link between the gluteus maximus muscle and pelvic floor tissues. Sci Rep 2023; 13:22901. [PMID: 38129498 PMCID: PMC10739724 DOI: 10.1038/s41598-023-50058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Stress urinary incontinence presents a condition not only found in female elderlies, but also in young athletes participating in high-impact sports such as volleyball or trampolining. Repeated jumps appear to be a predisposing factor. Yet the pathophysiology remains incompletely elucidated to date; especially with regard to the influence of the surrounding buttock tissues including gluteus maximus. The present study assessed the morpho-mechanical link between gluteus maximus and the pelvic floor female bodies. 25 pelves obtained from Thiel embalmed females were studied in a supine position. Strands of tissues connecting gluteus maximus with the pelvic floor obtained from 20 sides were assessed mechanically. Plastinates were evaluated to verify the dissection findings. In total, 49 hemipelves were included for data acquisition. The fascia of gluteus maximus yielded connections to the subcutaneous tissues, the fascia of the external anal sphincter and that of obturator internus and to the fascia of the urogenital diaphragm. The connection between gluteus maximus and the urogenital diaphragm withstood an average force of 23.6 ± 17.3 N. Cramér φ analyses demonstrated that the connections of the fasciae connecting gluteus maximus with its surroundings were consistent in the horizontal and sagittal planes, respectively. In conclusion, gluteus maximus is morphologically densely linked to the pelvic floor via strands of connective tissues investing the adjacent muscles. Though gluteus maximus has also been reported to facilitate urinary continence, the here presented morpho-mechanical link suggests that it may also have the potential to contribute to urinary stress incontinence. Future research combining clinical imaging with in-situ testing may help substantiate the potential influence from a clinical perspective.
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Affiliation(s)
- Maximilian Siess
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria
| | - Hanno Steinke
- Institute of Anatomy, University of Leipzig, Leipzig, Germany
| | - Johann Zwirner
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niels Hammer
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria.
- Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.
- Medical Branch, Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Chemnitz, Germany.
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Gutmann S, Heiderhoff M, Möbius R, Siegel T, Flegel T. Application accuracy of a frameless optical neuronavigation system as a guide for craniotomies in dogs. Acta Vet Scand 2023; 65:54. [PMID: 38098105 PMCID: PMC10722823 DOI: 10.1186/s13028-023-00720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Optical neuronavigation systems using infrared light to create a virtual reality image of the brain allow the surgeon to track instruments in real time. Due to the high vulnerability of the brain, neurosurgical interventions must be performed with a high precision. The aim of the experimental cadaveric study was to determine the application accuracy of a frameless optical neuronavigation system as guide for craniotomies by determining the target point deviation of predefined target points at the skull surface in the area of access to the cerebrum, cerebellum and the pituitary fossa. On each of the five canine cadaver heads ten target points were marked in a preoperative computed tomography (CT) scan. These target points were found on the cadaver skulls using the optical neuronavigation system. Then a small drill hole (1.5 mm) was drilled at these points. Subsequently, another CT scan was made. Both CT data sets were fused into the neuronavigation software, and the actual target point coordinates were identified. The target point deviation was determined as the difference between the planned and drilled target point coordinates. The calculated deviation was compared between two observers. RESULTS The analysis of the target point accuracies of all dogs in both observers taken together showed a median target point deviation of 1.57 mm (range: 0.42 to 5.14 mm). No significant differences were found between the observers or the different areas of target regions. CONCLUSION The application accuracy of the described system is similar to the accuracy of other optical neuronavigation systems previously described in veterinary medicine, in which mean values of 1.79 to 4.3 mm and median target point deviations of 0.79 to 3.53 mm were determined.
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Affiliation(s)
- Sarah Gutmann
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany.
| | - Miriam Heiderhoff
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
| | - Robert Möbius
- Department of Neurosurgery, Faculty of Medicine, University Clinic of Leipzig, Leipzig, Germany
| | - Tanja Siegel
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
| | - Thomas Flegel
- Department for Small Animals, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, 04103, Leipzig, Germany
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Pötzsch C, Kurch L, Naumann S, Georgi TW, Sabri O, Stoevesandt D, Cepelova M, Körholz D, Mauz-Körholz C, Hasenclever D, Kluge R. Prevention of activated brown adipose tissue on 18F-FDG-PET scans of young lymphoma patients: results of an ancillary study within the EuroNet-PHL-C2 trial. Sci Rep 2023; 13:21944. [PMID: 38081864 PMCID: PMC10713612 DOI: 10.1038/s41598-023-48871-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Activated brown fat (aBAT) is known to affect the evaluation of 18F-FDG PET scans, especially in young patients. The aim of this study was to determine factors influencing the occurrence of aBAT, and to investigate the effectiveness of the two preventive measures, warming and beta-blocker (propranolol) administration. Five-hundred-twenty-eight 18F-FDG-PET scans of 241 EuroNet-PHL-C2 trial patients from 41 nuclear medicine departments in Germany and Czech Republic were screened for aBAT. The occurrence of aBAT was analyzed with patient characteristics (age, sex, body mass index, predisposition to aBAT), weather data at the day of 18F-FDG PET scanning as well as the preventive measures taken. Potentially important factors from univariate analyses were included into a logistic regression model. Warming as a preventive measure was used in 243 18F-FDG-PET scans, propranolol was administered in 36, warming and propranolol were combined in 84, and no preventive measures were taken in 165 scans. Whereas age, sex and body mass index had no clear impact, there was an individual predisposition to aBAT. Logistic regression model revealed that the frequency of aBAT mainly depends on the outside temperature (p = 0.005) and can be effectively reduced by warming (p = 0.004), the administration of unselective beta-blocker or the combination of both. Warming is a simple, cheap and non-invasive method to reduce the frequency of aBAT. However, the effect of warming decreases with increasing outside temperatures. Administration of propranolol seems to be equally effective and provides advantages whenever the positive effect of warming is compromised. The combination of both preventive measures could have an additive effect.
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Affiliation(s)
- C Pötzsch
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany.
| | - S Naumann
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - T W Georgi
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
| | - D Stoevesandt
- Department of Radiology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - M Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - D Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University Giessen, Giessen, Germany
| | - C Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University Giessen, Giessen, Germany
| | - D Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - R Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, University of Leipzig, Liebigstraße 18, 04103, Leipzig, Germany
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Nerius L, Vogel M, Ceglarek U, Kiess W, Biemann R, Stepan H, Kratzsch J. Bone turnover in lactating and nonlactating women. Arch Gynecol Obstet 2023; 308:1853-1862. [PMID: 37707552 PMCID: PMC10579129 DOI: 10.1007/s00404-023-07189-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/07/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE During lactation, bone turnover increases, reflecting the mobilization of Calcium from maternal skeletal stores and resulting in bone loss. However, mechanisms are not yet fully understood, and previous studies have been comparatively small. We aim to assess bone metabolism during lactation by comparing bone-metabolism-related-parameters between large cohorts of lactating and nonlactating women. METHODS In a retrospective cohort study, we recruited 779 postpartum women and 742 healthy, nonpregnant, nonlactating controls. Postpartum women were examined 3 and 6 months after delivery and retrospectively assigned to either the exclusively breastfeeding (exc-bf) group if they had exclusively breastfed or the nonexclusively breastfeeding (nonexc-bf) group if they had not exclusively breastfed up to the respective visit. Serum levels of PTH, Estradiol, total Calcium, Phosphate, and bone turnover markers (ßCTX, P1NP, Osteocalcin) were compared between the groups. RESULTS Bone turnover markers were significantly increased in exc-bf and nonexc-bf women compared with the controls (all ps < .001). ßCTX was approximately twice as high in exc-bf women than in the controls. PTH levels were marginally higher in exc-bf (p < .001) and nonexc-bf women (p = .003) compared with the controls (6 months). Estradiol was suppressed in exc-bf women compared with the controls (p < .001, 3 months). CONCLUSION Exc-bf and even nonexc-bf states are characterized by an increase in bone formation and resorption markers. The PTH data distribution of exc-bf, nonexc-bf, and control groups in the underpart of the reference range suggest that lactational bone loss is relatively independent of PTH.
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Affiliation(s)
- Lena Nerius
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
| | - Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University of Leipzig, 04103, Leipzig, Germany
| | - Ronald Biemann
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University of Leipzig, 04103, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany.
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Alexa JM, Bertsche T. An online cross-sectional survey of community pharmacists to assess information needs for evidence-based self-medication counselling. Int J Clin Pharm 2023; 45:1452-1463. [PMID: 37532842 PMCID: PMC10682211 DOI: 10.1007/s11096-023-01624-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/08/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Community pharmacists play an important role in healthcare. They are frequently visited by patients to receive advice on self-medication products. Little research has been conducted to investigate pharmacists' information needs for evidence-based self-medication counselling. AIM To assess community pharmacists' information needs in five predefined areas: general and specific individual needs, quality needs, utilisation needs, implication needs, and access needs for evidence based self-medication counselling. METHOD After ethical approval, we conducted an exploratory, semi-quantitative, cross-sectional online survey. Members of three different chambers of pharmacists in Germany were invited to participate anonymously in the survey. They gave informed consent and received no incentive for their participation. Quantitative outcome: Frequency of relevance / importance of items within predefined information needs areas, except for access needs. Qualitative outcome: Open-text responses concerning all information needs. RESULTS We analysed data from a total of 823 participants who completed the survey. General and specific information such as dosage (74.2% [611/823]) and when to refer to a physician (64.6% [532/823]) as well as an over-the-counter product's effectiveness according to medical guidelines (71.4% [588/823]) were rated as very important. Participants reported to prefer digital information sources (50.5% [416/823] strongly agreed), especially in the form of an easily accessible database (61.6% [507/823] strongly agreed) that contains regularly updated, manufacturer-independent, critically appraised, concise information. CONCLUSION Community pharmacists expressed distinct information needs for evidence-based self-medication counselling. Further information services on essential evidence-based pharmacy knowledge may be necessary to support implementation.
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Affiliation(s)
- J M Alexa
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Bruederstr. 32, 04103, Leipzig, Germany
| | - T Bertsche
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany.
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Bruederstr. 32, 04103, Leipzig, Germany.
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Esser P, Müller H, Borchmann P, Kreissl S, Knoop H, Platzbecker U, Vucinic V, Mehnert-Theuerkauf A. Web-Based Cognitive-Behavioral Therapy to Reduce Severe Cancer-Related Fatigue Among Survivors of Hodgkin Lymphoma: A Feasibility Study. J Clin Psychol Med Settings 2023; 30:856-865. [PMID: 36808045 PMCID: PMC9943038 DOI: 10.1007/s10880-023-09944-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
We investigated the feasibility of a web-based cognitive-behavioral therapy to reduce cancer-related fatigue (CRF) among survivors of Hodgkin lymphoma. In this before-and-after trial, patients were primarily recruited via the German Hodgkin Study Group (GHSG). We assessed feasibility (response and drop-out rate) and preliminary efficacy including CRF, quality of life (QoL), and depressive symptomatology. T tests compared baseline levels with t1 (post treatment) and t2 (3 months of follow-up). Among 79 patients contacted via the GHSG, 33 provided interest (42%). Among the seventeen participants, four were treated face-to-face (pilot patients), 13 underwent the web-based version. Ten patients completed the treatment (41%). Among all participants, CRF, depressive symptomatology, and QoL improved at t1 (p ≤ .03). The effect in one of the CRF measures remained at t2 (p = .03). Except for QoL, post-treatment effects were replicated among the completers of the web-based version (p ≤ .04). The potential for this program has been demonstrated, but needs to be re-assessed after identified issues on feasibility have been resolved.Trial registration: The study was registered at ClinicalTrials.gov (Number: NCT03968250).
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Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
| | - Horst Müller
- German Hodgkin Study Group (GHSG), Clinic I for Internal Medicine at the University Medical Center of Cologne, Cologne, Germany
| | - Peter Borchmann
- German Hodgkin Study Group (GHSG), Clinic I for Internal Medicine at the University Medical Center of Cologne, Cologne, Germany
| | - Stefanie Kreissl
- German Hodgkin Study Group (GHSG), Clinic I for Internal Medicine at the University Medical Center of Cologne, Cologne, Germany
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Uwe Platzbecker
- Clinic for Hematology, Cellular Therapy and Hemostaseology, University Medical Center Leipzig, Leipzig, Germany
| | - Vladan Vucinic
- Clinic for Hematology, Cellular Therapy and Hemostaseology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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Poser M, Sing KEA, Ebert T, Ziebolz D, Schmalz G. The rosetta stone of successful ageing: does oral health have a role? Biogerontology 2023; 24:867-888. [PMID: 37421489 PMCID: PMC10615965 DOI: 10.1007/s10522-023-10047-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
Ageing is an inevitable aspect of life and thus successful ageing is an important focus of recent scientific efforts. The biological process of ageing is mediated through the interaction of genes with environmental factors, increasing the body's susceptibility to insults. Elucidating this process will increase our ability to prevent and treat age-related disease and consequently extend life expectancy. Notably, centenarians offer a unique perspective on the phenomenon of ageing. Current research highlights several age-associated alterations on the genetic, epigenetic and proteomic level. Consequently, nutrient sensing and mitochondrial function are altered, resulting in inflammation and exhaustion of regenerative ability.Oral health, an important contributor to overall health, remains underexplored in the context of extreme longevity. Good masticatory function ensures sufficient nutrient uptake, reducing morbidity and mortality in old age. The relationship between periodontal disease and systemic inflammatory pathologies is well established. Diabetes, rheumatoid arthritis and cardiovascular disease are among the most significant disease burdens influenced by inflammatory oral health conditions. Evidence suggests that the interaction is bi-directional, impacting progression, severity and mortality. Current models of ageing and longevity neglect an important factor in overall health and well-being, a gap that this review intends to illustrate and inspire avenues for future research.
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Affiliation(s)
- Maximilian Poser
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
| | - Katie E A Sing
- Department of Medicine, Royal Devon and Exeter Hospital, University of Exeter Medical School, Exeter, EX2 5DW, UK
| | - Thomas Ebert
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
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Schmidt R, Geisler D, Urban D, Pries R, Franzisket C, Voigt C, Ivanova G, Neumuth T, Classen J, Wagner M, Michalski D. Stroke survivors' preferences on assessing patient-reported outcome measures. J Patient Rep Outcomes 2023; 7:124. [PMID: 38032486 PMCID: PMC10689585 DOI: 10.1186/s41687-023-00660-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. METHODS A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. RESULTS 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15-30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. CONCLUSIONS For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care.
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Affiliation(s)
- Richard Schmidt
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Daniela Geisler
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Daniela Urban
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | | | | | | | - Galina Ivanova
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, 04109, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, 04109, Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | | | - Dominik Michalski
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
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Schenk M, Neumann J, Adler N, Trommer T, Theopold J, Neumuth T, Hepp P. A comparison between a maximum care university hospital and an outpatient clinic - potential for optimization in arthroscopic workflows? BMC Health Serv Res 2023; 23:1313. [PMID: 38017443 PMCID: PMC10685488 DOI: 10.1186/s12913-023-10259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/31/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Due to the growing economic pressure, there is an increasing interest in the optimization of operational processes within surgical operating rooms (ORs). Surgical departments are frequently dealing with limited resources, complex processes with unexpected events as well as constantly changing conditions. In order to use available resources efficiently, existing workflows and processes have to be analyzed and optimized continuously. Structural and procedural changes without prior data-driven analyses may impair the performance of the OR team and the overall efficiency of the department. The aim of this study is to develop an adaptable software toolset for surgical workflow analysis and perioperative process optimization in arthroscopic surgery. METHODS In this study, the perioperative processes of arthroscopic interventions have been recorded and analyzed subsequently. A total of 53 arthroscopic operations were recorded at a maximum care university hospital (UH) and 66 arthroscopic operations were acquired at a special outpatient clinic (OC). The recording includes regular perioperative processes (i.a. patient positioning, skin incision, application of wound dressing) and disruptive influences on these processes (e.g. telephone calls, missing or defective instruments, etc.). For this purpose, a software tool was developed ('s.w.an Suite Arthroscopic toolset'). Based on the data obtained, the processes of the maximum care provider and the special outpatient clinic have been analyzed in terms of performance measures (e.g. Closure-To-Incision-Time), efficiency (e.g. activity duration, OR resource utilization) as well as intra-process disturbances and then compared to one another. RESULTS Despite many similar processes, the results revealed considerable differences in performance indices. The OC required significantly less time than UH for surgical preoperative (UH: 30:47 min, OC: 26:01 min) and postoperative phase (UH: 15:04 min, OC: 9:56 min) as well as changeover time (UH: 32:33 min, OC: 6:02 min). In addition, these phases result in the Closure-to-Incision-Time, which lasted longer at the UH (UH: 80:01 min, OC: 41:12 min). CONCLUSION The perioperative process organization, team collaboration, and the avoidance of disruptive factors had a considerable influence on the progress of the surgeries. Furthermore, differences in terms of staffing and spatial capacities could be identified. Based on the acquired process data (such as the duration for different surgical steps or the number of interfering events) and the comparison of different arthroscopic departments, approaches for perioperative process optimization to decrease the time of work steps and reduce disruptive influences were identified.
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Affiliation(s)
- Martin Schenk
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany.
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical Center, Leipzig, Germany.
| | - Juliane Neumann
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Nadine Adler
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Jan Theopold
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Pierre Hepp
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Arthroscopic Surgery and Sports Medicine, University of Leipzig Medical Center, Leipzig, Germany
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Krause L, Poulain T, Kiess W, Vogel M. Body image and behavioural and emotional difficulties in German children and adolescents. BMC Pediatr 2023; 23:594. [PMID: 37996808 PMCID: PMC10666319 DOI: 10.1186/s12887-023-04405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Behavioural and emotional difficulties might play an important role in the development of body image disturbances, which represent serious risk factors for eating disorders or depression. The present study provides a detailed overview on body image disturbances and several behavioural and emotional difficulties (differences between gender, age, and weight status) and their inter-relations in German children and adolescents. METHODS Data on body image disturbances, assessed through a Figure Rating Scale, and on behavioural and emotional difficulties, assessed through Goodman's Strengths and Difficulties Questionnaire (SDQ), were available for 5255 observations of 1982 German children and adolescents aged 8 to 18 years from the LIFE Child study, based in Leipzig, Germany. Associations were investigated using multiple logistic regression. Each association was checked for interaction with gender, age, and weight status. RESULTS Boys reported more behavioural difficulties than girls, while girls reported more emotional difficulties. Gender, age and weight status were related to behavioural and emotional difficulties as well as body image disturbances. Individuals with fewer difficulties were more satisfied with their own body. Children and adolescents who desired to be larger showed more prosocial behaviour problems, conduct and emotional problems and more signs of hyperactivity. Those, who desired to be thinner showed more problems in all SDQ-subscales. A more accurate body size perception was associated with fewer behavioural and emotional difficulties. Children and adolescents who overestimated their body size showed more prosocial behaviour and emotional problems. Underestimation one's body size was associated with more signs of hyperactivity. CONCLUSION The current findings highlight the importance of raising the awareness about the association between behavioural and emotional difficulties and body image disturbances in children and adolescents to prevent negative outcomes.
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Affiliation(s)
- Lea Krause
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany.
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany.
| | - Tanja Poulain
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Wieland Kiess
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
| | - Mandy Vogel
- Department of Women and Child Health, University Hospital for Children and Adolescents, Center for Pediatric Research (CPL), Leipzig University, Liebigstrasse 20a, Leipzig, 04103, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany
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Zülke AE, Luppa M, van Boxtel M, Deckers K, Heger I, Köhler S, Riedel-Heller SG. Older adults' awareness of modifiable risk and protective factors for dementia and interest in eHealth interventions for brain health: a comparison between the Netherlands and Germany. BMC Public Health 2023; 23:2321. [PMID: 37996822 PMCID: PMC10668348 DOI: 10.1186/s12889-023-17247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Evidence on modifiable risk factors for dementia is accumulating rapidly, including e.g. smoking, hypertension, and diabetes. Comparing knowledge of risk factors for dementia and factors associated with knowledge and motivation to learn about dementia risk reduction in different countries may support the design of tailored public health campaigns. We investigated (1) differences in knowledge of risk and protective factors for dementia between the Netherlands and Germany, and interest in (2) information on brain health and (3) eHealth for brain health. MATERIALS AND METHODS Population-based telephone (Germany) or web-based surveys (Netherlands) were conducted among adults aged 60-75 (ntotal=614; Germany: n = 270; Netherlands: n = 344), assessing sociodemographic factors, knowledge of risk and protective factors for dementia, interest in information on brain health and respective eHealth-tools. Correlates of knowledge, interest in information on brain health and eHealth for brain health were analyzed using multivariable regression, by country and in pooled analyses. RESULTS In the total sample (Mage: 67.3 (SD: 4.3) years; %female: 48.6), knowledge of risk and protective factors (sum score assessing number of correctly identified factors) was higher among German participants (M (SD) = 7.6 (2.5) vs. 6.0 (4.3), p < .001). This was confirmed using linear regression analyses, controlling for sociodemographic covariates (b = 1.51; 95% CI: 1.00; 2.01). High education was linked to better knowledge of risk and protective factors (b = 1.61; 95% CI: 0.89; 2.34). Controlling for covariates, interest in information on brain health (OR: 0.05, 95% CI: 0.02; 0.09) and eHealth for brain health (OR: 0.40, 95% CI: 0.25; 0.65) was lower in German participants. Widowed participants were less interested in information on brain health, while widowed and single participants expressed less interest in eHealth for brain health in pooled analyses. Further associations between sociodemographic factors, interest in information on brain health and eHealth for brain health by country were detected. DISCUSSION Engaging older adults in the design of eHealth interventions and cooperation with trusted sources, e.g., general practitioners, might enhance appreciation of eHealth for brain health. Education on risk and protective factors for dementia is warranted in both countries. However, differences in recruitment and assessment need to be acknowledged.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Irene Heger
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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Schmalz G, Hennecke A, Haak R, Kottmann T, Garbade J, Binner C, Ziebolz D. Secondary analysis of potential associations between oral health and infection-related parameters in patients with severe heart failure-results of a German cohort. BMC Cardiovasc Disord 2023; 23:573. [PMID: 37990175 PMCID: PMC10664670 DOI: 10.1186/s12872-023-03612-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES Aim of this retrospective cohort study was to evaluate whether oral health parameters would be associated with infection-related parameters and overall survival of patients with severe heart failure (HF). METHODS Patients with severe HF, heart transplantation (HTx) and left-ventricular assist device (LVAD), which underwent a full oral examination between 2017 and 2018 were included. Infection-related and survival data were assessed from the patient´s medical records. The oral examination included: remaining teeth, caries and periodontal condition, including periodontal probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and diagnosis (staging/grading). In addition, the periodontal inflamed surface area (PISA) was determined. Statistical analysis included Chi-square, Fisher´s exact and Mann-Whitney-U test, as well as a logistic regression, considering age, gender, body-mass-index (BMI), diabetes and several oral health parameters with regard to overall survival and infections at heart/driveline. RESULTS 329 patients (HTx: 34%, LVAD: 38.9%, HF: 27.1%), were included. Patients had on average 18.96 ± 8.90 remaining teeth, whereby the majority had a periodontitis stage III or IV (88.7%) and a grade B (80.5%). Higher BOP was associated with infections at heart/driveline (p = 0.04) and outside the heart (p < 0.01) during follow-up. Increased PISA was significantly associated with bacterial infections outside the heart (p < 0.01) and sepsis (p = 0.02). Only BMI of 25 or higher correlated with an increased risk of infections at heart/driveline in regression analysis (OR 3.063, CI95 1.158-8.101, p = 0.02), while no associations between oral health parameters and infections at heart/driveline or overall survival were confirmed. CONCLUSIONS In patients with severe HF, periodontal inflammation might be associated with infection-related parameters. Improved dental care, especially including periodontal therapy and maintenance might be favourable to support prevention of infections in patients with severe HF.
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Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany.
| | - Alina Hennecke
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
| | | | - Jens Garbade
- Department of Cardiac Surgery, Klinikum Links der Weser, 28277, Bremen, Germany
| | - Christian Binner
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, D 04103, Leipzig, Germany
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Andraczek K, Weigelt A, Cantuarias CJB, Fischer M, Hinderling J, Prati D, Rauwolf EMN, van der Plas F. Relationships between species richness and biomass production are context dependent in grasslands differing in land-use and seed addition. Sci Rep 2023; 13:19663. [PMID: 37952061 PMCID: PMC10640580 DOI: 10.1038/s41598-023-47020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023] Open
Abstract
Despite evidence from grasslands experiments suggesting that plant species loss reduces biomass production, the strength of biodiversity-ecosystem functioning relationships in managed grasslands is still debated. High land-use intensity and reduced species pools are often suggested to make relationships between biodiversity and productivity less positive or even negative, but concrete evidence is still scarce. We investigated biodiversity-productivity relationships over two years in 150 managed grasslands in Germany. Specifically, we distinguished between relationships of biodiversity and biomass production in managed grasslands (1) varying in land-use intensity (e.g. of mowing, grazing and/or fertilization), (2) where land-use intensity is experimentally reduced, and (3) where additionally to land-use reductions, species pools are enlarged by seed addition. Among grasslands varying in land-use intensity, we found negative biodiversity-productivity relationships. Land-use reduction weakened these relationships, towards neutral, and sometimes, even positive relationships. Seed addition reduced species pool limitations, but this did not strengthen biodiversity-productivity relationships. Our findings indicate that land-use intensity is an important factor explaining the predominantly negative biodiversity-productivity relationships in managed grasslands. While we did not find that species pool limitations weakened biodiversity-productivity relationships, our results are based on a two-year-old experiment, possibly such effects are only visible in the long-term. Ultimately, advancing insights on biodiversity-ecosystem functioning relationships helps us to understand under which conditions agricultural production may benefit from promoting biodiversity.
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Affiliation(s)
- Karl Andraczek
- Faculty of Life Sciences, Systematic Botany and Functional Biodiversity, Leipzig University, Johannisallee 21, 04103, Leipzig, Germany.
| | - Alexandra Weigelt
- Faculty of Life Sciences, Systematic Botany and Functional Biodiversity, Leipzig University, Johannisallee 21, 04103, Leipzig, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstr. 4, 03401, Leipzig, Germany
| | - Cristóbal J Bottero Cantuarias
- Faculty of Life Sciences, Systematic Botany and Functional Biodiversity, Leipzig University, Johannisallee 21, 04103, Leipzig, Germany
| | - Markus Fischer
- Institute of Plant Sciences, University of Bern, Hochschulstrasse 4, 3012, Bern, Switzerland
| | - Judith Hinderling
- Institute of Plant Sciences, University of Bern, Hochschulstrasse 4, 3012, Bern, Switzerland
| | - Daniel Prati
- Institute of Plant Sciences, University of Bern, Hochschulstrasse 4, 3012, Bern, Switzerland
| | - Esther M N Rauwolf
- Faculty of Life Sciences, Systematic Botany and Functional Biodiversity, Leipzig University, Johannisallee 21, 04103, Leipzig, Germany
| | - Fons van der Plas
- Faculty of Life Sciences, Systematic Botany and Functional Biodiversity, Leipzig University, Johannisallee 21, 04103, Leipzig, Germany
- Plant Ecology and Nature Conservation Group, Wageningen University, P.O. Box 47, Wageningen, The Netherlands
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47
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Weinekötter J, Gurtner C, Protschka M, von Bomhard W, Böttcher D, Alber G, Kiefer I, Steiner JM, Seeger J, Heilmann RM. Tissue S100/calgranulin expression and blood neutrophil-to-lymphocyte ratio (NLR) in prostatic disorders in dogs. BMC Vet Res 2023; 19:234. [PMID: 37946179 PMCID: PMC10633940 DOI: 10.1186/s12917-023-03792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Prostatic carcinoma (PCA) is a rare but severe condition in dogs that is similar to the androgen-independent form of PCA in men. In contrast to humans, PCA is difficult to diagnose in dogs as reliable biomarkers, available for PCA screening in human medicine, are currently lacking in small animal oncology. Calprotectin (S100A8/A9) and S100A12 are Ca2+-binding proteins of the innate immune system with promising potential to distinguish malignant from benign urogenital tract conditions, similar to the blood neutrophil-to-lymphocyte-ratio (NLR). However, both have not yet been extensively investigated in dogs with PCA. Thus, this study aimed to evaluate the expression of the S100/calgranulins (calprotectin, S100A12, and their ratio [Cal-ratio]) in prostatic biopsies from nine dogs with PCA and compare them to those in dogs with benign prostatic lesions (eight dogs with prostatitis and ten dogs with benign prostatic hyperplasia [BPH]) as well as five healthy controls. In addition, blood NLRs were investigated in twelve dogs with PCA and 22 dogs with benign prostatic conditions. RESULTS Tissue S100A8/A9+ cell counts did not differ significantly between tissue from PCA and prostatitis cases (P = 0.0659) but were significantly higher in dogs with prostatitis than BPH (P = 0.0013) or controls (P = 0.0033). S100A12+ cell counts were significantly lower in PCA tissues than in prostatitis tissue (P = 0.0458) but did not differ compared to BPH tissue (P = 0.6499) or tissue from controls (P = 0.0622). Cal-ratios did not differ significantly among the groups but were highest in prostatitis tissues and significantly higher in those dogs with poor prostatitis outcomes than in patients that were still alive at the end of the study (P = 0.0455). Blood NLR strongly correlated with prostatic tissue S100A8/A9+ cell counts in dogs with PCA (ρ = 0.81, P = 0.0499) but did not differ among the disease groups of dogs. CONCLUSIONS This study suggests that the S100/calgranulins play a role in malignant (PCA) and benign (prostatic inflammation) prostatic conditions and supports previous results in lower urinary tract conditions in dogs. These molecules might be linked to the inflammatory environment with potential effects on the inflammasome. The blood NLR does not appear to aid in distinguishing prostatic conditions in dogs. Further investigation of the S100/calgranulin pathways and their role in modulation of tumor development, progression, and metastasis in PCA is warranted.
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Affiliation(s)
- Jana Weinekötter
- Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, DE-04103, Leipzig, SN, Germany
| | - Corinne Gurtner
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, Bern, BE, CH-3001, Switzerland
| | - Martina Protschka
- Institute of Immunology, College of Veterinary Medicine, Biotechnological-Biomedical Center, Leipzig University, Deutscher Platz 05, DE-04103, Leipzig, SN, Germany
| | - Wolf von Bomhard
- Synlab Specialty Center for Veterinary Pathology, Hartelstrasse 30, DE-80689, Munich, BY, Germany
| | - Denny Böttcher
- Institut for Veterinary Pathology, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, DE-04103, Leipzig, SN, Germany
| | - Gottfried Alber
- Institute of Immunology, College of Veterinary Medicine, Biotechnological-Biomedical Center, Leipzig University, Deutscher Platz 05, DE-04103, Leipzig, SN, Germany
| | - Ingmar Kiefer
- Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, DE-04103, Leipzig, SN, Germany
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU, College Station, TX, 4474, 77843-4474, USA
| | - Johannes Seeger
- Institute of Anatomy, Histology and Embryology, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, DE-04103, Leipzig, SN, Germany
| | - Romy M Heilmann
- Department for Small Animals, College of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, DE-04103, Leipzig, SN, Germany.
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Hönemann M, Scharfenberg E, Dietze N, Claus C, Jochmann C, Liebert UG. Rubella virus-associated uveitis at a tertiary care hospital in Germany between 2013 and 2019. BMC Ophthalmol 2023; 23:447. [PMID: 37932668 PMCID: PMC10629089 DOI: 10.1186/s12886-023-03182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
Uveitis is a process of intraocular inflammation that may involve different sections of the uveal tract. Apart from systemic or localized immune-mediated diseases, infections are key players in the etiology of uveitis and entail different treatment strategies. Rubella virus (RuV) is a recognized causative agent for the development of Fuchs uveitis, representing a major cause of virus-associated intraocular inflammation. A cohort of 159 patients diagnosed with different forms of uveitis between 2013 and 2019 was subjected to diagnostic antibody testing of the aqueous or vitreous humor. The diagnostic panel included RuV, cytomegalovirus, herpes simplex virus, varicella-zoster virus, and toxoplasmosis. Within this cohort, 38 RuV-associated uveitis (RAU) patients were identified based on a pathologic Goldman-Witmer coefficient indicative of an underlying RuV infection. With a mean age of 45.9 years, the RAU patients were younger than the non-RAU patients (56.3, p < 0.001). The evaluation of clinical parameters revealed a predominance of anterior uveitis and late sequalae such as cataract and glaucoma among the RAU patients. In 15 of the patients a history of prior RuV infections could be confirmed. The study underlines the importance of long-term surveillance of RuV associated diseases that originate from infections before the introduction of RuV vaccination programs.
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Affiliation(s)
- Mario Hönemann
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany.
| | - Elizabeth Scharfenberg
- Department of Ophthalmology, University Hospital Leipzig, Leipzig University, Liebigstrasse 21, 04103, Leipzig, Germany
| | - Nadine Dietze
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
| | - Claudia Claus
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
| | - Claudia Jochmann
- Department of Ophthalmology, University Hospital Leipzig, Leipzig University, Liebigstrasse 21, 04103, Leipzig, Germany
| | - Uwe Gerd Liebert
- Institute of Medical Microbiology and Virology, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany
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Baretton GB, Lordick F, Gaiser T, Hofheinz R, Horst D, Lorenzen S, Moehler M, Röcken C, Schirmacher P, Stahl M, Thuss-Patience P, Tiemann K. Standardized and quality-assured predictive PD-L1 testing in the upper gastrointestinal tract. J Cancer Res Clin Oncol 2023; 149:16231-16238. [PMID: 37874352 PMCID: PMC10620316 DOI: 10.1007/s00432-023-05180-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 10/25/2023]
Abstract
As a result of the high approval dynamics and the growing number of immuno-oncological concepts, the complexity of treatment decisions and control in the area of cancers of the esophagus, gastroesophageal junction and stomach is constantly increasing. Since the treatment indication for PD-1 inhibitors that are currently approved in the European Union is often linked to the expression of PD-L1 (programmed cell death-ligand 1), the evaluation of tissue-based predictive markers by the pathologist is of crucial importance for treatment stratification. Even though the immunohistochemical analysis of the PD-L1 expression status is one of the best studied, therapy-relevant biomarkers for an immuno-oncological treatment, due to the high heterogeneity of carcinomas of the upper gastrointestinal tract, there are challenges in daily clinical diagnostic work with regard to implementation, standardization and interpretation of testing. An interdisciplinary group of experts from Germany has taken a position on relevant questions from daily pathological and clinical practice, which concern the starting material, quality-assured testing and the interpretation of pathological findings, and has developed recommendations for structured reporting.
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Affiliation(s)
- Gustavo B Baretton
- Institute for Pathology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Florian Lordick
- Department of Medicine II (Oncology, Gastroenterology, Hepatology and Pulmonology) and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany.
| | - T Gaiser
- Institute of Applied Pathology, 67346, Speyer, Germany
| | - R Hofheinz
- University Medicine Mannheim, Mannheim, Germany
| | - D Horst
- Institute of Pathology of the Charité-University Medicine Berlin, Berlin, Germany
| | - S Lorenzen
- Department of Medicine III, Klinikum Rechts der Isar, Munich, Germany
| | - M Moehler
- Department of Medicine I, University Medicine Mainz, Mainz, Germany
| | - C Röcken
- Institute of Pathology, Christian-Albrechts University, Kiel, Germany
| | - P Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Stahl
- Department of Oncology and Palliative Care, Kliniken Essen Mitte, Evangelische Huyssens-Stiftung, Essen-Huttrop, Essen, Germany
| | - P Thuss-Patience
- Charité Center of Tumor Medicine CC14, Charité Campus Virchow-University Medicine Berlin, Berlin, Germany
| | - K Tiemann
- Institute of Hematopathology, Hamburg, Germany
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50
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Feistner L, Penk A, Böttner J, Büttner P, Thiele H, Huster D, Schlotter F. Nuclear magnetic resonance spectroscopy to quantify major extracellular matrix components in fibro-calcific aortic valve disease. Sci Rep 2023; 13:18823. [PMID: 37914797 PMCID: PMC10620231 DOI: 10.1038/s41598-023-46143-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023] Open
Abstract
Fibro-calcific aortic valve disease (FCAVD) is a pathological condition marked by overt fibrous and calcific extracellular matrix (ECM) accumulation that leads to valvular dysfunction and left ventricular outflow obstruction. Costly valve implantation is the only approved therapy. Multiple pharmacological interventions are under clinical investigation, however, none has proven clinically beneficial. This failure of translational approaches indicates incomplete understanding of the underlying pathomechanisms and may result from a limited toolbox of scientific methods to assess the cornerstones of FCAVD: lipid deposition, fibrous and calcific ECM accumulation. In this study, we evaluated magic-angle spinning (MAS) nuclear magnetic resonance (NMR) spectroscopy to both, qualitatively and quantitatively assess these key elements of FCAVD pathogenesis. NMR spectra showed collagen, elastin, triacylglycerols, and phospholipids in human control and FCAVD tissue samples (n = 5). Calcification, measured by the hydroxyapatite content, was detectable in FCAVD tissues and in valve interstitial cells under procalcifying media conditions. Hydroxyapatite was significantly higher in FCAVD tissues than in controls (p < 0.05) as measured by 31P MAS NMR. The relative collagen content was lower in FCAVD tissues vs. controls (p < 0.05). Overall, we demonstrate the versatility of NMR spectroscopy as a diagnostic tool in preclinical FCAVD assessment.
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Affiliation(s)
- Lukas Feistner
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Anja Penk
- Institute for Medical Physics and Biophysics, Leipzig University, Leipzig, Germany
| | - Julia Böttner
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Petra Büttner
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany
| | - Daniel Huster
- Institute for Medical Physics and Biophysics, Leipzig University, Leipzig, Germany
| | - Florian Schlotter
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Struempellstr. 39, 04289, Leipzig, Germany.
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