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Mester Z, Coqueugniot H, Tillier AM, Rosendahl W, Friedrich R, Zink A, Maixner F, Dutour O, Bereczki Z, Gasparik M, Pap I, Pálfi G. First direct dating of the Late Neanderthal remains from Subalyuk Cave in Northern Hungary. Anthropol Anz 2024; 81:169-181. [PMID: 37675658 DOI: 10.1127/anthranz/2023/1716] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/22/2023] [Accepted: 07/27/2023] [Indexed: 09/08/2023]
Abstract
The Subalyuk hominin remains were uncovered in 1932 in a cave of the same name in the Bükk Mountains, near the village of Cserépfalu in Borsod-Abaúj-Zemplén County, Northern Hungary. The remains represent two individuals, an adult and a young child who have been described in a few publications since their discovery, providing substantial anthropological data and general assessments of their Neanderthal affiliation. They were associated with Late Mousterian industry. Thus, the Bükk Mountains gain importance in the discussion concerning the contribution of East Central European sites to the debate on the peopling history of Europe during the Late Middle to Early Upper Palaeolithic transition. In this paper, we summarize the archaeological and chronological context of the two individuals, and publish the first direct dating results that place them among the Last Neanderthals of Central Europe.
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Affiliation(s)
- Zsolt Mester
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary
- UMR 7194 HNHP CNRS/MNHN/UPVD, Institut de Paléontologie humaine, Paris, France
| | - Hélène Coqueugniot
- UMR 5199 PACEA CNRS, Université de Bordeaux, Pessac, France
- Ecole Pratique des Hautes Etudes - PSL University, Paris, France
| | | | | | | | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Olivier Dutour
- UMR 5199 PACEA CNRS, Université de Bordeaux, Pessac, France
- Ecole Pratique des Hautes Etudes - PSL University, Paris, France
| | - Zsolt Bereczki
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
| | - Mihály Gasparik
- Department of Palaeontology and Geology, Hungarian Natural History Museum, Budapest, Hungary
| | - Ildikó Pap
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
- Department of Anthropology, Hungarian Natural History Museum, Budapest, Hungary
- Department of Biological Anthropology, Eötvös Loránd University, Budapest, Hungary
| | - György Pálfi
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary
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2
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Laffranchi Z, Zingale S, Tecchiati U, Amato A, Coia V, Paladin A, Salzani L, Thompson SR, Bersani M, Dori I, Szidat S, Lösch S, Ryan-Despraz J, Arenz G, Zink A, Milella M. "Until death do us part". A multidisciplinary study on human- Animal co- burials from the Late Iron Age necropolis of Seminario Vescovile in Verona (Northern Italy, 3rd-1st c. BCE). PLoS One 2024; 19:e0293434. [PMID: 38354185 PMCID: PMC10866530 DOI: 10.1371/journal.pone.0293434] [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: 07/07/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024] Open
Abstract
Animal remains are a common find in prehistoric and protohistoric funerary contexts. While taphonomic and osteological data provide insights about the proximate (depositional) factors responsible for these findings, the ultimate cultural causes leading to this observed mortuary behavior are obscured by the opacity of the archaeological record and the lack of written sources. Here, we apply an interdisciplinary suite of analytical approaches (zooarchaeological, anthropological, archaeological, paleogenetic, and isotopic) to explore the funerary deposition of animal remains and the nature of joint human-animal burials at Seminario Vescovile (Verona, Northern Italy 3rd-1st c. BCE). This context, culturally attributed to the Cenomane culture, features 161 inhumations, of which only 16 included animal remains in the form of full skeletons, isolated skeletal parts, or food offerings. Of these, four are of particular interest as they contain either horses (Equus caballus) or dogs (Canis lupus familiaris)-animals that did not play a dietary role. Analyses show no demographic, dietary, funerary similarities, or genetic relatedness between individuals buried with animals. Isotopic data from two analyzed dogs suggest differing management strategies for these animals, possibly linked to economic and/or ritual factors. Overall, our results point to the unsuitability of simple, straightforward explanations for the observed funerary variability. At the same time, they connect the evidence from Seminario Vescovile with documented Transalpine cultural traditions possibly influenced by local and Roman customs.
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Affiliation(s)
- Zita Laffranchi
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | | | - Umberto Tecchiati
- Dipartimento di Beni Culturali e Ambientali, PrEcLab—Laboratorio di Preistoria, Protostoria ed Ecologia Preistorica, Università degli Studi di Milano, Milano, Italy
| | - Alfonsina Amato
- Dipartimento di Beni Culturali e Ambientali, PrEcLab—Laboratorio di Preistoria, Protostoria ed Ecologia Preistorica, Università degli Studi di Milano, Milano, Italy
| | - Valentina Coia
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Luciano Salzani
- Ex-Soprintendenza per i Beni Archeologici del Veneto, Settore territorio, Sede di Padova-Nucleo di Verona, Padova, Italy
| | | | - Marzia Bersani
- Thompson Simon scavi e rilevamenti archeologici, Verona, Italy
| | - Irene Dori
- Soprintendenza Archeologia, Belle Arti e Paesaggio per le province di Verona Rovigo e Vicenza, Verona, Italy
- Dipartimento di Biologia, Università degli Studi di Firenze, Firenze, Italy
| | - Sönke Szidat
- Department of Chemistry, Biochemistry and Pharmaceutical Sciences and Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Sandra Lösch
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Jessica Ryan-Despraz
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Gabriele Arenz
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Marco Milella
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
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Rogner D, Heimerl L, Heyer S, Biedermann T, Sattler E, Zink A. Patients' perspective, quality of life and treatment goals in Hailey-Hailey disease: Lessons learned from the German National Registry. J Eur Acad Dermatol Venereol 2024; 38:419-429. [PMID: 37863661 DOI: 10.1111/jdv.19583] [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: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) remains a difficult-to-treat dermatosis and little is known about the patient's perception of the disease activity, the treatment success and its impact on quality-of-life (QoL). OBJECTIVE To obtain better understanding of HHD patients' needs regarding their medical condition, financial burden, QoL, subjective well-being and treatment thereof as well as satisfaction to evaluate common treatments' 'real-life' relevance. METHODS With initiation of the national registry for Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH) MDHHgermany, patients with HHD diagnosis were included starting June 2020. To assess subjective symptoms, patients filled out questionnaires such as the DLQI (dermatological life quality index), numeric rating scale (NRS) for itch, pain and burning sensation, as well as the SWLS (satisfaction with life scale) questionnaire to quantify overall satisfaction in life. Additionally, data on therapies were collected along with the patients' satisfaction of those and their medical care. Furthermore, patients assessed financial aspects and work ability. RESULTS One hundred and two patients were recruited from dermatology clinics, office-based dermatologists and self-help platforms across Germany between June 2020 and February 2023, 90 were eligible and analysed (mean: 49.91 years, 73.33% females, 26.67% males). 39.77% stated according to the DLQI their life is severely/very severely affected. Satisfaction with life was mediocre. Burning sensation was most pronounced among subjective symptoms (NRS 5.85 ± 2.80). Systemic treatments were rated as ineffective according to 56.92%, 25.56% had never received one. Most prescribed systemic treatments were corticosteroids (73.8%), followed by low-dose naltrexone (LDN) (26.2%), retinoids (15.4%) and antibiotics (13.8%). Satisfaction with medical care was generally low. CONCLUSION Our 'real-life' data state a major disease burden and impact on the QoL for affected individuals, as well as limited disease control due to inadequate therapies. MDHHgermany can provide insights into improvement of healthcare support with this debilitating disease and improve QoL. In the long term, it aims to provide basis for further clinical trials, epidemiological studies and immunological investigations.
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Affiliation(s)
- D Rogner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heimerl
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pharmacology and Toxicology, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - S Heyer
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Wurst C, Maixner F, Paladin A, Mussauer A, Valverde G, Narula J, Thompson R, Zink A. Genetic Predisposition of Atherosclerotic Cardiovascular Disease in Ancient Human Remains. Ann Glob Health 2024; 90:6. [PMID: 38273870 PMCID: PMC10809863 DOI: 10.5334/aogh.4366] [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: 11/17/2023] [Accepted: 12/30/2023] [Indexed: 01/27/2024] Open
Abstract
Background Several computed tomographic studies have shown the presence of atherosclerosis in ancient human remains. However, while it is important to understand the development of atherosclerotic cardiovascular disease (ASCVD), genetic data concerning the prevalence of the disease-associated single nucleotide polymorphisms (SNPs) in our ancestors are scarce. Objective For a better understanding of the role of genetics in the evolution of ASCVD, we applied an enrichment capture sequencing approach to mummified human remains from different geographic regions and time periods. Methods Twenty-two mummified individuals were analyzed for their genetic predisposition of ASCVD. Next-generation sequencing methods were applied to ancient DNA (aDNA) samples, including a novel enrichment approach specifically designed to capture SNPs associated with ASCVD in genome-wide association studies of modern humans. Findings Five out of 22 ancient individuals passed all filter steps for calculating a weighted polygenic risk score (PRS) based on 87 SNPs in 56 genes. PRSs were correlated to scores obtained from contemporary people from around the world and cover their complete range. The genetic results of the ancient individuals reflect their phenotypic results, given that the only two mummies showing calcified atherosclerotic arterial plaques on computed tomography scans are the ones exhibiting the highest calculated PRSs. Conclusions These data show that alleles associated with ASCVD have been widespread for at least 5,000 years. Despite some limitations due to the nature of aDNA, our approach has the potential to lead to a better understanding of the interaction between environmental and genetic influences on the development of ASCVD.
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Affiliation(s)
- Christina Wurst
- Eurac Research –Institute for Mummy Studies, Bozen/Bolzano, Italy
- Palaeogenetics Group, Institute of Organismic and Molecular Evolution (iomE), Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Frank Maixner
- Eurac Research –Institute for Mummy Studies, Bozen/Bolzano, Italy
| | - Alice Paladin
- Eurac Research –Institute for Mummy Studies, Bozen/Bolzano, Italy
| | | | - Guido Valverde
- Eurac Research –Institute for Mummy Studies, Bozen/Bolzano, Italy
| | - Jagat Narula
- Medicine & Cardiology, McGovern Medical School, Houston, Texas, USA
| | | | - Albert Zink
- Eurac Research –Institute for Mummy Studies, Bozen/Bolzano, Italy
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Lee OYC, Wu HHT, Besra GS, Minnikin DE, Jaeger HY, Maixner F, Zink A, Gasparik M, Pap I, Bereczki Z, Pálfi G. Sensitive lipid biomarker detection for tuberculosis in late Neanderthal skeletons from Subalyuk Cave, Hungary. Tuberculosis (Edinb) 2023; 143S:102420. [PMID: 38012927 DOI: 10.1016/j.tube.2023.102420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 11/29/2023]
Abstract
Skeletal remains of two Neanderthal individuals, a 25-35 year-old woman and a 3-4 year-old child, were discovered in a Subalyuk Cave in North-Eastern Hungary. Radiocarbon dating of the female and child remains revealed an age of 39,732-39,076 and 36,117-35,387 cal BP, respectively. Paleopathological studies of these Neanderthal remains revealed probable evidence of skeletal mycobacterial infection, including in the sacrum of the adult specimen and the endocranial surface of the child's skull. Application of PCR amplification to the juvenile cranium and a vertebra gave a positive result (IS6110) for tuberculosis, backed up by spoligotyping. Lipid biomarker analyses of the same two specimens revealed definitive signals for C32 mycoserosates, a very characteristic component of the Mycobacterium tuberculosis complex (MTBC). A vertebra from the adult provided weak evidence for mycocerosate biomarkers. The correlation of probable skeletal lesions with characteristic amplified DNA fragments and a proven lipid biomarker points to the presence of tuberculosis in these Neanderthals. In particular, the closely similar biomarker profiles, for two distinct juvenile cranial and vertebral bones, strengthen this diagnosis.
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Affiliation(s)
- Oona Y-C Lee
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Houdini H T Wu
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Gurdyal S Besra
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, B15 2TT, Birmingham, UK.
| | - David E Minnikin
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Heidi Y Jaeger
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | - Mihály Gasparik
- Department of Palaeontology and Geology, Hungarian Natural History Museum, Hungary
| | - Ildikó Pap
- Department of Anthropology, Hungarian Natural History Museum, Hungary; Department of Anthropology, Eötvös Loránd University, Budapest, Hungary; Department of Biological Anthropology, University of Szeged, Hungary
| | - Zsolt Bereczki
- Department of Biological Anthropology, University of Szeged, Hungary
| | - György Pálfi
- Department of Biological Anthropology, University of Szeged, Hungary
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Pálfi G, Dutour O, Hajdu T, Sola C, Zink A. Paleopathology and evolution of tuberculosis editorial. Tuberculosis (Edinb) 2023; 143S:102428. [PMID: 38012928 DOI: 10.1016/j.tube.2023.102428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Affiliation(s)
- György Pálfi
- Department of Biological Anthropology, University of Szeged, Szeged, Hungary.
| | - Olivier Dutour
- Ecole Pratique des Hautes Etudes - PSL University Paris, UMR 6034 Archéosciences Bordeaux, CNRS, Université Bordeaux Montaigne - 33607 Pessac Cedex, France
| | - Tamás Hajdu
- Department of Anthropology, Eötvös Loránd University, Budapest, Hungary
| | - Christophe Sola
- Université Paris-Saclay, Université Paris-Cité, IAME, UMR 1137, INSERM, 91190, Gif-sur-Yvette, Paris, France
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Italy
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7
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Pálfi G, Molnár E, Bereczki Z, Coqueugniot H, Dutour O, Tillier AM, Rosendahl W, Sklánitz A, Mester Z, Gasparik M, Maixner F, Zink A, Minnikin DE, Pap I. Re-examination of the Subalyuk Neanderthal remains uncovers signs of probable TB infection (Subalyuk Cave, Hungary). Tuberculosis (Edinb) 2023; 143S:102419. [PMID: 38012926 DOI: 10.1016/j.tube.2023.102419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/29/2023]
Abstract
In 1932, skeletal remains of two Neanderthal individuals, a young adult female and a 3-4-year-old child, were discovered in Subalyuk Cave in Northern Hungary [1,2]. Results of the anthropological examination were published some years after this important discovery. Methodological progress encouraged re-examination of the material during the last few years. Radiocarbon dating revealed a chronological age of 39,732-39,076 cal. BP for the adult female and 36,117-35,387 cal. BP for the child [3]. Morphological paleopathological studies of these Neanderthal remains uncovered distinct evidence of skeletal infections. Alterations of the adult individual's sacrum suggest probable early-stage sacroiliitis, while several vertebral bodies indicate superficial osseous remodelling of infectious origin. Traces of pathological lesions were observed on the endocranial surface of the child's skull, reflecting a reaction of meningeal tissues, a consequence of a probable TB-related meningeal infectious process. Results of recent paleomicrobiological examinations - lipid biomarker and aDNA studies - support the morphological diagnosis of probable TB infections [4].
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Affiliation(s)
- György Pálfi
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Erika Molnár
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Zsolt Bereczki
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Hélène Coqueugniot
- UMR 6034 Archéosciences Bordeaux, CNRS, Université Bordeaux Montaigne, 33607, Pessac Cedex, France; Ecole Pratique des Hautes Etudes - PSL University Paris, France.
| | - Olivier Dutour
- UMR 6034 Archéosciences Bordeaux, CNRS, Université Bordeaux Montaigne, 33607, Pessac Cedex, France; Ecole Pratique des Hautes Etudes - PSL University Paris, France.
| | | | | | - Antal Sklánitz
- Central Quality Laboratory, Continental Automotive Hungary Ltd, Budapest, Napmátka u. 6, 1106, Budapest, Hungary.
| | - Zsolt Mester
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary; UMR 7194 HNHP CNRS/MNHN/UPVD, Institut de Paléontologie Humaine, Paris, France.
| | - Mihály Gasparik
- Department of Palaeontology and Geology, Hungarian Natural History Museum, Hungary.
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy.
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy.
| | - David E Minnikin
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, UK.
| | - Ildikó Pap
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary; Department of Anthropology, Hungarian Natural History Museum, Budapest, Hungary; Department of Biological Anthropology, Eötvös Loránd University, Budapest, Hungary.
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Zink A, Maixner F, Jäger HY, Szikossy I, Pálfi G, Pap I. Tuberculosis in mummies - New findings, perspectives and limitations. Tuberculosis (Edinb) 2023; 143S:102371. [PMID: 38012931 DOI: 10.1016/j.tube.2023.102371] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 11/29/2023]
Abstract
The molecular analysis of ancient pathogen DNA represents a unique opportunity for the study of infectious diseases in ancient human remains. Among other diseases, paleogenetic studies have been successful in detecting tuberculous DNA in ancient human remains. In the beginning of ancient DNA (aDNA) studies, the presence of tuberculosis (TB) DNA was assessed using a PCR-based assay targeting specific regions of the Mycobacterium tuberculosis (MTB) complex, such as the repetitive element IS6110. The advent of high-throughput sequencing has enabled the reconstruction of full ancient TB genomes in the field of paleomicrobiology. However, despite the numerous paleopathological and PCR-based studies on the presence of tuberculosis in historic human remains, full genome wide reconstructions are still limited to well-preserved specimens with low environmental contamination and connected with extensive screening efforts. This has led to some controversies regarding the evolutionary history of its causative agent Mycobacterium tuberculosis. In this context, mummies have been shown to be a good source for the detection of MTB complex DNA due to a low exposure to environmental influences and the overall good state of preservation of hard and soft tissues in the human remains. Here, we present the major findings on the presence of TB infections in the 18th century naturally mummified human remains from Vác, Hungary and the current status of the detection of MTB complex DNA in mummified human remains. The future perspectives of detecting tuberculosis in mummies will be discussed in the light of methodological aspects, as well as ethical and curational challenges.
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Affiliation(s)
- Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy.
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | | | - Ildikó Szikossy
- Department of Anthropology, Hungarian Natural History Museum, Budapest, Hungary
| | - György Pálfi
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Ildikó Pap
- Department of Anthropology, Hungarian Natural History Museum, Budapest, Hungary; Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary; Department of Biological Anthropology, Institute of Biology, Eötvös Loránd University, Budapest, Hungary
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9
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Coia V, Paladin A, Zingale S, Wurst C, Croze M, Maixner F, Zink A. Ancestry and kinship in a Late Antiquity-Early Middle Ages cemetery in the Eastern Italian Alps. iScience 2023; 26:108215. [PMID: 37953960 PMCID: PMC10637928 DOI: 10.1016/j.isci.2023.108215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/31/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
In South Tyrol (Eastern Italian Alps), during Late Antiquity-Early Middle Ages, archeological records indicate cultural hybridization among alpine groups and peoples of various origin. Using paleogenomics, we reconstructed the ancestry of 20 individuals (4th-7th cent. AD) from a cemetery to analyze whether they had heterogeneous or homogeneous ancestry and to study their social organization. The results revealed a primary genetic ancestry from southern Europe and additional ancestries from south-western, western, and northern Europe, suggesting that cultural hybridization was accompanied by complex genetic admixture. Kinship analyses found no genetic relatedness between the only two individuals buried with grave goods. Instead, a father-son pair was discovered in one multiple grave, together with unrelated individuals and one possible non-local female. These genetic findings indicate the presence of a high social status familia, which is supported by the cultural materials and the proximity of the grave to the most sacred area of the church.
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Affiliation(s)
- Valentina Coia
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Stefania Zingale
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Christina Wurst
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Myriam Croze
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, 39100 Bolzano, Italy
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10
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du Crest D, Garibyan L, Hædersdal M, Zink A, Madhumita M, Harth Y, Bechstein S, Friis J, Riemer C, Kumar N, Parkkinen S, Shpudeiko V. Skin & Digital-the 2022 startups. Dermatologie (Heidelb) 2023; 74:899-903. [PMID: 37550513 DOI: 10.1007/s00105-023-05204-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Affiliation(s)
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, USA
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | - Sarah Bechstein
- Evident Medizin Gmbh, Carl-Benz-Str. 3, 68723, Schwetzingen, Germany
| | | | | | - Neal Kumar
- Piction Health and Andover Dermatology, Boston, USA
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11
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Wang K, Prüfer K, Krause-Kyora B, Childebayeva A, Schuenemann VJ, Coia V, Maixner F, Zink A, Schiffels S, Krause J. High-coverage genome of the Tyrolean Iceman reveals unusually high Anatolian farmer ancestry. Cell Genom 2023; 3:100377. [PMID: 37719142 PMCID: PMC10504632 DOI: 10.1016/j.xgen.2023.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/10/2023] [Accepted: 07/13/2023] [Indexed: 09/19/2023]
Abstract
The Tyrolean Iceman is known as one of the oldest human glacier mummies, directly dated to 3350-3120 calibrated BCE. A previously published low-coverage genome provided novel insights into European prehistory, despite high present-day DNA contamination. Here, we generate a high-coverage genome with low contamination (15.3×) to gain further insights into the genetic history and phenotype of this individual. Contrary to previous studies, we found no detectable Steppe-related ancestry in the Iceman. Instead, he retained the highest Anatolian-farmer-related ancestry among contemporaneous European populations, indicating a rather isolated Alpine population with limited gene flow from hunter-gatherer-ancestry-related populations. Phenotypic analysis revealed that the Iceman likely had darker skin than present-day Europeans and carried risk alleles associated with male-pattern baldness, type 2 diabetes, and obesity-related metabolic syndrome. These results corroborate phenotypic observations of the preserved mummified body, such as high pigmentation of his skin and the absence of hair on his head.
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Affiliation(s)
- Ke Wang
- MOE Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Science, Fudan University, Shanghai 200438, China
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Center of Evolutionary Biology, School of Life Sciences, Fudan University, Shanghai 200438, China
| | - Kay Prüfer
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Ben Krause-Kyora
- Institute of Clinical Molecular Biology, Kiel University, 24118 Kiel, Germany
| | | | - Verena J. Schuenemann
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria
- Institute of Evolutionary Medicine, University of Zurich, 8057 Zurich, Switzerland
- Human Evolution and Archaeological Sciences, University of Vienna, 1030 Vienna, Austria
| | - Valentina Coia
- Eurac Research - Institute for Mummy Studies, Viale Druso 1, 39100 Bolzano, Italy
| | - Frank Maixner
- Eurac Research - Institute for Mummy Studies, Viale Druso 1, 39100 Bolzano, Italy
| | - Albert Zink
- Eurac Research - Institute for Mummy Studies, Viale Druso 1, 39100 Bolzano, Italy
| | - Stephan Schiffels
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Johannes Krause
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
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12
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Schneider S, Wu J, Tizek L, Ziehfreund S, Zink A. Prevalence of scabies worldwide-An updated systematic literature review in 2022. J Eur Acad Dermatol Venereol 2023; 37:1749-1757. [PMID: 37147907 DOI: 10.1111/jdv.19167] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
Scabies is a World Health Organization-defined neglected tropical disease, with continuously rising incidence worldwide in recent years. The aim of this study was to provide an update of the worldwide prevalence and new treatment approaches of scabies in population-based settings. MEDLINE (PubMed), Embase and LILACS databases were reviewed for English and German language population-based studies from October 2014 to March 2022. Two authors independently screened the records for eligibility, extracted all data and one critically appraised the quality of the studies and risk of bias. Systematic review registration: PROSPERO CRD42021247140. Overall, 1273 records were identified through database searching, of which 43 studies were included for the systematic review. Most of the studies (n = 31) examined the scabies prevalence in medium or low human development index countries. The highest prevalence of scabies reported in the general population (children and adults) was recorded in five randomly selected communities in Ghana (71.0%), whereas the highest scabies prevalence in studies, which only examined children (76.9%), was recorded in an Indonesian boarding school. The lowest prevalence was recorded in Uganda (0.18%). The systematic review highlights the prevalence of scabies worldwide, showing that scabies is still a serious, increasing disease that occurs globally and is clustered in developing countries. More transparent data on scabies prevalence are needed to identify risk factors to find new prevention measures.
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Affiliation(s)
- S Schneider
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - J Wu
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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13
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Maixner F, Drescher D, Boccalini G, Piombino-Mascali D, Janko M, Berens-Riha N, Kim BJ, Gamble M, Schatterny J, Morty RE, Ludwig M, Krause-Kyora B, Stark R, An HJ, Neumann J, Cipollini G, Grimm R, Kilian N, Zink A. Microscopic Evidence of Malaria Infection in Visceral Tissue from Medici Family, Italy. Emerg Infect Dis 2023; 29:1280-1283. [PMID: 37209696 DOI: 10.3201/eid2906.230134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Microscopy of mummified visceral tissue from a Medici family member in Italy identified a potential blood vessel containing erythrocytes. Giemsa staining, atomic force microscopy, and immunohistochemistry confirmed Plasmodium falciparum inside those erythrocytes. Our results indicate an ancient Mediterranean presence of P. falciparum, which remains responsible for most malaria deaths in Africa.
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14
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Sarhan MS, Wurst C, Tzankov A, Bircher AJ, Wittig H, Briellmann T, Augsburger M, Hotz G, Zink A, Maixner F. A nontuberculous mycobacterium could solve the mystery of the lady from the Franciscan church in Basel, Switzerland. BMC Biol 2023; 21:9. [PMID: 36747166 PMCID: PMC9903526 DOI: 10.1186/s12915-022-01509-7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 12/15/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In 1975, the mummified body of a female has been found in the Franciscan church in Basel, Switzerland. Molecular and genealogic analyses unveiled her identity as Anna Catharina Bischoff (ACB), a member of the upper class of post-reformed Basel, who died at the age of 68 years, in 1787. The reason behind her death is still a mystery, especially that toxicological analyses revealed high levels of mercury, a common treatment against infections at that time, in different body organs. The computed tomography (CT) and histological analysis showed bone lesions in the femurs, the rib cage, and the skull, which refers to a potential syphilis case. RESULTS Although we could not detect any molecular signs of the syphilis-causing pathogen Treponema pallidum subsp. pallidum, we realized high prevalence of a nontuberculous mycobacterium (NTM) species in brain tissue sample. The genome analysis of this NTM displayed richness of virulence genes and toxins, and similarity to other infectious NTM, known to infect immunocompromised patients. In addition, it displayed potential resistance to mercury compounds, which might indicate a selective advantage against the applied treatment. This suggests that ACB might have suffered from an atypical mycobacteriosis during her life, which could explain the mummy's bone lesion and high mercury concentrations. CONCLUSIONS The study of this mummy exemplifies the importance of employing differential diagnostic approaches in paleopathological analysis, by combining classical anthropological, radiological, histological, and toxicological observations with molecular analysis. It represents a proof-of-concept for the discovery of not-yet-described ancient pathogens in well-preserved specimens, using de novo metagenomic assembly.
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Affiliation(s)
- Mohamed S Sarhan
- Eurac Research - Institute for Mummy Studies, 39100, Bolzano, Italy.
| | - Christina Wurst
- Eurac Research - Institute for Mummy Studies, 39100, Bolzano, Italy
| | - Alexandar Tzankov
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, 4031, Basel, Switzerland
| | - Andreas J Bircher
- Department of Allergology, University Hospital Basel, 4031, Basel, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Holger Wittig
- Department of Biomedical Engineering, Institute of Forensic Medicine, University of Basel, 4056, Basel, Switzerland
| | - Thomas Briellmann
- Citizen Science Basel; formerly Institute of Forensic Medicine, Forensic Chemistry and Toxicology, University of Basel, 4056, Basel, Switzerland
| | - Marc Augsburger
- University Center of Legal Medicine, Lausanne, Geneva, Switzerland
| | - Gerhard Hotz
- Natural History Museum Basel, 4051, Basel, Switzerland
- Integrative Prehistory and Archaeological Science, University of Basel, 4056, Basel, Switzerland
| | - Albert Zink
- Eurac Research - Institute for Mummy Studies, 39100, Bolzano, Italy
| | - Frank Maixner
- Eurac Research - Institute for Mummy Studies, 39100, Bolzano, Italy.
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15
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Heim‐Ohmayer P, Freiberger A, Gedik M, Beckmann J, Ziehfreund S, Zink A, Hähl W, Schielein MC. The impact of stigmatization of psoriasis, atopic dermatitis and mastocytosis in different areas of life-A qualitative interview study. Skin Health Dis 2022; 2:e62. [PMID: 36479263 PMCID: PMC9720196 DOI: 10.1002/ski2.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 06/07/2023]
Abstract
BACKGROUND Stereotypes and false assumptions about chronic and visible skin diseases can determine the behaviour towards affected individuals and result in stigmatization or discrimination. OBJECTIVE The aim of this study was to analyze the perceived disease-related stigmatization of individuals with psoriasis, atopic dermatitis (AD) or mastocytosis. The study also aims to broaden people-centred knowledge of the effects of stigmatization in different areas of life, namely in everyday life, at work, in sports and in relationships. METHODS Qualitative in-depth semi-structured interviews were conducted among individuals with either psoriasis, AD or mastocytosis. Participants were recruited via self-help networks and were asked to express their experience of stigmatization in different areas of life. All interviews were audio recorded, transcribed verbatim and evaluated based on Mayring's content analysis. RESULTS In total, 24 individuals aged 19-79 years and living in Germany were included in the study-eight for each disease. Stigmatization was experienced in all three diseases in all mentioned areas of life as well as in interaction with medical professionals. Self-exclusion, negative self-perception and negative behaviour of others were the most frequent experiences with stigmatization. CONCLUSION Stigmatization, both internal and external, is an important factor contributing to the mental burden of people with chronic skin diseases. More research is needed to gain deeper insight into stigmatization and its psychological burden in various contexts to enhance people-centred care in chronic skin diseases.
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Affiliation(s)
- P. Heim‐Ohmayer
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - A. Freiberger
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - M. Gedik
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - J. Beckmann
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - S. Ziehfreund
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
| | - A. Zink
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
- Unit of Dermatology and VenereologyDepartment of MedicineKarolinska University HospitalKarolinska InstitutetSolnaSweden
| | - W. Hähl
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - M. C. Schielein
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
- Unit of Dermatology and VenereologyDepartment of MedicineKarolinska University HospitalKarolinska InstitutetSolnaSweden
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16
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Ziehfreund S, Tizek L, Zink A. [Erratum to: Web search data as health data?]. Dermatologie (Heidelb) 2022; 73:756. [PMID: 35922674 PMCID: PMC9629308 DOI: 10.1007/s00105-022-05025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- S Ziehfreund
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland
- Technische Universität München, Fakultät für Medizin, Institut für Allgemeinmedizin und Versorgungsfoschung, München, Deutschland
| | - L Tizek
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland
| | - A Zink
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland.
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institute, Stockholm, Schweden.
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17
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Laffranchi Z, Granados‐Torres A, Lösch S, Zink A, Dori I, Delgado‐Huertas A, Milella M. “Celts” up and down the Alps. Insights on mobility patterns in the
pre‐Roman
/Celtic population from Verona (
NE
Italy, 3rd–1st c.
BCE
): A multi‐isotopic approach. American Journal of Biological Anthropology 2022. [PMCID: PMC9544713 DOI: 10.1002/ajpa.24523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives The Late Iron Age in continental Europe featured complex demographic processes including, among others, the establishment of transalpine “Celtic” communities on the Italian peninsula between the 4th and 1st centuries BCE. To date, only few data are available about mobility and migration in these populations. Here we explore these topics among the Cenomani of Seminario Vescovile (SV‐Verona, Italy, 3rd–1st c. BCE) through a multi‐isotopic approach and test the possible associations with sex, age and funerary treatment. Materials and methods We analyzed isotopic ratios of oxygen (δ18O) and carbon (δ13C) from bone phosphate and collagen, respectively, of 49 individuals (23 males, 17 females, and 9 nonadults). In addition, we explored possible intraindividual lifetime changes by comparing collagen δ13C from bone and dentine of 26 individuals. We assessed nonlocality based on individual deviation of isotopic values from the population mean plus three times the median absolute deviation from the median (±3MAD). We then checked for isotopic differences between sexes and type of funerary treatment using Mann–Whitney tests. Results One individual shows isotopic values consistent with a nonlocal origin. Five more individuals may have originated from a different locality. No statistical differences separate sexes and types of funerary treatment. Discussion Results suggest a local origin of most of the individuals of SV with the few exceptions pointing especially to an Alpine origin. The low frequency of nonlocals at SV suggest a reduced mobility in this population, or the preeminence of short distance movements undetected by our analyses.
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Affiliation(s)
- Zita Laffranchi
- Department of Physical Anthropology, Institute of Forensic Medicine University of Bern Bern Switzerland
| | - Arsenio Granados‐Torres
- Stable Isotopes Biogeochemistry Laboratory Andalusian Institute of Earth Sciences, (IACT‐CSIC‐UGR) Granada Spain
| | - Sandra Lösch
- Department of Physical Anthropology, Institute of Forensic Medicine University of Bern Bern Switzerland
| | - Albert Zink
- Institute for Mummy Studies Eurac Research Bolzano Italy
| | - Irene Dori
- Soprintendenza Archeologia Belle Arti e Paesaggio per le province di Verona Verona Italy
| | - Antonio Delgado‐Huertas
- Stable Isotopes Biogeochemistry Laboratory Andalusian Institute of Earth Sciences, (IACT‐CSIC‐UGR) Granada Spain
| | - Marco Milella
- Department of Physical Anthropology, Institute of Forensic Medicine University of Bern Bern Switzerland
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18
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Piombino-Mascali D, Zink A, Maixner F. The Blessed Antonio (Patrizi) from Monticiano, Sienna (Italy): Bioanthropological and Palaeohistological Considerations. Acta Med Litu 2022; 29:159-166. [PMID: 37733438 PMCID: PMC9799007 DOI: 10.15388/amed.2022.29.1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/16/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022] Open
Abstract
Background A medieval mummy known as the Blessed Antonio (Patrizi) is held in the church of Saints Peter and Paul at Monticiano, Sienna, central Italy. Objectives The aim of our investigation was to complete a biological profile of the subject, as well as to assess the impact of deterioration to the concerned remains. Methods As a follow-up of our bioanthropological, macroscopic approach, two of the samples taken underwent rehydration, fixation, desiccation, paraffin-embedding, and staining according to standard histological techniques applied to mummified remains. Results The body was determined to be that of an adult male, who showed some pathological changes such as dental calculus and what is suspected to be hallux valgus. The overall preservation of a skin sample revealed damage caused by a post-mortem infestation of insects, while a second, inner sample was identified as lung tissue, and revealed a case of anthracosis. Conclusions The Blessed Antonio was an adult male, who had poor dental hygiene and was likely exposed to smoke during his lifetime. Damage observed on the remains indicated that a conservation treatment was desirable for the future preservation of the body.
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Affiliation(s)
| | - Albert Zink
- Institute for Mummy Studies, EURAC, Bolzano, Italy
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19
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Spekker O, Váradi OA, Szekeres A, Jäger HY, Zink A, Berner M, Pany-Kucera D, Strondl L, Klostermann P, Samu L, Király K, Bereczki Z, Molnár E, Pálfi G, Tihanyi B. A rare case of calvarial tuberculosis from the Avar Age (8th century CE) cemetery of Kaba-Bitózug (Hajdú-Bihar county, Hungary) - Pathogenesis and differential diagnostic aspects. Tuberculosis (Edinb) 2022; 135:102226. [PMID: 35759869 DOI: 10.1016/j.tube.2022.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/27/2022] [Accepted: 06/19/2022] [Indexed: 11/26/2022]
Abstract
The aim of our paper is to present and discuss in detail the bony changes indicative of tuberculosis (TB) that were identified in a skeleton (KB67), unearthed from grave 67 of the 8th-century-CE cemetery of Kaba-Bitózug (Hungary). Furthermore, to provide the differential diagnoses of the observed alterations, with special attention to the cranial osteolytic lesions. During the macro- and micromorphological examinations of KB67, the skull revealed three small, well-circumscribed, punched-out osteolytic lesions accompanied by endocranial granular impressions, abnormal blood vessel impressions, periosteal appositions, and cortical erosion. The postcranial skeleton exhibited osteolytic lesions, cortical remodelling and erosion, and signs of hypervascularisation in the spine. Based on the differential diagnosis of the cranial osteolytic lesions and their co-occurrence with endocranial and vertebral bony changes indicative of TB, they most likely resulted from tuberculous involvement of the frontal and left parietal bones. The morphologically established diagnosis was confirmed by a PCR analysis that provided evidence for the presence of Mycobacterium tuberculosis DNA in KB67. KB67, the first reported archaeological case with calvarial TB from the present-day territory of Hungary, gives us a unique insight into the occurrence of a rare manifestation of TB in the Avar Age of the Great Plain.
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Affiliation(s)
- Olga Spekker
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary; Institute of Archaeological Sciences, Eötvös Loránd University, Múzeum körút 4/B, H-1088, Budapest, Hungary.
| | - Orsolya Anna Váradi
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary; Department of Archaeogenetics, Institute of Hungarian Research, Úri utca 54-56, H-1014, Budapest, Hungary; Department of Microbiology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - András Szekeres
- Department of Microbiology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Heidi Yoko Jäger
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100, Bolzano, Italy.
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100, Bolzano, Italy.
| | - Margit Berner
- Department of Anthropology, Natural History Museum Vienna, Burgring 7, A-1010, Vienna, Austria.
| | - Doris Pany-Kucera
- Department of Anthropology, Natural History Museum Vienna, Burgring 7, A-1010, Vienna, Austria.
| | - Liesa Strondl
- Department of Anthropology, Natural History Museum Vienna, Burgring 7, A-1010, Vienna, Austria.
| | - Paul Klostermann
- Department of Anthropology, Natural History Museum Vienna, Burgring 7, A-1010, Vienna, Austria.
| | - Levente Samu
- Institute of Archaeological Sciences, Eötvös Loránd University, Múzeum körút 4/B, H-1088, Budapest, Hungary.
| | - Kitty Király
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Zsolt Bereczki
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Erika Molnár
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - György Pálfi
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary.
| | - Balázs Tihanyi
- Department of Biological Anthropology, Institute of Biology, University of Szeged, Közép fasor 52, H-6726, Szeged, Hungary; Department of Archaeogenetics, Institute of Hungarian Research, Úri utca 54-56, H-1014, Budapest, Hungary.
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20
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Meissner Y, Huschek D, Zink A, Kaufmann J, Bohl-Buehler M, Strangfeld A. POS0234 HOW CLOSELY DO GERMAN RHEUMATOLOGISTS FOLLOW THE EULAR RECOMMENDATIONS FOR THE MANAGEMENT OF RHEUMATOID ARTHRITIS WHEN MAKING THERAPEUTIC DECISIONS? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundEULAR developed recommendations for the management of rheumatoid arthritis (RA) suggesting treatment escalation and changes at different stages of the disease to reach at least low disease activity with latest updates in 2013(1), 2016(2), and 2019(3). The recommendation to consider adding a biologic disease-modifying anti-rheumatic drug (bDMARD) – or, since 2016, a Januskinase inhibitor (JAKi) – after the first conventional synthetic (cs) DMARD had failed and if poor prognostic factors (PPF) are present, was strengthened 2019. Since then, it is recommended that a bDMARD or a tsDMARD should be added.ObjectivesHow closely are EULAR recommendations followed in daily rheumatologic practice in Germany?MethodsData were used from the long-term observational cohort RABBIT, which enrols patients with RA starting a bDMARD or JAKi, or a csDMARD after at least one previous csDMARD failure. According to the publication of the recommendations, periods from [I] 01/2014 – 12/2016, [II] 01/2017 – 06/2020 and [III] 07/2020 – 04/2021 were investigated. Patients who were in at least moderate disease activity (DAS28≥3.2) were selected and analysed, if they started a csDMARD, a bDMARD or a JAKi. Patients were further stratified by prior treatments and by the presence of PPF (≥4 swollen joints, positive rheumatoid factor or ACPA, erosions).ResultsOf the 15,150 patients with RA enrolled since 2007, 2,922 treatments were initiated in period [I], 4,580 in [II] and 415 in [III] (see Table 1). The proportion of patients with 1 previous csDMARD and ≥1 PPF who – in agreement with the recommendations – switched to bDMARD or JAKi, increased from 30% (only bDMARDs) in period [I] to 68% (bDMARDs + JAKi) in [III]. The proportions were even higher in patients with 2 previous csDMARDs (86% in [I], 93% in [III]). As recommended, JAKi were used more often as first line therapy (after csDMARD) in period [III].Table 1.Number and percentages of treatment changes at different stages of the disease.Patients with1 previous csDMARD & no PPF1 previous csDMARD & ≥1 PPF2 previous csDMARDs1 previous bDMARD/ JAKi≥2 previous bDMARDs/ JAKiEULAR Recommendationchange/add csDMARDadd bDMARD/ JAKi**add bDMARD/ JAKichange to another bDMARD/JAKiTotal numbers of treatment changes612073222017001863Period [I]n=25n=848n=986n=543n=52001/2014 – 12/2016*N=2,922csDMARD21 (84.0%)594 (70.0%)134 (13.6%)199 (36.6%)275 (52.9%)bDMARD4 (16.0%)254 (30.0%)852 (86.4%)344 (63.4%)245 (47.1%)Period [II]n=32n=1,090n=1,136n=1,054n=1,26801/2017 – 06/2020N=4,580csDMARD16 (50.0%)469 (43.0%)96 (8.5%)261 (24.8%)274 (21.6%)bDMARD13 (40.6%)509 (46.7%)822 (72.4%)403 (38.2%)288 (22.7%)JAKi3 (9.4%)112 (10.3%)218 (19.2%)390 (37.0%)706 (55.7%)Period [III]n=4n=135n=98n=103n=7507/2020 – 04/2021N=415csDMARD043 (31.9%)7 (7.1%)15 (14.6%)9 (12.0%)bDMARD1 (25.0%)64 (47.4%)60 (61.2%)36 (35.0%)23 (30.7%)JAKi3 (75.0%)28 (20.7%)31 (31.6%)52 (50.5%)43 (57.3%)EULAR treatment recommendations are indicated in green. *JAKi were not available. **Recommendation in period [I]: Addition of a bDMARD should be considered; in [II]: Addition of a bDMARD or a tsDMARD should be considered, current practice would be to start a bDMARD; in [III]: a bDMARD or a tsDMARD should be added. PPF, poor prognostic factor.ConclusionJAKi have become more established, especially in bionaive patients, but have not reached the significance of biologics in certain patient groups. The early decision for a bDMARD or JAKi has been made more frequently in recent years, yet one third of patients did not receive the recommended treatment escalation. We cannot conclude from the data, which considerations led to the decision not to escalate. Of note, German rheumatologists should rather follow the German treatment guidelines(4), which are, however, very similar to the EULAR recommendations.References[1]PMID: 24161836;[2]PMID: 28264816;[3]PMID: 31969328;[4]PMID: 29968101AcknowledgementsRABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Fresenius-Kabi, Galapagos, Hexal, Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, VIATRIS and UCB.Disclosure of InterestsYvette Meissner Speakers bureau: Pfizer, Doreen Huschek: None declared, Angela Zink Speakers bureau: AbbVie, Pfizer, Roche, Sanofi, Jörg Kaufmann: None declared, Martin Bohl-Buehler Speakers bureau: Speaker for several companies in unrestricted educational programs, each of them unrestricted state-of-the-art-talks., Consultant of: PreviPharma, basic research in osteology, no overlap with rheumatological diseases, Anja Strangfeld Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Janssen, Lilly, Pfizer, Roche, Sanofi, UCB.
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Thiele K, Albrecht K, Zink A, Aringer M, Karberg K, Spaethling-Mestekemper S, Von Hinueber U, Callhoff J. POS0002 IS THE RHEUMATOID ARTHRITIS IMPACT OF DISEASE SCORE (RAID) AN INFORMATIVE INSTRUMENT FOR OTHER INFLAMMATORY RHEUMATIC DISEASES? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe rheumatoid arthritis impact of disease score (RAID) is a patient-reported outcome measure to evaluate the impact of rheumatoid arthritis (RA) on patients’ quality of life (1). While an adapted instrument has been developed for psoriatic arthritis (2), there are no comparable instruments for other inflammatory rheumatic diseases. Since the RAID includes generic questions on pain, functional capacity, fatigue, physical and emotional well-being, sleep disturbances and coping, it could be an informative instrument beyond RA.ObjectivesTo analyse the performance of the RAID in ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), polymyalgia rheumatica (PMR), primary Sjögren’s syndrome (pSS), idiopathic inflammatory myositis (IIM), and systemic sclerosis (SSc) compared to RA.MethodsFrom 2015 to 2019, a total of 12,398 patients reported the RAID in the National Database of the German Collaborative Arthritis Centres. We calculated the age- and sex-adjusted partial correlation (0.3-0.5 weak, 0.5-0.7 moderate, > 0.7 strong correlation) between the RAID score and five other patient- or physician-reported outcomes, namely patient global (PtGl) health status, PtGl disease activity, physician global (PhGl) disease activity, the World Health Organisation Well-Being Index (WHO-5) and the EuroQoL-5 Dimensions (EQ-5D). Furthermore, for each of the diagnoses the mean difference between the RAID and the other outcomes was compared with the respective differences for RA. The EQ-5D and WHO-5 were rescaled to match the scale of the RAID (range 0-10). General linear regression was used to assess the age- and sex-adjusted effect of each diagnosis on the difference between the RAID and the five other scores with RA as the referent diagnosis. We defined the effect of a diagnosis as clinically relevant if the mean change of difference was at least one unit.ResultsThe mean RAID score in RA (3.6) was lower than in AS (4.0) and SSc (3.8) and higher than in SLE, PMR, pSS or IIM (Table 1). Across all diagnoses, the RAID correlated strongly with PtGl health status (0.72 to 0.83), moderately to strongly with PtGl disease activity (0.55 to 0.78) and WHO-5 (0.67 to 0.83), moderately with the EQ-5D (0.61 to 0.68), and weakly with PhGl disease activity (0.25 to 0.41). Small mean differences were found between the RAID and either PtGl disease activity (0 to -0.6), PtGl health status (-0.4 to -0.9) or WHO-5 (-0.7 to -1.3). A higher deviation was observed for EQ-5D (1.1 to 1.7) and PhGl disease activity (1.4 to 2.2). However, the discrepancies between the five outcomes and the RAID turned out to be similar across all diagnoses and, more importantly, comparable to RA. Linear regression revealed no clinically relevant effect of any of the diagnoses on the difference between RAID and the other outcomes (Figure 1).Table 1.Characteristics and patient- and physician-reported outcomes in patients with inflammatory rheumatic diseases.RAASSLEPMRpSSIIMSScNumber of cases7826153211421105301106386Female (%)74428964895876Age, in years (mean±SD)63±1451±1447±1573±853±1658±1458±14Disease duration, in years (mean±SD)13±1118±1315±105±612±911±812±10RAID (mean±SD)3.6±2.34.0±2.33.0±2.43.2±2.33.4±2.43.5±2.53.8±2.3PtGl health status (mean±SD)4.2±2.34.4±2.23.6±2.44.1±2.34.1±2.34.2±2.54.6±2.1PtGl disease activity (mean±SD)3.7±2.44.0±2.42.7±2.53.8±2.73.5±2.63.7±2.54.1±2.3PhGl disease activity (mean±SD)1.8±1.92.2±1.91.6±1.31.0±1.41.8±1.31.8±1.62.2±1.6EQ-5D (mean±SD)0.8±0.20.8±0.20.8±0.20.8±0.20.8±0.20.8±0.20.8±0.2WHO-5 (mean±SD)57±2553±2358±2556±2657±2560±2653±24SD, Standard Deviation; PtGl, Patient Global; PhGl, Physician Global; EuroQoL-5 Dimensions (EQ-5D); World Health Organisation Well-Being Index (WHO-5)Figure 1.ConclusionThe RAID score performed comparably well across all diagnoses investigated. These findings support the use of the RAID for measuring the impact of disease not only in RA, but also in AS, SLE, PMR, pSS, IIM and SSc.References[1]PMID: 21540201[2]PMID: 24790067AcknowledgementsWe thank all participating rheumatologists and patients for their valuable contributions.The National Database of the German Collaborative Arthritis centers is supported by the Association of Regional Cooperative Rheumatology Centres, the German Society for Rheumatology and joint contributions to the Rheumatological Training Academy and the German Rheumatism Research Centre by the following members of the Working Group of Corporate Members of the German Society for Rheumatology: AbbVie, AstraZeneca, BMS, GALAPAGOS, GSK, Lilly, Medac, MSD, Pfizer, Sanofi-Aventis and UCB.Disclosure of InterestsKatja Thiele: None declared, Katinka Albrecht: None declared, Angela Zink: None declared, Martin Aringer: None declared, Kirsten Karberg: None declared, Susanna Spaethling-Mestekemper Speakers bureau: BMS, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, Sanofi, UCB, Consultant of: Abbvie, Gilead, GSK, UCB, Novartis, Ulrich von Hinueber: None declared, Johanna Callhoff Paid instructor for: Rheumatologische Fortbildungsakademie GmbH, Grant/research support from: Abbvie, AstraZeneca, BMS, GALAPAGOS, GSK, Lilly, Medac, MSD, Pfizer, Sanofi, UCB
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Maróti Z, Neparáczki E, Schütz O, Maár K, Varga GIB, Kovács B, Kalmár T, Nyerki E, Nagy I, Latinovics D, Tihanyi B, Marcsik A, Pálfi G, Bernert Z, Gallina Z, Horváth C, Varga S, Költő L, Raskó I, Nagy PL, Balogh C, Zink A, Maixner F, Götherström A, George R, Szalontai C, Szenthe G, Gáll E, Kiss AP, Gulyás B, Kovacsóczy BN, Gál SS, Tomka P, Török T. The genetic origin of Huns, Avars, and conquering Hungarians. Curr Biol 2022; 32:2858-2870.e7. [PMID: 35617951 DOI: 10.1016/j.cub.2022.04.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/10/2022] [Accepted: 04/28/2022] [Indexed: 11/26/2022]
Abstract
Huns, Avars, and conquering Hungarians were migration-period nomadic tribal confederations that arrived in three successive waves in the Carpathian Basin between the 5th and 9th centuries. Based on the historical data, each of these groups are thought to have arrived from Asia, although their exact origin and relation to other ancient and modern populations have been debated. Recently, hundreds of ancient genomes were analyzed from Central Asia, Mongolia, and China, from which we aimed to identify putative source populations for the above-mentioned groups. In this study, we have sequenced 9 Hun, 143 Avar, and 113 Hungarian conquest period samples and identified three core populations, representing immigrants from each period with no recent European ancestry. Our results reveal that this "immigrant core" of both Huns and Avars likely originated in present day Mongolia, and their origin can be traced back to Xiongnus (Asian Huns), as suggested by several historians. On the other hand, the "immigrant core" of the conquering Hungarians derived from an earlier admixture of Mansis, early Sarmatians, and descendants of late Xiongnus. We have also shown that a common "proto-Ugric" gene pool appeared in the Bronze Age from the admixture of Mezhovskaya and Nganasan people, supporting genetic and linguistic data. In addition, we detected shared Hun-related ancestry in numerous Avar and Hungarian conquest period genetic outliers, indicating a genetic link between these successive nomadic groups. Aside from the immigrant core groups, we identified that the majority of the individuals from each period were local residents harboring "native European" ancestry.
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Affiliation(s)
- Zoltán Maróti
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Pediatrics and Pediatric Health Center, University of Szeged, 6725 Szeged, Hungary
| | - Endre Neparáczki
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Genetics, University of Szeged, 6726 Szeged, Hungary
| | - Oszkár Schütz
- Department of Genetics, University of Szeged, 6726 Szeged, Hungary
| | - Kitti Maár
- Department of Genetics, University of Szeged, 6726 Szeged, Hungary
| | - Gergely I B Varga
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary
| | - Bence Kovács
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Genetics, University of Szeged, 6726 Szeged, Hungary
| | - Tibor Kalmár
- Department of Pediatrics and Pediatric Health Center, University of Szeged, 6725 Szeged, Hungary
| | - Emil Nyerki
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Pediatrics and Pediatric Health Center, University of Szeged, 6725 Szeged, Hungary
| | - István Nagy
- SeqOmics Biotechnology Ltd., 6782 Mórahalom, Hungary; Institute of Biochemistry, Biological Research Centre, 6726 Szeged, Hungary
| | | | - Balázs Tihanyi
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Biological Anthropology, University of Szeged, 6726 Szeged, Hungary
| | - Antónia Marcsik
- Department of Biological Anthropology, University of Szeged, 6726 Szeged, Hungary
| | - György Pálfi
- Department of Biological Anthropology, University of Szeged, 6726 Szeged, Hungary
| | - Zsolt Bernert
- Department of Anthropology, Hungarian Natural History Museum, 1083 Budapest, Hungary
| | - Zsolt Gallina
- Ásatárs Ltd., 6000 Kecskemét, Hungary; Department of Archaeology, Institute of Hungarian Research, 1041 Budapest, Hungary
| | - Ciprián Horváth
- Department of Archaeology, Institute of Hungarian Research, 1041 Budapest, Hungary
| | | | - László Költő
- Rippl-Rónai Municipal Museum with Country Scope, 7400 Kaposvár, Hungary
| | - István Raskó
- Institute of Genetics, Biological Research Centre, 6726 Szeged, Hungary
| | | | - Csilla Balogh
- Department of Art History, Istanbul Medeniyet University, 34720 Istanbul, Turkey
| | - Albert Zink
- Institute for Mummy Studies, EURAC Research, 39100 Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, EURAC Research, 39100 Bolzano, Italy
| | - Anders Götherström
- Department of Archaeology and Classical Studies, Stockholm University, 11418 Stockholm, Sweden
| | - Robert George
- Department of Archaeology and Classical Studies, Stockholm University, 11418 Stockholm, Sweden
| | - Csaba Szalontai
- Hungarian National Museum, Department of Archaeology, 1088 Budapest, Hungary
| | - Gergely Szenthe
- Hungarian National Museum, Department of Archaeology, 1088 Budapest, Hungary
| | - Erwin Gáll
- "Vasile Pârvan" Institute of Archaeology, 010667 Bucharest, Romania
| | - Attila P Kiss
- Faculty of Humanities and Social Sciences, Institute of Archaeology, Pázmány Péter Catholic University, 1088 Budapest, Hungary
| | - Bence Gulyás
- Institute of Archaeological Sciences, Eötvös Loránd University, 1088 Budapest, Hungary
| | | | | | - Péter Tomka
- Department of Archaeology, Rómer Flóris Museum of Art and History, 9021 Győr, Hungary
| | - Tibor Török
- Department of Archaeogenetics, Institute of Hungarian Research, 1041 Budapest, Hungary; Department of Genetics, University of Szeged, 6726 Szeged, Hungary.
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Rösing FW, Rühli FJ, Zink A, Nägele A. Editorial. Homo 2021; 72:261. [PMID: 34806113 DOI: 10.1127/homo/2021/1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mick A, Tizek L, Schielein M, Zink A. Can crowdsourced data help to optimize atopic dermatitis treatment? Comparing web search data and environmental data in Germany. J Eur Acad Dermatol Venereol 2021; 36:557-565. [PMID: 34921466 DOI: 10.1111/jdv.17875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is one of the most common chronic skin diseases worldwide, showing various manifestations and having a severe impact on quality of life. As previous studies demonstrated, internet search analysis can help identify public interest in diseases and possible influencing factors on search behavior. OBJECTIVE To identify AD-related topics of interest in Germany using internet search volume. METHODS Google Ads Keyword Planner was used to identify AD-related search terms including their search volume in Germany on a national level as well as in 16 selected cities from January 2016 to December 2019. Identified keywords were qualitatively analyzed, and temporal trends as well as the influence of seasonal and environmental factors on search volume were assessed. RESULTS Overall, 1222 AD-related search terms with a search volume of 8 842 360 searches were identified. An increase from 2016 to 2019 and seasonal peaks from January to April of each year were observed. Nationwide, the search volume correlated with mean monthly temperature and sun duration. With increasing temperature and sun duration, a significant decrease in search queries was observed. The most populated cities showed the lowest number of searches per 100 000 inhabitants (Berlin, Hamburg, and Munich). In the eight categories formed (comorbidities, general, influential factors, localization, stage of life, symptoms/severity, therapy/information, and questions on AD), the highest proportion of search queries were assigned to the category "therapy/information" in most cities. In this category, a focus on the topics of "alternative medicine" and "home remedies" could be observed. CONCLUSION The overall high and increasing search volume indicates a high interest in AD-related topics, especially regarding treatment and disease education. Information provided by internet search volume analyses can optimize AD therapy and patient-centered care by providing insight into patient needs and predicting potential climatic trigger factors.
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Affiliation(s)
- A Mick
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Maixner F, Mitterer C, Jäger HY, Sarhan MS, Valverde G, Lücker S, Piombino‐Mascali D, Szikossy I, Molnár E, Pálfi G, Pap I, Cipollini G, Zink A. Linear polyacrylamide is highly efficient in precipitating and purifying environmental and ancient DNA. Methods Ecol Evol 2021. [DOI: 10.1111/2041-210x.13772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Maixner
- Institute for Mummy Studies Eurac Research Bolzano Italy
| | | | - Heidi Y. Jäger
- Institute for Mummy Studies Eurac Research Bolzano Italy
| | | | - Guido Valverde
- Institute for Mummy Studies Eurac Research Bolzano Italy
| | - Sebastian Lücker
- Department of Microbiology IWWR Radboud University Nijmegen the Netherlands
| | - Dario Piombino‐Mascali
- Department of Anatomy, Histology and Anthropology Faculty of Medicine Vilnius University Vilnius Lithuania
| | - Ildikó Szikossy
- Department of Anthropology Hungarian Natural History Museum Budapest Hungary
| | - Erika Molnár
- Department of Biological Anthropology University of Szeged Szeged Hungary
| | - György Pálfi
- Department of Biological Anthropology University of Szeged Szeged Hungary
| | - Ildikó Pap
- Department of Anthropology Hungarian Natural History Museum Budapest Hungary
| | | | - Albert Zink
- Institute for Mummy Studies Eurac Research Bolzano Italy
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Helmert C, Haufe E, Heinrich L, Siegels D, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Zink A, Pawlak M, Schäkel K, Wildberger J, Weidinger S, Werfel T, Schmitt J. Atopic dermatitis and depressive symptoms. Results of the German national AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2021; 36:e279-e282. [PMID: 34779054 DOI: 10.1111/jdv.17812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Helmert
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - D Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Pilz AC, Schielein MC, Schuster B, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Pawlak M, Schäkel K, Wildberger J, Hilgers M, Werfel T, Weidinger S, Schmitt J, Biedermann T, Zink A. Atopic Dermatitis: Disease Characteristics and Comorbidities in Smoking and Nonsmoking Patients from the TREATgermany Registry. J Eur Acad Dermatol Venereol 2021; 36:413-421. [PMID: 34743344 DOI: 10.1111/jdv.17789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/15/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. OBJECTIVES In this study AD characteristics and its atopic comorbidities are compared in smoking and nonsmoking AD patients. METHODS TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included into TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analyzed comparing AD disease characteristics and comorbidities in smokers versus non-smokers. RESULTS Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n=352; 38.8%) and nonsmokers, however lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to nonsmoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than nonsmokers. Total IgE levels were more elevated in smokers and they displayed a younger age at initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to nonsmokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet. CONCLUSIONS German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
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Affiliation(s)
- A C Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf
| | | | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg
| | | | - M Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Wurst C, Maixner F, Castella V, Cipollini G, Hotz G, Zink A. The Lady from Basel's Barfüsserkirche - Molecular confirmation of the Mummy's identity through mitochondrial DNA of living relatives spanning 22 generations. Forensic Sci Int Genet 2021; 56:102604. [PMID: 34656830 DOI: 10.1016/j.fsigen.2021.102604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Abstract
The identity of the mummified Lady from the Barfüsser Church in Basel, Switzerland has been unsolved for decades, despite the prominent location of the burial place in front of the choir screen. A recent multidisciplinary research approach came up with a possible candidate, Anna Catharina Bischoff who died in Basel in 1787 with an age of 69 years (1719-1787). To verify the identity of the mummy, genealogists of the Citizen Science Basel discovered three living individuals of the maternal lineage of two different family branches, separated from Anna Catharina Bischoff by up to 22 generations. In this study we compare the ancient mitochondrial DNA of the mummy recovered from a premolar to the mitochondrial DNA of these three candidates. Initially the mitochondrial hypervariable regions I and II of the living individuals were screened using the Sanger sequencing method. This was followed by a mitochondrial capture approach and next generation sequencing to enrich for the whole mitochondrial genome of the mummy and one living person. A full mitochondrial genome has been recovered of both individuals sharing an identical haplotype. The sequence was assigned to the mitochondrial haplogroup U5a1+!16192 including two private mutations 10006G and 16293C. Only by using an interdisciplinary approach combining ancient DNA analysis and genealogy a maternal lineage of a non-noble family spanning 22 generations could be confirmed.
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Affiliation(s)
- Christina Wurst
- Institute for Mummy Studies, Eurac Research, Drususallee/Viale Druso 1, 39100 Bozen, Bolzano, Italy; Palaeogenetics Group, Institute of Organismic and Molecular Evolution (iomE), Johannes Gutenberg-University Mainz, Saarstraße 21, 55122 Mainz, Germany.
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Drususallee/Viale Druso 1, 39100 Bozen, Bolzano, Italy
| | - Vincent Castella
- Forensic Genetics Unit, University Center of Legal Medicine, Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Ch. de la Vulliette 4, 1000 Lausanne 25, Switzerland
| | - Giovanna Cipollini
- Institute for Mummy Studies, Eurac Research, Drususallee/Viale Druso 1, 39100 Bozen, Bolzano, Italy
| | - Gerhard Hotz
- Natural History Museum Basel, Augustinergasse 2, 4051 Basel, Switzerland; Integrative Prehistory and Archaeological Science, University of Basel, Bernoullistrasse 32, 4056 Basel, Switzerland
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Drususallee/Viale Druso 1, 39100 Bozen, Bolzano, Italy
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Maixner F, Sarhan MS, Huang KD, Tett A, Schoenafinger A, Zingale S, Blanco-Míguez A, Manghi P, Cemper-Kiesslich J, Rosendahl W, Kusebauch U, Morrone SR, Hoopmann MR, Rota-Stabelli O, Rattei T, Moritz RL, Oeggl K, Segata N, Zink A, Reschreiter H, Kowarik K. Hallstatt miners consumed blue cheese and beer during the Iron Age and retained a non-Westernized gut microbiome until the Baroque period. Curr Biol 2021; 31:5149-5162.e6. [PMID: 34648730 PMCID: PMC8660109 DOI: 10.1016/j.cub.2021.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023]
Abstract
We subjected human paleofeces dating from the Bronze Age to the Baroque period (18th century AD) to in-depth microscopic, metagenomic, and proteomic analyses. The paleofeces were preserved in the underground salt mines of the UNESCO World Heritage site of Hallstatt in Austria. This allowed us to reconstruct the diet of the former population and gain insights into their ancient gut microbiome composition. Our dietary survey identified bran and glumes of different cereals as some of the most prevalent plant fragments. This highly fibrous, carbohydrate-rich diet was supplemented with proteins from broad beans and occasionally with fruits, nuts, or animal food products. Due to these traditional dietary habits, all ancient miners up to the Baroque period have gut microbiome structures akin to modern non-Westernized individuals whose diets are also mainly composed of unprocessed foods and fresh fruits and vegetables. This may indicate a shift in the gut community composition of modern Westernized populations due to quite recent dietary and lifestyle changes. When we extended our microbial survey to fungi present in the paleofeces, in one of the Iron Age samples, we observed a high abundance of Penicillium roqueforti and Saccharomyces cerevisiae DNA. Genome-wide analysis indicates that both fungi were involved in food fermentation and provides the first molecular evidence for blue cheese and beer consumption in Iron Age Europe. Gut microbiome and diet of European salt miners determined using paleofeces Until the Baroque, the microbiome resembled that of modern non-Westernized people Food-fermenting fungi in Iron Age feces indicates blue cheese and beer consumption
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Affiliation(s)
- Frank Maixner
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy.
| | - Mohamed S Sarhan
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Kun D Huang
- Department CIBIO, University of Trento, Via Sommarive 9, 38123 Povo (Trento), Italy; Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, Via Edmund Mach 1, 38010 San Michele all'Adige (TN), Italy
| | - Adrian Tett
- Department CIBIO, University of Trento, Via Sommarive 9, 38123 Povo (Trento), Italy; CUBE (Division of Computational Systems Biology), Centre for Microbiology and Environmental Systems Science, University of Vienna, Althanstraße 14, 1090 Vienna, Austria
| | - Alexander Schoenafinger
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy; Institute of Botany, University of Innsbruck, Sternwartestraße 15, 6020 Innsbruck, Austria
| | - Stefania Zingale
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Aitor Blanco-Míguez
- Department CIBIO, University of Trento, Via Sommarive 9, 38123 Povo (Trento), Italy
| | - Paolo Manghi
- Department CIBIO, University of Trento, Via Sommarive 9, 38123 Povo (Trento), Italy
| | - Jan Cemper-Kiesslich
- Interfaculty Department of Legal Medicine & Department of Classics, University of Salzburg, Ignaz-Harrer-Straße 79, 5020 Salzburg, Austria
| | - Wilfried Rosendahl
- Reiss-Engelhorn-Museen, Zeughaus C5, 68159 Mannheim, Germany; Curt-Egelhorn-Zentrum Archäomtrie, D6,3, 61859 Mannheim, Germany
| | - Ulrike Kusebauch
- Institute for Systems Biology, 401 Terry Avenue North, Seattle, WA 98109, USA
| | - Seamus R Morrone
- Institute for Systems Biology, 401 Terry Avenue North, Seattle, WA 98109, USA
| | - Michael R Hoopmann
- Institute for Systems Biology, 401 Terry Avenue North, Seattle, WA 98109, USA
| | - Omar Rota-Stabelli
- Center Agriculture Food Environment (C3A), University of Trento, 38010 San Michele all'Adige (TN), Italy
| | - Thomas Rattei
- CUBE (Division of Computational Systems Biology), Centre for Microbiology and Environmental Systems Science, University of Vienna, Althanstraße 14, 1090 Vienna, Austria
| | - Robert L Moritz
- Institute for Systems Biology, 401 Terry Avenue North, Seattle, WA 98109, USA
| | - Klaus Oeggl
- Institute of Botany, University of Innsbruck, Sternwartestraße 15, 6020 Innsbruck, Austria
| | - Nicola Segata
- Department CIBIO, University of Trento, Via Sommarive 9, 38123 Povo (Trento), Italy
| | - Albert Zink
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Hans Reschreiter
- Prehistoric Department, Museum of Natural History Vienna, Burgring 7, 1010 Vienna, Austria
| | - Kerstin Kowarik
- Prehistoric Department, Museum of Natural History Vienna, Burgring 7, 1010 Vienna, Austria.
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30
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Pilz AC, Durner V, Schielein MC, Schuster B, Beckmann J, Biedermann T, Eyerich K, Zink A. Addictions in patients with atopic dermatitis: a cross-sectional pilot study in Germany. J Eur Acad Dermatol Venereol 2021; 36:84-90. [PMID: 34585798 DOI: 10.1111/jdv.17708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide and displays many atopic, but also non-atopic comorbidities. Among the latter, mental health disorders such as depression have been extensively studied. However, data on addictions are still rare. OBJECTIVES The aim of this study was to assess the prevalence of different kinds of addictions in adult AD patients using a single-centre approach. METHODS This non-interventional cross-sectional study was performed from 03/2020 to 05/2020 at the Department of Dermatology of a large German university hospital. Participants with a diagnosis of AD confirmed by a dermatologist answered questions about disease severity (patient-oriented eczema measure, POEM), quality of life (Dermatology Life Quality Index, DLQI) and smoking habits. They were screened for problematic alcohol consumption, drug abuse, internet addiction and pathological gambling using internationally established and validated questionnaires. RESULTS 157 patients (56.1% female; mean age of 49.9 ± 20.4) with an average POEM of 13.7 ± 7.5 and DLQI of 6.1 ± 5.4 were evaluated. 14.1% were identified as regular smokers, 12.1% screened positive for alcohol dependency, 6.4% for drug use disorders, 4.5% for Internet addiction and 3.2% for pathological gambling. Co-occurrences of different addictions were observed, and a positive correlation was noted between DLQI scores and smoking. CONCLUSIONS In summary, this study hints at elevated positive screening rates for problematic alcohol consumption, drug use disorders, Internet addiction and problem gambling compared with the general population. Screening routinely for addictions may improve patient-centred health care of AD patients.
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Affiliation(s)
- A C Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - V Durner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University of Munich, Munich, Germany
| | - M C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - B Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - J Beckmann
- Department of Sport and Health Sciences, Chair of Sport Psychology, Technical University of Munich, Munich, Germany.,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Qld, Australia
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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31
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Granehäll L, Huang KD, Tett A, Manghi P, Paladin A, O’Sullivan N, Rota-Stabelli O, Segata N, Zink A, Maixner F. Metagenomic analysis of ancient dental calculus reveals unexplored diversity of oral archaeal Methanobrevibacter. Microbiome 2021; 9:197. [PMID: 34593021 PMCID: PMC8485483 DOI: 10.1186/s40168-021-01132-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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] [Received: 03/12/2021] [Accepted: 07/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Dental calculus (mineralised dental plaque) preserves many types of microfossils and biomolecules, including microbial and host DNA, and ancient calculus are thus an important source of information regarding our ancestral human oral microbiome. In this study, we taxonomically characterised the dental calculus microbiome from 20 ancient human skeletal remains originating from Trentino-South Tyrol, Italy, dating from the Neolithic (6000-3500 BCE) to the Early Middle Ages (400-1000 CE). RESULTS We found a high abundance of the archaeal genus Methanobrevibacter in the calculus. However, only a fraction of the sequences showed high similarity to Methanobrevibacter oralis, the only described Methanobrevibacter species in the human oral microbiome so far. To further investigate the diversity of this genus, we used de novo metagenome assembly to reconstruct 11 Methanobrevibacter genomes from the ancient calculus samples. Besides the presence of M. oralis in one of the samples, our phylogenetic analysis revealed two hitherto uncharacterised and unnamed oral Methanobrevibacter species that are prevalent in ancient calculus samples sampled from a broad range of geographical locations and time periods. CONCLUSIONS We have shown the potential of using de novo metagenomic assembly on ancient samples to explore microbial diversity and evolution. Our study suggests that there has been a possible shift in the human oral microbiome member Methanobrevibacter over the last millennia. Video abstract.
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Affiliation(s)
- Lena Granehäll
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
- Faculty of Biology, Department of Biology II, Anthropology and Human Genomics, Ludwig-Maximilians-University of Munich, 82152 Planegg-Martinsried, Germany
| | - Kun D. Huang
- CIBIO Department, University of Trento, 38123 Trento, Italy
- Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, 38010 San Michele all’Adige, Italy
| | - Adrian Tett
- CIBIO Department, University of Trento, 38123 Trento, Italy
- CUBE - Division of Computational Systems Biology, Centre for Microbiology and Environmental Systems Science, University of Vienna, Vienna, Austria
| | - Paolo Manghi
- CIBIO Department, University of Trento, 38123 Trento, Italy
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Niall O’Sullivan
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Omar Rota-Stabelli
- Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, 38010 San Michele all’Adige, Italy
- Center Agriculture Food Environment, University of Trento, 38123 Trento, Italy
| | - Nicola Segata
- CIBIO Department, University of Trento, 38123 Trento, Italy
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, 39100 Bolzano, Italy
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Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Weisshaar E, Wiemers F, Ertner K, Schäkel K, Augustin M, Wildberger J, von Kiedrowski R, Zink A, Pawlak M, Worm M, Sticherling M, Effendy I, Hilgers M, Quist S, Asmussen A, Handrick C, Bell M, Staubauch-Renz P, Schwarz B, Hong-Weldemann SH, Homey B, Werfel T, Weidinger S, Schmitt J. Einschätzung der Erkrankungsschwere der Neurodermitis durch Ärzte und Patienten in Abhängigkeit vom Geschlecht: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany+. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- Universitäts AllergieCentrum Dresden, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitäts-klinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München
| | - E Weisshaar
- Berufsdermatologie, Klinik für Dermatologie, Universität Heidelberg
| | - F Wiemers
- Praxis Dr. Ulrike Wiemers/Dr. Franca Wiemers
| | | | - K Schäkel
- Klinik für Dermatologie, Universität Heidelberg
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf
| | | | | | - A Zink
- Klinik für Dermatologie und Allergologie, TU München & Zentrum für Umweltmedizin GmbH
| | - M Pawlak
- Praxis Dr. Anika Hünermund, Mario Pawlak
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Berlin
| | - M Sticherling
- Klinik für Dermatologie, Universität Erlangen-Nürnberg
| | - I Effendy
- Klinik für Dermatologie, Klinikum Rosenhöhe
| | - M Hilgers
- Universitätsklinikum Aachen, Uniklinik RWTH Aachen
| | | | - A Asmussen
- Praxis Dr. Andrea Asmussen, Dermatologie an der Lesum
| | | | - M Bell
- Praxis Dr. Magnus Bell, Thomas Kaiser
| | - P Staubauch-Renz
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Mainz
| | | | | | - B Homey
- Klinik für Dermatologie, Universität Düsseldorf
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Schmidt M, Maixner F, Hotz G, Pap I, Szikossy I, Pálfi G, Zink A, Wagner W. DNA methylation profiling in mummified human remains from the eighteenth-century. Sci Rep 2021; 11:15493. [PMID: 34326450 PMCID: PMC8322318 DOI: 10.1038/s41598-021-95021-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/19/2021] [Indexed: 12/19/2022] Open
Abstract
Reconstruction of ancient epigenomes by DNA methylation (DNAm) can shed light into the composition of cell types, disease states, and age at death. However, such analysis is hampered by impaired DNA quality and little is known how decomposition affects DNAm. In this study, we determined if EPIC Illumina BeadChip technology is applicable for specimens from mummies of the eighteenth century CE. Overall, the signal intensity on the microarray was extremely low, but for one of two samples we were able to detect characteristic DNAm signals in a subset of CG dinucleotides (CpGs), which were selected with a stringent processing pipeline. Using only these CpGs we could train epigenetic signatures with reference DNAm profiles of multiple tissues and our predictions matched the fact that the specimen was lung tissue from a 28-year-old woman. Thus, we provide proof of principle that Illumina BeadChips are applicable for DNAm profiling in ancient samples.
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Affiliation(s)
- Marco Schmidt
- Helmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Pauwelsstrasse 20, 52074, Aachen, Germany
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Viale Druso, 1, 39100, Bolzano, Italy
| | - Gerhard Hotz
- Anthropological Collection, Natural History Museum of Basel, 4051, Basel, Switzerland.,Integrative Prehistory and Archaeological Science (IPAS), University of Basel, 4051, Basel, Switzerland
| | - Ildikó Pap
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, 6726, Szeged, Hungary.,Department of Anthropology, Hungarian Natural History Museum, 1083, Budapest, Hungary.,Department of Biological Anthropology, Eötvös University, 1117, Budapest, Hungary
| | - Ildikó Szikossy
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, 6726, Szeged, Hungary.,Department of Anthropology, Hungarian Natural History Museum, 1083, Budapest, Hungary
| | - György Pálfi
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, 6726, Szeged, Hungary
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso, 1, 39100, Bolzano, Italy
| | - Wolfgang Wagner
- Helmholtz-Institute for Biomedical Engineering, Stem Cell Biology and Cellular Engineering, RWTH Aachen University Medical School, Pauwelsstrasse 20, 52074, Aachen, Germany.
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Maixner F, Gresky J, Zink A. Ancient DNA analysis of rare genetic bone disorders. Int J Paleopathol 2021; 33:182-187. [PMID: 33971396 DOI: 10.1016/j.ijpp.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Review of the current advancements in the field of paleogenetics that provide new opportunities in studying the evolution of rare genetic bone diseases. MATERIAL AND METHODS Based on cases from the literature, the genetics of rare bone diseases will be introduced and the main methodological issues will be addressed, focusing on the opportunities presented by the application of aDNA analyses in the field of paleopathology. RESULTS Medical literature provides large datasets on the genes responsible for rare bone disorders. These genes, subdivided in functional categories, display important future targets when analyzing rare genetic bone disorders in ancient human remains. CONCLUSIONS Knowledge on both phenotype and genotype is required to study rare diseases in ancient human remains. SIGNIFICANCE The proposed interdisciplinary research will provide new insight into the occurrence and spread of genetic risk factors in the past and will help in the diagnostics of these rare and often neglected diseases. LIMITATIONS The current limitations in ancient DNA research and targeting the disease-causing specific mutations (e.g., somatic or germline). SUGGESTIONS FOR FURTHER RESEARCH Methodological advancements and candidate gene lists provide the optimal basis for future interdisciplinary studies of rare genetic bone disorders in ancient human remains.
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Affiliation(s)
- Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy.
| | - Julia Gresky
- German Archaeological Institute, Department of Natural Sciences, Berlin, Germany
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
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Schultz M, Weber M, Schmidt-Schultz TH, Dorn J, Zink A, Nerlich A. A possible case of Langerhans-cell histiocytosis? Differential diagnosis in a rare case from the Late Antiquity Bavaria (Germany). Int J Paleopathol 2021; 33:270-279. [PMID: 34051633 DOI: 10.1016/j.ijpp.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To outline the importance of accurate diagnosis in ancient rare diseases by presenting a possible case of Langerhans-cell histiocytosis. MATERIALS Skeletal elements from a well-preserved skeleton of a nine to eleven-year-old, probably female child who lived around 300-400 AD Late Roman Neuburg / Donau (Germany). METHODS Macroscopic, radiologic, light and scanning-electron microscopic and physical techniques were used. RESULTS Resorptive defects, particularly in the cranium, but also in the left hip bone and the right femur, suggest the presence of Langerhans-cell histiocytosis macroscopically and radiologically. The presence of morphological changes along the edges of osteolytic lesions and in the diploic spaces appear to be post-mortem artifacts based on microscopic investigation and elemental analysis. CONCLUSIONS Re-evaluation of morphological structures and elemental constitution of lesions is critical to differential diagnosis. In the case examined here, the identification of post-mortem structures rules out the former diagnosis of Langerhans-cell histiocytosis. Re-evaluation of cases of rare diseases require applying a range of methods during the analysis, as every single case makes a difference in the numbers of this very small group of diseases. SIGNIFICANCE This study emphasizes the importance of utilizing different analytical techniques to avoid false diagnoses. LIMITATIONS Not all morphological features can reliably be diagnosed using microscopic and elemental techniques. SUGGESTIONS FOR FURTHER RESEARCH In the case of rare diseases that are difficult to diagnose, the widest possible spectrum of techniques should always be used, particularly microscopy.
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Affiliation(s)
- Michael Schultz
- Institute of Anatomy and Embryology, University Medical School Göttingen, Göttingen, Germany; Department of Biology, Institute of Biology and Chemistry, University of Hildesheim, Germany.
| | - Martina Weber
- Institute of Anatomy and Embryology, University Medical School Göttingen, Göttingen, Germany
| | - Tyede H Schmidt-Schultz
- Institute of Anatomy and Embryology, University Medical School Göttingen, Göttingen, Germany
| | - Juliane Dorn
- Division of Natural Sciences, German Archaeological Institute, Berlin, Germany
| | - Albert Zink
- Eurac Research, Institute for Mummy Studies, Bolzano, Italy
| | - Andreas Nerlich
- Department of Pathology, Munich Clinic Bogenhausen, Munich, Germany
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Albrecht K, De Pablo P, Eidner T, Hoese G, Wassenberg S, Zink A, Callhoff J. POS0026 ASSOCIATION BETWEEN RA DISEASE ACTIVITY AND TOOTH LOSS: RESULTS OF TWO NATIONAL COHORTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Cross-sectional studies suggest an association between the presence of tooth loss and/or periodontitis, cytokine levels and disease activity in patients with rheumatoid arthritis (RA) (1).Objectives:To analyze the association between tooth loss and disease activity/inflammatory activity in patients with early arthritis and established RA.Methods:Two data sources were used for analysis. Participants of the early arthritis cohort study CAPEA, conducted between 2010 and 2013, reported their number of teeth present at baseline and were followed over 2 years. Tooth loss categories were defined according to the number of teeth present, as follows: 0, 1-19, 19-27, and all 28 teeth. Disease activity/inflammatory activity data, such as disease activity scores (DAS28-ESR) and disease activity parameters, including swollen joint count (SJC) and inflammatory markers, i.e. erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), were collected longitudinally at baseline, 3, 6, 12, 18, and 24 months. We used linear mixed regression models (with negative binomial distribution for SJC) to estimate the association between tooth loss and disease activity scores, SJC and inflammatory markers (ESR, CRP), over time. We also investigated the association between tooth loss and disease activity/inflammatory markers in patients with established RA, using cross-sectional data from the German National database (NDB) collected between 2015 and 2018. All models were adjusted for age, sex, smoking (ever vs. never), rheumatoid factor and education level, defined as years in education. Models with the NDB data were additionally adjusted for disease duration, missing data were imputed using multiple imputation. In all models, number of teeth was entered as a continuous variable.Results:Of a total of 1,124 CAPEA participants included, those with higher tooth loss were older, more often smokers, had a lower level of education, higher inflammatory markers and higher disease activity scores at baseline (Table 1). Inflammatory markers decreased comparably across all categories of tooth loss over time (Figure 1), in particular CRP. Tooth loss was not significantly associated with CRP or SJC alone. Glucocorticoid use was higher among those with more tooth loss, however dose reduction was similar across tooth loss categories. Among 7,179 NDB participants, adjusted disease activity scores and inflammatory markers were higher across tooth loss categories (DAS28 no teeth: 2.7, all teeth: 2.4; ESR no teeth: 23 mm/h, all teeth: 17 mm/h). SJC was not relevantly associated with tooth loss (no teeth: 1.2, all teeth: 1.2). Mean disease duration in the NDB sample was 13 years.Table 1.Early arthritis cohort (CAPEA) baseline characteristics, stratified by number of teethNumber of teeth presentTotaln01-1920-27All 28N893154522681,1241,124Female, %57656469651,124Age (years), mean69645445561,124ESR (mm), mean42382824311,074CRP (mg/l), mean25241515191,069SJC, mean6.16.95.65.25.91,120DAS28-ESR, mean5.55.24.74.54.9983RF positive, %63535254541,124Education, %1,020<=8 years80583521429-10 years163043463811-13 years412223320Smoking (ever), %73646156611,102ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, DAS28: disease activity score, RF: rheumatoid factor, SJC: swollen joint countFigure 1.Disease activity parameters during the 24-months follow-up, stratified by the number of teeth at baseline: results from mixed models, adjusted for age, sex, smoking and education level.Conclusion:While we observed a significant association between tooth loss and disease activity and inflammation markers in both early arthritis and established RA, our longitudinal results suggest that tooth loss has no influence on response to therapy.References:[1]Rodriguez-Lozano B, Gonzalez-Febles J, Garnier-Rodriguez JL, Dadlani S, Bustabad-Reyes S, Sanz M, et al. Association between severity of periodontitis and clinical activity in rheumatoid arthritis patients: a case-control study. Arthritis Res Ther. 2019;21(1):27.Acknowledgements:We thank all participating rheumatologists and patients for their valuable contributions.The CAPEA periodontitis project was funded by the Deutsche Rheuma-Liga Bundesverband e.V.Capea was funded by an unconditional research grant from Pfizer.The National Database of the German Collaborative Arthritis centers has been supported since 2007 by the Association of Regional Cooperative Rheumatology Centres and joint contributions to the Rheumatological Training Academy and the DRFZ by the following members of the Working Group of Corporate Members of the German Society for Rheumatology: AbbVie, Actelion, BMS, GSK, Lilly, Medac, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis and UCB. The researchers have full academic freedom.Disclosure of Interests:None declared.
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Strangfeld A, Manger B, Worsch M, Schmeiser T, Zink A, Schaefer M. OP0116 ELDERLY PATIENTS ARE NOT AT INCREASED RISK OF SERIOUS INFECTIONS WHEN RECEIVING BDMARDS OR JAK INHIBITORS COMPARED TO CSDMARD TREATMENT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.763] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Elderly rheumatoid arthritis (RA) patients are generally at increased risk of serious infections (SI). At the same time, treatment with bDMARDs has been associated with a higher SI risk than treatment with csDMARDs (1). However, long-term use of bDMARDs did not increase the risk of SI in a small group of elderly patients over 65 (2). The extent to which elderly patients are exposed to a higher SI risk when treated with JAK inhibitors (JAKi) is an open question.Objectives:To assess the effects of bDMARDs and specifically JAKi on the risk of SI in elderly patients with RA.Methods:The German register RABBIT is a prospective, longitudinally followed cohort of RA patients enrolled with a new start of a DMARD after at least one csDMARD failure. This analysis comprises patients over 70 years of age who were enrolled between 01/2007 and 04/2020 and had at least one follow-up.Results:Of 13,491 patients followed-up in RABBIT, 2274 with an age > 70 years were included in the analysis. 626 SI were observed in 425 of these patients. Baseline characteristics at start of the respective DMARD are shown in Table 1. In most characteristics, patients on JAKi were more comparable to patients under bDMARDs than to those on csDMARDs. JAKi patients received glucocorticoids (GC) less frequently than patients on other treatments. The HR for SI was lower than 1 in patients receiving bDMARDs or JAKi compared to csDMARDs, but without statistical significance (Figure 1). GC use (HR 1.6, 95% CI: 1.2 – 2.2 for ≤ 10 mg/d), higher DAS28-ESR values (HR 1.1, 95% CI: 1.0 – 1.2 per 1 point increase), COPD or pulmonary fibrosis (HR 1. 8, 95% CI: 1.3 – 2.4), chronic kidney disease (HR 1.5, 95% CI: 1.2 – 1.9) and diabetes mellitus (HR 1.3, 95% CI: 1.0 – 1.7) were associated with an increased risk of SI. Better physical capacity was associated with a decreased risk of SI (HR 0.9, 95% CI: 0.88 – 0.98 for a 10 point increase).Table 1.Patient characteristics by treatment at baselineParametercsDMARDsTNFiRTXABAIL-6iJAKiN=758N=840N=209N=147N=212N=108Age (years)75.9 (3.9)75.5 (3.6)74.8 (3.6)76.1 (3.9)75.9 (3.7)76.7 (3.7)Male sex184 (24.3)220 (26.2)50 (23.9)36 (24.5)46 (21.7)28 (25.9)Ever smoker249 (32.8)287 (34.2)77 (36.8)50 (34)73 (34.4)39 (36.1)Disease duration (years)7.9 (8.8)12.3 (11.4)17 (11.1)12.8 (10)13.8 (11.7)11.9 (10.9)Seropositivity487 (64.3)671 (79.9)201 (96.2)126 (85.4)182 (85.8)79 (73.5)Number of previous DMARDs1.4 (0.7)2.5 (1.3)4.2 (1.8)3.6 (1.9)3.3 (1.8)2.6 (1.5)DAS28-ESR4.6 (1.2)5.1 (1.2)5.4 (1.3)5.3 (1.3)5.3 (1.3)5 (1.2)Proportion of full physical function64.8 (23.1)57.1 (23.6)50.4 (23.7)52.9 (23.5)55.3 (24.1)55.2 (23.7)Number of comorbidities3.1 (2.5)3.8 (2.6)4.2 (2.6)4.6 (2.9)3.6 (2.4)3.8 (2.2)No comorbidity52 (6.9)29 (3.5)4 (1.9)4 (2.7)9 (4.2)5 (4.6)Three and more comorbidities385 (50.8)528 (62.9)147 (70.3)107 (72.8)131 (61.8)76 (70.4)COPD or pulmonary fibrosis69 (9.1)89 (10.6)29 (13.9)26 (17.7)12 (5.7)11 (10.2)Chronic kidney disease94 (12.4)151 (18)28 (13.4)21 (14.3)39 (18.4)22 (20.4)Diabetes mellitus151 (19.9)172 (20.5)31 (14.8)23 (15.6)42 (19.8)25 (23.1)GCs (last 6 months)347 (45.8)526 (62.6)143 (68.8)82 (56.2)127 (59.9)44 (40.7)GCs (<5mg)447 (58.9)384 (45.7)101 (48.2)88 (60)118 (55.8)72 (66.7)GCs (5-9mg)252 (33.3)375 (44.6)81 (38.7)43 (29)72 (34.2)27 (25.1)GCs (>=10mg)59 (7.8)82 (9.8)274 (13.1)16 (11)21 (10)9 (8.2)Results are presented as mean ± SD for continuous variables and number (percentage) for discrete variables.Figure 1.Hazard ratios for serious infections with 95% confidence intervalsConclusion:Treatment with JAKi as well as treatment with bDMARDs was not associated with an increased risk of SI in elderly patients above 70 years of age. Key comorbidities such as diabetes mellitus, chronic pulmonary and kidney diseases were associated with increased risk, as was concomitant GC use and higher disease activity.References:[1] Listing J et al., Rheumatology 2013; 52 (1): 53-61.[2] Kawashima H. et al., Rheum. Intern. 2017; 37: 369-376.Acknowledgements:RABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Celltrion, Fresenius-Kabi, Gilead, Hexal, Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, UCB, and Viatris.Disclosure of Interests:None declared
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Panova-Noeva M, Schulz A, Köck T, ten Cate V, Wagner B, Rapp S, Lenz M, Zink A, Ghadessi M, Konstantinides S, ten Cate H, Heitmeier S, Wild P. OC-09 Proteomic profiling in cancer-associated VTE. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pereira MP, Ziehfreund S, Rueth M, Ewering T, Legat FJ, Lambert J, Elberling J, Misery L, Brenaut E, Papadavid E, Garcovich S, Evers AWM, Halvorsen JA, Szepietowski JC, Reich A, Gonçalo M, Lvov A, Bobko S, Serra-Baldrich E, Wallengren J, Savk E, Leslie T, Ständer S, Zink A. Google search trends for itch in Europe: a retrospective longitudinal study. J Eur Acad Dermatol Venereol 2021; 35:1362-1370. [PMID: 33295009 DOI: 10.1111/jdv.17077] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/10/2020] [Accepted: 10/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Itch is a common symptom in the general population. Affected individuals often do not seek medical consultation and rely on Internet searches to obtain information regarding their itch. OBJECTIVES The aim of this study was to attain insights into common concerns of the general population regarding itch can by analysing itch-related Internet search behaviour. METHODS Google AdWords Keyword Planner was used to assess search volumes for itch-related terms in 15 European countries between September 2014 and August 2018. All identified keywords were qualitatively categorized. Itch-related terms were descriptively analysed and are shown as number of searches/100 000 inhabitants. RESULTS The search volume for the keyword 'itch' per 100 000 inhabitants was highest in Northern Europe, followed by Eastern, Central and Southern Europe. In 4/15 countries, itch was searched for more often in the autumn/winter months compared to in the spring/summer months. Most itch-related terms were related to dermatological conditions such as inflammatory skin diseases (e.g. psoriasis, atopic dermatitis), allergic or immunologic conditions (e.g. urticaria), and infectious diseases or infestations (e.g. scabies). In terms of body location, genitoanal itch dominated the searches. Symptoms and signs related to itch, possible non-dermatological aetiologies, and treatment options were also among the most searched terms. CONCLUSIONS These analyses provided for the first time insights into the search behaviour patterns related to itch across Europe. People from Northern and Eastern Europe are more likely to seek online information regarding itch. Causes for the itch, especially dermatological conditions, and genitoanal itch are the most important concerns for Internet users. This unconventional and inexpensive method identifies medical needs of people beyond the medical setting, including people who do not seek medical consultation. Accordingly, the data could be used to guide public health interventions and manage respective inhabitants' medical needs.
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Affiliation(s)
- M P Pereira
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Rueth
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Ewering
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium
| | - J Elberling
- Department of Dermatology, University Hospital Gentofte, Copenhagen, Denmark
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - E Brenaut
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - E Papadavid
- Department of Dermatology and Venereology, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - S Garcovich
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A W M Evers
- Department of Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - J A Halvorsen
- Department of Dermatology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - A Reich
- Department of Dermatology, University of Rzeszów, Rzeszów, Poland
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Lvov
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - S Bobko
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | | | - J Wallengren
- Department of Clinical Sciences Lund, Dermatology and Venereology, Lund University, Lund, Sweden.,Skane University Hospital, Lund, Sweden
| | - E Savk
- Department of Dermatology, Aydin Adnan Menderes University, Aydın, Turkey
| | | | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Loufouma Mbouaka A, Gamble M, Wurst C, Jäger HY, Maixner F, Zink A, Noedl H, Binder M. The elusive parasite: comparing macroscopic, immunological, and genomic approaches to identifying malaria in human skeletal remains from Sayala, Egypt (third to sixth centuries AD). Archaeol Anthropol Sci 2021; 13:115. [PMID: 34149953 PMCID: PMC8202054 DOI: 10.1007/s12520-021-01350-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/19/2021] [Indexed: 05/12/2023]
Abstract
UNLABELLED Although malaria is one of the oldest and most widely distributed diseases affecting humans, identifying and characterizing its presence in ancient human remains continue to challenge researchers. We attempted to establish a reliable approach to detecting malaria in human skeletons using multiple avenues of analysis: macroscopic observations, rapid diagnostic tests, and shotgun-capture sequencing techniques, to identify pathological changes, Plasmodium antigens, and Plasmodium DNA, respectively. Bone and tooth samples from ten individuals who displayed skeletal lesions associated with anaemia, from a site in southern Egypt (third to sixth centuries AD), were selected. Plasmodium antigens were detected in five of the ten bone samples, and traces of Plasmodium aDNA were detected in six of the twenty bone and tooth samples. There was relatively good synchronicity between the biomolecular findings, despite not being able to authenticate the results. This study highlights the complexity and limitations in the conclusive identification of the Plasmodium parasite in ancient human skeletons. Limitations regarding antigen and aDNA preservation and the importance of sample selection are at the forefront of the search for malaria in the past. We confirm that, currently, palaeopathological changes such as cribra orbitalia are not enough to be certain of the presence of malaria. While biomolecular methods are likely the best chance for conclusive identification, we were unable to obtain results which correspond to the current authentication criteria of biomolecules. This study represents an important contribution in the refinement of biomolecular techniques used; also, it raises new insight regarding the consistency of combining several approaches in the identification of malaria in past populations. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12520-021-01350-z.
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Affiliation(s)
- Alvie Loufouma Mbouaka
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Michelle Gamble
- Bioarchaeology Department, Austrian Archaeological Institute at the Austrian Academy of Sciences, Franz Klein-Gasse 1, 1190 Vienna, Austria
- Present Address: Heritage and Archaeological Research Practice, 101 Rose Street South Lane, EH2 3JG Edinburgh, Scotland
| | - Christina Wurst
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Heidi Yoko Jäger
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Frank Maixner
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Albert Zink
- Institute for Mummy Studies, EURAC Research, Viale Druso 1, 39100 Bolzano, Italy
| | - Harald Noedl
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
- Present Address: Malaria Research Initiative Bandarban, Vienna, Austria
| | - Michaela Binder
- Bioarchaeology Department, Austrian Archaeological Institute at the Austrian Academy of Sciences, Franz Klein-Gasse 1, 1190 Vienna, Austria
- Present Address: Planen und Bauen im Bestand, Novetus, Belvederegasse 41, 1040 Vienna, Austria
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Váradi OA, Rakk D, Spekker O, Terhes G, Urbán E, Berthon W, Pap I, Szikossy I, Maixner F, Zink A, Vágvölgyi C, Donoghue HD, Minnikin DE, Szekeres A, Pálfi G. Verification of tuberculosis infection among Vác mummies (18th century CE, Hungary) based on lipid biomarker profiling with a new HPLC-HESI-MS approach. Tuberculosis (Edinb) 2020; 126:102037. [PMID: 33338873 DOI: 10.1016/j.tube.2020.102037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/25/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022]
Abstract
Tuberculosis (TB) was a large burden of infections that peaked during the 19th century in Europe. Mummies from the 18th century CE, discovered in the crypt of a church at Vác, Hungary, had high TB prevalence, as revealed by amplification of key fragments of TB DNA and genome-wide TB analysis. Complementary methods are needed to confirm these diagnoses and one approach uses the identification of specific lipid biomarkers, such as TB mycocerosic acids (MCs). Previously, MC derivatives were profiled by specialised gas chromatography-mass spectrometry (GC-MS), so an alternative more direct approach has been developed. Underivatized MCs are extracted and analysed by high-performance liquid chromatography linked to a mass spectrometer, in heated electrospray ionisation mode (HPLC-HESI-MS). The method was validated using representatives of the Mycobacterium tuberculosis complex and other mycobacteria and tested on six Vác mummy cases, previously considered positive for TB infection. Analysing both rib and soft tissue samples, four out of six cases gave profiles of main C32 and major C29 and C39 mycocerosates correlating well with those of M. tuberculosis. Multidisciplinary methods are needed in the diagnosis of ancient tuberculosis; this new protocol accesses important confirmatory evidence, as demonstrated by the confirmation of TB in the Vác mummies.
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Affiliation(s)
- Orsolya Anna Váradi
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary; Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - Dávid Rakk
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - Olga Spekker
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - Gabriella Terhes
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Hungary. Postal address: P.O.B. 427, H-6701, Szeged, Hungary.
| | - Edit Urbán
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Hungary. Postal address: Szigeti út 12, H-7624 Pécs, Hungary; Institute of Translational Medicine, Medical School, University of Pécs, Hungary. Postal address: Szigeti út 12, H-7624, Pécs, Hungary.
| | - William Berthon
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - Ildikó Pap
- Department of Anthropology, Hungarian Natural History Museum, Hungary. Postal address: Ludovika tér 2-6, H-1083, Budapest, Hungary.
| | - Ildikó Szikossy
- Department of Anthropology, Hungarian Natural History Museum, Hungary. Postal address: Ludovika tér 2-6, H-1083, Budapest, Hungary.
| | - Frank Maixner
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy. Postal address: Viale Druso, 1, I-39100, Bolzano, Italy.
| | - Albert Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy. Postal address: Viale Druso, 1, I-39100, Bolzano, Italy.
| | - Csaba Vágvölgyi
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - Helen D Donoghue
- Centre for Clinical Microbiology, University College London, London, UK. Postal address: Gower Street, London, WC1E 6BT, UK.
| | - David E Minnikin
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, UK. Postal Address: B15 2TT Birmingham, UK.
| | - András Szekeres
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
| | - György Pálfi
- Department of Biological Anthropology, Faculty of Science and Informatics, University of Szeged, Hungary. Postal address: Közép fasor 52, H-6726, Szeged, Hungary.
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Abstract
In the journal Nature, under the headline "Retire statistical significance", Amrhein et al. called for the concept of statistical significance to be abolished. This appeal, which was signed by about 800 other researchers, triggered a controversial discussion. One reason for the deliberately provocative call is the scientific practice in which the concept of statistical significance is often applied in an incorrect way for yes/no decisions. The criticism is not new and has been repeatedly expressed over the last 50 years. We refer to current and previously published caveats, give an overview of different applications of the concept of statistical significance as well as possible alternatives. We agree in principle with the criticism of the concept expressed by Amrhein et al. but in the absence of agreed alternatives and insufficient consideration of the many different applications of the concept of statistical significance, we consider the demand for its abolition to be exaggerated. A more pragmatic approach to the problem, supported by targeted instructions for scientists and reviewers, seems to be a more appropriate way forward.
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Affiliation(s)
- A Richter
- Institut für Community Medicine, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 48, 17475, Greifswald, Deutschland.
| | - A Zink
- Deutsches Rheuma-Forschungszentrum Berlin, Ein Institut der Leibniz-Gemeinschaft, Berlin, Deutschland
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Tizek L, Schielein MC, Berger U, Ege MJ, Schneider S, Zink A. Skin cancer risk and shade: comparing the risk of foresters with other outdoor workers. J Eur Acad Dermatol Venereol 2020; 34:2526-2533. [PMID: 32365247 DOI: 10.1111/jdv.16560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/07/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Keratinocyte carcinoma (KC) is an increasingly important public health problem with an especially high prevalence in outdoor workers. In contrast to other occupations, foresters spend most of their outdoor time under the shade of trees. OBJECTIVES We aimed to compare the unique sun exposure patterns and sun protection behaviour of foresters with those of other outdoor workers and their relation to the KC risk. METHODS In July 2018, a cross-sectional study was conducted at an international forestry fair using a questionnaire about health awareness and skin cancer screening by dermatologists to assess the prevalence of KC. RESULTS A total of 591 participants (78.7% male; mean age 46.8 ± 16.2 years) including 193 foresters were enrolled. Of all foresters, 72% experienced sunburns (solar erythema) within the past year and 50% of them experienced the worst sunburn during work. Foresters were most likely to often/always wear protective clothes (29.0%) but were least likely to often/always avoid midday sun (23.8%) and stay in the shade (31.1%). Having an outdoor profession or spending hours outside for leisure was negatively associated with sun protection. Skin examination revealed an overall KC prevalence of 16.7%, with 16.5% of foresters being affected. CONCLUSION Despite being protected by trees, the risk of KC for foresters is comparable to that of other professional groups. Shade alone may not provide sufficient protection. Additional sun protection measures are necessary.
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Affiliation(s)
- L Tizek
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians University Munich, Munich, Germany
| | - M C Schielein
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians University Munich, Munich, Germany
| | - U Berger
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians University Munich, Munich, Germany
| | - M J Ege
- Dr. von Hauner Children's Hospital, Member of the German Center of Lung Research (DZL), Ludwig-Maximilians University Munich, Munich, Germany
| | - S Schneider
- Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Heidelberg University, Mannheim, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
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Kaczmarczyk R, Bauerdorf F, Tizek L, Biedermann T, Zink A. A network analysis of the EADV 2019 conference. J Eur Acad Dermatol Venereol 2020; 34:e820-e822. [PMID: 32485060 DOI: 10.1111/jdv.16700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Affiliation(s)
- R Kaczmarczyk
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - F Bauerdorf
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Schaefer M, Schneider M, Graessler A, Ochs W, Zink A, Strangfeld A. OP0012 TNF INHIBITORS ARE ASSOCIATED WITH A REDUCED RISK OF VENOUS THROMBOEMBOLISM COMPARED TO CSDMARDS IN RA PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:While the short-term use of bDMARDs up to 180 days has been associated with an increased risk of venous thromboembolism (VTE) compared to csDMARDs in patients with rheumatoid arthritis (RA), the long term use of more than 730 days has been associated with a decreased risk based on claims data [1]. Among patients with inflammatory bowel disease, observational data indicated that TNF inhibitors may have a protective effect regarding the VTE risk [2].Objectives:To assess the effects of TNF inhibitors and newer bDMARDs (including abatacept, rituximab, sarilumab, and tocilizumab) on the VTE risk based on observational data from RA patients.Methods:The German register RABBIT is a prospective longitudinally followed cohort of RA patients enrolled with a new start of a DMARD after at least one csDMARD failure. This analysis comprises patients who were enrolled with start of a bDMARD between 01/2009 and 04/2019 and had at least one follow-up.Cox regression models were used to calculate hazard ratios (HRs) for VTEs, for csDMARDs, TNF inhibitors and other bDMARDs. Propensity score weighting was used to adjust for confounding by indication.Results:Patients receiving TNF inhibitors or other bDMARDs on average had higher CRP levels and a higher prevalence of cardiovascular diseases at baseline than patients receiving csDMARDs. They also received more often glucocorticoids (Table 1).The HR of patients receiving TNF inhibitors for a serious VTE event was 0.53 (95% CI: 0.33 – 0.86) compared to csDMARDs, while the HR for patients receiving other bDMARDs was 0.66 (95% CI: 0.40 – 1.09). A CRP level of more than 5 mg/L (HR 2.09, 95% CI: 1.39 – 3.14) and an age above 65 years (HR 2.96, 95% CI: 1.94 – 4.52) increased the risk for a serious VTE event. Better physical function was associated with a decreased risk for VTEs (Table 2).Table 1.Patient characteristics at baseline for DMARD groupsParameter (at time of event/end of observation unless specified otherwise)Hazard ratio95% confidence intervalTNF inhibitors (reference: csDMARDs)0.530.330.86Other bDMARDs (reference: csDMARDs)0.660.401.09Age ≥ 65 years (baseline)2.961.944.52CRP ≥ 5 ml2.091.393.14> 5 mg and ≤ 10 mg glucocorticoids/day1.040.551.98> 10 mg and ≤ 15 mg glucocorticoids/day2.350.816.79> 15 mg glucocorticoids/day2.030.765.41% of full physical capacity (per 10 percentage points increase, time of event)0.850.780.92Current smoking (baseline)0.980.611.55Former smoking (baseline)0.800.451.43Table 2.Hazard ratios for VTE eventsParametercsDMARDsTNFiOther bDMARDsN350050602534VTE event38 (1.1)55 (1.1)23 (0.9)Age [years]58.8 (12.6)56.5 (12.9)58.1 (12.4)Female sex2575 (73.6)3734 (73.8)1933 (76.3)Disease duration [years]6.2 (7.2)9.4 (8.6)11.9 (9.2)Seropositivity2189 (62.6)3739 (73.9)2048 (80.8)Joint erosions1024 (31.0)2566 (52.4)1523 (63.3)Prior bDMARD therapies0 (0.2)0.3 (0.6)1.2 (1.2)CRP8.8 (8.1)11.6 (10.6)12.4 (11.8)DAS28-ESR4.4 (1.3)4.9 (1.2)5.1 (1.3)% of full physical capacity71.3 (21.8)66.2 (22.6)62.1 (23.5)Current glucocorticoid therapy2564 (73.3)3951 (78.1)2036 (80.4)Heart failure36 (1)113 (2.2)93 (3.7)Coronary artery disease196 (5.6)326 (6.4)183 (7.2)Cerebrovascular disease60 (1.7)86 (1.7)44 (1.7)Osteoporosis400 (11.4)771 (15.2)530 (20.9)Ever smoker1875 (53.6)2738 (54.1)1402 (55.3)Results are presented as mean ± SD or number (percentage).Conclusion:Treatment with TNF inhibitors (compared to csDMARDs) and better physical function significantly reduced the risk of serious VTE events, while age above 65 years and high CRP levels increased this risk.References:[1]Kim S. C. et al. Am. J. Med. 2015; 128(5): 539.e7–539.e17.[2]Desaj R.J. et al. CMAJ 2017; 189:E1438-47.Acknowledgments:RABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Fresenius-Kabi, Hexal, Lilly, MSD, Mylan, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, and UCB.Disclosure of Interests:Martin Schaefer: None declared, Matthias Schneider Grant/research support from: GSK, UCB, Abbvie, Consultant of: Abbvie, Alexion, Astra Zeneca, BMS, Boehringer Ingelheim, Gilead, Lilly, Sanofi, UCB, Speakers bureau: Abbvie, Astra Zeneca, BMS, Chugai, GSK, Lilly, Pfizer, Sanofi, Anett Graessler: None declared, Wolfgang Ochs: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis
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Rudi T, Schaefer M, Manger B, Zink A, Strangfeld A. SAT0088 NO INCREASED RISK OF FALLS IN PATIENTS TREATED WITH BIOLOGICS COMPARED TO THOSE UNDER CSDMARDS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Adults with rheumatoid arthritis (RA) have an increased risk of falling. Previous studies on causes of falls have neither sufficiently nor adequately considered the effects of bDMARDs. In addition, a risk analysis of the individual substances has been lacking until now.Objectives:To analyze the fall risk under exposure to TNFi’s, abatacept (ABA), rituximab (RTX) and tocilizumab (TOC) in comparison to csDMARDs taking co-medication and other risk factors such as disease activity, comorbidities and other biological risks into account.Methods:Data of RA patients observed in RABBIT from 01/2009 - 02/2018 with a follow-up of up to 5 years was used for the analysis. In accordance with consensus guidelines, a fall was defined as “an unexpected event in which participants come to rest on the ground, floor or other lower level” [1].Effects of bDMARDs were examined using “inverse probability weighting“ (IPW) with time-varying treatment on a monthly basis. Directed acyclic graphs were applied to support causal considerations.Results:The percentage of patients with falls (2.7%) was significantly lower than the previously reported 10% and 50% [2]. This underreporting is explained by the fact that falls in RABBIT are reported by the physicians and are not recorded in patient diaries. In line with other studies, falls occurred with older age, longer disease duration, poorer physical function and higher DAS28. Patients with a higher number of comorbidities had a significantly higher risk of falling. The number of patients treated with analgesics was higher in the fall group and fallers had higher glucocorticoid doses. However, the values for pain and fatigue were comparable between the two groups (Table 1). The descriptive analysis showed that patients starting second / third line biologics therapy had a shorter duration from the initiation of treatment to the fall event than patients starting with csDMARDs. None of the regression models showed an increased risk for biologics compared to csDMARDs.Table 1.Characteristics at baseline in fallers and non-fallersFallerNon- FallerN2639405Age, years62.9 (11.9)57.3 (12.6)BMI, kg/m227.4 (5.8)27.3 (5.5)Female, %79.574.2Disease duration, years10.8 (9.8)8.7 (8.5)ACPA+, %46.455.1RF+, %59.765.3DAS285 (1.3)4.8 (1.3)% of full physical function61.2 (24.2)67.3 (22.7)Joint replacement, yes %16.39.8Pain, 0 – 10 scale5.8 (2.3)5.8 (2.3)Fatigue, 0 – 10 scale5.1 (2.7)5.2 (2.7)No. of comorbidities3.4 (3)2.2 (2.2)Osteoporosis, %33.514.4Analgesics, yes %2415.8Glucocorticoid dose, mg/d6 (5.1)5.4 (6.3)Values are means (SDs) unless otherwise specifiedConclusion:None of the inferential analyses could demonstrate an increased risk of falling for any of the bDMARDs compared to csDMARDs. Although descriptive analyses pointed to an earlier fall event in patients treated with second-/third line biologics, these results could be explained by their particular characteristics. These patients tended to be older and were more affected by RA. This suggests that these risks override the effects of bDMARDs.Table 2.Results of weighted* Cox regression, Reference are csDMARDsVariablesUnivariate HR95% CIWeighted HR95% CITNFi‘s1.12(0.85; 1.48)1.05(0.80; 1.39)ABA1.00(0.57; 1.74)0.98(0.57; 1.70)RTX1.39(0.88; 2.22)1.09(0.65; 1.81)TOC0.88(0.59; 1.33)0.77(0.50; 1.18)*Include: age, disease duration, gender, education, joint replacement, fatigue, functional status, pain, stiffness, analgesics, no. of comorbidities, selected comorbiditiesReferences:[1] Lamb SE, et al. Journal of the American Geriatrics Society. 2005;53(9):1618-22.[2] Brenton-Rule A, et al.Seminars in Arthritis and Rheumatism. 2015;44(4):389-98.Acknowledgments :RABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Fresenius Kabi, Hexal, Lilly, MSD, Mylan, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, and UCB.Disclosure of Interests:Tatjana Rudi: None declared, Martin Schaefer: None declared, Bernhard Manger Consultant of: Lilly, Celgene, Janssen, MSD, UCB, Speakers bureau: AbbVie, AstraZeneca, Alexion, Berlin-Chemie, BMS, Celgene, Chugai, Sanofi-Genzyme, GSK, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, SOBI, UCB, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis
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Regierer A, Weiß A, Baraliakos X, Poddubnyy D, Schwarze I, Braun J, Sieper J, Zink A, Strangfeld A. SAT0391 DEPRESSIVE SYMPTOMS ARE ASSOCIATED WITH HIGHER DISEASE ACTIVITY AND WORSE FUNCTIONAL STATUS IN AXSPA: A CROSS-SECTIONAL ANALYSIS FROM RABBIT-SPA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Axial spondyloarthritis (axSpA) is a potentially severe chronic inflammatory disease with impact on function and quality of life. About 20-30% of axSpA patients show symptoms of depression or are diagnosed with depression [1]. Depression may influence outcome, especially patient reported outcomes.Objectives:To assess differences in baseline characteristics and outcome parameters between patients with and without symptoms of depression using WHO-5 score.Methods:RABBIT-SpA is a prospective longitudinal cohort study including axSpA patients enrolled at start of a new conventional treatment (including NSAID) or bDMARD. WHO-5 score was used to identify depressive symptoms categorised into 3 groups using validated cut-offs: moderate to severe depressive symptoms <=28, mild depressive symptoms 29-50, good well-being >50. Baseline values of patients categorised as having moderate to severe depressive symptoms were compared with the rest of the patients using t-test. Spearman correlation coefficient was calculated to analyse the relationship between WHO-5 score and other outcome parameters.Results:A total of 848 axSpA patients were included in this analysis (table 1). Moderate to severe depressive symptoms were found in 221 patients (30%), 226 (31%) had mild depressive symptoms and 285 (39%) reported a good well-being. Percentages of patients with inflammatory back pain, peripheral arthritis or enthesitis as well as the number of affected joints (44 JC) and entheseal sites (using SPARCC) were higher in the group of patients with moderate to severe depressive symptoms.Table 1.ParameterWHO-5 (<=28)Moderate severeN=221WHO-5 (29-50/>50)Mild/well-beingN=511Age, mean43.844.1Female, n (%)100 (45.2)229 (44.8)Disease duration, years, mean6.86.5Inflammatory back pain, n (%)195 (88.6)416 (81.6)Enthesitis, n (%)49 (22.3)78 (15.4)Peripheral arthritis (44 JC), n (%)64 (29.1)134 (26.3)Uveitis, n (%)45 (20.4)76 (15)IBD, n (%)13 (5.9)31 (6.1)Psoriasis, n (%)35 (15.8)58 (11.4)CRP positive (≥5mg/l), n (%)115 (59)243 (55.1)HLA-B27, n (%)151 (72.6)354 (74.2)BMI≥30, n (%)66 (30)117 (23.6)Comorbidities ≥3, n (%)50 (22.6)89 (17.4)Current smoking, n (%)102 (47.2)185 (36.7)All analysed outcome parameters (e.g. ASDAS, ASAS-HI, BASDAI, BASFI, patient global, physician global, pain, sleep) were significantly worse in the group of patients with moderate to severe depressive symptoms versus the other patients (table 2). This includes physician-reported, patient-reported and composite scores.Table 2.ParameterWHO-5 (<=28)Moderate severeN=221WHO-5 (29-50/>50)Mild/well-beingN=511p-valuePhysGA (NRS 0-10)6.2 (1.6)5.4 (1.9)0.0001ASDAS6.1 (1.6)4.2 (1.8)0.0001BASDAI (NRS 0-10)3.5 (0.8)2.9 (0.9)0.0001BASFI (NRS 0-10)5.5 (2.2)3.2 (2.2)0.0001ASAS-HI (0-17)9.8 (3.1)5.8 (3.1)0.0001PatGA (NRS 0-10)7 (1.8)5.4 (2.3)0.0001PatPain (NRS 0-10)6.9 (1.9)5.2 (2.3)0.0001PatSleep (NRS 0-10)7.2 (2.4)4.6 (2.9)0.0001Results are presented as mean ± SD.WHO-5 was highly correlated with all outcome parameters regardless of gender. Figure 1 shows the correlation of BASDAI and WHO-5 stratified for gender.Figure 1.Conclusion:Almost one third (30%) of axSpA patients in this analysis reported scores indicative of depressive symptoms and depression. The strong correlation of WHO-5 scores with patient and physician reported outcomes may be relevant for the management of patients with axSpA.References:[1]Redeker I, et al. Ann Rheum Dis 2018;0:1–8. doi:10.1136Acknowledgments:RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Janssen-Cilag, Lilly, MSD, Mylan, Novartis, Pfizer, and UCB.Disclosure of Interests:Anne Regierer Speakers bureau: Novartis, Celgene, Janssen-Cilag, Anja Weiß: None declared, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Denis Poddubnyy Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB, Ilka Schwarze: None declared, Juergen Braun Grant/research support from: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Eli Lilly and Company, Medac, MSD (Schering Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi- Aventis, and UCB Pharma, Consultant of: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma, Speakers bureau: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma, Joachim Sieper Consultant of: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Speakers bureau: AbbVie, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck, Novartis, Pfizer, Roche, and UCB Pharma, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis
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Albrecht K, Dörner T, Redeker I, Karberg K, Marschall U, Zink A, Callhoff J. THU0554 COMORBIDITY AND HEALTH CARE UTILIZATION IN PERSONS WITH SJÖGREN’S SYNDROME: A CLAIMS DATA ANALYSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Sjögren’s syndrome (SS) can affect numerous organs, including the muscles, the peripheral nervous system, kidneys and lungs. Epidemiological studies assessing comorbidity and health care utilization are needed to improve health care for this multifaceted disease.Objectives:To capture comorbidity and medication of persons with SS in a population-based cohort in comparison to matched controls.Methods:Individuals with an outpatient diagnosis of M35.0 (ICD-10) in ≥2 quarters of a year or an inpatient diagnosis of M35.0 were identified in a German statutory health insurance fund covering 7.2 million people. Persons in rheumatologic care were grouped by incident or prevalent diagnosis and by co-existing autoimmune disease (sSS) or primary (p)SS and compared to age- and sex-matched controls regarding comorbidity (ICD-10), medical prescriptions, hospitalization and inability to work in the previous year.Results:In 2018, 7,374 persons (0.1%) had incident and 53,917 persons (0.73%) prevalent SS diagnosis, and 5,920 (11%) were in rheumatologic care. Of these (90% female, mean age 66 years), 3,431 (58%) had further autoimmune disease (sSS), mostly rheumatoid arthritis (80%) and systemic lupus erythematosus (13%). Compared to controls, frequent comorbid conditions in SS were hypertension, osteoarthritis, osteoporosis and depression (table 1). Systemic antirheumatic drugs were prescribed in 31% (pSS) and 66% (sSS) while < 4% received topical therapies. Glucocorticoids (7% controls/34% pSS/59% sSS), NSAIDs (28%/41%/45%), opioids (9%/15%/22%), analgesics (19%/30%/36%) and antidepressants (14%/21%/22%) were more frequently prescribed in SS than in controls, and also hospitalization (21%/32%/39%) and inability to work in persons <65 years (41%/48%/44%, median days 17/24/31) were more frequent in pSS and sSS than in controls.Table 1Comorbidity claims diagnoses (%) in persons with Sjögren’s syndrome and controlsControlspSSsSSN29,9102,4893,431Age in years, mean66.065.266.6Female, %88.989.190.1Keratoconjunctivitis sicca0.527.928.3Interstitial kidney disease7.612.817.0Lung involvement0.01.21.4Myopathy0.02.43.0Polyneuropathy6.112.515.7Hypertension51.554.863.0Osteoarthritis21.939.946.9Osteoporosis10.326.638.1Fibromyalgia1.110.811.2Depression17.830.132.3Hypothyroidism12.820.819.9Solid Tumour8.810.39.9Metastatic Cancer1.11.21.8Conclusion:SS claims diagnosis is associated with substantial comorbidity and frequent prescription of anti-inflammatory drugs, analgesics and antidepressants. The individual and societal burden of SS shows that, in addition to effective treatment strategies, intensive attention to comorbidities is important in this disease.Acknowledgments:Funding The study was supported by the Wolfgang Schulze Foundation of the German Rheuma-LigaDisclosure of Interests:Katinka Albrecht: None declared, Thomas Dörner Grant/research support from: Janssen, Novartis, Roche, UCB, Consultant of: Abbvie, Celgene, Eli Lilly, Roche, Janssen, EMD, Speakers bureau: Eli Lilly, Roche, Samsung, Janssen, Imke Redeker: None declared, Kirsten Karberg: None declared, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Johanna Callhoff: None declared
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Albrecht K, Redeker I, Aringer M, Marschall U, Zink A, Callhoff J. FRI0151 COMORBIDITY IN INCIDENT SYSTEMIC LUPUS ERYTHEMATOSUS: ANALYSIS OF A CLAIMS DATA COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) targets many tissues including heart, kidney, bone and brain, causing a variety of comorbidities. Epidemiological studies assessing comorbidity in SLE facilitate earlier detection to limit its progression.Objectives:To analyze comorbidities in individuals with an incident diagnosis of systemic lupus erythematosus (SLE) in claims data in comparison to matched controls.Methods:Individuals with ≥2 outpatient or 1 inpatient SLE diagnosis (M32.1, M32.8, M32.9, ICD10) in 2016-2018 and no diagnosis in 2015 or 2014 were identified in a German statutory health insurance fund covering 7.2 million people > 18 years old. Comorbidities defined by the Elixhauser index, medical prescriptions, hospitalization and sick leave were analyzed in the year prior to diagnosis and during a two year follow-up in comparison to age and sex-matched controls without related autoimmune diseases (1:10). To account for detection bias, a second age and sex-matched control group with incident diabetes mellitus (E10-14) was drawn (1:5). To consider diagnostic uncertainty, two sensitivity analyses were performed, namely (i) excluding cases with ICD diagnosis of Sjögren’s syndrome, mixed connective tissue disease, systemic sclerosis and tubulointerstitial nephritis and (ii) excluding cases without any prescription of antimalarials.Results:A total of 559 persons were included (87% female, mean age 55 years). The mean Elixhauser score increased from 1.1 in 2015 to 4.2 in the index year and to 4.5 in the 2nd year after diagnosis. Hypertension (47%), depression (31%), hyperlipidemia (25%), osteoarthritis (25%) and osteoporosis (21%) were among the most frequent comorbidities in the index year. Drug prescriptions (mean 9.7, Δ+6.3), among these glucocorticoids (56%), HCQ (50%) and azathioprine (13%), and hospitalization (40%, Δ+26%) increased in the 1st year after the SLE diagnosis. The increase in comorbidity diagnoses was low in controls without related autoimmune disease, while controls with incident diabetes showed a more pronounced increase in cardiovascular risk factors and and a lesser increase in osteoporosis and cerebrovascular disease (figure 1). Comparable results were found in the sensitivity analyses, where patients with HCQ were younger and had less general comorbidity.Figure 1.Comorbidity claims in persons with incident systemic lupus erythematosus in 2016 (N=559, M32.1,8,9) and age and sex-matched controls (N=5,590 without related autoimmune disease, N=2,795 with incident diabetes, E10-14)Conclusion:Cardiovascular, bone and neurologic comorbidities are frequently detected already at the time of diagnosing SLE. High numbers of medical prescriptions and hospitalization following SLE diagnosis reflect the comprehensive disease burden. Differences to controls without autoimmune disease are overestimated by detection bias.References:FundingThe study was supported by the Wolfgang Schulze Foundation of the German Rheuma-LigaDisclosure of Interests:Katinka Albrecht: None declared, Imke Redeker: None declared, Martin Aringer Consultant of: Boehringer Ingelheim, Roche, Speakers bureau: Boehringer Ingelheim, Roche, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Johanna Callhoff: None declared
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Redeker I, Strangfeld A, Marschall U, Zink A, Baraliakos X. FRI0306 WOMEN WITH AXIAL SPONDYLOARTHRITIS HAVE COMPARABLE RATES OF COMPLICATIONS IN PREGNANCY TO WOMEN IN THE GENERAL POPULATION BUT MORE CAESAREAN DELIVERIES: RESULTS FROM NATIONWIDE CLAIMS DATA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:In contrast to other rheumatic inflammatory diseases, studies on pregnancy outcomes in axial spondyloarthritis (axSpA) are scarce, despite its onset in early adulthood affecting women in their reproductive years.Objectives:To investigate maternal and infant pregnancy outcomes among women with axSpA compared with population-based controls.Methods:Taking advantage of a large health insurance dataset, comprising the period 2006 – 2018, maternal and infant pregnancy outcomes and delivery outcomes of women with axSpA were assessed and compared with population-based controls (matched by maternal age and calendar year of birth). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using generalised estimating equation analyses.Results:A total of 611 singleton births among 535 women with axSpA were included in the analysis. The mean age at delivery was 32.5 years. The pharmacological treatment within 12 months prior to and after conception is illustrated in the Figure. Infants of women with axSpA were only slightly more often preterm (5.2% vs 4.7%) and small-for-gestational-age (1.6% vs 1.1%) than infants of matched population-based controls, respectively. Caesarean section was performed in 36% of deliveries among women with axSpA compared with 29.5% in population-based controls, resulting in a significantly increased risk for receiving caesarean section (OR 1.35; 95% CI 1.06-1.73) (Table). The occurrence of pre-eclampsia, preterm birth, and small-for-gestational-age was moderately higher, but not significantly increased, among women with axSpA as compared to population-based controls.Conclusion:Women with axSpA had no significantly increased risks for adverse maternal or infant pregnancy outcomes compared to non-axSpA women. However, a significantly increased risk for receiving caesarean section and a tendency for a higher number of preterm deliveries and of small-for-gestational-age infants was observed in women with axSpA.Table.Prevalences and odds ratios with 95% confidence intervals for adverse pregnancy outcomesPregnancies in women with axSpAN=611Pregnancies in population-based controlsN=611Odds Ratio(95% CI)Preterm birth (< week 37)5.2% (32)4.7% (29)1.11 (0.66, 1.85)Gestational week 28-364.9% (30)4.7% (29)1.03 (0.61, 1.75)Gestational week <280.3% (2)0.2% (1)2.01 (0.18, 22.18)Small for gestational age1.6% (10)1.1% (7)1.43 (0.54, 3.79)Low birth weight (<2500 g)2.8% (17)2.6% (16)1.06 (0.53, 2.13)Exceptionally large baby(birth weight ≥4500 g)1.1% (7)0.2% (1)7.07 (0.87, 57.63)Pre-eclampsia7.5% (46)6.4% (39)1.21 (0.78, 1.90)Assisted vaginal delivery4.3% (26)3.1% (19)1.39 (0.76, 2.56)Caesarean section36.0% (220)29.5% (180)1.35 (1.06, 1.73)axSpA, axial Spondyloarthritis; CI, confidence interval.Acknowledgments:We would like to thank the BARMER Statutory Health Insurance for providing data for this study.Disclosure of Interests:Imke Redeker: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Ursula Marschall: None declared, Angela Zink Speakers bureau: AbbVie, Amgen, BMS, Gilead, Hexal, Janssen, Lilly, MSD, Pfizer, Roche, Sanofi Aventis, UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen
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