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Lange A, Petros FG. Editorial Comment. Urol Pract 2024; 11:365. [PMID: 38315877 DOI: 10.1097/upj.0000000000000507.01] [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] [Received: 06/05/2023] [Accepted: 11/22/2023] [Indexed: 02/07/2024]
Affiliation(s)
- Alyssa Lange
- Department of Urology, College of Medicine and Life Sciences, The University of Toledo, Toledo, Ohio
| | - Firas G Petros
- Department of Urology, College of Medicine and Life Sciences, The University of Toledo, Toledo, Ohio
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Malakooti SK, Siddiqui H, Wilson B, Bej T, O’Mara M, Desotelle A, Lange A, Shive CL, Singer NG, McComsey GA, Kostadinova L, Mattar M, Zidar DA, Anthony DD. Higher Vitamin D Levels before Methotrexate Therapy Initiation Are Associated with Lower Subsequent Mortality in Patients with Rheumatoid Arthritis. Nutrients 2024; 16:401. [PMID: 38337687 PMCID: PMC10857393 DOI: 10.3390/nu16030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Vitamin D deficiency is associated with mortality in the general population and has been observed in one rheumatoid arthritis (RA) cohort. Here, we investigate the relationship between 25-hydroxyvitamin D (25(OH)D) levels before methotrexate (MTX) therapy initiation in patients with RA and the subsequent all-cause mortality in a national Veterans Affairs (VA) cohort. (2) This is a retrospective study on RA patients time-oriented around the initial MTX prescription and 25(OH)D levels before starting MTX. We examined survival in patients with 25(OH)D levels > 50 nmol/L and ≤50 nmol/L using the Cox Proportional Hazard Model and fully adjusted for risk factors. (3) In total, 15,109 RA patients were included in the nationwide cohort. RA patients with 25(OH)D levels > 50 nmol/L before starting MTX had a 28% reduced risk of mortality when compared to those with levels ≤ 50 nmol/L (HR: 0.72, CI: 0.64-0.80, p < 0.001) after adjusting for traditional risk factors. (4) In this national RA cohort receiving standard-of-care MTX, patients with 25(OH)D levels > 50 nmol/L have a lower subsequent mortality when compared to those with 25(OH)D levels ≤ 50 nmol/L. It remains to be determined whether increasing Vitamin D levels in RA patients initially found to be Vitamin D deficient impacts their all-cause mortality.
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Affiliation(s)
- Shahdi K. Malakooti
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Hinnah Siddiqui
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Brigid Wilson
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Taissa Bej
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Megan O’Mara
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Alexandra Desotelle
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Alyssa Lange
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Carey L. Shive
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Nora G. Singer
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
| | - Grace A. McComsey
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Lenche Kostadinova
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Maya Mattar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - David A. Zidar
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
| | - Donald D. Anthony
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH 44109, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA; (H.S.); (B.W.)
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Kostadinova L, Lange A, Damjanovska S, Gad I, Syed S, Siddiqui H, Yousif P, Kowal CM, Shive C, Burant C, Singer N, Bej T, Al-Kindi S, Wilson B, Mattar M, Zidar DA, Anthony DD. Dr. Kostadinova et al reply. J Rheumatol 2023; 50:1356. [PMID: 37399468 DOI: 10.3899/jrheum.2023-0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Affiliation(s)
- Lenche Kostadinova
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Alyssa Lange
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sofi Damjanovska
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Ibtissam Gad
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sameena Syed
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Husna Siddiqui
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Patrick Yousif
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Corinne M Kowal
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Carey Shive
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
- Department of Pathology, Case Western Reserve University
| | - Christopher Burant
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Nora Singer
- Division of Rheumatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Taissa Bej
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sadeer Al-Kindi
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Brigid Wilson
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Maya Mattar
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - David A Zidar
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Donald D Anthony
- Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University;
- Department of Pathology, Case Western Reserve University
- Division of Rheumatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
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Lange A, Wutke M, Ammer S, Appel AK, Henne H, Deermann A, Traulsen I. Old breeds, new solutions? Effects of two different traditional sire breeds on skin lesions, tail lesions, tail losses, performance and behaviour of rearing pigs. Animal 2023; 17:100721. [PMID: 36857817 DOI: 10.1016/j.animal.2023.100721] [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: 06/28/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Some studies indicated a relationship between modern, fast-growing, lean-meat-producing hybrid pigs and the occurrence of tail-biting, one of the major issues of conventional pig husbandry. Therefore, this study investigated the effects of different local, traditional sire breeds on the behaviour and performance of rearing pigs. Between December 2019 and November 2020, a total of 1 561 piglets were weaned from hybrid sows (Bundes Hybrid Zucht Programm (BHZP) Landrace × BHZP Large White) that were paired with either Swabian-Hall (SH), Bentheim Black Pied (BB) or BHZP-Piétrain (Pi) boars. Tails of the piglets were left intact (43.5%) or docked (56.5%), and male piglets were castrated. Piglets were conventionally reared on fully slatted plastic flooring in mixed-sex groups. Starting one day after weaning, skin lesions were scored once per pig, and tail lesions and losses were scored weekly until the end of rearing. The average daily gain was documented for the suckling and rearing period. The activity behaviour of eight focal pens was analysed using video recordings. Differences between modern and traditional breeds were found in this study for so-called aggressive and non-aggressive biting pronounced by skin and tail lesions and tail losses. Significantly fewer BB pigs had severe skin lesions on the front body than SH or Pi pigs (P < 0.05). Additionally, piglets that were classified as light (<5.6 kg) at weaning showed skin lesion scores of 0 more often than piglets that were classified with a medium (≥5.6-≤8.3 kg) or heavy (>8.3 kg) weaning weight (P < 0.05). In the first half of the rearing period, significantly more BB pigs were assessed as having no tail lesions and tail losses than SH and Pi pigs (P < 0.01). However, these differences disappeared in the second half of rearing. Either docked or undocked Pi pigs had significantly higher average daily gains than SH and BB pigs (P < 0.05). The activity of the focal pens was not influenced by the sire breed or tail lesion class, which might be due to the limited sample size of eight pens. To conclude, the use of the traditional sire breed BB has the potential to reduce injurious behaviour in the offspring. However, adjustments to the housing and feeding should be taken to further reduce the incidence of tail lesions and losses and to enhance performance.
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Affiliation(s)
- A Lange
- Department of Animal Sciences, Livestock Systems, Georg-August-University, Albrecht-Thaer-Weg 3, 37075 Göttingen, Germany.
| | - M Wutke
- Department of Animal Sciences, Breeding Informatics Group, Georg-August-University, Margarethe von Wrangell-Weg 7, 37075 Göttingen, Germany
| | - S Ammer
- Department of Animal Sciences, Livestock Systems, Georg-August-University, Albrecht-Thaer-Weg 3, 37075 Göttingen, Germany
| | - A K Appel
- BHZP GmbH, An der Wassermühle 8, 21368 Dahlenburg-Ellringen, Germany
| | - H Henne
- BHZP GmbH, An der Wassermühle 8, 21368 Dahlenburg-Ellringen, Germany
| | - A Deermann
- ASB GmbH, Boschstraße 9, 49770 Herzlake, Germany
| | - I Traulsen
- Department of Animal Sciences, Livestock Systems, Georg-August-University, Albrecht-Thaer-Weg 3, 37075 Göttingen, Germany
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Lange A, Kostadinova L, Damjanovska S, Gad I, Syed S, Siddiqui H, Yousif P, Kowal CM, Shive C, Burant C, Singer N, Bej T, Al-Kindi S, Wilson B, Mattar M, Zidar DA, Anthony DD. Red Cell Distribution Width and Absolute Lymphocyte Count Associate With Biomarkers of Inflammation and Subsequent Mortality in Rheumatoid Arthritis. J Rheumatol 2023; 50:166-174. [PMID: 36319020 PMCID: PMC9898085 DOI: 10.3899/jrheum.211411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Morbidity and mortality in rheumatoid arthritis (RA) is partly mitigated by maintaining immune and hematologic homeostasis. Identification of those at risk is challenging. Red cell distribution width (RDW) and absolute lymphocyte count (ALC) associate with cardiovascular disease (CVD) and mortality in the general population, and with disease activity in RA. How these variables relate to inflammation and mortality in RA was investigated. METHODS In a retrospective single Veterans Affairs (VA) Rheumatology Clinic cohort of 327 patients with RA treated with methotrexate (MTX)+/- a tumor necrosis factor (TNF) inhibitor (TNFi), we evaluated RDW and ALC before and during therapy and in relation to subsequent mortality. Findings were validated in a national VA cohort (n = 13,914). In a subset of patients and controls, we evaluated inflammatory markers. RESULTS In the local cohort, high RDW and low ALC prior to MTX treatment was associated with subsequent mortality over 10 years (both P < 0.001). The highest mortality was observed in those with both high RDW and low ALC. This remained after adjusting for age and comorbidities and was validated in the national RA cohort. In the immunology cohort, soluble and cellular inflammatory markers were higher in patients with RA than in controls. ALC correlated with age, plasma TNF receptor II, natural killer HLA-DR mean fluorescence intensity, and CD4CM/CD8CM HLA-DR/CD38%, whereas RDW associated with age and ALC. MTX initiation was followed by an increase in RDW and a decrease in ALC. TNFi therapy added to MTX resulted in an increase in ALC. CONCLUSION RDW and ALC before disease-modifying antirheumatic drug therapy are associated with biomarkers of monocyte/macrophage inflammation and subsequent mortality. The mechanistic linkage between TNF signaling and lymphopenia found here warrants further investigation.
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Affiliation(s)
- Alyssa Lange
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Lenche Kostadinova
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sofi Damjanovska
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Ibtissam Gad
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sameena Syed
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Husna Siddiqui
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Patrick Yousif
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Corinne M Kowal
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Carey Shive
- C. Shive, PhD, Department of Medicine, VA Medical Center and VA GRECC, and Department of Pathology, Case Western Reserve University
| | - Christopher Burant
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Nora Singer
- N. Singer, MD, Division of Rheumatology, MetroHealth Medical Center, Case Western Reserve University
| | - Taissa Bej
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Sadeer Al-Kindi
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Brigid Wilson
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Maya Mattar
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - David A Zidar
- A. Lange, MS, L. Kostadinova, MD, S. Damjanovska, MD, I. Gad, MD, S. Syed, MD, H. Siddiqui, MD, P. Yousif, MD, C.M. Kowal, BS, C. Burant, PhD, T. Bej, MS, S. Al-Kindi, MD, B. Wilson, PhD, M. Mattar, MD, D.A. Zidar, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, Case Western Reserve University
| | - Donald D Anthony
- D.D. Anthony, MD, PhD, Department of Medicine, VA Medical Center and VA GRECC, and Department of Pathology, and Division of Rheumatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
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Honarpisheh M, Lei Y, Zhang Y, Pehl M, Kemter E, Kraetzl M, Lange A, Wolf E, Wolf-van Buerck L, Seissler J. Formation of Re-Aggregated Neonatal Porcine Islet Clusters Improves In Vitro Function and Transplantation Outcome. Transpl Int 2022; 35:10697. [PMID: 36685665 PMCID: PMC9846776 DOI: 10.3389/ti.2022.10697] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Neonatal porcine islet-like cell clusters (NPICCs) are a promising source for islet cell transplantation. Excellent islet quality is important to achieve a cure for type 1 diabetes. We investigated formation of cell clusters from dispersed NPICCs on microwell cell culture plates, evaluated the composition of re-aggregated porcine islets (REPIs) and compared in vivo function by transplantation into diabetic NOD-SCID IL2rγ-/- (NSG) mice with native NPICCs. Dissociation of NPICCs into single cells and re-aggregation resulted in the formation of uniform REPI clusters. A higher prevalence of normoglycemia was observed in diabetic NSG mice after transplantation with a limited number (n = 1500) of REPIs (85.7%) versus NPICCs (n = 1500) (33.3%) (p < 0.05). Transplanted REPIs and NPICCs displayed a similar architecture of endocrine and endothelial cells. Intraperitoneal glucose tolerance tests revealed an improved beta cell function after transplantation of 1500 REPIs (AUC glucose 0-120 min 6260 ± 305.3) as compared to transplantation of 3000 native NPICCs (AUC glucose 0-120 min 8073 ± 536.2) (p < 0.01). Re-aggregation of single cells from dissociated NPICCs generates cell clusters with excellent functionality and improved in vivo function as compared to native NPICCs.
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Affiliation(s)
- M. Honarpisheh
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Y. Lei
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - Y. Zhang
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - M. Pehl
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - E. Kemter
- Chair for Molecular Animal Breeding and Biotechnology, Gene Centre and Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - M. Kraetzl
- Chair for Molecular Animal Breeding and Biotechnology, Gene Centre and Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
| | - A. Lange
- Chair for Molecular Animal Breeding and Biotechnology, Gene Centre and Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
| | - E. Wolf
- Chair for Molecular Animal Breeding and Biotechnology, Gene Centre and Department of Veterinary Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - L. Wolf-van Buerck
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - J. Seissler
- Medizinische Klinik und Poliklinik IV, Diabetes Zentrum - Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
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Damjanovska S, Davitkov P, Gopal S, Kostadinova L, Kowal C, Lange A, Moreland A, Shive CL, Wilson B, Bej T, Al-Kindi S, Falck-Ytter Y, Zidar DA, Anthony DD. High Red Cell Distribution Width and Low Absolute Lymphocyte Count Associate With Subsequent Mortality in HCV Infection. Pathog Immun 2022; 6:90-104. [PMID: 34988340 PMCID: PMC8714176 DOI: 10.20411/pai.v6i2.467] [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: 07/01/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Hepatitis-C virus (HCV) chronic infection can lead to cirrhosis, hepatocellular carcinoma (HCC), end-stage liver disease, cardiovascular disease (CVD), and mortality. Transient Elastography (TE) is used to non-invasively assess fibrosis. Whether immune monitoring provides additive prognostic value is not established. Increased red-cell distribution width (RDW) and decreased absolute lymphocyte count (ALC) predict mortality in those without liver disease. Whether these relationships remain during HCV infection is unknown. Materials and Methods: A retrospective cohort of 1,715 single-site VA Liver Clinic patients receiving Transient Elastography (TE) 2014-2019 to evaluate HCV-associated liver damage were evaluated for RDW and ALC in relation to traditional parameters of cardiovascular risk, liver health, development of HCC, and mortality. Results: The cohort was 97% male, 55% African American, 26% with diabetes mellitus, 67% with hypertension, and 66% with tobacco use. After TE, 3% were subsequently diagnosed with HCC, and 12% (n=208) died. Most deaths (n=189) were due to non-liver causes. The TE score associated with prevalent CVD, positively correlated with atherosclerotic cardiovascular disease (ASCVD) 10-Year Risk Score, age, RDW, and negatively correlated with ALC. Patients with anisocytosis (RDW above 14%) or lymphopenia (ALC level under 1.2×109/L) had greater subsequent all-cause mortality, even after adjusting for age, TE score, and comorbidities. TE score, and to a modest degree RDW, were associated with subsequent liver-associated mortality, while TE score, RDW, and ALC were each independently associated with non-liver cause of death. Conclusion: Widely available mortality calculators generally require multiple pieces of clinical information. RDW and ALC, parameters collected on a single laboratory test that is commonly performed, prior to HCV therapy may be pragmatic markers of long-term risk of mortality.
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Affiliation(s)
- Sofi Damjanovska
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Medicine, University Hospitals Cleveland Medical Center
| | - Perica Davitkov
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - Surya Gopal
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Lenche Kostadinova
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Medicine, University Hospitals Cleveland Medical Center
| | - Corrine Kowal
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Alyssa Lange
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Anita Moreland
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - Carey L Shive
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Brigid Wilson
- Research and Education Foundation for Cleveland VA, Cleveland, OH
| | - Taissa Bej
- Research and Education Foundation for Cleveland VA, Cleveland, OH
| | - Sadeer Al-Kindi
- University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - David A Zidar
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Donald D Anthony
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Pathology, Case Western Reserve University, Cleveland, OH.,Department of Medicine, MetroHealth Medical Center, Cleveland, OH
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8
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Lange A, Palka P, Huntress H, Steindl J. Incremental Role Of Ct Coronary Angiography In The Assessment Of Left Ventricular Diastolic Function. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.217] [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: 11/15/2022]
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9
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Auma AWN, Shive CL, Lange A, Damjanovska S, Kowal C, Zebrowski E, Pandiyan P, Wilson B, Kalayjian RC, Canaday DH, Anthony DD. Naïve CD4+ T Cell Lymphopenia and Apoptosis in Chronic Hepatitis C Virus Infection Is Driven by the CD31+ Subset and Is Partially Normalized in Direct-Acting Antiviral Treated Persons. Front Immunol 2021; 12:641230. [PMID: 33912168 PMCID: PMC8075159 DOI: 10.3389/fimmu.2021.641230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/24/2021] [Indexed: 12/29/2022] Open
Abstract
Background The mechanisms underlying naïve CD4+ lymphopenia during chronic Hepatitis C Virus (HCV) infection are unclear. Whether direct-acting antiviral (DAA) therapy restores peripheral naïve CD4+ T cell numbers and function is unknown. Methods We enumerated frequencies and counts of peripheral naïve CD4+, CD4+CD31+ and CD4+CD31- T cells by flow cytometry in a cross sectional analysis comparing chronic HCV infected (n=34), DAA-treated(n=29), and age-range matched controls (n=25), as well as in a longitudinal cohort of HCV DAA treated persons (n=16). The cross-sectional cohort was stratified by cirrhosis state. Cell apoptosis/survival (AnnexinV+7AAD+/BCL-2 labeling) and cell cycle entry (Ki67 expression) of CD31+ and CD31- naïve CD4+ T cells was analyzed directly ex vivo and following 3 and 5 days of in vitro culture with media, interleukin (IL) -7 or CD3/CD28 activator. Results In the cross-sectional cohort, naïve CD4+ proportions were lower in chronic HCV infected persons compared to controls and DAA-treated persons, an effect in part attributed to cirrhosis. Age was associated with naïve cell counts and proportions in HCV infected and treated persons as well. Naïve CD4+ cell proportions negatively correlated with plasma levels of soluble CD14 following therapy in DAA-treated persons. Naïve CD4+ cells from HCV infected persons exhibited greater direct ex vivo apoptosis and cell-cycling compared to cells from DAA-treated persons and controls, and this was localized to the CD4+CD31+ subset. On the other hand, no remarkable differences in expression of BCL-2 or IL-7 Receptor (CD127) at baseline or following in vitro media or IL7 containing culture were observed. In the longitudinal cohort, naïve CD4+CD31+/CD31- ratio tended to increase 24 weeks after DAA therapy initiation. Conclusions Activation and apoptosis of peripheral naïve CD4+CD31+ T cells appear to contribute to naïve CD4+ lymphopenia in chronic HCV infection, and this defect is partially reversible with HCV DAA therapy. Age and cirrhosis -associated naïve CD4+ lymphopenia is present both before and after HCV DAA therapy. These findings have implications for restoration of host immune function after DAA therapy.
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Affiliation(s)
- Ann W N Auma
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Carey L Shive
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States.,GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Alyssa Lange
- GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Sofi Damjanovska
- GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Corinne Kowal
- GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | | | - Pushpa Pandiyan
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Brigid Wilson
- GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Robert C Kalayjian
- Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - David H Canaday
- GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States
| | - Donald D Anthony
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States.,GRECC, VA Northeast Ohio Healthcare System, Cleveland, OH, United States.,Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
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10
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Lange A, Weixler V, Kramer P, Romanchenko O, Murin P, Mykychak Y, Cho MY, Berger F, Dähnert I, Photiadis J. 30 Years of Surgical Repair of Complex D-Transposition of the Great Arteries: How to Avoid Outflow Tract Obstructions? Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725697] [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: 10/21/2022]
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11
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Abstract
ZusammenfassungDie Verkehrsmedizin als Teil der Rechtsmedizin erfüllt in der Schweiz eine wichtige präventive Aufgabe in der Sicherung aller Verkehrsteilnehmer: Sie begutachtet die medizinisch basierte Fahrfähigkeit und Fahreignung. Als empirisch konsolidiertes Querschnittsfach hat sie Informationen aus einer Vielzahl von medizinischen Fachgebieten. Wie reagiert die Verkehrsmedizin aber auf den vermehrten Anspruch evidenzbasierter Gutachten und auf anstehende Herausforderungen?Über einen historischen Abriss motivierten wir die Vorteile und das Potential einer teilweise durch Fahrsimulation ergänzten Untersuchung und einer dediziert auf Fahrsimulation basierenden, klinisch-prospektiven Forschung.Neben vorhandener Literatur stützen sich historische Aspekte u.a. auf vorhandene Expertise. Die Bewertung der Fahrsimulation für die Verkehrs- bzw. Rechtsmedizin der Schweiz stützt sich auf die Diskussion selektierter Literatur.Auftrag und Anspruch der Verkehrsmedizin haben sich mehrfach verändert. Eine übersichtsartige Betrachtung existenter Literatur legt nahe, dass massgeschneiderte Fahrsimulatoren Teil einer modernisierten Verkehrsmedizin sein können, um anstehende Herausforderungen adäquat adressieren zu können. Bisher existiert kein derartiges dediziertes Forschungsinstrument in der Schweiz.Eine auf verkehrsmedizinische Fragestellungen massgeschneiderte, realitätsnahe und niedrigschwellige Fahrsimulation als Werkzeug für klinische Studien und Individualuntersuchungen verspricht neben einer wissenschaftlichen Produktivität einen umsetzbaren und vermittelbaren Mehrwert für das übergeordnete Ziel der Sicherheit aller Verkehrsteilnehmer.
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Affiliation(s)
- A. Lange
- Technische Universität Hamburg Institut für Prozess- und Anlagentechnik Am Schwarzenberg-Campus 4 21075 Hamburg Deutschland
| | - G. Fieg
- Technische Universität Hamburg Institut für Prozess- und Anlagentechnik Am Schwarzenberg-Campus 4 21075 Hamburg Deutschland
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Paszkiewicz-Kozik E, Michalski W, Taszner M, Knopińska-Posłuszny W, Mordak-Domagała M, Najda J, Borawska A, Romejko-Jarosińska J, Chełstowska M, Świerkowska M, Dąbrowska-Iwanicka A, Malenda A, Druzd-Sitek A, Konecki R, Kuniega B, Osowiecki M, Ostrowska B, Szpila T, Domańska-Czyż K, Szymański M, Targoński Ł, Poplawska L, Kotarska M, Giebel S, Lange A, Pluta A, Warzocha K, Zaucha J, Rymkiewicz G, Walewski J. OFATUMUMAB WITH IVAC FOR DLBCL PATIENTS WHO FAILED R-CHOP AND WERE NOT CANDIDATES FOR HIGH-DOSE THERAPY AND ASCT - PHASE 2 TRIAL OF THE POLISH LYMPHOMA RESEARCH GROUP (PLRG-8). Hematol Oncol 2019. [DOI: 10.1002/hon.111_2631] [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: 11/07/2022]
Affiliation(s)
- E. Paszkiewicz-Kozik
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - W. Michalski
- Biostatistics Unit; Maria Sklodowska-Curie Institute - Oncology Center; Warsaw Poland
| | - M. Taszner
- Hematology Department; Medical University; Gdansk Poland
| | - W. Knopińska-Posłuszny
- Hematology Department; Independent Public Health Care of the Ministry of the Internal Affairs with the Oncology Centre; Olsztyn Poland
| | - M. Mordak-Domagała
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - J. Najda
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Borawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Romejko-Jarosińska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Chełstowska
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - M. Świerkowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Dąbrowska-Iwanicka
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Malenda
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - A. Druzd-Sitek
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - R. Konecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Kuniega
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - M. Osowiecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Ostrowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - T. Szpila
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - K. Domańska-Czyż
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Szymański
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - Ł. Targoński
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - L. Poplawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Kotarska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - S. Giebel
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Lange
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - A. Pluta
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - K. Warzocha
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - J. Zaucha
- Oncology Department; Maritime Hospital; Gdynia Poland
| | - G. Rymkiewicz
- Pathology Department; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Walewski
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
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Gomulka K, Liebhart J, Jaskula E, Lange A, Medrala W. The -2549 -2567 del18 Polymorphism in VEGF and Irreversible Bronchoconstriction in Asthmatics. J Investig Allergol Clin Immunol 2018; 29:431-435. [PMID: 30574871 DOI: 10.18176/jiaci.0369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND While the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of several diseases (eg, neoplasms) has been proven, its role in asthma, especially in terms of the potential associations between genetic variants of VEGF and airway remodeling, has received relatively little attention. Objectives: This study aimed to evaluate the possible connection between a genetic factor, ie, the polymorphism del/ins in the VEGF promoter region, and airway remodeling potential in asthmatics with and without irreversible bronchoconstriction. MATERIAL AND METHODS The study population comprised 82 patients with asthma (of whom 42 had irreversible bronchoconstriction) and a group of 40 controls. DNA was isolated from peripheral blood leukocytes. Polymerase chain reaction was used to type the VEGF (18-bp deletion/insertion) gene polymorphism at loci -2549 -2567. Other factors (ie, smoking, disease duration) were also taken into consideration. RESULTS The del/del genotype was found in 74.39% of patients with asthma (P=.031; OR=2.38), 80.95% of patients with irreversible bronchoconstriction (P=.012; OR=3.48), and 67.5% patients with reversible bronchoconstriction (P=.251; OR=1.70). The proportion of smokers to nonsmokers was higher (P=.032) and disease duration was longer (P=.041) in patients with irreversible bronchoconstriction than in those with reversible bronchoconstriction. CONCLUSIONS Our results showed that the risk of irreversible bronchoconstriction in asthmatics was associated with the presence of the del18 genotype at the -2549 -2567 position in the promoter region of the VEGF gene, as were disease duration and other factors such as smoking.
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Affiliation(s)
- K Gomulka
- Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - J Liebhart
- Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - E Jaskula
- Laboratory of Clinical Immunology, L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science and Lower Silesian Cell Transplant Centre and National Bank of Bone Marrow Donors, Wroclaw, Poland
| | - A Lange
- Laboratory of Clinical Immunology, L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science and Lower Silesian Cell Transplant Centre and National Bank of Bone Marrow Donors, Wroclaw, Poland
| | - W Medrala
- Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Bott N, Lange A, Rentz D, Buffalo E, Clopton P, Zola S. A - 01Web Camera Based Eye Tracking on a Visual Paired Comparison Task: Replication and Relationships with Preclinical Alzheimer Cognitive Indices. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arnold L, Keller B, Lange A, Szagun B. „Mein Haus, mein Auto, mein Boot“. Zufriedenheit mit dem Lebensstandard als geschlechtsspezifischer Mortalitätsprädiktor. Gesundheitswesen 2018; 80:S88-S96. [DOI: 10.1055/s-0042-102348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Hintergrund: Männer haben ein höheres Mortalitätsrisiko als Frauen und reagieren wesentlich sensibler auf statusbezogene Stressbelastungen. Mögliche Erklärungen für die stärker ausgeprägte männliche Empfindlichkeit liefert der über die HPA-Achse vermittelte Zusammenhang zwischen hierarchischem Rang und Gesundheit. Viel Aufmerksamkeit hat in diesem Zusammenhang das Konstrukt des Statusunbehagens erfahren, wonach soziale Vergleichsprozesse das generelle Wohlbefinden senken und als wesentliche Risikofaktoren für verschiedene Erkrankungen angesehen werden.
Methodik: Mittels Sekundärdatenanalyse des sozio-ökonomischen Panels (SOEP) soll analysiert werden, inwiefern die subjektive Unzufriedenheit mit dem eigenen Lebensstandard mit einem erhöhten geschlechtsabhängigen Mortalitätsrisiko assoziiert werden kann. Zur statistischen Modellierung der Fragestellung werden geschlechtsdifferenzierte Cox-Regressionsmodelle berechnet. Die unbalancierte Teilstichprobe umfasst 6 963 Männer (764 Todesfälle) und 7 461 Frauen (663 Todesfälle).
Ergebnisse: Unzufriedenheit mit dem eigenen Lebensstandard hat einen signifikanten Einfluss auf das Mortalitätsrisiko von Männern nicht jedoch von Frauen. Unzufriedene Männer weisen ein nahezu doppelt so hohes Mortalitätsrisiko auf als die Referenzgruppe (HR=1,95, 95% KI 1,48–2,58), Männer mit mittlerer Zufriedenheit ein um 25% höheres Mortalitätsrisiko (HR=1,26, 95% KI 1,08–1,49). Außerdem zeigt der subjektive Statusindikator stärkere Dosis-Wirkungs-Beziehungen als die klassischen objektiven Statusparameter.
Schlussfolgerung: Unzufriedenheit mit dem eigenen Lebensstandard kann mit einem erhöhten geschlechtsabhängigen Mortalitätsrisiko in Verbindung gebracht werden und erweist sich als klarer Prädiktor insbesondere für die männliche Mortalität. Eine zentrale Ursache können über die HPA-Achse vermittelte Stressreaktionen aufgrund von herabsetzenden sozialen Vergleichsprozessen zu sein. Die Ergebnisse sprechen für eine standardisierte Einbeziehung subjektiver Statusindikatoren; der ausgeprägte Geschlechterunterschied legt darüber hinaus eine geschlechtergerechte epidemiologische Datenanalyse nahe.
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Affiliation(s)
- L. Arnold
- Fakultät Soziale Arbeit, Gesundheit und Pflege, Hochschule Ravensburg-Weingarten, Weingarten
| | - B. Keller
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Zentrum für Gesundheitswissenschaften, Bachelorstudiengang Gesundheitsförderung und Prävention, Winterthur, Schweiz
| | - A. Lange
- Fakultät Soziale Arbeit, Gesundheit und Pflege, Hochschule Ravensburg-Weingarten, Weingarten
| | - B. Szagun
- Fakultät Soziale Arbeit, Gesundheit und Pflege, Hochschule Ravensburg-Weingarten, Weingarten
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Lange A, Plaku-Alakbarova B, Yeh J, Messerlian C, Toth T. Female, male, and joint couple BMI are associated with infertilty among users of a large U.S. fertilty app. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.755] [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: 10/18/2022]
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Messerlian C, Plaku-Alakbarova B, Lange A, Yeh J, Toth T, Hauser R. Self-reported home and work stress and trying to conceive - using big data in the study of infertility. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Siol V, Lange A, Prenzler A, Neubauer S, Frank M. [Willingness of Students of Economics to Pay for Predictive Oncological Genetic Testing - An Empirical Analysis]. Gesundheitswesen 2017; 79:425-437. [PMID: 28575925 DOI: 10.1055/s-0035-1547300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: The present study aims to investigate the interest of young adults in predictive oncological genetic testing and their willingness to pay for such a test. Furthermore, major determinants of the 2 variables of interest were identified. Methods: 348 students of economics from the Leibniz University of Hanover were queried in July 2013 using an extensive questionnaire. Among other things, the participants were asked if they are interested in information about the probability to develop cancer in the future and their willingness to pay for such information. Data were analysed using descriptive statistics and ordinal probit regressions. Additionally marginal effects were calculated. Results: About 50% of the students were interested in predictive oncological genetic testing and were willing to pay for the test. Moreover, the participants who were willing to pay for the test partly attach high monetary values to the information that could so be obtained. The study shows that the interest of the students and their willingness to pay were primarily influenced by individual attitudes and perceptions. Conclusions: The study proves that young adults were interested in predictive genetic testing and appreciate information about their probability of develop cancer someday.
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Affiliation(s)
- V Siol
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - A Lange
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - A Prenzler
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - S Neubauer
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
| | - M Frank
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Hannover
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Krüger P, Schmidt F, Otto S, Lange A, Langner S. Röntgenaufnahmen des pädiatrischen Thorax im Kontext der aktuellen Leitlinien der Europäischen Kommission – Sind die Vorgaben in der täglichen Routine realisierbar? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P Krüger
- Universitätsmedizin Greifswald, Institut für Diagnostische Radiologie und Neuroradiologie, Greifswald
| | - F Schmidt
- Universitätsmedizin Greifswald, Institut für Diagnostische Radiologie und Neuroradiologie, Greifswald
| | - S Otto
- Universitätsmedizin Greifswald, Institut für Diagnostische Radiologie und Neuroradiologie, Greifswald
| | - A Lange
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Kinder- und Jugendmedizin, Greifswald
| | - S Langner
- Universitätsmedizin Greifswald, Institut für Diagnostische Radiologie und Neuroradiologie, Greifswald
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Müller T, August P, Jesse M, Lange A. Diagnosis of an Invisible Iris Cyst Using Autorefractometry and Anterior Segment Optical Coherence Tomography. Klin Monbl Augenheilkd 2017; 234:604-605. [DOI: 10.1055/s-0042-122913] [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)
- T. Müller
- Vista Klinik, Hauptstrasse 55, 4102 Binningen, Switzerland
| | - P. August
- Augenarztpraxis am Marktplatz, Gerbergasse 1, 4001 Basel, Switzerland
| | - M. Jesse
- Vista Klinik, Hauptstrasse 55, 4102 Binningen, Switzerland
| | - A. Lange
- Vista Klinik, Hauptstrasse 55, 4102 Binningen, Switzerland
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Ebert DD, Donkin L, Andersson G, Andrews G, Berger T, Carlbring P, Rozenthal A, Choi I, Laferton JAC, Johansson R, Kleiboer A, Lange A, Lehr D, Reins JA, Funk B, Newby J, Perini S, Riper H, Ruwaard J, Sheeber L, Snoek FJ, Titov N, Ince BÜ, van Bastelaar K, Vernmark K, van Straten A, Warmerdam L, Salsman N, Cuijpers P. Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychol Med 2016; 46:2679-2693. [PMID: 27649340 PMCID: PMC5560500 DOI: 10.1017/s0033291716001562] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach. METHOD Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data. RESULTS A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration. CONCLUSIONS Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
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Affiliation(s)
- D. D. Ebert
- Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - L. Donkin
- The Brain and Mind Research Institute, University of Sydney, NSW, Australia
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - G. Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - G. Andrews
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - T. Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - P. Carlbring
- Department of Psychology, Stockholm University, Sweden
| | - A. Rozenthal
- Department of Psychology, Stockholm University, Sweden
| | - I. Choi
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - R. Johansson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - A. Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - A. Lange
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - D. Lehr
- Leuphana University Lüneburg, Germany
| | | | - B. Funk
- Leuphana University Lüneburg, Germany
| | - J. Newby
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, Darlinghurst, NSW, Australia
| | - S. Perini
- Centre for Emotional Health, Macquarie University, Australia
| | - H. Riper
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - J. Ruwaard
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - L. Sheeber
- Oregon Research Institute, Eugene, Oregon, USA
| | - F. J. Snoek
- Department of Medical Psychology, VU University Medical Center Amsterdam, The Netherlands
- Academic Medical Center/University of Amsterdam, The Netherlands
| | - N. Titov
- eCentreClinic and MindSpot Clinic, Department of Psychology, Macquarie University, Australia
| | - B. Ünlü Ince
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - K. van Bastelaar
- Department of Medical Psychology, VU University Medical Center Amsterdam, The Netherlands
| | - K. Vernmark
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Psykologpartners, Private Practice, Linköping, Sweden
| | - A. van Straten
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - L. Warmerdam
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - N. Salsman
- School of Psychology, Xavier University, Cincinnati, USA
| | - P. Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, the Netherlands
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Lange A, Yeh J, Messerlian C, Hauser R, Chavarro J, Gaskins A, Toth T. Smartphone fertility app use among couples of reproductive age: potential use of big data to improve fertility care and advance reproductive health research. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Klein A, Lange A, Stelzenmueller W. Physiotherapeutische Interventionen als Mittel der Wahl bei kraniomandibulärer Dysfunktion? Manuelle Medizin 2016. [DOI: 10.1007/s00337-016-0150-7] [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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Kasch R, Baum P, Dokter M, Zygmunt M, Wirkner J, Lange A, Fröhlich S, Merk H, Kasch J. Nursing Practicum in Gynaecology and Obstetrics - Early Influence Possibilities for a Specialty. Geburtshilfe Frauenheilkd 2015; 75:1270-1275. [PMID: 26726269 DOI: 10.1055/s-0035-1558053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key aspect in the recruitment of new medical colleagues. The significance of the nursing practicum in its function as gateway to the gynaecology and obstetrics discipline is practically unexplored. Methods: In an online questionnaire, medical students in all German faculties were questioned about the practica in their courses. The questionnaire reached 9079 medical students. 149 participants in nursing practica were selectively asked to answer 140 questions. We analysed those students who could, on the basis of their experiences in nursing practica, imagine undertaking an internship (clinical elective) in gynaecology (internship yes "Iy") separately from those who could not or were still undecided (internship no "In" or, respectively, internship perhaps "Ip"). Results: Altogether 149 medical students who participated in a nursing practicum in the gynaecology discipline were selected, of these 94.9 % were female. 92 (61.7 %) of the students replied that, after their gynaecological nursing practicum, they wanted to undertake an internship in gynaecology (Iy); 39 (26.2 %) answered negatively (In) and 18 (12.1 %) were still undecided (Ip). With regard to the parameters gender, age and duration of study, there were no significant differences among the 3 groups (χ2 0.83). Besides the didactic and professional quality of the training, Iy also mentioned having had a higher practical orientation. They attained their aims more frequently, were better integrated in the health-care team and acquired more practical competences. Satisfaction with the practicum was evaluated as highest among the Iy. Discussion: Those students who could imagine taking an internship in gynaecology were seen to be more satisfied with their practica than those participants who declined or were undecided. The high proportion of females is an early indicator for a feminisation of the specialty. If necessary this could be countered with the help of nursing management.
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Affiliation(s)
- R Kasch
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Greifswald
| | - P Baum
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Greifswald
| | - M Dokter
- Institut für Anatomie, Universitätsmedizin Greifswald, Greifswald
| | - M Zygmunt
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Greifswald, Greifswald
| | - J Wirkner
- Klinik für Innere Medizin A, Universitätsmedizin Greifswald, Greifswald
| | - A Lange
- Klinik für Kinder- und Jugendmedizin, Universitätsmedizin Greifswald, Greifswald
| | - S Fröhlich
- Klinik für Orthopädie, Universitätsmedizin Rostock, Rostock
| | - H Merk
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Greifswald
| | - J Kasch
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Greifswald, Greifswald
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Hosemann R, Hentschel M, Lange A, Uther B, Brückner R. Dreidimensionale Analyse der parakristallinen Struktur von Kieselglas. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1984.169.14.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lange A, Carignan C, Minguez-Alarcon L, Williams P, Calafat A, Toth T, Hauser R. Triclosan exposure and treatment outcomes in women undergoing in vitro fertilization. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lange A, Karmon A, Murtadi G, Souter I, Petrozza J. Can anti-Mullerian hormone (AMH) levels predict clinical pregnancy rates (CPR) in ovulation induction/intrauterine insemination (OI/IUI) cycles? Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kazankov K, Møller HJ, Lange A, Birkebaek NH, Holland-Fischer P, Solvig J, Hørlyck A, Kristensen K, Rittig S, Handberg A, Vilstrup H, Grønbaek H. The macrophage activation marker sCD163 is associated with changes in NAFLD and metabolic profile during lifestyle intervention in obese children. Pediatr Obes 2015; 10:226-33. [PMID: 25073966 DOI: 10.1111/ijpo.252] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/03/2014] [Accepted: 06/25/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Obesity is associated with metabolic derangement and non-alcoholic fatty liver disease (NAFLD). Macrophages are involved in liver inflammation and fibrosis, and soluble (s)CD163 is a macrophage activation marker. OBJECTIVES To associate sCD163 with parameters of paediatric obesity and NAFLD, as well as changes in these parameters during lifestyle intervention. METHODS We studied 117 obese children during a 10-week lifestyle intervention; 71 completed the 12-month follow-up. We recorded clinical and biochemical data, and performed liver ultrasonography. RESULTS Baseline sCD163 was higher in children with elevated alanine transaminase (ALT) (2.3 ± 0.7 vs. 2.0 ± 0.6 mg L(-1), P = 0.03), steatosis (2.3 ± 0.7 vs. 2.0 ± 0.6 mg L(-1), P = 0.01) and high paediatric NAFLD fibrosis index (2.3 ± 0.7 vs. 1.9 ± 0.6 mg L(-1) , P = 0.03). Baseline sCD163 was independently associated with ALT, cholesterol and high-sensitivity C-reactive protein (hs-CRP). The change in sCD163 during lifestyle intervention was associated with changes in ALT, homeostatic model assessment of insulin resistance (HOMA-IR), hs-CRP and cholesterol, and inversely associated with the change in high-density lipoprotein cholesterol. CONCLUSION sCD163 was associated with markers of liver injury and metabolic parameters in obese children, and changes in these parameters during lifestyle intervention. This may suggest that activated macrophages play a role in NAFLD and sCD163 may serve as a marker of liver disease severity and treatment effect.
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Affiliation(s)
- K Kazankov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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Rodrigues M, Rabêlo F, Bernardi D, Lange A. Análise econômica de consórcios de Brachiaria brizantha com culturas graníferas anuais voltados para a recuperação de pastagens na Amazônia. ACTA ACUST UNITED AC 2015. [DOI: 10.5039/agraria.v10i1a5084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lange A, Jaskula E. Can determination of gene polymorphism be of practical value in tailoring the treatment of HSCT patients? Bone Marrow Transplant 2015; 50:161-2. [PMID: 25649165 DOI: 10.1038/bmt.2014.295] [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: 11/09/2022]
Affiliation(s)
- A Lange
- 1] L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland [2] Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
| | - E Jaskula
- 1] L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland [2] Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
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Wetzka S, Fleßa S, Lange A, Zygmunt M. Epidemiological and Financial Burden of Preterm Labor Hospitalizations - An Analysis of German Claims Data. Value Health 2014; 17:A507. [PMID: 27201549 DOI: 10.1016/j.jval.2014.08.1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Wetzka
- Department of Health Care Management, Faculty of Law and Economics, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - S Fleßa
- Department of Health Care Management, Faculty of Law and Economics, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - A Lange
- Department of Neonatology and Pediatric Intensive Care, Hospital for Pediatrics, University of Greifswald, Greifswald, Germany
| | - M Zygmunt
- Department of Obstetrics and Gynecology, University of Greifswald, Greifswald, Germany
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Jaskula E, Lange A, Dlubek D, Kyrcz-Krzemień S, Markiewicz M, Dzierzak-Mietla M, Jedrzejczak WW, Gronkowska A, Nowak J, Warzocha K, Hellmann A, Kowalczyk J, Drabko K, Goździk J, Mizia S. IL-10 promoter polymorphisms influence susceptibility to aGvHD and are associated with proportions of CD4+FoxP3+ lymphocytes in blood after hematopoietic stem cell transplantation. ACTA ACUST UNITED AC 2014; 82:387-96. [PMID: 24498995 DOI: 10.1111/tan.12255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/13/2013] [Accepted: 10/21/2013] [Indexed: 01/17/2023]
Abstract
Four hundred and ninety-five patients (390 and 105 grafted from unrelated and sibling (SIB) donors, respectively) and their donors were analyzed for the impact of interleukin-10 (IL-10) promoter genotype [rs18000896 (-1082 G/A), rs18000871 (-819 C/T) and rs18000872 (-592 C/A)] on the outcome of hematopoietic stem cell transplantation (HSCT). Patients having ACC haplotype were at a lower risk of acute graft versus host disease (aGvHD, grade > I) if transplanted from human leukocyte antigen (HLA) well-matched (10/10) unrelated donors (20/135 vs 39/117, P < 0.001, Pcorr = 0.002), which was not seen if patients were transplanted from either sibling (SIB) or poorly matched (<10/10) unrelated donors (MUD). In addition, GCC haplotype positive recipients of unrelated donor transplants tended to be more susceptible to aGvHD (68/199 vs 39/169, P = 0.019, Pcorr = 0.057). Multivariate logistic regression analysis in the MUD transplanted group showed that donor-recipient human leukocyte antigen (HLA) mismatch [odds ratio (OR) = 3.937, P = 0.001] and a lack of ACC haplotype in recipients (OR = 0.417, P = 0.013) played a significant role as independent risk factors of aGvHD grade > I. ACC carriers had higher proportions of FoxP3+ lymphocytes gated in CD4+ lymphocytes as compared with patients with other IL-10 haplotypes. It was seen at the time of hematological recovery (mean ± SEM: 3.80 ± 0.91% vs 2.06 ± 0.98%, P = 0.012) and 2 weeks later (5.32 ± 0.87% vs 2.50 ± 0.83%, P = 0.013); -592 C/A polymorphism was separately analyzed and it was found that AA homozygotes tended to have a higher incidence of aGvHD (8/15 vs 116/456, P = 0.034) and low proportions of FoxP3 CD4+ lymphocytes in blood (0.43 ± 0.22% vs 4.32 ± 0.71%, P = 0.051) measured 2 weeks after hematological recovery. Functional IL-10 polymorphism associated features influenced the risk of aGvHD with a positive effect of ACC on the pool of Treg in blood.
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Affiliation(s)
- E Jaskula
- L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Lange A, Zeidler J, Braun S. One-year disease-related health care costs of incident vertebral fractures in osteoporotic patients. Osteoporos Int 2014; 25:2435-43. [PMID: 25001983 DOI: 10.1007/s00198-014-2776-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022]
Abstract
SUMMARY The study aims to estimate the direct disease-related costs of osteoporotic vertebral compression fractures (OVCF) in patients with newly diagnosed fracture in the first year after index in Germany. Analyses reveal that OVCFs are associated with significant costs. In light of high and increasing incidence, the results emphasize importance of research in this field. INTRODUCTION OVCF are among the most common fractures related to osteoporosis. They have been shown to be associated with excess mortality and meaningful healthcare costs. Costs calculations have illustrated the significant financial burden to society and national social security systems. However, this information is not available for Germany. Therefore, aim of the study was to estimate the direct disease-related costs of OVCF in patients with newly diagnosed fracture in the first year after index in Germany. METHODS Data were obtained from a claims dataset of a large German health insurance fund. Subjects ≥ 60 years with a new vertebral fracture between 2006 and 2010 were studied retrospectively compared to a matched paired OVCF-free patient group. All-cause and fracture-specific medical costs were calculated in the 1-year baseline and follow-up period. Generalized linear model (GLM) was estimated for total follow-up healthcare cost. RESULTS A total of 2,277 pairs of matched OVCF and OVCF-free patients were included in the analysis. Baseline costs were higher in the OVCF group. Mean unadjusted all-cause healthcare cost difference in the four quarters following the index date between OVCF and OVCF-free patients was 8,200 <euro> (p < 0.001). Of the difference, almost two third was attributable to inpatient services and one quarter to prescription drug costs. The GLM procedure revealed that OVCF-related costs in the first year after the index date add up to 6,490 <euro> (p < 0.001; CI 5,809 <euro>-6,731 <euro>). CONCLUSIONS Despite limitations of this study, our results are consistent with other research and demonstrate that OVCFs are associated with significant costs. The results underline the importance of medical interventions that can help to prevent fractures and treatments, which are cost-effective and can prevent recurrent fractures.
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Affiliation(s)
- A Lange
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Koenigsworther Platz 1, 30167, Hannover, Germany,
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Bauer G, Lange A, Gribova N, Holm C, Gross J. Effective potentials between gold nano crystals – functional dependence on temperature. Molecular Simulation 2014. [DOI: 10.1080/08927022.2014.951521] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hausen HZ, Reinauer H, Fröhlich J, Lange A. Lipidspeicherung in permanenten Mäusefibroblasten (L-strain, Earle) in Abhängigkeit von der Serumkonzentration Histochemische und quantitative Untersuchungen. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1964-1210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Es wird über Untersuchungen an einem permanenten Zellstamm (Mäusefibroblasten, L-strain, Earle) in der Gewebekultur berichtet, die sich mit der Lipidspeicherung dieser Zellen in Abhängigkeit von der Serumkonzentration befassen. Die Untersuchungen wurden morphologisch im Phasenkontrastmikroskop, histochemisch mittels der Sudanschwarz-B-Färbung sowie quantitativ vorgenommen.
Bei steigender Serumzugabe zeigt sich eine zunehmende Lipideinlagerung, die als Speicherungsprozeß gedeutet wird. Eine gewisse Absättigung der Lipidaufnahme scheint mit 20-proz. Serumzusatz erreicht zu sein, da sich darüber hinaus keine Zunahme mehr beobachten ließ.
Bei hohem Serumzusatz (ca. 40%) zum Nährmedium kommt es zu einer relativ verringerten Aufnahme von Phospholipiden bei Zunahme der Neutralfette.
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Affiliation(s)
- H. Zur Hausen
- Aus dem Institut für Hygiene und Mikrobiologie
- Physiologisch-Chemischen Institut der Medizinischen Akademie Düsseldorf
| | - H. Reinauer
- Aus dem Institut für Hygiene und Mikrobiologie
- Physiologisch-Chemischen Institut der Medizinischen Akademie Düsseldorf
| | - J. Fröhlich
- Aus dem Institut für Hygiene und Mikrobiologie
- Physiologisch-Chemischen Institut der Medizinischen Akademie Düsseldorf
| | - A. Lange
- Aus dem Institut für Hygiene und Mikrobiologie
- Physiologisch-Chemischen Institut der Medizinischen Akademie Düsseldorf
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Lange A, Zimmermann MO, Boeckler MF. Scaffold dependencies for halogen bonding: quantum mechanical investigation of nitrogen-bearing heterocycles. J Cheminform 2014. [PMCID: PMC3980075 DOI: 10.1186/1758-2946-6-s1-p16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Klos K, Lange A, Matziolis G, Wagner A. [Tibiocalcaneal arthrodesis with retrograde nails. Description of a hindfoot procedure after massive talus destruction]. Orthopade 2014; 42:364-6, 368-70. [PMID: 23624611 DOI: 10.1007/s00132-013-2086-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Following loss of the talus, tibiocalcaneal fusion is often the only available means of obtaining weight-bearing ability in the lower limb. Length discrepancy may be managed with an allograft. This casuistic describes 6 patients with tibiocalcaneal fusion (mean age 64 years) who had received a structural femoral head allograft fusion for failed total ankle arthroplasty (3 cases), Charcot arthropathy (2 cases) and osteomyelitis (1 case). The mean follow-up was 33 months and all limbs could be salvaged. There were two cases of non-union (one with infection). The mean AOFAS score was 51 and the mean Mazur score was 37. In the SF-36 the mean PCS was 34.4 and the mean MCS was 48.4. It was shown that in the hindfoot, as at other sites, allografts may be used for the filling of major bone defects; however, the patient function will still be massively impaired. Therefore, the procedure should be confined to cases where less complex and less invasive techniques are unlikely to be of benefit.
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Affiliation(s)
- K Klos
- Department Hand- und Fußchirurgie, Klinik für Orthopädie Waldkrankenhaus Rudolf Elle GmbH, Friedrich-Schiller-Universität Jena, Eisenberg, Deutschland.
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Kempe A, Lautenschläger T, Lange A, Neinhuis C. How to become a tree without wood--biomechanical analysis of the stem of Carica papaya L. Plant Biol (Stuttg) 2014; 16:264-271. [PMID: 23656471 DOI: 10.1111/plb.12035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 03/10/2013] [Indexed: 06/02/2023]
Abstract
Carica papaya L. does not contain wood, according to the botanical definition of wood as lignified secondary xylem. Despite its parenchymatous secondary xylem, these plants are able to grow up to 10-m high. This is surprising, as wooden structural elements are the ubiquitous strategy for supporting height growth in plants. Proposed possible alternative principles to explain the compensation for lack of wood in C. papaya are turgor pressure of the parenchyma, lignified phloem fibres in the bark, or a combination of the two. Interestingly, lignified tissue comprises only 5-8% of the entire stem mass. Furthermore, the phloem fibres do not form a compact tube enclosing the xylem, but instead form a mesh tubular structure. To investigate the mechanism of papaya's unusually high mechanical strength, a set of mechanical measurements were undertaken on whole stems and tissue sections of secondary phloem and xylem. The structural Young's modulus of mature stems reached 2.5 GPa. Since this is low compared to woody plants, the flexural rigidity of papaya stem construction may mainly be based on a higher second moment of inertia. Additionally, stem turgor pressure was determined indirectly by immersing specimens in sucrose solutions of different osmolalities, followed by mechanical tests; turgor pressure was between 0.82 and 1.25 MPa, indicating that turgor is essential for flexural rigidity of the entire stem.
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Affiliation(s)
- A Kempe
- Department of Biology, Faculty of Science, Institute of Botany, Technische Universität Dresden, Dresden, Germany
| | - T Lautenschläger
- Department of Biology, Faculty of Science, Institute of Botany, Technische Universität Dresden, Dresden, Germany
| | - A Lange
- Department of Biology, Faculty of Science, Institute of Botany, Technische Universität Dresden, Dresden, Germany
| | - C Neinhuis
- Department of Biology, Faculty of Science, Institute of Botany, Technische Universität Dresden, Dresden, Germany
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Lange A, Prenzler A, Frank M, Kirstein M, Vogel A, von der Schulenburg JM. A systematic review of cost-effectiveness of monoclonal antibodies for metastatic colorectal cancer. Eur J Cancer 2013; 50:40-9. [PMID: 24011538 DOI: 10.1016/j.ejca.2013.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [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: 05/27/2013] [Revised: 07/24/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Metastatic colorectal cancer (mCRC) imposes a substantial health burden on patients and society. In recent years, advances in the treatment of mCRC have mainly resulted from the introduction of monoclonal antibodies (MoAbs). However, the application of these MoAbs considerably increases treatment costs. The objective of this article is to review and assess the economic evidence of MoAB treatment in mCRC. A systematic literature review was conducted and cost-effectiveness (CE) as well as cost-utility-studies were identified. For this, Medline, Embase, SciSearch, Cochrane, and nine other databases were searched from 2000 through February 2013 for full-text publications. The quality of the studies was assessed via a validated assessment tool (Quality of Health Economic Studies (QHES)). A total of 843 publications were screened. Of those, 15 studies involving the MoAbs bevacizumab, cetuximab and panitumumab met all inclusion criteria. Four studies analysed the CE of first-line treatment with bevacizumab and nine the CE of cetuximab in subsequent treatment lines. Two studies dealt with the CE of panitumumab. The analysis of sequential regimes and the direct comparison of two MoABs were analysed by only one study each. The quality of the included studies was high with the exception of one study. CONCLUSIONS The treatment with bevacizumab, cetuximab and panitumumab is mainly considered to be not cost-effective in patients with mCRC. However, testing for Kirsten ras oncogene (KRAS) mutation prior to the treatment with cetuximab or panitumumab is found to be clearly cost-effective compared to no testing. Future research should focus on the CE of first-line treatment with cetuximab or panitumumab and studies on upcoming agents like regorafenib and aflibercept.
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Affiliation(s)
- A Lange
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Germany.
| | - A Prenzler
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Germany.
| | - M Frank
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Germany.
| | - M Kirstein
- Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany.
| | - A Vogel
- Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany.
| | - J M von der Schulenburg
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Hannover, Germany.
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Zeidler J, Lange A, Braun S, Linder R, Engel S, Verheyen F, Graf von der Schulenburg JM. Die Berechnung indikationsspezifischer Kosten bei GKV-Routinedatenanalysen am Beispiel von ADHS. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:430-8. [DOI: 10.1007/s00103-012-1624-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Naumova E, Ivanova M, Pawelec G, Constantinescu I, Bogunia-Kubik K, Lange A, Oguz F, Ozdilli K, Franceschi C, Caruso C, Mishra M, Middleton D. 16thIHIW: Immunogenetics of Aging. Int J Immunogenet 2013; 40:77-81. [DOI: 10.1111/iji.12027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 01/22/2023]
Affiliation(s)
- E. Naumova
- Department of Clinical Immunology; University Hospital Alexandrovska; Sofia Bulgaria
| | - M. Ivanova
- Department of Clinical Immunology; University Hospital Alexandrovska; Sofia Bulgaria
| | - G. Pawelec
- Center for Medical Research; University of Tubingen; Tubingen Germany
| | - I. Constantinescu
- Fundeni Clinical Institute Centre for Immunogenetics and Virology; Bucharest Romania
| | - K. Bogunia-Kubik
- Department of Clinical Immunology; Ludwik Hirszfeld Institute of Immunology and Experimental Therapy; Wroclaw Poland
| | - A. Lange
- Department of Clinical Immunology; Ludwik Hirszfeld Institute of Immunology and Experimental Therapy; Wroclaw Poland
| | - F. Oguz
- Department of Medical Biology; Istanbul Medical Faculty, Istanbul University; Istanbul Turkey
| | - K. Ozdilli
- Department of Medical Biology; Istanbul Medical Faculty, Istanbul University; Istanbul Turkey
| | - C. Franceschi
- Department of Experimental Pathology; University of Bologna; Bologna Italy
| | - C. Caruso
- Dipartimento di Biopatologia e Metodologie Biomediche; Universit'a di Palermo; Palermo Italy
| | - M. Mishra
- National Reference Laboratory; New Delhi India
| | - D. Middleton
- Transplant Immunology; Royal Liverpool University Hospital; Liverpool UK
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Tyler C, Hamilton P, Lange A, Filby A, Soffkar M, Lee O, Takesono A, Kudoh T, Paull G, Iguchi T. Health impacts of exposure to environmental oestrogens in fish. Comp Biochem Physiol A Mol Integr Physiol 2012. [DOI: 10.1016/j.cbpa.2012.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hinken B, Lange A, Zygmunt M. Der extrem frühe vorzeitige Blasensprung <24+0 SSW: Therapie und fetal outcome. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293241] [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: 10/15/2022]
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Naumova E, Ivanova M, Pawelec G, Constantinescu I, Bogunia-Kubik K, Lange A, Qguz F, Carin M, Franceschi C, Caruso C, Middleton D. 'Immunogenetics of Aging': report on the activities of the 15th International HLA and Immunogenetics Working Group and 15th International HLA and Immunogenetics Workshop. ACTA ACUST UNITED AC 2011; 77:187-92. [PMID: 21299522 DOI: 10.1111/j.1399-0039.2010.01603.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
'Immunogenetics of Aging' is a component that was first included in the 14th International HLA and Immunogenetics Workshop (IHIWS) and developed further within the 15th Workshop. The aim of this component was to assess the impact of human leukocyte antigen (HLA) genes, cytokine genes, and some innate immunity genes such as killer-cell immunoglobulin-like receptors (KIRs) and mannose-binding lectin 2 (MBL2) in successful aging and their contribution to the better understanding of immune dysfunction in old age. Within the 15th IHIWS new populations were included in the analysis. Additional cytokine gene polymorphisms were assessed and innate immunity genes were analyzed for possible relevance in longevity. The results showed that longevity might be associated with anti-inflammatory cytokine gene profiles, decreased frequency of interleukin-10 (IL-10) and transforming growth factor-B1 haplotypes associated with a low level of gene expression, and increased frequency of haplotypes determining a high level of expression. Extended tumor necrosis factor-A and IL-12B genotypes were also likely relevant to longevity. Data also showed that innate immunity genes are associated with susceptibility to infections in the elderly and showed that these genes might be an important genetic marker in aging. Decreased frequencies of KIR2DS5 and A1B10 haplotypes, and an increased proportion of MBL2-deficient haplotypes were found in the group with higher cytomegalovirus-specific IgG antibody levels. Together, these studies emphasize the relevance of genes regulating immune functions in maintaining human longevity and stress the importance of further clarifying their impact on successful aging.
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Affiliation(s)
- E Naumova
- Department of Clinical Immunology, University Hospital Alexandrovska, Sofia, Bulgaria.
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Dlubek D, Turlej E, Sedzimirska M, Lange J, Lange A. Interleukin-17-producing cells increase among CD4+ lymphocytes before overt manifestation of acute graft-versus-host disease. Transplant Proc 2011; 42:3277-9. [PMID: 20970671 DOI: 10.1016/j.transproceed.2010.07.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Interleukin-17A is a hallmark of a subset of CD4+ lymphocytes called T(H)17. Allogeneic hematopoietic stem cell transplantation (HSCT) induces an immune response that facilitates graft acceptance, but if clinically apparent as acute graft-versus-host disease (aGvHD), it may adversely affect transplantation outcomes. TH17 cells are involved in the inflammatory processes associated with several diseases, including inflammatory bowel disease (IBD) as a prototype. In this study we investigated the presence of IL-17-producing cells among peripheral blood mononuclear cells (PBMC) of patients after HSCT. The 48 patients of median age 45 years (range, 1.0-64 years), experienced hematologic malignancies (n=45) or nonmalignant disorders (n=3), treated with matched unrelated (n=24) or sibling (n=24) transplants. We examined IL-17-producing cells in alloreactive reactions after HSCT. PBMC were stimulated with BD Leukocyte Activation Cocktail (Ionomycin, Brefeldin A, and phorbol myristic acetate (PMA)) in the presence of BD GolgiStop. After stimulation the cells were labeled with anti-CD4 and intracellular anti-IL-17A monoclonal antibodies. IL-17+ cell proportions were analyzed in the CD4+ lymphocyte gate. We observed that patients at the time of hematologic reconstitution had higher proportions of IL-17-producing cells than healthy control subjects (0.73±0.13 vs 0.19±0.06%; P=.019). Fourteen patients displayed the first symptoms of aGvHD at the time of hematologic reconstitution, when they showed lower proportions of IL-17+ cells among CD4+ lymphocytes than their counterparts lacking aGvHD at a similar time after transplantation (0.29±0.09 vs 0.73±0.13%; P=.024). Eight patients developed aGvHD after hematologic reconstitution (median, 34 days). All of these patients displayed lower proportions of IL-17-producing CD4+ cells on the day of aGvHD compared with their initial measurements preceding this complication (0.34±0.14 vs 1.07±0.37%; P=.01).
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Affiliation(s)
- D Dlubek
- Institute of Immunology and Experimental Therapy, Polish Academy of Science, Wroclaw, Poland
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Birkebaek NH, Lange A, Holland-Fischer P, Kristensen K, Rittig S, Vilstrup H, Handberg A, Gronbaek H. Effect of weight reduction on insulin sensitivity, sex hormone-binding globulin, sex hormones and gonadotrophins in obese children. Eur J Endocrinol 2010; 163:895-900. [PMID: 20829367 DOI: 10.1530/eje-10-0538] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Obesity in men is associated with reduced insulin sensitivity and hypoandrogenism, while obesity in women is associated with reduced insulin sensitivity and hyperandrogenism. In children, the effect of obesity and weight reduction on the hypothalamo-pituitary-gonadal axis is rarely investigated. The aim of the present study was to investigate the effect of weight reduction in obese Caucasian children on insulin sensitivity, sex hormone-binding globulin (SHBG), DHEAS and the hypothalamo-pituitary-gonadal axis. METHODS One hundred and sixteen (65 females) obese children with a median age of 12.3 (7-15) years were examined before and after a 10-week stay at a weight loss camp. Examination included anthropometry and fasting blood samples measuring plasma glucose, serum insulin, SHBG, DHEAS, testosterone, 17β-oestradiol, FSH and LH. RESULTS Body mass index (BMI) decreased (P<0.01), insulin sensitivity and SHBG increased (P<0.01), independent of gender and puberty. The changes in insulin sensitivity and the changes in SHBG correlated significantly (P<0.01) independent of gender, puberty and the changes in BMI. Testosterone increased in boys (P<0.01) and tended to decrease in girls (P=0.05, in girls after menarche (P=0.03)). FSH increased in boys and girls. LH increased in boys and was unchanged in girls. CONCLUSIONS During weight loss, insulin sensitivity and SHBG increased significantly in obese children, and the changes in insulin sensitivity and the changes in SHBG correlated significantly independent of gender, puberty and the changes in BMI. There was sexual dimorphism in the changes of testosterone, with the changes in boys towards increased virilisation and the changes in girls towards less virilisation.
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Affiliation(s)
- N H Birkebaek
- Department of Paediatric, Aarhus University Hospital, Skejby, DK-8200 Aarhus, Denmark.
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Davies S, Asghar S, Cooper V, Lange A, Robertson C, Vrijens B, White DJ. Does feedback of medication execution using MEMS caps aid adherence to HAART?: the MEMRI study (MEMS as Realistic Intervention). J Int AIDS Soc 2010. [PMCID: PMC3112895 DOI: 10.1186/1758-2652-13-s4-p120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Lange A, Dera-Joachimiak D, Madej S, Polak M, Koscinska K, Pietraszek E, Skurjat L. Activity of the National Polish Bone Marrow Donor Registry--analysis of the matching process successfully completed with hematopoietic stem cell transplantation. Transplant Proc 2010; 42:3316-8. [PMID: 20970680 DOI: 10.1016/j.transproceed.2010.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The activity of the National Polish Bone Marrow Donor Registry includes: (1) recruitment and typing of volunteer donors for the registry; (2) primary and confirmatory typing of patients and their families for sibling and family alternative donor transplantations; and (3) donor-recipient matching. There has been an improvement regarding the number of procedures (184 vs 201) and the successfully completed matches (102 vs 145) in 2006-2007 vs 2008-2009, respectively. The success rate of conclusive matching depended on the number of donors in a given registry and the incidence of rare HLA B-C or DR-DQ associations and specificities. In 2008-2009, Polish, German and all European registries, finally matched 129 (out of all 145) donors including 3, 18, 4 donors for patients with and 30, 68, 6 donors for patients without difficult HLA specificities and associations, respectively. Among the HLA-difficult patient group those lacking a donor in Europe and Israel were successfully matched in the USA (10/11 patients); the only one other subject was matched with a donor from Australia.
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Affiliation(s)
- A Lange
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland.
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Bogunia-Kubik K, Lange A. Human Leukocyte Antigen Proficiency Testing for Central and Eastern Europe: A Summary of Over 10 Years of Activity. Transplant Proc 2010; 42:3263-5. [DOI: 10.1016/j.transproceed.2010.07.020] [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: 10/18/2022]
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