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Milasan LH, Farr A, Turnbull I, Scott-Purdy D. Behind the creative canvas: An innovative trauma-informed art-based educational approach using an immersive learning pedagogy. Int J Ment Health Nurs 2024; 33:431-441. [PMID: 37949831 DOI: 10.1111/inm.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/13/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
Trauma has been increasingly considered in mental health policies and strategies worldwide. However, the implementation of such initiatives into practice remains inconsistent resulting in a fragmented approach to trauma-informed care. One explanation for the current state of trauma services is the unpreparedness of mental health nurses in line with emerging traumagenic theoretical frameworks. We addressed this gap by implementing an innovative pedagogic project co-produced with people with lived experience of trauma. The aim of this qualitative study was to explore mental health nursing students' perspective on the usefulness of an art-based approach to learning about, and working with, trauma in a non-interactive virtual reality (VR) environment. Ten mental health nursing students have been conveniently selected to take part in a focus group. The thematic analysis revealed authenticity, the power of arts, and underutilisation of arts in mental health nursing as key themes following students' reflections and critical discussions. Recommendations to enhance trauma-informed nursing education and practice are made to support an approach that has the potential to instil positive changes in the way mental health nursing students perceive and work with trauma in their practice.
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Affiliation(s)
- Lucian H Milasan
- Nottingham Trent University, Institute of Health and Allied Professions, Mansfield, UK
| | - Andy Farr
- Independent Visual Artist, Coventry, UK
| | - Isabel Turnbull
- Nottingham Trent University, Institute of Health and Allied Professions, Mansfield, UK
| | - Daniel Scott-Purdy
- Nottingham Trent University, Institute of Health and Allied Professions, Mansfield, UK
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Smith L, Farr A, Zurriaga O, Cuttini M, Verdenik I, Vidal Benedé MJ, Kearns K, Sakkeus L, Kyprianou T, Barros H. Socioeconomic differences in perinatal health outcomes: perinatal health surveillance through a health-equity prism. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Socioeconomic status (SES) is strongly associated with perinatal health outcomes, perpetuating intergenerational health inequalities. Our aim was to assess the utility of population data in Europe to monitor social inequalities in key perinatal health indicators.
Methods
Using the PHIRI federated analysis protocol to aggregate routine birth data from across Europe, we collected data on selected perinatal health indicators by SES from 2015 to 2020. Mothers’ education level (primary/lower secondary; upper secondary; postsecondary) was the preferred SES indicator; if unavailable, parents’ occupation or area-based deprivation scores were provided. The International Standard Classification of Occupations was used to group parents’ occupations into 4 categories, while area-based deprivation scores were measured in quintiles. For each country, we calculated risk ratios (RR) for preterm birth, stillbirth, neonatal death and caesarean delivery (CD) comparing the most with the least disadvantaged group
Results
17 countries provided data on maternal education, 5 on area-based deprivation, 1 on parents’ occupation and 2 could not provide data. For preterm birth, stillbirth and neonatal death, lower SES was associated with worse outcomes with most RR between lowest and highest groups in the range of 1.5 to 3.0. In contrast, in some countries, such as Croatia, Latvia, Lithuania and Spain, CD rates were higher for socially advantaged groups whereas the gradient was reversed in others (Denmark, Luxembourg, the Netherlands and Italy).
Conclusions
European countries can provide perinatal health indicators by SES, revealing marked socioeconomic inequalities in perinatal health. The differing SES gradient between countries for CD raise questions about care organization and clinical practice. Further exploration of the harmonization of differing SES measure across countries is required, while countries that do not monitor SES data should aim to improve existing systems.
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Affiliation(s)
- L Smith
- Department of Health Sciences, University of Leicester , Leicester, UK
| | - A Farr
- Department of Obstetrics and Gynecology, Medical University of Vienna , Vienna, Austria
| | - O Zurriaga
- Public Health and Preventive Medicine Department, University of Valencia , Valencia, Spain
| | - M Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children’s Hospital , Rome, Italy
| | - I Verdenik
- Department of Obstetrics and Gynecology, University Medical Centre , Ljubljana, Slovenia
| | | | - K Kearns
- Healthcare Pricing Office, National Finance Division, HSE , Dublin, Ireland
| | - L Sakkeus
- Estonian Institute for Population Studies, Tallinn University , Tallinn, Estonia
| | - T Kyprianou
- Health Monitoring Unit, Ministry of Health , Nicosia, Cyprus
| | - H Barros
- EPIUnit, Instituto de Saúde Pública, University of Porto , Porto, Portugal
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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Granser S, Foessleitner P, Kiss H, Wisgrill L, Pummer L, Berger A, Berry D, Pjevac P, Hausmann B, Graf A, Farr A. Das Mikrobiom in der Schwangerschaft, bei Geburt und des Neugeborenen: Eine prospektive, longitudinale Pilotstudie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750240] [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: 10/17/2022] Open
Affiliation(s)
- S Granser
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - P Foessleitner
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - H Kiss
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - L Wisgrill
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - L Pummer
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - A Berger
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care Medicine and Neuropediatrics, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
| | - D Berry
- Joint Microbiome Facility, Medical University of Vienna and University of Vienna; Vienna, Austria
- University of Vienna, Center for Microbiology and Environmental Systems Science, Joint Microbiome Facility (JMF), Department of Microbiology and Ecosystem Science; Vienna, Austria
| | - P Pjevac
- Joint Microbiome Facility, Medical University of Vienna and University of Vienna; Vienna, Austria
- University of Vienna, Center for Microbiology and Environmental Systems Science, Joint Microbiome Facility (JMF), Department of Microbiology and Ecosystem Science; Vienna, Austria
| | - B Hausmann
- Joint Microbiome Facility, Medical University of Vienna and University of Vienna; Vienna, Austria
- Department of Laboratory Medicine, Medical University of Vienna; Vienna, Austria
| | - A Graf
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna
| | - A Farr
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, and Comprehensive Center for Pediatrics (CCP), Medical University of Vienna; Vienna, Austria
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Rager L, Farr A, Eckel F, Mayrhofer A, Haslacher H, Ristl R, Foessleitner P. Vitamin-C-haltiger Kaugummi zur Therapie der Emesis gravidarum: eine randomisiert-kontrollierte Studie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750248] [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: 10/17/2022] Open
Affiliation(s)
- L Rager
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - F Eckel
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Mayrhofer
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - H Haslacher
- Klinisches Institut für Labormedizin, Medizinische Universität Wien, Österreich
| | - R Ristl
- Zentrum für Medizinische Statistik, Informatik und Intelligente Systeme, Medizinische Universität Wien, Österreich
| | - P Foessleitner
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
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Windsperger K, Kiss H, Muin DA, Neururer SB, Delmarko I, Farr A. Einfluss der Covid-19-Pandemie auf den mütterlichen Gewichtsverlauf und Übergewichts-assoziierte Komplikationen: Eine landesweite Datenanalyse. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750260] [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: 10/17/2022] Open
Affiliation(s)
- K Windsperger
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - H Kiss
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - D A Muin
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - S B Neururer
- Landesinstitut für Integrative Versorgung, Institut für Klinische Epidemiologie, Tirol Kliniken
| | - I Delmarko
- Landesinstitut für Integrative Versorgung, Institut für Klinische Epidemiologie, Tirol Kliniken
| | - A Farr
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Schirwani N, Koren T, Farr A, Kiss H, Bancher D. Effekt von Aufklärung und Beratung auf die COVID-19 Impfbereitschaft bei Wöchnerinnen: eine prospektive Pilotstudie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750255] [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: 10/17/2022] Open
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Falcone V, Catic A, Wagner M, Steinbauer P, Bibl K, Kiss H, Farr A. Schulterdystokie-Training mittels Virtual Reality: eine Pilot-Studie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750239] [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: 10/17/2022] Open
Affiliation(s)
- V Falcone
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Comprehensive Center for Pediatrics, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - A Catic
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Comprehensive Center for Pediatrics, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - M Wagner
- Klinische Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Comprehensive Center for Pediatrics, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien
| | - P Steinbauer
- Klinische Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Comprehensive Center for Pediatrics, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien
| | - K Bibl
- Klinische Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Comprehensive Center for Pediatrics, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien
| | - H Kiss
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Comprehensive Center for Pediatrics, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - A Farr
- Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Comprehensive Center for Pediatrics, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Janjic N, Petricevic L, Foessleitner P, Rosicky I, Kiss H, Farr A. Behandlung von Frauen mit intermediärer vaginaler Mikrobiota mit vaginalen Probiotika und Lactobacillus casei rhamnosus (Lcr regenerans) zur Verbesserung des Schwangerschaftsoutcomes. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717184] [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: 10/23/2022] Open
Affiliation(s)
- N. Janjic
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - L. Petricevic
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - P. Foessleitner
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - I. Rosicky
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - H. Kiss
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - A. Farr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
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Foessleitner P, Farr A, Boerger I, Kiss H, Rieger A, Touzeau-Roemer V, Petricevic L. HIV als Risikofaktor für vaginale Infektionen während der Schwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717916] [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: 10/23/2022] Open
Affiliation(s)
- P Foessleitner
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - A Farr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - I Boerger
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - H Kiss
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - A Rieger
- Medizinische Universität Wien, Universitätsklinik für Dermatologie
| | - V Touzeau-Roemer
- Medizinische Universität Wien, Universitätsklinik für Dermatologie
| | - L Petricevic
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
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Windsperger K, Kiss H, Oberaigner W, Leitner H, Binder F, Muin D, Fößleitner P, Husslein P, Farr A. Die vorherrschende Lichtverschmutzung erhöht das Risiko für ein schlechtes neonatales Outcome – eine retrospektive Kohortenstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717991] [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: 10/23/2022] Open
Affiliation(s)
- K Windsperger
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
| | - H Kiss
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
| | - W Oberaigner
- Institut für Public Health, Medical Decision Making und HTA
| | - H Leitner
- Institut für klinische Epidemiologie
| | | | - D Muin
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
| | - P Fößleitner
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
| | - P Husslein
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
| | - A Farr
- Medizinische Universität Wien, Frauenheilkunde, Geburtshilfe und feto-maternale Medizin
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Sustr V, Petricevic L, Foessleitner P, Rosicky I, Kiss H, Farr A. Orale Probiotika bei Kolonisation mit vaginalen Gruppe B Streptokokken (GBS) in der Schwangerschaft: eine randomisierte placebo-kontrollierte Doppelblindstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717977] [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: 10/23/2022] Open
Affiliation(s)
- V Sustr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - L Petricevic
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - P Foessleitner
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - I Rosicky
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - H Kiss
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
| | - A Farr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde
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13
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Foessleitner P, Farr A, Boerger I, Kiss H, Rieger A, Touzeau-Roemer V, Petricevic L. HIV als Risikofaktor für vaginale Infektionen während der Schwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713214] [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: 10/24/2022] Open
Affiliation(s)
- P Foessleitner
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - I Boerger
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Rieger
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Österreich
| | - V Touzeau-Roemer
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Österreich
| | - L Petricevic
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
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Windsperger K, Kiss H, Oberaigner W, Leitner H, Binder F, Muin D, Fößleitner P, Husslein P, Farr A. Die vorherrschende Lichtverschmutzung in Österreich erhöht das Risiko für ein schlechtes neonatales Outcome – eine retrospektive Kohortenstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713228] [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: 10/24/2022] Open
Affiliation(s)
- K Windsperger
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - W Oberaigner
- Department für Public Health, Versorgungsforschung und HTA, Institut für Public Health, Medical Decision Making und HTA, UMIT, Hall i. T., Österreich
| | - H Leitner
- Institut für Klinische Epidemiologie, Tirol Kliniken, Innsbruck, Österreich
| | - F Binder
- Institut für Klinische Epidemiologie, Tirol Kliniken, Innsbruck, Österreich
| | - D Muin
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - P Fößleitner
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - P Husslein
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
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15
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Sustr V, Petricevic L, Foessleitner P, Rosicky I, Kiss H, Farr A. Orale Probiotika bei Kolonisation mit vaginalen Gruppe B Streptokokken (GBS) in der Schwangerschaft: eine randomisierte placebo-kontrollierte Doppelblindstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713203] [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: 10/24/2022] Open
Affiliation(s)
- V Sustr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - L Petricevic
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - P Foessleitner
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - I Rosicky
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
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16
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Janjic N, Petricevic L, Foessleitner P, Rosicky I, Kiss H, Farr A. Behandlung von Frauen mit intermediärer vaginaler Mikrobiota mit vaginalen Probiotika und Lactobacillus casei rhamnosus (Lcr regenerans) zur Verbesserung des Schwangerschaftsoutcomes. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713202] [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: 10/24/2022] Open
Affiliation(s)
- N Janjic
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - L Petricevic
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - P Foessleitner
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - I Rosicky
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien
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17
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Foessleitner P, Just U, Kiss H, Farr A. Pyoderma gangraenosum nach Sectio: ein Fallbericht. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693872] [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: 10/26/2022] Open
Affiliation(s)
- P Foessleitner
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - U Just
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Österreich
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
| | - A Farr
- Universitätsklinik für Frauenheilkunde, Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Österreich
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18
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Farr A, Gasser J, Flunt A, Presterl E, Holzer I, Kiss H, Petricevic L. Evaluation des Schwangerschaftsoutcomes nach vaginaler Kolonisation mit Extended-Spectrum Beta-Lactamase (ESBL) produzierenden Bakterienarten: eine Fallserie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Farr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - J Gasser
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - A Flunt
- Medizinische Universität Wien, Universitätsklinik für Kinder- und Jugendheilkunde, Klinische Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Wien, Österreich
| | - E Presterl
- Medizinische Universität Wien, Universitätsklinik für Krankenhaushygiene und Infektionskontrolle, Wien, Österreich
| | - I Holzer
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - H Kiss
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - L Petricevic
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
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Farr A, Wachutka E, Bettelheim D, Farr S. Perinatales Outcome bei angeborener Fehlbildung der Extremität. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Farr
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - E Wachutka
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - D Bettelheim
- Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Abt. für Geburtshilfe und fetomaternale Medizin, Wien, Österreich
| | - S Farr
- Orthopädisches Spital Speising, Abteilung für Kinderorthopädie und Fußchirurgie, Wien, Österreich
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Holzer I, Farr A, Kiss H, Hagmann M, Petricevic L. Einfluss des Trimesters einer Kolonisation mit Candida albicans auf das Schwangerschaftsoutcome. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- I Holzer
- Medizinische Universität Wien, Gynäkologie und Geburtshilfe, Wien, Österreich
| | - A Farr
- Medizinische Universität Wien, Gynäkologie und Geburtshilfe, Wien, Österreich
| | - H Kiss
- Medizinische Universität Wien, Geburtshilfe und feto-maternale Medizin, Wien, Österreich
| | - M Hagmann
- Medizinische Universität Wien, Abteilung für Statistik, Wien, Österreich
| | - L Petricevic
- Medizinische Universität Wien, Geburtshilfe und feto-maternale Medizin, Wien, Österreich
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Farr A, Holzer I, Kiss H, Hagmann M, Husslein P, Petricevic L. Evaluation der Vaginalflora bei schwangeren Frauen unter Opioid-Substitutionstherapie: eine gematchte Fall-Kontroll-Studie. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602320] [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] Open
Affiliation(s)
- A Farr
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - I Holzer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - H Kiss
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - M Hagmann
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - P Husslein
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - L Petricevic
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Farr A, Stolz M, Pfeiler M, Singer CF. Der Effekt von Übergewicht bei Frauen unter neoadjuvanter Chemotherapie bei primärem Mammakarzinom. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602324] [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] Open
Affiliation(s)
- A Farr
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Wien
| | - M Stolz
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Wien
| | - M Pfeiler
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Wien
| | - CF Singer
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Wien
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Teague W, Antonova E, Farr A, Ding Y, Iqbal A, Chipps B. P120 Burden of severe or poorly-controlled asthma in school-age children: healthcare use and allergic co-morbidities. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Farr A, Kiss H, Holzer I, Hagmann M, Husslein P, Petricevic L. Einfluss der asymptomatischen vulvovaginalen Candidose in der Frühschwangerschaft auf das geburtshilfliche Outcome. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Einig S, Farr A, Holzer I, Franz M, Lenz-Gebhart A, Husslein P, Lehner R. Intensivpflichtige Patientinnen in der Geburtshilfe: Trends über zwei Jahrzehnte. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Holzer I, Farr A, Ristl R, Husslein P, Berger A, Lehner R. Der Einfluss des Geburtsmodus auf das neonatale Outcome von Frühgeburten: eine Beobachtungsstudie in einem geburtshilflichen Hochrisiko-Setting. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Farr A, Kiss H, Holzer I, Hagmann M, Husslein P, Petricevic L. Effekt des Laktobazillenmangel bei Frauen mit intermediärer Vaginalflora in der Frühschwangerschaft auf das geburtshilfliche Outcome. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582186] [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] Open
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Weber M, Farr A, Pfeiler G, Oppolzer E, Bago-Horvath Z, Seifert M, Singer CF. Proliferationsmarker Ki67 als prädiktiver Marker für das Therapieansprechen der neoadjuvanten Chemotherapie bei Patientinnen mit primärem Mammakarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1579615] [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: 10/22/2022] Open
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Burgmann M, Hermelink K, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Wuerstlein R. Abstract P4-11-13: Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-11-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
It is known that young breast cancer (BC) patients tend to suffer more psychological stress and have lower quality of life than older women, are less sexually active and have more body image issues than healthy women of the same age. They may also be challenged by reproductive concerns. To our knowledge, no data exist about the effect of the disease on the life satisfaction of premenopausal BC patients. This study tries to elucidate life satisfaction in several aspects of daily life in this special cohort as well as aspects of cancer-specific distress and parenting concerns in order to improve our support strategies.
Materials and methods
In a cross-sectional study design, all patients with < 40 years at primary BC diagnosis treated at Breast Center, CCC LMU Munich (Germany) between 2006 and 2013 were eligible for participation. Standardized questionnaires assessing life satisfaction (Life Satisfaction Questionnaire; Fahrenberg et al, 2000) and cancer-specific distress (Questionnaire on Stress in Cancer patients; Herschbach et al, 2003), as well as a self-developed questionnaire on partnership, employment situation, family planning, demographic and medical data were mailed in 2014.
Results
88 patients responded (55%). Compared with population data stratified for age and sex, patients showed significantly less satisfaction in the domains of health (p<0.001) and sexuality (p=0.002) but not in any other domains or overall life satisfaction. The patients' most pronounced cancer-specific problems were fear of cancer recurrence and fear of further hospital stays, diminished sexual activity, and psychosomatic problems like nervousness, fatigue and insomnia. Of those patients who retrospectively evaluated their decision for or against fertility preservation, 76.4% were satisfied with their choice. Current desire to have children was reported by 45.8% of patients and another 15.6% were uncertain, but only 21.7% actually planned to have children. The most frequently reported reasons to refrain from childbearing were shortened life expectancy, negative impact of pregnancy on prognosis, and treatment-related infertility.
Discussion
In our cohort, the general life satisfaction of young breast cancer survivors showed no difference from women without cancer, but these patients were not satisfied with their general health status and with their sexuality. Also, cancer-related fears and psychosomatic problems considerably stress young patients and thus need to be addressed by supportive care programs. There is also a need for counselling regarding childbearing after BC treatment. In contrast, fertility preservation seems to be well established in medical consultations. In conclusion, tailored supportive care programs have to be realized to respond the unique needs of young BC patients.
Citation Format: Burgmann M, Hermelink K, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Wuerstlein R. Cancer-specific distress, life satisfaction and parenting concerns in young breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-11-13.
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Affiliation(s)
- M Burgmann
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - K Hermelink
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - A Farr
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - A Heiduschka
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - F van Meegen
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - J Engel
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - N Harbeck
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
| | - R Wuerstlein
- Breast Center, CCC of LMU University Hospital of Munich, Munich, Germany; Munich Cancer Registry (MCR) of the Munich Tumour Centre at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany; Breast Center of Medical University of Vienna-General Hospital, Vienna, Austria
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Mukherjee M, Stoddart A, Gupta R, Nwaru B, Heaven M, Farr A, Fitzsimmons D, Bandyopadhyay A, Aftab C, Simpson C, Lyons R, Fischbacher C, Dibben C, Shields M, Phillips C, Strachan D, Davies G, McKinstry B, Sheikh A. P218 The epidemiological, healthcare and societal burden and costs of asthma in the UK and member nations: analyses of national databases. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.354] [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: 11/04/2022]
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Burgmann M, Hermelink K, Heiduschka A, Farr A, Engel J, Harbeck N, Wuerstlein R. Die junge Mammakarzinom-Patientin – Lebenszufriedenheit und krebsspezifische Beschwerden. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Farr A, Einig S, Holzer I, Franz M, Husslein P, Lehner R. Charakteristika intensivpflichtiger Patientinnen in der Geburtshilfe: Eine retrospektive Langzeitanalyse. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Raimundo K, Farr A, Kim G, Duna G. THU0287 Clinical and Economic Burden of Patients with Microscopic Polyangiitis (MPA) in the United States. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3205] [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: 11/03/2022]
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Raimundo K, Farr A, Kim G, Duna G. FRI0267 Clinical and Economical Burden of Granulomatosis with Polyangiitis (GPA) in the US. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3196] [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: 11/03/2022]
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36
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Best J, Farr A, Sarsour K, Stott-Miller M, Hwang Y. SAT0344 The Association Between Cumulative Glucocorticoid Exposure and Glucocorticoid-Related Adverse Events Among Patients with Rheumatoid Arthritis: A US Database Analysis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3577] [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: 11/04/2022]
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Farr A, Hagmann M, Kiss H, Marschalek J, Husslein PW, Petricevic L. Konsequentes Infektionsscreening in der Schwangerschaft zur Reduktion der Frühgeburtenrate. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388594] [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: 10/24/2022] Open
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Burgmann M, Wuerstlein R, Farr A, Heiduschka A, van Meegen F, Engel J, Harbeck N, Hermelink K. Die junge Mammakarzinompatientin: Biographische Veränderungen, Belastung und Lebenszufriedenheit in den ersten Jahren nach Diagnose. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388468] [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: 10/24/2022] Open
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Farr A, Bader Y, Husslein P, Mühlbacher F, Böhmig G, Margreiter M. Schwangerschaften bei Frauen mit zusätzlichen Hochrisikofaktoren nach Nierentransplantation. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1374771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Farr A, Wuerstlein R, Neff J, Issels R, Lindner L, Belka C, Lauber K, Rauch J, Scheithauer H, Salat C, Pastorekova S, Takacova M, Friese K, Harbeck N. Identifikation von prädiktiven Biomarkern für Hyperthermie und Re-Bestrahlung beim loko-regionären Rezidiv des Mammakarzinoms. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347878] [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: 10/26/2022] Open
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Artigas A, Vassilakopoulos T, Brochard L, Dellweg D, Farr A, Ferrer M, Geiseler J, Larsson A, Nava S, Navalesi P, Noe¨l JL, Orfanos S, Palange P, Schoenhofer B, Simonds A, Pelosi P. Respiratory Critical Care HERMES: a European core syllabus in respiratory critical care medicine. Breathe (Sheff) 2012. [DOI: 10.1183/20734735.000112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gerson LB, Bonafede M, Princic N, Gregory C, Farr A, Balu S. Development of a refractory gastro-oesophageal reflux score using an administrative claims database. Aliment Pharmacol Ther 2011; 34:555-67. [PMID: 21714794 DOI: 10.1111/j.1365-2036.2011.04755.x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Approximately one-third of gastro-oesophageal reflux disease (GERD) patients demonstrate refractory symptoms following treatment with proton pump inhibitor (PPI) therapy. AIM To develop a refractory GERD score that can be applied to predict patients' healthcare utilisation. METHODS We enrolled adults (≥18 years) with a diagnosis of GERD. Refractory GERD was evaluated on an 8-point scale where 1 point was given for each of the following criteria: doubling, addition, or switching of GERD medication dose, receipt of a GERD-related endoscopic procedure or surgery, or ≥3 GERD-related outpatient visits. Refractory GERD was defined as the presence of two or more points. RESULTS A total of 135,139 GERD patients (44% male) were analysed with a mean (±s.d.) age of 52.9 ± 15 years. The mean overall refractory GERD score was 1.12 ± 1.2 (range 0-8 on an 8-point scale); 31% of patients had refractory GERD with a mean score of 2.56 ± 0.82. Among patients with refractory GERD, 31% doubled their GERD medication, 28% added a new GERD medication, 60% switched GERD medications, 54% had a GERD-related procedure and 1% had a GERD-related surgery. Patients with refractory GERD were more likely to be female (59% vs. 55%, P < 0.001) and had a higher co-morbidity score (0.78 vs. 0.56, P < 0.001). The overall mean costs for refractory patients during the study period were significantly higher compared with treatment-responsive patients ($18,088 ± $36,220 vs. $11,044 ± $22,955, P < 0.001). CONCLUSIONS Refractory GERD was present in approximately one-third of the GERD patients. We created a GERD refractory score that could define need for increased anti-reflux therapy and predict higher healthcare resource utilisation.
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Affiliation(s)
- L B Gerson
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, CA, USA.
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Sims JE, Williams DE, Morrissey PJ, Garka K, Foxworthe D, Price V, Friend SL, Farr A, Bedell MA, Jenkins NA, Copeland NG, Grabstein K, Paxton RJ. Molecular cloning and biological characterization of a novel murine lymphoid growth factor. J Exp Med 2000; 192:671-80. [PMID: 10974033 PMCID: PMC2193273 DOI: 10.1084/jem.192.5.671] [Citation(s) in RCA: 182] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Using a bioassay consisting of the proliferation of a murine B cell line, a cDNA of a gene whose product supports the growth of that cell line was isolated from a thymic stromal cell line. This factor, termed thymic stromal lymphopoietin (TSLP), is a protein of 140 amino acids. The gene encoding TSLP was mapped to murine chromosome 18. Purified recombinant TSLP supported the growth of pre-B cell colonies in vitro, but had no myelopoietic activity. TSLP had comitogenic activity for fetal thymocytes, but was not as potent as interleukin 7 in lobe submersion cultures. Injection of TSLP into neonatal mice induced the expansion of B220(+)BP-1(+) pre-B cells.
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Affiliation(s)
- J E Sims
- Department of Molecular Biology, Immunex Corporation, Seattle, Washington 98101, USA.
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Abstract
BACKGROUND Rel/NF-kappaB, an oxidative stress-responsive transcription factor, participates transiently in the control of gene expression. The cellular mechanisms that mediate NF-kappaB activation during ischemia (and during reperfusion in the course of treating ischemia) are not known. METHODS AND RESULTS To investigate the NF-kappaB activation induced during oxidative stress, we examined human cardiac tissue obtained during surgical procedures requiring cardiopulmonary bypass. In vitro, we examined human umbilical vein endothelial cells (HUVECs) exposed to hypoxia, reoxygenation after hypoxia, or a reactive oxygen intermediate (H(2)O(2)). Electrophoretic mobility shift assays performed on right atrial tissue revealed prominent NF-kappaB activation after hearts had been exposed to ischemia and reperfusion. The assays also showed that NF-kappaB activation was observed in hypoxic HUVECs after reoxygenation and in cultures treated with H(2)O(2) (500 micromol/L). Pervanadate (200 micromol/L) also induced marked NF-kappaB activation in HUVECs, indicating that H(2)O(2)-induced NF-kappaB activation is potentiated by the inhibition of tyrosine phosphatases. Western blotting of cytoplasmic IkappaBalpha demonstrated that NF-kappaB activation induced by oxidative stress was not associated with IkappaBalpha degradation. In contrast, tumor necrosis factor-alpha-induced NF-kappaB activation occurred in concert with degradation of IkappaBalpha. Inhibition of IkappaBalpha degradation with a proteasome inhibitor, MG-115, blocked NF-kappaB activation induced by tumor necrosis factor-alpha; however, MG-115 had no effect on NF-kappaB activation during oxidative stress. CONCLUSIONS This study demonstrated a stimulus-specific mechanism of NF-kappaB activation in endothelial cells that acts independently of IkappaBalpha degradation and may require tyrosine phosphorylation.
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Affiliation(s)
- T G Canty
- Department of Surgery, University of Washington, Seattle 98104-2924, USA
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45
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Abstract
To investigate the influence of endogenous peptides on the developmental processes that occur during thymocyte selection, we have used monoclonal antibodies that preferentially recognize the major histocompatibility complex (MHC) molecule I-Ek when it is bound to the moth cytochrome c peptide (88-103). One of these antibodies (G35) specifically blocks the positive selection of transgenic thymocytes expressing a T cell receptor that is reactive to this peptide- MHC complex. Furthermore, G35 does not block the differentiation of transgenic T cells bearing receptors for a different I-Ek-peptide complex. This antibody recognizes a subset of endogenous I-Ek-peptide complexes found on a significant fraction of thymic antigen-presenting cells, including cortical and medullary epithelial cells. The sensitivity of G35 to minor alterations in peptide sequence suggests that the thymic peptide-MHC complexes that mediate the positive selection of a particular class II MHC-restricted thymocyte are structurally related to the complexes that can activate it in the periphery.
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Affiliation(s)
- K K Baldwin
- Howard Hughes Medical Institute, and the Department of Microbiology and Immunology, Stanford University, Stanford, California 94305, USA
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46
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Martínez A, Farr A, Vos MD, Cuttitta F, Treston AM. Peptide-amidating enzymes are expressed in the stellate epithelial cells of the thymic medulla. J Histochem Cytochem 1998; 46:661-8. [PMID: 9562574 DOI: 10.1177/002215549804600511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
C-terminal amidation is a post-translational processing step necessary to convey biological activity to a large number of regulatory peptides. In this study we have demonstrated that the peptidyl-glycine alpha-amidating monooxygenase enzyme complex (PAM) responsible for this activity is located in the medullary stellate epithelial cells of the thymus and in cultured epithelial cells bearing a medullary phenotype, using Northern blot, immunocytochemistry, in situ hybridization, and enzyme assays. Immunocytochemical localization revealed a granular pattern in the cytoplasm of the stellate cells, which were also positive for cytokeratins and a B-lymphocyte-associated antigen. The presence of PAM activity in medium conditioned by thymic epithelial cell lines suggests that PAM is a secreted product of these cells. Among the four epithelial cell lines examined, there was a direct correlation between PAM activity and content of oxytocin, an amidated peptide. Taken together, these data provide convincing evidence that thymic epithelial cells have the capacity to generate amidated peptides that may influence T-cell differentiation and suggest that the amidating enzymes could play an important role in the regulation of thymic physiology.
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Affiliation(s)
- A Martínez
- Cell and Cancer Biology Department, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland 20850-3300, USA
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Nakagawa T, Roth W, Wong P, Nelson A, Farr A, Deussing J, Villadangos JA, Ploegh H, Peters C, Rudensky AY. Cathepsin L: critical role in Ii degradation and CD4 T cell selection in the thymus. Science 1998; 280:450-3. [PMID: 9545226 DOI: 10.1126/science.280.5362.450] [Citation(s) in RCA: 534] [Impact Index Per Article: 20.5] [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: 11/02/2022]
Abstract
Degradation of invariant chain (Ii) is a critical step in major histocompatibility complex class II-restricted antigen presentation. Cathepsin L was found to be necessary for Ii degradation in cortical thymic epithelial cells (cTECs), but not in bone marrow (BM)-derived antigen-presenting cells (APCs). Consequently, positive selection of CD4+ T cells was reduced. Because different cysteine proteinases are responsible for specific Ii degradation steps in cTECs and BM-derived APCs, the proteolytic environment in cells mediating positive and negative selection may be distinct. The identification of a protease involved in class II presentation in a tissue-specific manner suggests a potential means of manipulating CD4+ T cell responsiveness in vivo.
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Affiliation(s)
- T Nakagawa
- Howard Hughes Medical Institute and Department of Immunology, University of Washington School of Medicine, Seattle, WA 98195, USA
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Farr A, DeRoos PC, Eastman S, Rudensky AY. Differential expression of CLIP:MHC class II and conventional endogenous peptide:MHC class II complexes by thymic epithelial cells and peripheral antigen-presenting cells. Eur J Immunol 1996; 26:3185-93. [PMID: 8977321 DOI: 10.1002/eji.1830261252] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Major histocompatibility complex (MHC) class II molecules expressed by thymic epithelial cells are involved in positive selection of CD4 T cells, whereas the high-avidity interaction of T cell receptors with the endogenous peptide: MHC class II complexes expressed on bone marrow (BM)-derived antigen-presenting cells (APC) and, to a lesser extent, on thymic epithelial cells mediate negative selection. To understand better the generation of the CD4 T cell repertoire both in the thymus and in the periphery we analyzed relative levels of expression of specific endogenous peptide: MHC class II complexes in thymic epithelial cells (TEC) and peripheral APC. Expression of E alpha52-68: I-A(b) and class II-associated invariant chain peptide (CLIP): I-A(b) complexes in thymic epithelial cells and in the bone-marrow derived splenic APC, i.e. B cells, was studied using YAe and 30-2 monoclonal antibodies which are specific for the corresponding complexes. To distinguish between expression of both complexes in radioresistant thymic epithelial elements and radiation sensitive BM-derived APC, radiation BM chimeras were constructed. Using immunohistochemical and immunochemical approaches we demonstrated that the level of expression of E alpha52-68: I-A(b) complexes in thymic epithelial cells is approximately 5-10% of that seen in splenic cells whereas total class II levels were comparable. In contrast, CLIP: I-A(b) complexes are expressed at substantially higher levels in TEC vs. splenic APC. This result demonstrates quantitative differences in expression of distinct peptide: MHC class II complexes in thymic epithelial cells and peripheral splenic APC.
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Affiliation(s)
- A Farr
- Department of Immunology, University of Washington School of Medicine, Seattle 98195, USA
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Kahn SJ, Wleklinski M, Ezekowitz RA, Coder D, Aruffo A, Farr A. The major surface glycoprotein of Trypanosoma cruzi amastigotes are ligands of the human serum mannose-binding protein. Infect Immun 1996; 64:2649-56. [PMID: 8698491 PMCID: PMC174122 DOI: 10.1128/iai.64.7.2649-2656.1996] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Trypanosoma cruzi, an obligate intracellular protozoan parasite, chronically infects mammals and causes Chagas' disease in humans. T. cruzi evasion of the mammalian immune response and establishment of chronic infection are poorly understood. During T. cruzi infection, amastigotes and trypomastigotes disseminate in the mammalian host and invade multiple cell types. Parasite surface carbohydrates and mammalian lectins have been implicated in the invasion of mammalian cells. A recent study has demonstrated that the human mannose-binding protein and the macrophage mannose receptor, two mammalian C-type lectins, bind to T. cruzi (S. J. Kahn, M. Wleklinski, A. Aruffo, A. Farr, D. Coder, and M. Kahn, J. Exp. Med. 182:1243-1258,1995). In this report we identify the major surface glycoproteins, including the SA85-1 glycoproteins, as T. cruzi ligands of the mannose-binding protein. Further characterization of the interaction between the mannose-binding protein and T. cruzi demonstrates that (i) the SA85-1 glycoproteins are expressed by amastigotes and trypomastigotes but only amastigotes express the mannose-binding protein ligand, (ii) treatment of amastigotes with alpha-mannosidase inhibits the binding of mannose-binding protein, and (iii) amastigote binding of mannose-binding protein is stable despite the spontaneous shedding of some glycoproteins from its surface. Together, the data indicate that developmentally regulated glycosylation of surface glycoproteins controls the expression of ligands that affect the interactions between T. cruzi and mannose-binding protein. It has been established that the binding of mannose-binding protein to microorganisms facilitates their uptake into phagocytic cells. Preferential opsonization of amastigotes with mannose-binding proteins may account for their clearance from the circulation and may contribute to the parasite's ability to invade different cell types.
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Affiliation(s)
- S J Kahn
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98195,
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Abstract
Trypanosoma cruzi is an obligate intracellular protozoan parasite. The mammalian stage of the parasite life cycle describes amastigotes as an intracellular form that replicates, and trypomastigotes as an extracellular form that disseminates and invades cells. Recent studies, however, have demonstrated that amastigotes circulate in the blood of infected mammals and can invade mammalian cells. In this report, a T. cruzi surface glycoprotein gene, SA85-1.1, was expressed as an immunoglobulin chimera, and this recombinant globulin was used to screen normal mouse tissues for adhesive interactions. This approach identified a subset of macrophages in the skin and peripheral lymph node that bind the T. cruzi surface glycoproteins through the mannose receptor. To further examine the T. cruzi mannose receptor carbohydrate ligands, the interaction between T. cruzi and the mannose-binding protein, a mammalian lectin with similar carbohydrate binding specificities as the mannose receptor, was examined. These studies demonstrated that the mannose-binding protein recognized amastigotes, but not trypomastigotes or epimastigotes, and suggested that amastigotes would also be recognized by the mannose receptor. Therefore, amastigote adhesion to macrophages was investigated, and these experiments demonstrated that the mannose receptor contributes to amastigote adhesion. The data identify the first mammalian lectins that bind to T. cruzi, and are involved in T. cruzi invasion of mammalian cells. The data suggest that amastigotes and trypomastigotes may have developed different mechanisms to adhere to and invade host cells. In addition, it has been established that IFN-gamma-activated macrophages express low levels of the mannose receptor and are trypanocidal; this suggests that the interaction between amastigotes and the mannose receptor enables amastigotes to increase their adherence with a population of macrophages that are nontrypanocidal and permissive for their intracellular replication.
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Affiliation(s)
- S Kahn
- Department of Pediatrics, University of Washington, Seattle 98195, USA
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