1
|
Koch A, Gruber-Rouh T, Zangos S, Eichler K, Vogl T, Basten L. Radiation protection in CT-guided interventions: does real-time dose visualisation lead to a reduction in radiation dose to participating radiologists? A single-centre evaluation. Clin Radiol 2024; 79:e785-e790. [PMID: 38388255 DOI: 10.1016/j.crad.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024]
Abstract
AIM To evaluate if real-time dose visualisation during computed tomography (CT)-guided interventions leads to a reduction in radiation dose to participating radiologists. MATERIALS AND METHODS The individual radiation dose radiologists are exposed to during CT interventions was measured using dedicated dosimeters (RaySafe i2-system, Unfors RaySafe GmbH, Billdal, Sweden) worn over the usual radiation protective apron. Initially, only the total radiation dose was measured, without visualisation (control group). In the following study period, the radiation dose was shown to participants on a live screen in real-time (experimental group). In both groups, the dose was recorded in 1-second intervals. The results collected were evaluated by comparison using descriptive statistics and mixed-effect models. In particular, the variables experience, gender, role, and position during the intervention were analysed. RESULTS In total, 517 measurements of 304 interventions (n=249 with and n=268 without live screen) performed by 29 radiologists acting as interventionalists or assistants were analysed. All CT-guided interventions were performed percutaneously, the majority of which (n=280) were microwave ablations (MWA). Radiation doses in the group without visualisation were comparable with usual dose rates for the corresponding intervention type. The mean total radiation dose was reduced by 58.1% (11.6 versus 4.86 μSv) in the experimental group (p=0.034). The highest reduction of 78.5% (15.55 versus 3.35 μSv) was observed in radiologists with the role of assistant (p=0.002). Sub-analysis showed significant dose reduction (p<0.0001) for the use of live screen in general; considering all variables, the role "assistant" alone had a statistically significant influence (p=0.002). CONCLUSION The real-time visualisation of active radiation dose during CT interventions leads to a relevant reduction in radiation dose to participating radiologists.
Collapse
Affiliation(s)
- A Koch
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - T Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - S Zangos
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - K Eichler
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - T Vogl
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - L Basten
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
| |
Collapse
|
2
|
Kraef C, Öbrink-Hansen K, Hertz M, Hagen TL, Deutch S, Holler JG, Olesen BR, Holm M, Gaini S, Koch A, Benfield T, Rosenvinge FS, Johansen IS. Hospital-based antimicrobial stewardship in Denmark, Greenland and the Faroe Islands - current landscape and barriers. J Hosp Infect 2024; 146:66-75. [PMID: 38354955 DOI: 10.1016/j.jhin.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To describe the current organization and implementation of formalized, multi-disciplinary hospital-based antimicrobial stewardship (AMS) structures in Denmark, the Faroe Islands and Greenland. METHODS A structured electronic questionnaire was sent to all trainees and specialists in clinical microbiology (N=207) and infectious diseases (N=260), as well as clinical pharmacists (N=20) and paediatricians (N=10) with expertise in infectious diseases. The survey had 30 multiple-choice, rating-scale, and open-ended questions based on an international consensus checklist for hospital AMS, adapted to a Danish context. RESULTS Overall, 145 individual responses representing 20 hospitals were received. Nine hospitals (45%) reported a formal AMS strategy, eight (40%) a formal organizational multi-disciplinary structure and a multi-disciplinary AMS team, and six (30%) a designated professional as a leader of the AMS team. A majority of hospitals reported access to updated guidelines (80%) and regularly monitored and reported the quantity of antibiotics prescribed (70% and 65%, respectively). Only one hospital (5%) reported a dedicated, sustainable and sufficient AMS budget, three hospitals (15%) audited courses of therapy for specific agents/clinical conditions and four hospitals (20%) had a document clearly defining roles, procedures of collaboration and responsibilities for AMS. A total of 42% of all individual respondents had received formal AMS training. Main barriers were a lack of financial resources (52%), a lack of mandate from the hospital management (30%) and AMS not being a priority (18%). CONCLUSIONS Core elements important for multi-disciplinary hospital-based AMS can be strengthened in Danish hospitals. Funding, clear mandates, prioritization from the hospital management and the implementation of multi-disciplinary AMS structures may help close the identified gaps.
Collapse
Affiliation(s)
- C Kraef
- Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - K Öbrink-Hansen
- Department of Infectious Diseases, Internal Medicine, Gødstrup Hospital, Herning, Denmark
| | - M Hertz
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - T L Hagen
- Department of Internal Medicine, Aalborg University Hospital Thisted, Thisted, Denmark
| | - S Deutch
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - J G Holler
- Department of Pulmonary and Infectious Diseases, North Zealand Hospital, Hillerød, Denmark
| | - B R Olesen
- Pharmacist, Administration, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - M Holm
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - S Gaini
- Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands; Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - A Koch
- Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Center for Health Research in Greenland, Ilisimatusarfik, University of Greenland, Greenland; Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - T Benfield
- Department of Infectious Diseases, Copenhagen University Hospital - Hvidovre, Copenhagen, Denmark
| | - F S Rosenvinge
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - I S Johansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| |
Collapse
|
3
|
Sonigo C, Robin G, Boitrelle F, Fraison E, Sermondade N, Mathieu d'Argent E, Bouet PE, Dupont C, Creux H, Peigné M, Pirrello O, Trombert S, Lecorche E, Dion L, Rocher L, Arama E, Bernard V, Monnet M, Miquel L, Birsal E, Haïm-Boukobza S, Plotton I, Ravel C, Grzegorczyk-Martin V, Huyghe E, Dupuis HGA, Lefevre T, Leperlier F, Bardet L, Lalami I, Robin C, Simon V, Dijols L, Riss J, Koch A, Bailly C, Rio C, Lebret M, Jegaden M, Fernandez H, Pouly JL, Torre A, Antoine JM, Courbiere B. [First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00037-0. [PMID: 38311310 DOI: 10.1016/j.gofs.2024.01.014] [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] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples. MATERIALS AND METHODS Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts. RESULTS The fertility work-up is recommended to be prescribed according to the woman's age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple's initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery. CONCLUSION Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.
Collapse
Affiliation(s)
- Charlotte Sonigo
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Antoine-Béclère, 157, rue de la Porte-Trivaux, 92140 Clamart, France; Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - Geoffroy Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Florence Boitrelle
- Service de biologie de la reproduction, préservation de fertilité, CECOS, CHI de Poissy, Poissy, France; INRAe, ENVA, BREED, UVSQ, université Paris Saclay, Jouy-en Josas, France
| | - Eloïse Fraison
- Département médecine de la reproduction, CHU Lyon, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69500 Bron, France
| | - Nathalie Sermondade
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Emmanuelle Mathieu d'Argent
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Pierre-Emmanuel Bouet
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Charlotte Dupont
- Service de biologie de la reproduction - CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75012 Paris, France
| | - Hélène Creux
- Centre AMP, polyclinique Saint-Roch, 550, avenue du Colonel-André-Pavelet, 34070 Montpellier cedex, France
| | - Maeliss Peigné
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier-Béclère, avenue du 14-Juillet, Bondy, France
| | - Olivier Pirrello
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Sabine Trombert
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Emmanuel Lecorche
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Ludivine Dion
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Laurence Rocher
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Emmanuel Arama
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Valérie Bernard
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU Pellegrin, Bordeaux, France
| | - Margaux Monnet
- Département de gynécologie médicale, maternité régionale de Nancy, hôpitaux universitaires de Nancy, Nancy, France
| | - Laura Miquel
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - Eva Birsal
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | | | - Ingrid Plotton
- Service d'hormonologie, endocrinologie moléculaire et maladies rares, CPBE, groupement hospitalier Lyon-Est, Lyon-Bron, France; Université Claude-Bernard, Lyon 1, Lyon, France; Unité Inserm 1208, Lyon, France
| | - Célia Ravel
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Véronika Grzegorczyk-Martin
- Centre d'assistance médicale à la procréation et de préservation de la fertilité, clinique Mathilde, 76100 Rouen, France
| | - Eric Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; Inserm 1203, UMR DEFE, université de Toulouse, université de Montpellier, Montpellier, France
| | - Hugo G A Dupuis
- Service d'urologie et d'andrologie, CHU - hôpitaux de Rouen, CHU Charles-Nicolle, 76031 Rouen, France
| | - Tiphaine Lefevre
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Florence Leperlier
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Léna Bardet
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Imane Lalami
- Service de gynécologie-obstétrique et de médecine de la reproduction, grand hôpital de l'Est Francilien - site de Meaux, 6-8, rue Saint-Fiacre, 77100 Meaux, France
| | - Camille Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Virginie Simon
- Unité fonctionnelle de gynécologie endocrinienne, service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - Laura Dijols
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Bretonneau, CHU de Tours, Tours, France
| | - Justine Riss
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Antoine Koch
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Clément Bailly
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Constance Rio
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Marine Lebret
- Service de gynécologie-obstétrique, CHU Charles-Nicolle, 37, boulevard Gambetta, 76000 Rouen, France
| | - Margaux Jegaden
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Hervé Fernandez
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Jean-Luc Pouly
- Service de gynécologie chirurgicale, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - Antoine Torre
- Centre d'assistance médicale à la procréation clinicobiologique, centre hospitalier Sud Francilien Corbeil-Essonnes, 40, avenue Serge-Dassault, 91106 Corbeil-Essonnes, France
| | - Jean-Marie Antoine
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Blandine Courbiere
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IMBE, CNRS, IRD, Aix-Marseille université, Avignon université, Marseille, France.
| |
Collapse
|
4
|
Andersson AM, Ingham AC, Edslev SM, Sølberg J, Skov L, Koch A, Ghauharali-van der Vlugt K, Stet FS, Brüggen CM, Jakasa I, Kezic S, Thyssen JP. Ethnic endotypes in paediatric atopic dermatitis depend on immunotype, lipid composition and microbiota of the skin. J Eur Acad Dermatol Venereol 2024; 38:365-374. [PMID: 37822011 DOI: 10.1111/jdv.19565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/21/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) endotypes differ with ethnicity. We examined the skin microbiota, cytokine and lipid profiles in Greenlandic Inuit and Danish children with AD. METHODS Twenty-five Inuit children with AD and 25 Inuit control children were clinically examined and compared to previously collected data from 25 Danish children with AD. Skin tape strips and skin swabs were collected from lesional and non-lesional skin. Levels of cutaneous immune biomarkers, free sphingoid bases and their (glycosyl)ceramides were analysed. Skin swabs were analysed with 16S rRNA and tuf gene for characterization of bacterial species communities. RESULTS Bacterial β-diversity was significantly different between Inuit and Danish AD skin, in both lesional (p < 0.001) and non-lesional (p < 0.001) AD skin, and there was a higher relative abundance of Staphylococcus aureus in Danish compared to Inuit lesional (53% vs. 8%, p < 0.01) and non-lesional skin (55% vs. 5%, p < 0.001). Danish AD children had a higher α-diversity than Inuit children in non-lesional (p < 0.05) but not in lesional skin. Significantly higher levels of type 2 immunity cytokine interleukin (IL)-4 (p < 0.05) and IL-5 (p < 0.01) were identified in Inuit compared to Danish AD children. In contrast, IL-33 (p < 0.01) was higher in Danish lesional and non-lesional AD skin. Higher levels of long-chain glucosylceramide (GlcCER)[S](d26:1) were found in lesional (p < 0.001) and non-lesional (p < 0.001) Inuit skin compared with Danish AD skin. NMF levels were similar in Inuit and Danish AD skin. CONCLUSION Skin microbiota, cytokine and lipid composition differed significantly between Inuit and Danish children with AD and showed a stronger type 2 immune signature in Inuit children.
Collapse
Affiliation(s)
- A M Andersson
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Ilisimatusarfik, University of Greenland, Nuuk, Greenland
- Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A C Ingham
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - S M Edslev
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - J Sølberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A Koch
- Ilisimatusarfik, University of Greenland, Nuuk, Greenland
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - K Ghauharali-van der Vlugt
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F S Stet
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - C M Brüggen
- Faculty of Medicine, University Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - I Jakasa
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - S Kezic
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - J P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
5
|
Van den Dop LM, Van Rooijen MMJ, Tollens T, Jørgensen LN, De Vries-Reilingh TS, Piessen G, Köckerling F, Miserez M, Dean M, Berrevoet F, Dousset B, Van Westreenen HL, Gossetti F, Tetteroo GWM, Koch A, Boomsma MF, Lange JF, Jeekel J. Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair. Ann Surg Open 2023; 4:e366. [PMID: 38144487 PMCID: PMC10735126 DOI: 10.1097/as9.0000000000000366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/02/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh. Summary Background Data Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce. Methods Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10]. Results In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2). Conclusions Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.
Collapse
Affiliation(s)
- L M Van den Dop
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - M M J Van Rooijen
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - T Tollens
- Department of Surgery, Imelda Hospital, Bonheiden, Belgium
| | - L N Jørgensen
- Department of Surgery, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - G Piessen
- Department of Surgery, University Hospital Lille, Lille, France
| | - F Köckerling
- Department of Surgery, Vivantes Klinikum Spandau, Berlin, Germany
| | - M Miserez
- Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - M Dean
- Department of Surgery, University College London Hospital, London, United Kingdom
| | - F Berrevoet
- Department of Surgery, University Hospital Gent, Gent, Belgium
| | - B Dousset
- Department of Surgery, Hôpital Cochin, Paris, France
| | | | - F Gossetti
- Department of Surgery, Università di Roma Sapienza, Rome, Italy
| | - G W M Tetteroo
- Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - A Koch
- Department of Surgery, Chirurgische Praxis Ärztehaus, Cottbus, Germany
| | - M F Boomsma
- Department of Radiology, Isala hospital, Zwolle, the Netherlands
| | - J F Lange
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - J Jeekel
- From the Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Minella C, Jeandidier E, Koch A, Antal MC, Favre R, Sananes N, Weingertner AS. Trisomy 22: First and Second Trimester Cytogenetic Analysis and Phenotypic Presentation in a Series of Seven Cases. Fetal Diagn Ther 2023; 51:112-124. [PMID: 37926071 DOI: 10.1159/000534619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Trisomy 22 is a chromosomal disorder rarely encountered prenatally. Even fewer live births are observed and generally correspond to confined placental mosaic trisomy 22, or even more uncommonly, to true fetal mosaic trisomy 22. CASE PRESENTATION We examine and describe a series of seven cases of trisomy 22 encountered prenatally in terms of their cytogenetic and phenotypic presentations and discuss their interrelationships along with case management and outcomes. We aimed to identify aspects of prenatal data suggestive of fetal trisomy 22 and to determine whether a prognosis can be established from these factors. CONCLUSION Our conclusion is that prenatal data elements can provide key elements of information to guide multidisciplinary care and support for the couple and the neonate.
Collapse
Affiliation(s)
- Chris Minella
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Eric Jeandidier
- Department of Genetics, Groupe Hospitalier de la Region de Mulhouse et Sud Alsace, Mulhouse, France
| | - Antoine Koch
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Maria Cristina Antal
- Department of Anatomopathology and Fetopathology, Strasbourg University Hospital, Strasbourg, France
| | - Romain Favre
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Nicolas Sananes
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, Strasbourg, France
| | | |
Collapse
|
7
|
Hauss AS, Kiehl A, Arnalsteen C, Deshaies A, Deruelle P, Bettahar K, Koch A. [Pain assessment during medical abortion up to 14 weeks: A 1-year prospective comparative study]. Gynecol Obstet Fertil Senol 2023; 51:511-516. [PMID: 37597754 DOI: 10.1016/j.gofs.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES Pain assessment of patients requesting a medical abortion according to the term, up to 14 weeks, by a numerical rating scale (NRS). METHODS This was a single-centre prospective observational study conducted at the University Hospitals of Strasbourg from 1st October 2019 to 31st December 2020. RESULTS There was no significant difference in pain assessed by the NRS for medical abortion performed between 7-9 weeks and those performed between 9-14 weeks (6.5±2.5 vs. 6.6±2.2, P=0.85). Regardless of the term (before 7 weeks, between 7-9 weeks and between 9-14 weeks), patients felt relieved by taking painkillers in the case of medical abortion in 88.9%, 80.3% and 87.3% of cases respectively (P=0.18). The use of analgesics allowed a decrease of 3 points of the NRS in the 3 groups (P=0.67). Patients were more painful in case of medical protocol vs. surgical (maximum pain at 6.0±2.6 vs. 1.4±2.0, P<0.01), but declared to be relieved by analgesics in 85.1 and 94.3% of cases (P=0.24). CONCLUSIONS As pain is similar whatever the term in the case of medical abortion, and its management by analgesics seems to be effective, this criterion should not guide the professional in the choice of method, particularly between 9 and 14 weeks. This choice must be made by the patient.
Collapse
Affiliation(s)
- Anne-Sophie Hauss
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France.
| | - Amélie Kiehl
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - Charlotte Arnalsteen
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - Anne Deshaies
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - Philippe Deruelle
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - Karima Bettahar
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - Antoine Koch
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| |
Collapse
|
8
|
Flament E, Blanc-Petitjean P, Koch A, Deruelle P, Le Ray C, Sananès N. Women satisfaction on choosing the cervical ripening method: Oral misoprostol versus balloon catheter. Eur J Obstet Gynecol Reprod Biol X 2023; 19:100202. [PMID: 37426940 PMCID: PMC10329108 DOI: 10.1016/j.eurox.2023.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Induction of labor concerns about 29 % of women in Unites States and 33 % in Europe. Among the various methods for cervical ripening, the efficacy and safety profiles of oral misoprostol and balloon catheter are comparable, but data in the literature on maternal satisfaction during induction of labor are few. The objective of this study was to assess the satisfaction of women who chose the method of cervical ripening, i.e. either balloon catheter or oral misoprostol, for induction of labor. Study design This retrospective study asked women who had undergone induction of labor between February 1, 2020 and February 28, 2021. After receiving verbal and written information, the choice of method between oral misoprostol and balloon catheter was left to the patient's free appreciation. Satisfaction was assessed by means of a questionnaire distributed to all women during their stay in the maternity unit. The principal assessment criterion was based on women' inclination to choose the same cervical ripening method if induction of labor were to prove necessary in a future pregnancy, and their willingness to recommend this method to a friend. Univariate analyses were conducted using Student's t-test, Chi-2 test or Fisher's exact test. Results On 575 women eligible for analysis, 365 (63.5 %) of these women replied to the satisfaction questionnaire. Of this number, 236 (64.7 %) chose cervical ripening by balloon catheter, and 129 (35.3 %) by oral misoprostol. No significant difference was found between the two groups: 68.2 % of women in the balloon catheter group would opt for the same method of cervical ripening if it proved necessary in a future pregnancy and 64.7% would recommend it to a pregnant friend, versus 65.9 % and 63.6 % in the oral misoprostol group, respectively. Women were overall pleased to be able to choose their method of cervical ripening: 90.5 % of patients in the balloon catheter group and 95.3 % in the oral misoprostol group. Conclusions When women choose the method of cervical ripening, satisfaction is overall good, irrespective of the method, whether by balloon catheter or misoprostol.
Collapse
Affiliation(s)
- Emeline Flament
- Department of Obstetrics and Gynecology, Strasbourg University Hospital, 1 Avenue Moliere, 67200 Strasbourg, France
| | - Pauline Blanc-Petitjean
- Department of Epidemiology and Public Health, Rennes University Hospital, 2 Rue Henri Leguilloux, 35033 Rennes, France
| | - Antoine Koch
- Department of Obstetrics and Gynecology, Strasbourg University Hospital, 1 Avenue Moliere, 67200 Strasbourg, France
| | - Philippe Deruelle
- Department of Obstetrics and Gynecology, Strasbourg University Hospital, 1 Avenue Moliere, 67200 Strasbourg, France
| | - Camille Le Ray
- Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, 75014 Paris, France
| | - Nicolas Sananès
- Department of Obstetrics and Gynecology, Strasbourg University Hospital, 1 Avenue Moliere, 67200 Strasbourg, France
- INSERM 1121 'Biomaterials and Bioengineering', Strasbourg University, 1 Pl. de l′Hôpital, 67000 Strasbourg, France
| |
Collapse
|
9
|
Früh A, Schaumann A, Cohrs G, Pennacchietti V, Schulz M, Hernáiz Driever P, Koch A, Thomale UW. Biopsies of caudal brainstem tumors in pediatric patients - a single center retrospective case series. World Neurosurg 2023:S1878-8750(23)00754-4. [PMID: 37271255 DOI: 10.1016/j.wneu.2023.05.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The indication for performing biopsies in patients with diffuse lesions in the brain stem is controversial. Possible risks associated with the technical challenging interventions need to be balanced against clarifying the diagnosis and possible therapeutic options. We reviewed the feasibility, risk profile and diagnostic yield of different biopsy techniques in a pediatric cohort. METHODS We retrospectively included all patients under 18 years of age that received a biopsy of the caudal brainstem region (pons, medulla oblongata) at our pediatric neurosurgical center from 2009-2022. RESULTS We identified 27 children. Biopsies were performed using frameless stereotactic (Varioguide) (n=12), robotic assisted (Autoguide) (n=4), endoscopic (n=3) and open biopsy (n=8) technique. Intervention related mortality was not observed. Three patients experienced transient post-surgical neurological deficit. No patient showed intervention related permanent morbidity. Biopsy yielded histopathological diagnosis in all cases. Molecular analysis was feasible in 97% of cases. Most common diagnosis was H3K27M mutated diffuse midline glioma (60%). Low-grade gliomas were identified in 14%. Overall survival was 62.5% after 24 months of follow up. CONCLUSION Biopsies of the caudal brainstem in children were feasible and safe in the presented setup. The amount of acquired tumor material allowing integrated diagnosis and was obtained at reasonable risk. The selection of the surgical technique depends on tumor location and growth pattern. We recommend brainstem tumor biopsies in children being performed at specialized centers to better understand the biology and enable possible novel therapeutic options.
Collapse
Affiliation(s)
- A Früh
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German; Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - A Schaumann
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German
| | - G Cohrs
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German
| | - V Pennacchietti
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German
| | - M Schulz
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German
| | - P Hernáiz Driever
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Koch
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - U-W Thomale
- Pediatric Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, German.
| |
Collapse
|
10
|
Milot C, Koch A, Averous G, Mayeur S, Deruelle P. Development of placental lesions after recovery from COVID-19 during pregnancy: case-control study. BJOG 2023. [PMID: 37005912 DOI: 10.1111/1471-0528.17458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/21/2023] [Accepted: 03/12/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVE To study whether the occurrence and type of placental lesions vary according to the time of onset of COVID-19 in pregnant women. DESIGN Case-control study. SETTING Departments of Gynaecology-Obstetrics and Pathology, Strasbourg University Hospital, France. POPULATION Cases were 49 placentas of women with COVID-19. Controls were 50 placentas from women who had a past history of molar pregnancy. COVID-19 placentas were categorised based on whether birth occurred at more or less than 14 days post-infection. METHODS Comparison between case and controls. MAIN OUTCOME MEASURES Maternal and neonatal outcomes were recorded. Macroscopic and microscopic examination of the placentas was performed. RESULTS The rate of vascular complications was higher in the COVID groups than in the controls (8 [16.3%] versus 1 [2%], p = 0.02). Signs of fetal (22[44.9%] versus 13 [26%], p = 0.05) and maternal (44 [89.8%] versus 36 [72.0%], p = 0.02) vascular malperfusion and signs of inflammation (11 [22.4%] versus 3 [6.0%], p = 0.019) were significantly more common in the COVID-19 groups than in the control group. Fetal malperfusion lesions (9 [39.1%] versus 13 [50.0%], p = 0.45) and placental inflammation (4 [17.4%] versus 7 [26.9%], p = 0.42) rates were not significantly different between the two COVID-19 groups. Chronic villitis was significantly more common when the delivery occurred >14 days after infection than in the group that delivered <14 days after infection (7 [26.9%] versus 1 [4.4%], p = 0.05). CONCLUSIONS Our study suggests that SARS-COV-2 induces placental lesions that evolve after disease recovery, especially with the development of inflammatory lesions, such as chronic villitis.
Collapse
Affiliation(s)
- C Milot
- Obstetrics and Gynaecology Department, Strasbourg University Hospitals, Strasbourg, France
| | - A Koch
- Obstetrics and Gynaecology Department, Strasbourg University Hospitals, Strasbourg, France
| | - G Averous
- Pathology Department, Strasbourg University Hospitals, Strasbourg, France
| | - S Mayeur
- Pathology Department, Strasbourg University Hospitals, Strasbourg, France
| | - P Deruelle
- Obstetrics and Gynaecology Department, Strasbourg University Hospitals, Strasbourg, France
| |
Collapse
|
11
|
Shehada S, Jasarevic M, Jarkas S, Haddad A, Al-Rashid F, Thielmann M, Koch A, Pizanis N, Kamler M, Ruhparwar A, Schmack B. Mechanical Circulatory Support Using Impella 5.5 for Patients Presented with Ischemic Heart Disease and Severely Impaired Left Ventricular Function Undergoing Coronary Artery Bypass Surgery: A Three-Year Single Centre Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1051] [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: 04/05/2023] Open
|
12
|
Niebuhr H, Köckerling F, Fortelny R, Hoffmann H, Conze J, Holzheimer RG, Koch A, Köhler G, Krones C, Kukleta J, Kuthe A, Lammers B, Lorenz R, Mayer F, Pöllath M, Reinpold W, Schwab R, Stechemesser B, Weyhe D, Wiese M, Zarras K, Meyer HJ. [Inguinal hernia operations-Always outpatient?]. Chirurgie (Heidelb) 2023; 94:230-236. [PMID: 36786812 PMCID: PMC9950173 DOI: 10.1007/s00104-023-01818-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite the announced political willingness and the increasing pressure from the legislator to avoid costly inpatient treatment by carrying out as many outpatient operations as possible, outpatient treatment has so far played a subordinate role in the DACH region. The Boards of the specialist societies the German Hernia Society (DHG), the Surgical Working Group Hernia (CAH of the DHG), the Austrian Hernia Society (ÖHG) and the Swiss Working Group Hernia Surgery (SAHC) make inroads into this problem, describe the initial position and assess the current situation.
Collapse
Affiliation(s)
- H Niebuhr
- Hamburger Hernien Centrum, Eppendorfer Baum 8, 20249, Hamburg, Deutschland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Arnalsteen C, Jochum F, Hauss AS, Kiehl A, Deshaies A, Martel C, Koch A, Bettahar K. [Single dose of misoprostol for abortion until 9 weeks of gestation]. Gynecol Obstet Fertil Senol 2023; 51:41-45. [PMID: 36423881 DOI: 10.1016/j.gofs.2022.11.005] [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] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/13/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The primary objective was to compare the efficacy of a single-dose misoprostol for abortion before 7 weeks of gestation and between 7 and 9 weeks of gestation. The secondary objectives were to compare the amount of misoprostol required for complete expulsion, the need for endo-uterine aspiration, and to assess pain and patient experience in these two groups. METHODS This was a single-centre prospective observational study conducted at the University Hospitals of Strasbourg from 1st October 2019 to 31st December 2020. RESULTS A total of 306 patients were included, 150 in the group before 7 weeks of gestation and 156 in the group between 7 and 9 weeks of gestation. There was no significant difference in the success rate of the single dose of misoprostol between the two groups with 34.7 and 37.8% respectively (P=0.63). After taking painkillers, there is no difference in terms of pain relief (EN ≤ 4 for 92 et 95% of patients P=0.37). CONCLUSION The single dose of misoprostol for in-hospital abortion is as effective between 7 and 9 weeks of gestation as it is before 7. By extension, therefore, we would suggest that there should be no difference in efficacy between home abortions before 7 weeks of gestation and between 7 and 9 weeks of gestation and therefore suggest that home abortions can be performed up to 9 weeks of gestation without fear of a decrease in the rate of complete expulsion and the efficacy of analgesia, with potentially less use of misoprostol compared with the hospital setting.
Collapse
Affiliation(s)
- C Arnalsteen
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France.
| | - F Jochum
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - A-S Hauss
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - A Kiehl
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - A Deshaies
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - C Martel
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - A Koch
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - K Bettahar
- Pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| |
Collapse
|
14
|
Othman H, Koch A, Purdie T, Chan M, Tadic T, Weiss J, Liu Z, Isfahanian N, Glicksman R, Helou J, Liu F, Hahn E, Rodin D, Fyles A, Barry A, Croke J. Early Institutional Experience of Ultra-Hypofractionated Breast Radiotherapy in a Large Academic Cancer Center. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.719] [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: 10/31/2022]
|
15
|
Bettahar K, Koch A, Deruelle P. [Medical strategy for abortions between 14 and 16 weeks of gestation]. Gynecol Obstet Fertil Senol 2022; 50:735-740. [PMID: 36183986 DOI: 10.1016/j.gofs.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To adapt the protocols for the management of voluntary termination of pregnancy following the new law extending the practice to 16 weeks of gestation. MATERIAL AND METHOD A systematic review of the literature in French and English concerning the management of patients requesting medically induced abortion was performed on PubMed, Cochrane Library and on the recommendations of international learned societies. RESULTS The efficacy of the medical method is greater than 95% when the protocols are adapted to the gestational age. The combination of mifepristone and misoprostol currently represents the "gold standard" of drug-based management. Mifepristone 200mg is sufficient, followed 24 to 48hours later by misoprostol 800μg administered sublingually or buccally. After the first dose, 400μg should be administered every 3hours buccally or sublingually until expulsion. Adverse effects (digestive and thermoregulatory disorders) during medical abortion are usually mild and short-lived. An anti-emetic treatment should be proposed as a prophylactic measure. For pain, ibuprofen is the analgesic treatment of choice, with the addition of level 2 analgesics if necessary. CONCLUSION Medical abortion is a safe and effective method up to 16 weeks of gestation, provided that the protocols, which differ according to gestational age, are respected. Women must be informed of the advantages and disadvantages of the methods according to the term and the side effects, which will allow them to choose the method that fits them best.
Collapse
Affiliation(s)
- K Bettahar
- Service de gynecologie obstetrique, CHU de Strasbourg, 1, place de l'Hôpital, BP 426, site du CMCO, 67091 Strasbourg cedex, France.
| | - A Koch
- Service de gynecologie obstetrique, CHU de Strasbourg, 1, place de l'Hôpital, BP 426, site du CMCO, 67091 Strasbourg cedex, France.
| | - P Deruelle
- Service de gynecologie obstetrique, CHU de Strasbourg, 1, place de l'Hôpital, BP 426, site du CMCO, 67091 Strasbourg cedex, France.
| |
Collapse
|
16
|
Kahles F, Mertens R, Diebold S, Arrivas MC, Moellmann J, Steitz J, Mirzaei Y, Sandoval D, Martin L, Schuerholz T, Koch A, Tacke F, Drucker DJ, Marx N, Lehrke M. GLP-2 as an indicator and modulator of acute inflammation improves cardiac function and survival in sepsis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
GLP-1 and GLP-2 (glucagon-like peptide-1/2) are gut hormones secreted in response to food. While GLP-1 controls glucose metabolism, GLP-2 is a local gut growth factor regulating intestinal nutrient absorption. GLP-2 has been found to be upregulated in patients with colitis. We hypothesize that beyond its local intestinal function GLP-2 might be involved in systemic immune responses.
Methods and results
To analyze whether GLP-2 secretion is modulated by the immune system, we measured circulating GLP-2 levels in 2 clinical cohorts. In the first cohort (n=34) GLP-2 levels increased over time following cardiac surgery as an inflammatory stimulus. In the second cohort 223 patients with sepsis had a 3.9 fold increase of GLP-2 plasma levels vs. 53 healthy controls (3.0 ng/mL vs. 11.4 ng/mL; p<0.001). High GLP-2 levels were associated with markers of inflammation (IL-6, PCT, CRP), septic cardiomyopathy (NT-proBNP) and independently predicted mortality in humans with sepsis. Induction of sepsis in mice by endotoxin or cecal ligation puncture strongly increased GLP-2 levels independent from food intake. By injecting various proinflammatory cytokines and inducing sepsis in IL1R−/− and IL6−/− mice we identified that inflammation upregulates GLP-2 secretion through IL-6. To identify the source of GLP-2 secretion under inflammation, we induced sepsis in Gcg−/− mice lacking endogenous GLP-2 production with a tissue-specific reactivation of Gcg in gut L-cells (GcgRAΔvilCre) or pancretic alpha cells (GcgRAΔPDX1-Cre). We observed sepsis-induced GLP-2 secretion to be derived from the pancreas and not from the gut. Additional in-vitro and ex-vivo approaches revealed that IL-6 directly activates GLP-2 secretion from pancreatic alpha cells. Gcg−/− mice lacking GLP-2 production and Glp2r−/− mice show aggravated sepsis indicating that endogenous upregulation of GLP-2 is protective. Finally, we analyzed whether inflammatory upregulation of GLP-2 has immunomodulatory relevance. We administered GLP-2 or saline as control per central jugular vein catheter mice who underwent CLP. GLP-2 treatment improved LV-contractility (dp/dtmax) in septic cardiomyopathy (control 7361 vs. GLP-2 9500 mmHg/s; p<0.01), inhibited sepsis-induced hypotension and reduced mortality (p=0.018). Mechanistically GLP-2 reduced myeloid immune cell infiltration into heart and liver tissue and decreased proinflammatory cytokine levels in various organs and the blood (TNF-α, IL-6 and IL-1β). After broad GLP-2 receptor profiling we found maximum mRNA expression in gut tissues with no expression on immune cells. By further mechanistic studies we found GLP-2 to protect against sepsis-induced gut barrier dysfunction.
Conclusions
Here we identified a counter-regulatory control system in which IL-6 derived upregulation of GLP-2 secretion limits excessive innate immune responses and protects against sepsis. These findings might open new avenues for the treatment of patients with inflammatory diseases.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): European Foundation for the Study of Diabetes, European Research Area Network on Cardiovascular Diseases (ERA-CVD and BMBF), Deutsche Forschungsgemeinschaft (DFG)
Collapse
Affiliation(s)
- F Kahles
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - R Mertens
- University Hospital of Heidelberg, Department of Cardiology, Angiology, and Pneumology , Heidelberg , Germany
| | - S Diebold
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - M C Arrivas
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - J Moellmann
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - J Steitz
- RWTH University Hospital Aachen, Institute for Laboratory Animal Science , Aachen , Germany
| | - Y Mirzaei
- RWTH University Hospital Aachen, Institute for Laboratory Animal Science , Aachen , Germany
| | - D Sandoval
- University of Michigan, School of Public Health, University of Michigan , Ann Arbor , United States of America
| | - L Martin
- RWTH University Hospital Aachen, Department of Intensive Care and Intermediate Care , Aachen , Germany
| | - T Schuerholz
- RWTH University Hospital Aachen, Department of Intensive Care and Intermediate Care , Aachen , Germany
| | - A Koch
- RWTH University Hospital Aachen, Department of Gastroenterology , Aachen , Germany
| | - F Tacke
- RWTH University Hospital Aachen, Department of Gastroenterology , Aachen , Germany
| | - D J Drucker
- Mount Sinai Hospital of the University Health Network, Lunenfeld-Tanenbaum Research Institute , Toronto , Canada
| | - N Marx
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - M Lehrke
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| |
Collapse
|
17
|
Simon M, Kuschel LP, von Hoff K, Hernáiz Driever P, Hain EG, Koch A, Capper D, Schulz M, Thomale U, Euskirchen P. P04.03.B Rapid DNA methylation-based classification of pediatric brain tumors from ultrasonic aspirate specimens. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.118] [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: 11/14/2022] Open
Abstract
Abstract
Background
Cavitating ultrasonic aspirator (CUSA) devices are commonly used in neurosurgical procedures to carefully debulk tumor from adjacent healthy brain tissue. Here, we explore the feasibility of using ultrasonic minced tumor tissue to classify otherwise discarded sample material by DNA methylation according to the respective World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) using low pass nanopore whole genome sequencing.
Material and Methods
21 ultrasonic aspirated specimens from patients undergoing surgery in the department of pediatric neurosurgery at the Charité-Universitätsmedizin Berlin with either newly diagnosed cerebral lesions or pre-treated lesions were processed by nanopore sequencing to generate copy number profiles and ad-hoc random forest classification. Results were compared to microarray-based routine profiling. Tumor purity was assessed.
Results
In 19/21 (90.5 %) samples the minimum amount of 1,000 CpG sites were sequenced. In 20/21 (95.2 %) cases copy number variation profiles could be generated and matched microarray derived copy number profiles, allowing for identification of diagnostically or therapeutically relevant pathognomonic alterations. 12/17 (70.6 %) samples were concordantly classified to the corresponding microarray-based diagnosis by routine neuropathological workup. Applying recently defined thresholds for nanopore-based classification resulted in sensitivity of 64.7 % and specificity of 100 %.
Conclusion
CUSA referred sample material of pediatric brain tumors allows for methylation-based classification according to the respective WHO classification of CNS tumors with acceptable sensitivity and high specificity. Hereby, a promising opportunity for accurate classification of pediatric brain tumors by a time- and cost-efficient advanced molecular technique is offered using otherwise discarded tumor tissue.
Collapse
Affiliation(s)
- M Simon
- Charité Universitätsmedizin Berlin - Department of Pediatric Oncology and Hematology , Berlin , Germany
| | - L P Kuschel
- Charité Universitätsmedizin Berlin - Department of Neurology with Experimental Neurology , Berlin , Germany
| | - K von Hoff
- Charité Universitätsmedizin Berlin - Department of Pediatric Oncology and Hematology , Berlin , Germany
| | - P Hernáiz Driever
- Charité Universitätsmedizin Berlin - Department of Pediatric Oncology and Hematology , Berlin , Germany
| | - E G Hain
- Charité Universitätsmedizin Berlin - Department of Neuropathology , Berlin , Germany
| | - A Koch
- Charité Universitätsmedizin Berlin - Department of Neuropathology , Berlin , Germany
| | - D Capper
- Charité Universitätsmedizin Berlin - Department of Neuropathology , Berlin , Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - M Schulz
- Charité Universitätsmedizin Berlin - Department of Pediatric Neurosurgery , Berlin , Germany
| | - U Thomale
- Charité Universitätsmedizin Berlin - Department of Pediatric Neurosurgery , Berlin , Germany
| | - P Euskirchen
- Charité Universitätsmedizin Berlin - Department of Neurology with Experimental Neurology , Berlin , Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| |
Collapse
|
18
|
Münch A, Teichmann D, Kuzman P, Spille D, Perez E, May S, Mueller W, Kombos T, Nazari-Dehkordi S, Onken J, Vajkoczy P, Ntoulias G, Paulus W, Heppner F, Koch A, Capper D, Kaul D, Thomas C, Schweizer L. P05.05.B A new IDH-wildtype glioma subtype characterized by highly diffuse growth pattern, distinct epigenetic profile and relatively favorable prognosis. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.124] [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: 11/12/2022] Open
Abstract
Abstract
Background
DNA methylation profiling has emerges as a powerful approach to CNS tumor classification and the discovery of novel, molecularly distinct entities. With the release of the 12.5 version of the Heidelberg Brain Tumor Classifier, some unclassifiable cases can be assigned to novel methylation classes. We retrospectively reviewed our databases and identified 16 previously unclassifiable cases, all of which belong to the provisional methylation class “adult-type diffuse high-grade glioma, IDH-wildtype, subtype F (HGG_F)”.
Material and Methods
We clinically, radiologically and morphologically characterized 16 HGG_F cases and compared them to 347 glioblastomas. We additionally analyzed copy-number alterations and performed DNA exome sequencing.
Results
Median age at diagnosis of the 12 males and 4 females was 65 years. Upon initial diagnostic workup, specimens were classified as CNS tissue with reactive changes (n=3) or suspicious for the infiltration zone of a diffuse glioma (n = 13). None of the cases demonstrated endothelial proliferation or necrosis and 10/16 tumors had flat copy number profiles. Radiological characteristics were reminiscent of gliomatosis cerebri in eight cases and 9/9 cases had normal FET-PET scans. Whole-exome sequencing revealed genetic alterations frequently found in IDH-wildtype glioblastomas, including TERT promoter mutations in 11/14 (78.6%) and PIK3 mutations (10/14, 71.4%). Outcome was significantly better compared to TCGA IDH-wildtype glioblastomas with a median progression-free survival of 58 months and overall survival of 73 months (both p<0.001).
Conclusion
We provide evidence that TERT promoter mutations in diffusely infiltrating gliomas without further morphological or molecular signs of high-grade glioma should be interpreted in the context of the clinico-radiological presentation as well as epigenetic prolife and may not be suitable as standalone diagnostic marker for glioblastoma, IDH wildtype.
Collapse
Affiliation(s)
- A Münch
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - D Teichmann
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - P Kuzman
- Institute of Neuropathology, University Hospital Leipzig , Leipzig , Germany
| | - D Spille
- Department of Neurosurgery, University Hospital Münster , Münster , Germany
| | - E Perez
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - S May
- Klinikum Chemnitz, Department of Neurosurgery , Chemnitz , Germany
| | - W Mueller
- Institute of Neuropathology, University Hospital Leipzig , Leipzig , Germany
| | - T Kombos
- Schlosspark-Klinik Charlottenburg, Department of Neurosurgery , Berlin , Germany
| | - S Nazari-Dehkordi
- Schlosspark-Klinik Charlottenburg, Department of Neurosurgery , Berlin , Germany
| | - J Onken
- Charité - Universitätsmedizin Berlin, Department of Neurosurgery , Berlin , Germany
| | - P Vajkoczy
- Charité - Universitätsmedizin Berlin, Department of Neurosurgery , Berlin , Germany
| | - G Ntoulias
- Vivantes Klinikum Neukölln, Department of Neurosurgery , Berlin , Germany
| | - W Paulus
- Institute of Neuropathology, University Hospital Münster , Münster , Germany
| | - F Heppner
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - A Koch
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - D Capper
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| | - D Kaul
- Charité - Universitätsmedizin Berlin, Department of Radiation Oncology and Radiotherapy , Berlin , Germany
| | - C Thomas
- Institute of Neuropathology, University Hospital Münster , Münster , Germany
| | - L Schweizer
- Charité - Universitätsmedizin Berlin, Department of Neuropathology , Berlin , Germany
| |
Collapse
|
19
|
Moonen L, Mangiante L, Alcala N, Leunissen D, Lap L, Gabriel A, Hillen L, Roemen G, Koch A, Van Engeland M, Dingemans A, Foll M, Fernandez-Cuesta L, Derks J, Speel E. P66.09 Differential Orthopedia Homeobox (OTP) Expression in Pulmonary Carcinoids is Regulated Through Methylation. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.685] [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: 11/16/2022]
|
20
|
Lecointre L, Venkatasamy A, Wehr M, Koch A, Sananes A, Debry C, Lodi M, Sananes N. Multicentric evaluation of a 3D-printed simulator for COVID- 19 nasopharyngeal swab collection in testing centers. J Infect 2021; 83:709-737. [PMID: 34571116 PMCID: PMC8461264 DOI: 10.1016/j.jinf.2021.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Lise Lecointre
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France; I-Cube UMR 7357, Engineering, Information Processing and Image Sciences Lab, Strasbourg University, Strasbourg, France; IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France.
| | - Aïna Venkatasamy
- IHU-Strasbourg (Institut Hospitalo-Universitaire), Strasbourg, France; Streinth Lab (Stress Response and Innovative Therapies), Inserm UMR_S 1113 IRFAC, Interface Recherche Fondamental et Appliquée à la Cancérologie, 3 avenue Molière, Strasbourg, France
| | - Mégane Wehr
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France
| | - Antoine Koch
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France
| | - Axel Sananes
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France
| | - Christian Debry
- Streinth Lab (Stress Response and Innovative Therapies), Inserm UMR_S 1113 IRFAC, Interface Recherche Fondamental et Appliquée à la Cancérologie, 3 avenue Molière, Strasbourg, France; ENT Department, Strasbourg University Hospital, Strasbourg, France
| | - Massimo Lodi
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France
| | - Nicolas Sananes
- Obstetrics and Gynecology Department, Strasbourg University Hospital, 1 avenue Molière, Strasbourg 67200, France; ENT Department, Strasbourg University Hospital, Strasbourg, France; INSERM UMR-S 1121 'Biomaterials and Bioengineering', Strasbourg University, Strasbourg, France
| |
Collapse
|
21
|
Sananès N, Haller L, Jochum F, Koch A, Lecointre L, Rozenberg P. Morbidity associated with planned cesarean deliveries performed before the scheduled date: A cohort study. Eur J Obstet Gynecol Reprod Biol 2021; 264:83-87. [PMID: 34284272 DOI: 10.1016/j.ejogrb.2021.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Women with planned cesareans can require delivery before the scheduled date. However, data describing the morbidity associated with planned cesarean deliveries performed before the originally scheduled date is lacking. The objective of this study was to compare the morbidity associated with planned cesarean delivery performed before compared with on the scheduled date. STUDY DESIGN This retrospective single-center cohort study included all 3595 women with singleton pregnancies and cesarean deliveries after 36+6 weeks. All cases were reviewed individually to identify the initial intended mode of delivery, determined before 37 weeks. We excluded the 2145 (59.7%) unplanned cesareans initially planned as vaginal deliveries. Finally, the analysis included 1450 women with planned cesareans: 1232 (85.0%) performed as scheduled, and 218 (15.0%) before that date. The composite outcomes of maternal morbidity was one or more of the morbidity measures, including surgical complications, postpartum hemorrhage, infection and thrombo-embolism. Neonatal morbidity measures included 5 min Apgar score < 7, arterial cord blood pH < 7.00, and admission to the neonatal intensive care unit (NICU). RESULTS Reasons for performing planned cesarean delivery before the scheduled date were as follows: onset of labor (n = 109; 50.0%), rupture of membranes (n = 85; 39.0%), preeclampsia (n = 9; 4.1%), scar pain in women with a previous cesarean (n = 6; 2.8%), unexplained vaginal bleeding (n = 5; 2.3%), and nonreassuring fetal heart rate (n = 4; 1.8%). Mean gestational age for planned cesarean deliveries before the scheduled date was 38.7 weeks ± 0.8 versus 39.2 weeks ± 0.7 for those performed when scheduled (P < 0.0001). The maternal morbidity composite outcome rate was significantly higher among planned cesareans performed early compared with those on the scheduled date: 18.3% vs 9.7%, respectively, P = 0.0002. It was still higher in the multivariable analysis: aOR 2.17, 95% CI 1.46-3.21, P = 0.0001. The neonatal composite outcome did not differ significantly between the two groups. CONCLUSION In planned cesarean deliveries, maternal morbidity is higher for cesareans performed before rather than on the scheduled date. Studies without accurate intent-to-treat analyses underestimate the morbidity associated with planned cesareans. Accordingly, medical records must make it possible to distinguish planned cesarean deliveries performed before the scheduled date from those performed as planned.
Collapse
Affiliation(s)
- Nicolas Sananès
- Department of Obstetrics, Strasbourg University Hospital, Strasbourg, France; INSERM UMR-S 1121 "Biomaterials and Bioengineering", Strasbourg University, France.
| | - Laure Haller
- Department of Obstetrics, Strasbourg University Hospital, Strasbourg, France
| | - Floriane Jochum
- Department of Obstetrics, Strasbourg University Hospital, Strasbourg, France; Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - Antoine Koch
- Department of Obstetrics, Strasbourg University Hospital, Strasbourg, France
| | - Lise Lecointre
- Department of Obstetrics, Strasbourg University Hospital, Strasbourg, France; I-Cube UMR 7357, Strasbourg University, France
| | - Patrick Rozenberg
- Department of Obstetrics, Poissy-Saint-Germain-en-Laye Hospital Poissy, France; Research Unit EA 7285, Versailles St-Quentin University, Montigny-le-Bretonneux, France
| |
Collapse
|
22
|
Asperger H, Cieslik JP, Alberter B, Köstler C, Polzer B, Müller V, Pantel K, Riethdorf S, Koch A, Hartkopf A, Wiesmüller L, Janni W, Schochter F, Franken A, Niederacher D, Fehm T, Neubauer H. ViBiBa: Virtual BioBanking for the DETECT multicenter trial program - decentralized storage and processing. Transl Oncol 2021; 14:101132. [PMID: 34051621 PMCID: PMC8176360 DOI: 10.1016/j.tranon.2021.101132] [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: 04/26/2021] [Accepted: 05/19/2021] [Indexed: 12/05/2022] Open
Abstract
ViBiBa is an open-source sample banking tool. ViBiBa was purpose built for liquid biopsy specimen. ViBiBa allows for decentralized storage while promoting collaboration. ViBiBa's plugin support requires no change in existing data structures. ViBiBa empowers translational research projects and cohort formation.
Background Liquid Biopsy (LB) in the form of e.g., circulating tumor cells (CTCs) is a promising non-invasive approach to support current therapeutic cancer management. However, the proof of clinical utility of CTCs in informing therapeutic decision-making for e.g., breast cancer in clinical trials and associated translational research projects is facing the issues of low CTC positivity rates and low CTC numbers – even in the metastasized situation. To compensate for this dilemma, clinical CTC trials are designed as large multicenter endeavors with decentralized sample collection, processing and storage of products, making data management highly important to enable high-quality translational CTC research. Aim In the DETECT clinical CTC trials we aimed at developing a custom-made, browser-based virtual database to harmonize and organize both decentralized processing and storage of LB specimens and to enable the collection of clinically meaningful LB sample. Methods ViBiBa processes data from various sources, harmonizes the data and creates an easily searchable multilayered database. Results An open-source virtual bio-banking web-application termed ViBiBa was created, which automatically processes data from multiple non-standardized sources. These data are automatically checked and merged into one centralized databank and are providing the opportunity to extract clinically relevant patient cohorts and CTC sample collections. Summary ViBiBa, which is a highly flexible tool that allows for decentralized sample storage of liquid biopsy specimens, facilitates a solution which promotes collaboration in a user-friendly, federalist and highly structured way. The source code is available under the MIT license from https://vibiba.com or https://github.com/asperciesl/ViBiBa
Collapse
Affiliation(s)
- H Asperger
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - J-P Cieslik
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - B Alberter
- Division of Personalized Tumor Therapy, Fraunhofer ITEM, Germany, Am Biopark 9, Regensburg, Germany
| | - C Köstler
- Division of Personalized Tumor Therapy, Fraunhofer ITEM, Germany, Am Biopark 9, Regensburg, Germany
| | - B Polzer
- Division of Personalized Tumor Therapy, Fraunhofer ITEM, Germany, Am Biopark 9, Regensburg, Germany
| | - V Müller
- Department of Obstetrics and Gynecology, University Hospital Hamburg-Eppendorf, Germany, Martinistraße 52, Hamburg, Germany
| | - K Pantel
- Department of Tumor Biology, University Hospital Hamburg-Eppendorf, Germany, Martinistraße 52, Hamburg, Germany
| | - S Riethdorf
- Department of Tumor Biology, University Hospital Hamburg-Eppendorf, Germany, Martinistraße 52, Hamburg, Germany
| | - A Koch
- Department of Obstetrics and Gynecology, University of Tübingen, Germany, Calwerstraße 7, Tübingen, Germany
| | - A Hartkopf
- Department of Obstetrics and Gynecology, University of Tübingen, Germany, Calwerstraße 7, Tübingen, Germany
| | - L Wiesmüller
- Department of Obstetrics and Gynecology, University Hospital Ulm, Germany, Albert-Einstein-Allee 23, Ulm, Germany
| | - W Janni
- Department of Obstetrics and Gynecology, University Hospital Ulm, Germany, Albert-Einstein-Allee 23, Ulm, Germany
| | - F Schochter
- Department of Obstetrics and Gynecology, University Hospital Ulm, Germany, Albert-Einstein-Allee 23, Ulm, Germany
| | - A Franken
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - D Niederacher
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - T Fehm
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany
| | - H Neubauer
- Department of Obstetrics and Gynecology, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, Germany.
| |
Collapse
|
23
|
Andersson AM, Halling AS, Loft N, Skov L, Koch A, Guttman-Yassky E, Thyssen JP. Atopic dermatitis among children and adolescents in the Arctic region - a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2021; 35:1642-1654. [PMID: 33829579 DOI: 10.1111/jdv.17276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
The prevalence of atopic dermatitis (AD) varies across the globe, and the clinical phenotype with racial background and ethnicity. AD in the Arctic region has only been scarcely studied. We performed a systematic review and meta-analysis to examine the prevalence, clinical manifestations and risk factors for AD among children and adolescents in the Arctic. Three medical databases PubMed, Embase and Web of Science were screened. All studies published between 1990 to 2020 with epidemiologic data on AD in children and adolescents in the Arctic region, were included. Data were extracted and a meta-analysis was performed to obtain pooled proportions and incidences with 95% confidence intervals (CI). We identified 21 studies from 8 different Arctic regions with 31 403 participants. The cumulative incidence of AD was 23% (95% CI 20-26) and 1-year prevalence was 19% (95% CI 15-25). The incidence of AD was higher in the Arctic parts of Scandinavia and lower in Greenland and Russia. Children of indigenous descent had a slightly lower incidence of AD (19%, 95% CI 13-26) compared to the overall population. The dominant phenotype of AD was mild to moderate flexural dermatitis with facial involvement. Asthma and allergic rhinitis were common and observed in 20-30% of children with AD. In conclusion, AD is highly prevalent in the Arctic, but varies between regions and races. Indigenous children living in less urbanized countries appear to have a slightly lower risk of AD. Future studies should confirm this and examine whether this correlation relates to behavioural differences or genetic signature.
Collapse
Affiliation(s)
- A M Andersson
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Greenlandic University, Nuuk, Greenland.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A S Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - N Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A Koch
- Greenlandic University, Nuuk, Greenland.,Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - E Guttman-Yassky
- Department of Dermatology, Ichan School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - J P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
24
|
Joosten SC, Odeh SNO, Koch A, Buekers N, Aarts MJB, Baldewijns MMLL, Van Neste L, van Kuijk S, Schouten LJ, van den Brandt PA, Tjan-Heijnen VC, van Engeland M, Smits KM. Development of a prognostic risk model for clear cell renal cell carcinoma by systematic evaluation of DNA methylation markers. Clin Epigenetics 2021; 13:103. [PMID: 33947447 PMCID: PMC8094610 DOI: 10.1186/s13148-021-01084-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 09/01/2020] [Accepted: 04/19/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Current risk models for renal cell carcinoma (RCC) based on clinicopathological factors are sub-optimal in accurately identifying high-risk patients. Here, we perform a head-to-head comparison of previously published DNA methylation markers and propose a potential prognostic model for clear cell RCC (ccRCC). PATIENTS AND METHODS Promoter methylation of PCDH8, BNC1, SCUBE3, GREM1, LAD1, NEFH, RASSF1A, GATA5, SFRP1, CDO1, and NEURL was determined by nested methylation-specific PCR. To identify clinically relevant methylated regions, The Cancer Genome Atlas (TCGA) was used to guide primer design. Formalin-fixed paraffin-embedded (FFPE) tissue samples from 336 non-metastatic ccRCC patients from the prospective Netherlands Cohort Study (NLCS) were used to develop a Cox proportional hazards model using stepwise backward elimination and bootstrapping to correct for optimism. For validation purposes, FFPE ccRCC tissue of 64 patients from the University Hospitals Leuven and a series of 232 cases from The Cancer Genome Atlas (TCGA) were used. RESULTS Methylation of GREM1, GATA5, LAD1, NEFH, NEURL, and SFRP1 was associated with poor ccRCC-specific survival, independent of age, sex, tumor size, TNM stage or tumor grade. Moreover, the association between GREM1, NEFH, and NEURL methylation and outcome was shown to be dependent on the genomic region. A prognostic biomarker model containing GREM1, GATA5, LAD1, NEFH and NEURL methylation in combination with clinicopathological characteristics, performed better compared to the model with clinicopathological characteristics only (clinical model), in both the NLCS and the validation population with a c-statistic of 0.71 versus 0.65 and a c-statistic of 0.95 versus 0.86 consecutively. However, the biomarker model had limited added prognostic value in the TCGA series with a c-statistic of 0.76 versus 0.75 for the clinical model. CONCLUSION In this study we performed a head-to-head comparison of potential prognostic methylation markers for ccRCC using a novel approach to guide primers design which utilizes the optimal location for measuring DNA methylation. Using this approach, we identified five methylation markers that potentially show prognostic value in addition to currently known clinicopathological factors.
Collapse
Affiliation(s)
- S C Joosten
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
- Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - S N O Odeh
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - A Koch
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - N Buekers
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - M J B Aarts
- Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - L Van Neste
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - S van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - L J Schouten
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - P A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - V C Tjan-Heijnen
- Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M van Engeland
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - K M Smits
- Department of Pathology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
| |
Collapse
|
25
|
Minella C, Costantino B, Ruano R, Koch A, Weingertner AS, Favre R, Sananes N. Fetoscopic Release of Amniotic Band Syndrome: An Update. J Ultrasound Med 2021; 40:1039-1048. [PMID: 32951245 DOI: 10.1002/jum.15480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/30/2020] [Revised: 07/17/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
Amniotic band syndrome is a rare condition. There have been few cases reported of fetoscopic band dissection. The aim of this case series is to report 3 cases of fetoscopic treatment for amniotic band syndrome, including indication for surgery, technical aspects, complications and outcomes. Fetoscopic treatment was performed respectively at 23 5/7 , 26 5/7 and 18 3/7 weeks' gestation. Two procedures were performed with a laser fiber through a single trocar whereas one surgery was performed with scissors. In conclusion, fetoscopic release of the amniotic bands in case of amniotic band syndrome is feasible with encouraging results in order to prevent amputation and dysfunction of the extremities.
Collapse
Affiliation(s)
- Chris Minella
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | | | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Antoine Koch
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | | | - Romain Favre
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | - Nicolas Sananes
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
- INSERM, UMR-S 1121, "Biomatériaux et Bioingénierie", Strasbourg University, France
| |
Collapse
|
26
|
Mackens S, Santos-Ribeiro S, Racca A, Daneels D, Koch A, Essahib W, Verpoest W, Bourgain C, Van Riet I, Tournaye H, Brosens JJ, Lee YH, Blockeel C, Van de Velde H. The proliferative phase endometrium in IVF/ICSI: an in-cycle molecular analysis predictive of the outcome following fresh embryo transfer. Hum Reprod 2021; 35:130-144. [PMID: 31916571 DOI: 10.1093/humrep/dez218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/07/2019] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Does an early proliferative phase endometrial biopsy harvested during ovarian stimulation harbour information predictive of the outcome following fresh embryo transfer (ET) in that same cycle? SUMMARY ANSWER Transcriptome analysis of the whole-tissue endometrium did not reveal significant differential gene expression (DGE) in relation to the outcome; however, the secretome profile of isolated, cultured and in vitro decidualized endometrial stromal cells (EnSCs) varied significantly between patients who had a live birth compared to those with an implantation failure following fresh ET in the same cycle as the biopsy. WHAT IS KNOWN ALREADY In the majority of endometrial receptivity research protocols, biopsies are harvested during the window of implantation (WOI). This, however, precludes ET in that same cycle, which is preferable as the endometrium has been shown to adapt over time. Endometrial biopsies taken during ovarian stimulation have been reported not to harm the chances of implantation, and in such biopsies DGE has been observed between women who achieve pregnancy versus those who do not. The impact of the endometrial proliferative phase on human embryo implantation remains unclear, but deserves further attention, especially since in luteal phase endometrial biopsies, a transcriptional signature predictive for repeated implantation failure has been associated with reduced cell proliferation, possibly indicating proliferative phase involvement. Isolation, culture and in vitro decidualization (IVD) of EnSCs is a frequently applied basic research technique to assess endometrial functioning, and a disordered EnSC secretome has previously been linked with failed implantation. STUDY DESIGN, SIZE, DURATION This study was nested in a randomized controlled trial (RCT) investigating the effect of endometrial scratching during the early follicular phase of ovarian stimulation on clinical pregnancy rates after IVF/ICSI. Of the 96 endometrial biopsies available, after eliminating those without fresh ET and after extensive matching in order to minimize the risk of potential confounding, 18 samples were retained to study two clinical groups: nine biopsies of patients with a live birth versus nine biopsies of patients with an implantation failure, both following fresh ET performed in the same cycle as the biopsy. We studied the proliferative endometrium by analysing its transcriptome and by isolating, culturing and decidualizing EnSCs in vitro. We applied this latter technique for the first time on proliferative endometrial biopsies obtained during ovarian stimulation for in-cycle outcome prediction, in an attempt to overcome inter-cycle variability. PARTICIPANTS/MATERIALS, SETTING, METHODS RNA-sequencing was performed for 18 individual whole-tissue endometrial biopsies on an Illumina HiSeq1500 machine. DGE was analysed three times using different approaches (DESeq2, EdgeR and the Wilcoxon rank-sum test, all in R). EnSC isolation and IVD was performed (for 2 and 4 days) for a subset of nine samples, after which media from undifferentiated and decidualized cultures were harvested, stored at -80°C and later assayed for 45 cytokines using a multiplex suspension bead immunoassay. The analysis was performed by partial least squares regression modelling. MAIN RESULTS AND THE ROLE OF CHANCE After correction for multiple hypothesis testing, DGE analysis revealed no significant differences between endometrial samples from patients who had a live birth and those with an implantation failure following fresh ET. However secretome analysis after EnSC isolation and culture, showed two distinct clusters that clearly corresponded to the two clinical groups. Upon IVD, the secretome profiles shifted from that of undifferentiated cells but the difference between the two clinical groups remained yet were muted, suggesting convergence of cytokine profiles after decidualization. LIMITATIONS, REASONS FOR CAUTION Caution is warranted due to the limited sample size of the study and the in vitro nature of the EnSC experiment. Validation on a larger scale is necessary, however, hard to fulfil given the very limited availability of in-cycle proliferative endometrial biopsies outside a RCT setting. WIDER IMPLICATIONS OF THE FINDINGS These data support the hypothesis that the endometrium should be assessed not only during the WOI and that certain endometrial dysfunctionalities can probably be detected early in a cycle by making use of the proliferative phase. This insight opens new horizons for the development of endometrial tests, whether diagnostic or predictive of IVF/ICSI treatment outcome. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by Fonds Wetenschappelijk Onderzoek (FWO, Flanders, Belgium, 11M9415N, 1 524 417N), Wetenschappelijk Fonds Willy Gepts (WFWG G160, Universitair Ziekenhuis Brussel, Belgium) and the National Medicine Research Council (NMRC/CG/M003/2017, Singapore). There are no conflicts of interests. TRIAL REGISTRATION NUMBER NCT02061228.
Collapse
Affiliation(s)
- S Mackens
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Research group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - S Santos-Ribeiro
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,IVI-RMA Lisboa, Avenida Infante Dom Henrique 333 H 1-9, 1800-282 Lisbon, Portugal
| | - A Racca
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - D Daneels
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - A Koch
- Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - W Essahib
- Research group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - W Verpoest
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Research group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - C Bourgain
- Research group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Pathology, Imelda Ziekenhuis Bonheiden, Bonheiden, Belgium
| | - I Van Riet
- Department of Hematology and Immunology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - J J Brosens
- Division of Biomedical Sciences, Clinical Science Research Laboratories, Warwick Medical School, University of Warwick, Coventry, UK
| | - Y H Lee
- KK Research Centre, KK Women's and Children's Hospital, Singapore, Singapore.,Obstetrics & Gynaecology-Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - C Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - H Van de Velde
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,Research group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
27
|
Pizanis N, Dimitriou A, Koch A, Ayoub G, Luedike P, Papathanasiou M, Ruhparwar A, Schmack B, Weymann A, Kamler M. Introduction of Machine Perfusion in Donor Hearts. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.567] [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
|
28
|
Koch A, Pizanis N, Ayoub G, Slama A, Weymann A, Bessa V, Taube C, Aigner C, Ruhparwar A, Kamler M. Use of Ex Vivo Lung Perfusion for Lung Transplantation: Midterm Results. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.877] [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
|
29
|
Jung A, Jochum F, Langer B, Fritz G, Koch A. [Selective embolization of a ruptured splenic artery aneurysm after a cesarean section at 32 weeks of gestation]. Gynecol Obstet Fertil Senol 2021; 49:298-300. [PMID: 33166701 DOI: 10.1016/j.gofs.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Indexed: 06/11/2023]
Affiliation(s)
- A Jung
- Département de gynécologie obstétrique, hôpital universitaire de Strasbourg, Strasbourg, France.
| | - F Jochum
- Département de gynécologie obstétrique, hôpital universitaire de Strasbourg, Strasbourg, France
| | - B Langer
- Département de gynécologie obstétrique, hôpital universitaire de Strasbourg, Strasbourg, France
| | - G Fritz
- Département de gynécologie obstétrique, hôpital universitaire de Strasbourg, Strasbourg, France
| | - A Koch
- Département de gynécologie obstétrique, hôpital universitaire de Strasbourg, Strasbourg, France
| |
Collapse
|
30
|
Radomsky L, Koch A, Olbertz C, Liu Y, Kuehne J, Beushausen K, Keil J, Rauen U, Falk C, Kamler M. Composition of Ex Vivo Lung Perfusion Solutions and Kinetics Define Differential Cytokine and Chemokine Secretion in a Porcine Cardiac Arrest Model of Lung Preservation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.975] [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: 11/28/2022] Open
|
31
|
Koch A, Favre R, Weingertner AS, Zaloszyc A, Kohler M, Guerra F, Rosenblatt J, Muller F, Dreux S, Sananès N. Evaluation of Sequential Urine Analysis when Selecting Candidates for Vesicoamniotic Shunting in Lower Urinary Tract Obstruction. Fetal Diagn Ther 2021; 48:265-271. [PMID: 33756463 DOI: 10.1159/000514911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/31/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of our study was to assess the utility of sequential fetal urine analysis in severe lower urinary tract obstruction (LUTO) when selecting cases suitable for vesicoamniotic shunting. MATERIAL AND METHODS This was a retrospective cohort study of cases of severe LUTO treated in our fetal medicine center from 1994 to 2013. Two fetal bladder samples were taken 24-48 h apart to assess renal function. A vesicoamniotic shunt was inserted in case of improvement in urinary biochemistry between the 2 samples. We assessed perinatal morbidity and mortality and renal function at 5 years. RESULTS Among a total of 26 LUTO cases with sequential urine analysis, 5 showed normal urinary biochemistry, 13 were abnormal, and 8 improved between the 2 samples. These 8 cases underwent vesicoamniotic shunt placement, leading to the birth of 6/8 (75%) live infants, 5/6 (83%) of whom had normal renal function at 5 years. The 5 cases with normal biochemistry occasioned 2 neonatal deaths and 3 children with normal renal function at 5 years. Elective termination of pregnancy was requested by parents for the fetuses exhibiting abnormal biochemistry. CONCLUSION An improvement in urinary biochemistry between 2 sequential fetal bladder punctures in severe LUTO could be an effective criterion in the selection of candidates for vesicoamniotic shunting. However, the benefit of a shunt in fetuses with normal amniotic fluid remains to be evaluated in clinical trials.
Collapse
Affiliation(s)
- Antoine Koch
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France,
| | - Romain Favre
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | | | - Ariane Zaloszyc
- Pediatric Nephrology Department, Strasbourg University Hospital, Strasbourg, France
| | - Monique Kohler
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Fernando Guerra
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Jonathan Rosenblatt
- Maternal Fetal Medicine Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Françoise Muller
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Sophie Dreux
- Biochemistry-Hormonology Department, Robert Debré Hospital, AP-HP, Paris, France
| | - Nicolas Sananès
- Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France.,INSERM, UMR-S 1121, "Biomatériaux et Bioingénierie", Strasbourg, France
| |
Collapse
|
32
|
Anderle N, Ruoff F, Koch A, Hartkopf A, Brucker S, Templin M, Schmees C. Project PRIMO – Combining Patient Derived Breast Cancer Microtumors and DigiWest protein signaling pathway profiling for therapeutic response prediction. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30721-8] [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]
|
33
|
Pietzsch M, Rall K, Brucker S, Koch A. Establishment and characterization of endometrial organoids derived from MRKHS patients. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718115] [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)
- M Pietzsch
- Universitäts-Frauenklinik, Department für Frauengesundheit Tübingen
| | - K.K Rall
- Universitäts-Frauenklinik, Department für Frauengesundheit Tübingen
| | - S.Y Brucker
- Universitäts-Frauenklinik, Department für Frauengesundheit Tübingen
| | - A Koch
- Universitäts-Frauenklinik, Department für Frauengesundheit Tübingen
| |
Collapse
|
34
|
Koch A, Asrar H, Akopova A, Eichbaum M, Klee A. Kongenitale diaphragmale Hernie (CDH) bei bichoreale biamniale Drillingsschwangerschaft – Case Report. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718343] [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)
- A Koch
- HSK Wiesbaden, Klinik für Gynäkologie und gynäkologische Onkologie
| | - H Asrar
- HSK Wiesbaden, Klinik für Geburtshilfe und Pränatalmedizin
| | - A Akopova
- HSK Wiesbaden, Klinik für Geburtshilfe und Pränatalmedizin
| | - M Eichbaum
- HSK Wiesbaden, Klinik für Gynäkologie und gynäkologische Onkologie
| | - A Klee
- HSK Wiesbaden, Klinik für Geburtshilfe und Pränatalmedizin
| |
Collapse
|
35
|
Petersen K, Morrison J, Oprea V, Grischkan D, Koch A, Lorenz R, Bendavid R, Iakovlev V. Necessary duration of follow-up to assess complications of mesh in hernia surgery: a time-lapse study based on 460 explants. Hernia 2020; 25:1239-1251. [PMID: 32960368 DOI: 10.1007/s10029-020-02297-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/09/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Risk of complications following hernia repair is the key parameter to assess risk/benefit ratio of a technique. As mesh devices are permanent, their risks are life-long. Too many reports in the past assessed mesh safety prematurely after short follow-ups. We aimed to explore what length of follow up would reveal the full extent of complications. METHODS Time lapses between implantation and excision were analyzed in 460 cases of meshes excised for complications after hernia repair. Patterns of percentage growth and time lapses at 50th and 95th percentiles were used to compare groups of different hernia type, age, gender and reason for excision. RESULTS The 50th and 95th case percentiles in the dataset were at 3.75 and 15.0 years between mesh implantation and excision. For hernia types, the longest time lapses were for groin hernias (4.0 and 16.11 years at 50th and 95th percentiles). The shortest were for umbilical hernias (2.16 and 9.68 years). Males had later excisions than females (4.11 and 16.1 vs. 2.47 and 9.79 years). Younger patients (< 45 y.o.) had later excisions than older patients (4.12 and 17.68 vs. 3.37 and 10.0 years). Out of all subgroups, the longest time lapses were for groin hernias in younger males (4.77 and 18.89 years) and for mesh erosion into organs (4.67 and 17.0 years). CONCLUSIONS Follow-up of more than 15 years is needed to fully assess complications after mesh hernia repair. Especially longer periods are needed to detect mesh erosion into organs and complications in younger males. Presently, short observations and lack of reporting standard in the literature prohibit accurate assessment of complication risks. We propose to use cumulative incidence for standardized risk reporting (y% risk at x years). This will show time-dependent patterns and allow comparisons between different techniques and studies of variable duration. Standardization will also help to predict long-term risks beyond shorter (practical) follow-ups and facilitate real-time monitoring during surveillance.
Collapse
Affiliation(s)
| | - J Morrison
- Chatham Kent Health Alliance, Chatham, Ontario, Canada
| | - V Oprea
- Military Hospital of Cluj, Cluj-Napoca, Romania, Romania
| | | | - A Koch
- Day Surgery and Hernia Center, Cottbus, Germany
| | - R Lorenz
- , Hernia Center 3+CHIRURGEN, Berlin, Germany
| | - R Bendavid
- Department of Surgery, Shouldice Hospital, Thornhill, University of Toronto, Toronto, ON, Canada
| | - V Iakovlev
- Department of Laboratory Medicine, St. Michael's Hospital, Keenan Research Centre of the Li Ka Shing Knowledge Institute, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
36
|
Biedenkopf D, Will T, Knauer T, Jelonek L, Furch ACU, Busche T, Koch A. Systemic spreading of exogenous applied RNA biopesticides in the crop plant Hordeum vulgare. ACTA ACUST UNITED AC 2020. [DOI: 10.1186/s41544-020-00052-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
37
|
Oberhauser FB, Koch A, De Agrò M, Rex K, Czaczkes TJ. Ants resort to heuristics when facing relational-learning tasks they cannot solve. Proc Biol Sci 2020; 287:20201262. [PMID: 32781947 DOI: 10.1098/rspb.2020.1262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We humans sort the world around us into conceptual groups, such as 'the same' or 'different', which facilitates many cognitive tasks. Applying such abstract concepts can improve problem-solving success and is therefore worth the cognitive investment. In this study, we investigated whether ants (Lasius niger) can learn the relational rule of 'the same' or 'different' by training them in an odour match-to-sample test over 48 visits. While ants in the 'different' treatment improved significantly over time, reaching around 65% correct decisions, ants in the 'same' treatment did not. Ants did not seem able to learn such abstract relational concepts, but instead created their own individual strategy to try to solve the problem: some ants decided to 'always go left', others preferred a 'go to the more salient cue' heuristic which systematically biased their decisions. These heuristics even occasionally lowered the success rate in the experiment below chance, indicating that following any rule may be more desirable then making truly random decisions. As the finding that ants resort to heuristics when facing hard-to-solve decisions was discovered post-hoc, we strongly encourage other researchers to ask whether employing heuristics in the face of challenging tasks is a widespread phenomenon in insects.
Collapse
Affiliation(s)
- F B Oberhauser
- Animal Comparative Economics Laboratory, Department of Zoology and Evolutionary Biology, University of Regensburg, Germany.,Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Germany
| | - A Koch
- Animal Comparative Economics Laboratory, Department of Zoology and Evolutionary Biology, University of Regensburg, Germany
| | - M De Agrò
- Animal Comparative Economics Laboratory, Department of Zoology and Evolutionary Biology, University of Regensburg, Germany.,Department of General Psychology, University of Padova, Italy
| | - K Rex
- Department of Biology, Pestalozzi-Gymnasium, Munich, Germany
| | - T J Czaczkes
- Animal Comparative Economics Laboratory, Department of Zoology and Evolutionary Biology, University of Regensburg, Germany
| |
Collapse
|
38
|
Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. [CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy-Short Text]. Gynecol Obstet Fertil Senol 2020; 48:539-545. [PMID: 32289497 DOI: 10.1016/j.gofs.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. METHODS Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest). RESULTS "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. CONCLUSIONS Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
Collapse
Affiliation(s)
- G Grangé
- Maternité Port-Royal, université de Paris, AP-HP, 75014 Paris, France.
| | - I Berlin
- Département de pharmacologie, AP-HP, 75000 Paris, France; Centre universitaire de médecine générale et de santé publique, 1000 Lausanne, Suisse
| | - F Bretelle
- Department of obstetrics and gynecology, conception hospital, Aix Marseille université, prenatal diagnosis Timone Conception, IHU, IRD, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - C Bertholdt
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France; IADI, Inserm U1254, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain-en-Laye, 78300 Poissy, France
| | - J Blanc
- Service de gynécologie obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA3279, CEReSS, health service research and quality of life center, université Aix-Marseille, 13284 Marseille, France
| | - C DiGuisto
- Université de Paris, epidemiology and statistics research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, hôpital Tenon, bâtiment Recherche, rue de la Chine, 75020 Paris, France; Maternité Olympe de Gouges, centre hospitalier régional universitaire Tours, Tours, France; Université François-Rabelais, 37000 Tours, France
| | - V Dochez
- Service de gynécologie-obstétrique, CHU de Nantes, 44093 Nantes, France
| | - C Garabedian
- EA 4489 - Perinatal Environment and Health, université de Lille, hôpital Jeanne-de-Flandre, clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - P Guerby
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Koch
- Service de gynécologie-obstétrique, CHU de Strasbourg, 67000 Strasbourg, France
| | - M Le Lous
- Département de gynécologie obstétrique et médecine de la reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, université de Rennes 1, UMR 1099, 35000 Rennes, France
| | - E Perdriolle-Galet
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de gynécologie obstétrique, hôpital L.-Mourier, AP-HP, 92700 Colombes, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - H Torchin
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, epidemiology and statistics research center/CRESS, Inserm, INRA, 75004 Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800 Villejuif, France; Department of obstetrics and gynecology, Angers university hospital, 49000 Angers, France
| |
Collapse
|
39
|
Peyronnet V, Koch A, Rault E, Perdriolle-Galet E, Bertholdt C. [N on-pharmacological management of smoking cessation during pregnancy- CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy]. Gynecol Obstet Fertil Senol 2020; 48:590-603. [PMID: 32247854 DOI: 10.1016/j.gofs.2020.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To assess the benefit of non-pharmacological intervention promoting on smoking cessation, obstetric and neonatal outcomes, to offer pregnant women who smoke (PWS) optimal care. METHODS We searched Medline Database, Cochrane Library and consulted international guidelines. RESULTS "Counselling" involving globally all kind of non-pharmacological interventions has a benefit on smoking cessation (NP1) and a moderate benefit on birth weight and prematurity (NP2). The brief intervention seems ineffective on smoking cessation (NP2). The effects of motivational interviewing have not been demonstrated during pregnancy (NP2). Cognitive-behavioral interventions do not show superiority (NP2). Financial incentives have a benefit for smoking cessation and possibly for neonatal outcomes (NP1). Feedback interventions (Co tester) provide heterogeneous results (NP2). Self-help interventions (NP2) and health education (NP2) seem effective on smoking cessation. Hypnotherapy and acupuncture have been little or not studied in PWS. Moderate physical activity did not show a significant effect (NP2) on smoking cessation but seem to reduce craving for tobacco (NP3). CONCLUSIONS We recommend asking all PWS about their smoking consumption and detailing their smoking history, offering them different types of counselling according to their preferences and involving them multidisciplinary (grade A). The systematic use of feedback is not recommended (grade C) but experience suggests that the CO tester is important in establishing a therapeutic alliance (professional consensus). The use of self-help interventions (grade C) and health education (grade B) are recommended.
Collapse
Affiliation(s)
- V Peyronnet
- Service de gynécologie-obstétrique, hôpital Louis-Mourier, Université de Paris, 178 rue des Renouillers, 92700 Colombes, France.
| | - A Koch
- Pôle de gynécologie-obstétrique, CHU de Strasbourg, 67000 Strasbourg, France
| | - E Rault
- Service d'obstétrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant Lyon, 69500 Bron, France
| | - E Perdriolle-Galet
- Service d'obstétrique et de médecine fœtale, maternité régionale, CHRU de Nancy, 54035 Nancy, France
| | - C Bertholdt
- Service d'obstétrique et de médecine fœtale, maternité régionale du CHRU de Nancy, 10, rue du Dr-Heydenreich, 54000 Nancy, France; IADI, Inserm U1254, rue du Morvan, 54500 Vandœuvre-les-Nancy, France
| |
Collapse
|
40
|
Koch A, Blanc J, Berlin I. [What Policy for the Management of Smoking During Pregnancy? - CNGOF-SFT Expert Report and Guidelines on the management for Smoking Management During Pregnancy]. Gynecol Obstet Fertil Senol 2020; 48:587-589. [PMID: 32247099 DOI: 10.1016/j.gofs.2020.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Smoking during pregnancy is a public health problem. Individual screening is carried out in France during pregnancy consultations, followed by non-systemic care (with or without nicotine replacement therapy). In the UK, pregnant smokers are routinely screened during pregnancy follow-up and then referred to smoking cessation services. In order to improve their adherence, and smoking cessation, patients can be contacted, in particular by phone. We therefore recommend to systematically screen for smoking during pregnancy by asking the question of smoking or by measuring the CO exhaled during the various consultations, to offer care in collaboration with a local smoking cessation service and renew the requests if necessary. We need to develop these care networks in France.
Collapse
Affiliation(s)
- A Koch
- Pôle de gynécologie-obstétrique, CHU de Strasbourg, 67091 Strasbourg cedex, France.
| | - J Blanc
- Service de gynécologie-obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA 3279, CEReSS, unité de recherche, santé publique, maladies chroniques et qualité de vie, Aix-Marseille université, 13284 Marseille, France
| | - I Berlin
- Département de pharmacologie, APHP, 75000 Paris, France; Centre Universitaire de Médecine Générale et de Santé Publique, 1011 Lausanne, Suisse
| |
Collapse
|
41
|
Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. Smoking and smoking cessation in pregnancy. Synthesis of a systematic review. J Gynecol Obstet Hum Reprod 2020; 49:101847. [PMID: 32619725 DOI: 10.1016/j.jogoh.2020.101847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy and the post-partum period. STUDY DESIGN A systematic review of the international literature was undertaken between January 2003 and April 2019. MEDLINE, EMBASE databases and the Cochrane library were searched for a range of predefined key words. All relevant reports in English and French were classified according to their level of evidence ranging from 1(highest) to 4(lowest). The strength of each recommendation was classified according to the Haute Autorité de Santé (French National Authority for Health) ranging from A (highest) to C (lowest). RESULTS "Counselling", including all types of non-pharmacological interventions, has a moderate benefit on smoking cessation, birth weight and prematurity. The systematic use of measuring expired air CO concentration does not influence smoking abstinence, however, it may be useful in assessing smoked tobacco exposure prior to and after quitting. The use of self-help therapies and health education are recommended in helping pregnant smokers quit and should be advised by healthcare professionals. Nicotine replacement therapies (NRT) may be prescribed to pregnant women who have failed to stop smoking after trying non-pharmacological interventions. Different modes of delivery and dosages can be used in optimizing their efficacy. Smoking in the postpartum period is essential to consider. The same treatment options as during pregnancy can be used. CONCLUSION Smoking during pregnancy concerns more than a hundred thousand women each year in France resulting in a major public health burden. Healthcare professionals should be mobilised to employ a range of methods to reduce or even eradicate it.
Collapse
Affiliation(s)
- G Grangé
- Maternité Port-Royal, Université de Paris, AP-HP.Centre, FHU Prema, 75014, Paris, France.
| | - I Berlin
- Département de Pharmacologie, AP-HP, 75000, Paris, France; Centre Universitaire de Médecine Générale et de Santé Publique, 1011 Lausanne, Switzerland
| | - F Bretelle
- Department of Obstetrics and Gynecology, Conception Hospital, Aix Marseille Université, Prenatal Diagnosis Timone Conception, IHU, IRD, Assistance Publique des Hôpitaux de Marseille (AP-HM), 13005, Marseille, France
| | - C Bertholdt
- Pôle de la Femme, Maternité Régionale du CHRU de Nancy, 10, Rue Dr-Heydenreich, 54000, Nancy, France; IADI, Inserm U1254, Rue du Morvan, 54500, Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de Gynécologie-Obstétrique, CHI Poissy-St-Germain-en-Laye, 78300, Poissy, France
| | - J Blanc
- Service de Gynécologie Obstétrique, Hôpital Nord, AP-HM, Chemin des Bourrely, 13015, Marseille, France; EA3279, CEReSS, Health Service Research and Quality of Life Center, Université Aix-Marseille, 13284, Marseille, France
| | - C DiGuisto
- Centre Universitaire de Médecine Générale et de Santé Publique, 1011 Lausanne, Switzerland; Université de Paris, Epidemiology and Statistics Research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, Hôpital Tenon, Bâtiment Recherche, Rue de la Chine, 75020, Paris, France; Maternité Olympe de Gouges, Centre Hospitalier Régional Universitaire Tours, Tours, France; Université François-Rabelais, 37000, Tours, France
| | - V Dochez
- Service de Gynécologie-Obstétrique, CHU de Nantes, 44093, Nantes, France
| | - C Garabedian
- CHU Lille Clinique d'obstetrique Univ. LILLE ULR 2694 Évaluation des technologies de santé. F-59000 Lille, France
| | - P Guerby
- Service de Gynécologie Obstétrique, Hôpital Paule-de-Viguier, CHU de Toulouse, 330, Avenue de Grande-Bretagne, 31059, Toulouse, France
| | - A Koch
- Service de Gynécologie-Obstétrique, CHU de Strasbourg, 67000, Strasbourg, France
| | - M Le Lous
- Département de Gynécologie Obstétrique et Médecine de la Reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, Université de Rennes 1, UMR 1099, 35000, Rennes, France
| | - E Perdriolle-Galet
- Pôle de la Femme, Maternité Régionale du CHRU de Nancy, 10, Rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de Gynécologie Obstétrique, Hôpital L.-Mourier, AP-HP, 92700 Colombes, France; Université de Paris, Paris, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500, Bron, France
| | - H Torchin
- Service de Médecine et Réanimation Néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, Epidemiology and Statistics Research center/CRESS, Inserm, INRA, 75004, Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800, Villejuif, France; Department of Obstetrics and Gynecology, Angers University Hospital, 49000, Angers, France
| |
Collapse
|
42
|
Klapa S, Müller A, Koch A, Kerstein-Staehle A, Kaehler W, Heidecke H, Schinke S, Huber-Lang M, Nitschke M, Pitann S, Karsten C, Riemekasten G, Lamprecht P. AB0496 AUTOANTIBODIES TARGETING COMPLEMENT RECEPTORS 3A AND 5A1 ARE DECREASED IN ANCA-ASSOCIATED VASCULITIS AND CORRELATE WITH HIGHER RELAPSE RATE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Activation of the alternative and final common pathways have been shown in ANCA-associated vasculitis (AAV) (1). Circulating titers of C5a are elevated and correlate with disease activity in AAV. Binding to the corresponding G protein-coupled receptor (GPCR) C5aR1 enhances the influx of neutrophils, leading to ROS generation and severe necrotizing of vascular walls (2). Moreover, subsequent interaction of C5a with C5aR1 may represent a proinflammatory amplification loop (3). Blocking of the receptor is protective in a murine model in AAV (4). In humans, avacopan, a C5aR1-inhibitor showed promising results as glucocorticoid-sparing agent in two randomized phase II and one ongoing phase III clinicals trials in AAV (NCT02994927). Notably, disease-specific anti-GPCR autoantibody (aab) signatures have been found in different autoimmune diseases (5).Objectives:The aim of the present study was to examine whether (patho)physiological anti-C3aR and anti-C5aR1 aabs correlate with clinical findings in AAV, and whether this is linked to the clinical outcome.Methods:Sera and plasma of AAV patients [granulomatosis with polyangiitis (GPA), n=64; microscopic polyangiitis (MPA), n=26; eosinophilic granulomatosis with polyangiitis (EGPA), n=11] were measured by Elisa for circulating autoantibodies against complement receptors C3a (anti-C3aR aab) and C5a (anti-C5aR1 aab) and plasma levels of C3a and C5a. Expression of C3aR and C5aR1 on T-cells was determined using flow cytometry. Clinical data were assessed at the time of serum sampling and during follow-up for 48 monthsResults:GPA displayed low titers of anti-C3aR aab (GPA:5.33±2.54vs. HD:6.47±2.61, P=0.0031). Anti-C5aR1 aab were decreased in AAV, especially in GPA (GPA:1.02±1.07vs. HD:6.63±2.91, P=<0.0001). Plasma levels of C5a and anti-C5aR aab yielded an inverse correlation in AAV (r=-0.6813, P=0.0127). C5aR1 expression was increased on T-cells in GPA (CD4+C5aR1+T-cells: GPA:10.76±2.55%vs. HD:3.44±0.68%, P=0.0021; CD8+C5aR1+T-cells GPA:9.74±2.10%vs.HD:4.11±0.92%, P=0.0198). Reduced titers of anti-C5aR1 aab <0.45U/ml displayed an increased relapse risk for major organ involvement in GPA (HR 12.85, P=0.0014).Conclusion:As potential diagnostic marker, anti-C5aR1 aab titer may additionally be useful to monitor disease activity in AAV.References:[1]Chen M et al.Complement deposition in renal histopathology of patients with ANCA-associated pauci-immune glomerulonephritis.Nephrol Dial Transpl. 2009;24:1247-1252[2]Schreiber A et al.C5a receptor mediates neutrophil activation an ANCA-induced glomerulonephritis.J Am Soc Nephrol. 2009; 20:289-298[3]Lamprecht P et al.: Pathogenetic and clinical aspects of Anti-Neutrophil Cytoplasmic Autoantibody-associated vasculitides.Front Immunol.2018 Apr 9;9-680[4]Xiao H et al.C5a receptor (CD88) blockade protects against MPO-ANCA GN.J Am Soc Nephrol. 2014;25(2):225-31[5]Klapa S et al. Decreased endothelin receptor A autoantibody levels are associated with early ischaemic events in patients with giant-cell arteritis.Ann Rheum Dis2019 Oct;78(19):1443-1444Disclosure of Interests:Sebastian Klapa Grant/research support from: Actelion, Consultant of: Pfizer, Abbvie, Antje Müller: None declared, Andreas Koch: None declared, Anja Kerstein-Staehle: None declared, Wataru Kaehler: None declared, Harald Heidecke Shareholder of: Cell Trend GmbH, Employee of: Cell Trend GmbH, Speakers bureau: Cell Trend GmbH, Susanne Schinke Speakers bureau: Pfizer, Markus Huber-Lang: None declared, Martin Nitschke: None declared, Silke Pitann: None declared, Christian Karsten: None declared, Gabriela Riemekasten Consultant of: Cell Trend GmbH, Janssen, Actelion, Boehringer Ingelheim, Speakers bureau: Actelion, Novartis, Janssen, Roche, GlaxoSmithKline, Boehringer Ingelheim, Pfizer, Peter Lamprecht: None declared
Collapse
|
43
|
Herzog C, Homøe P, Koch A, Niclasen J, Dammeyer J, Lous J, Kørvel-Hanquist A. Effects of early childhood otitis media and ventilation tubes on psychosocial wellbeing - A prospective cohort study within the Danish National Birth Cohort. Int J Pediatr Otorhinolaryngol 2020; 133:109961. [PMID: 32169775 DOI: 10.1016/j.ijporl.2020.109961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Otitis Media (OM) is one of the most common infections among children in developed countries and may result in temporary conductive hearing loss (HL) if accompanied by middle ear effusion (MEE). Ventilation tube insertion (VTI) is recommended as treatment for recurrent acute OM or chronic MEE with HL. HL may lead to impaired development of psychosocial skills. However, evidence for the developmental consequences of OM and the effect of VTI is inconsistent. The objectives of this study were to investigate 1) whether OM in early childhood is associated with long-term consequences of psychosocial development and 2) if VTI prevents the possible negative consequences of OM. METHODS This study examined prospectively collected data from 52.877 children registered in the Danish National Birth Cohort (DNBC). Information about previous OM-episodes and VTI was obtained through systematic follow-up interviews at seven years, and The Strength and Difficulties Questionnaire (SDQ) containing questions about psychological wellbeing was completed. Five groups were defined based on OM-exposure and the presence of VTI. Baseline characteristics were analysed, and comparison of mean SDQ-scores for the five exposure groups was conducted. Means were adjusted for à priori defined confounding factors. RESULTS Data from 52,877 children in the DNBC showed an association between OM and poorer SDQ-scores. VTI was associated with an additional increase, i.e. worsening, of the SDQ-score for boys, and only a slight beneficial effect on the girls' outcome. The groups differed in their baseline characteristics in e.g. maternal education, socio-economic status, breastfeeding, and prematurity. CONCLUSION Significant associations between parent-reported OM in early childhood and later psychosocial health difficulties were found. VTI did not resolve this association.
Collapse
Affiliation(s)
- C Herzog
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - P Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - A Koch
- Center for Infectious Disease Epidemiology, Statens Serum Institute, Copenhagen, Denmark
| | - J Niclasen
- Steno Diabetes Center, Copenhagen, Denmark
| | - J Dammeyer
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - J Lous
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - A Kørvel-Hanquist
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.
| |
Collapse
|
44
|
Höfle L, Biedenkopf D, Werner BT, Shrestha A, Jelonek L, Koch A. Study on the efficiency of dsRNAs with increasing length in RNA-based silencing of the Fusarium CYP51 genes. RNA Biol 2020. [PMID: 31814508 DOI: 10.1101/824953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Previously, we have demonstrated that transgenic Arabidopsis and barley plants, expressing a 791 nucleotide (nt) dsRNA (CYP3RNA) that targets all three CYP51 genes (FgCYP51A, FgCYP51B, FgCYP51C) in Fusarium graminearum (Fg), inhibited fungal infection via a process designated as host-induced gene silencing (HIGS). More recently, we have shown that spray applications of CYP3RNA also protect barley from fungal infection via a process termed spray-induced gene silencing (SIGS). Thus, RNAi technology may have the potential to revolutionize plant protection in agriculture. Therefore, successful field application will require optimization of RNAi design necessary to maximize the efficacy of the RNA silencing construct for making RNAi-based strategies a realistic and sustainable approach in agriculture. Previous studies indicate that silencing is correlated with the number of siRNAs generated from a dsRNA precursor. To prove the hypothesis that silencing efficiency is correlated with the number of siRNAs processed out of the dsRNA precursor, we tested in a HIGS and SIGS approach dsRNA precursors of increasing length ranging from 400 nt to 1500 nt to assess gene silencing efficiency of individual FgCYP51 genes. Concerning HIGS-mediated disease control, we found that there is no significant correlation between the length of the dsRNA precursor and the reduction of Fg infection on CYP51-dsRNA-expressing Arabidopsis plants. Importantly and in clear contrast to HIGS, we measured a decrease in SIGS-mediated Fg disease resistance that significantly correlates with the length of the dsRNA construct that was sprayed, indicating that the size of the dsRNA interferes with a sufficient uptake of dsRNAs by the fungus.
Collapse
Affiliation(s)
- L Höfle
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - D Biedenkopf
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - B T Werner
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - A Shrestha
- Institute for Epidemiology and Pathogen Diagnostics, Julius Kühn-Institute, Braunschweig, Germany
| | - L Jelonek
- Institute of Bioinformatics and Systems Biology, Justus Liebig University, Giessen, Germany
| | - A Koch
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| |
Collapse
|
45
|
Blanc J, Koch A. [Pharmacotherapy for Smoking Cessation During Pregnancy - CNGOF-SFT Expert Report and Guidelines for Smoking Management During Pregnancy]. ACTA ACUST UNITED AC 2020; 48:604-611. [PMID: 32247100 DOI: 10.1016/j.gofs.2020.03.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To review and describe available pharmacotherapy interventions for smoking cessation during pregnancy: nicotine replacement therapy (NRT) and non-nicotine replacement therapy. METHODS The PubMed, Medline®, and Cochrane databases® (1/01/2003 au 5/04/2019) were accessed to identify relevant studies, using the search terms "tobacco use cessation devices", "nicotine replacement product or therapy", "smoking cessation", "pregnancy", "pregnant women", "varenicline", "bupropion". RESULTS There is no data on the impact of NRT on the rate of smoking cessation during pre conception period. According to randomised studies versus placebo, the prescription of NRT during pregnancy (16-hours patches and gums being mainly studied) is not associated with smoking cessation during pregnancy or at the end of pregnancy (LE1). Based on the analysis of all available studies, the prescription of NRT during pregnancy is associated with smoking cessation during pregnancy and at the end of pregnancy (LE2). Coadministration of different galenic forms of pharmacotherapy during pregnancy could improve efficacy subject to tolerance and remains to be studied. The prescription of NRT during pregnancy (patches and gums being mainly studied) is not associated with postpartum smoking cessation (LE1). The prescription of NRT may be associated with the occurrence of non-serious adverse reactions (headache, nausea, vomiting, etc.) (LE2). The risk of adverse effects from NRT is not increased by pregnancy (LE2). The prescription of NRT is not associated with spontaneous abortion (LE2). There is insufficient data to establish an excess risk of congenital malformations in case of the prescription of NRT. The prescription of NRT versus placebo is associated with a reduction in the risk of preterm delivery (LE2). There is insufficient data on the prescription of NRT and neonatal outcomes. The prescription of NRT (by decreasing smoking) could be associated with better development scores at 2 years of age in children born to smoking women who received NRT versus placebo (LE2). The prescription of NRT may be offered to any pregnant woman who has failed a spontaneous smoking cessation without NRT (grade B). The data of the literature do not allow recommending one form more than another (forms of rapid action versus transdermal) nor an optimal duration of treatment (professional consensus). This prescription can be initiated by the professional taking care of the pregnant woman in early pregnancy (professional consensus). It is recommended to refer the pregnant woman to a tobacco specialist to assess and adapt the initial prescription (professional consensus). Maintenance of NRT in case of misstep is associated with a reduction in smoking (LE3). These elements suggest that in the event of a misstep or resumption of smoking, it is recommended to continue nicotine substitution (grade C). In the absence of data, second-line non-nicotinic prescriptions, nortriptyline and clonidine, are not recommended during pregnancy (professional consensus). There is insufficient data and low level of evidence to assess the impact of bupropion during the three trimesters of pregnancy, and in particular the neonatal consequences. Because of its amphetamine properties, bupoprion is not recommended for smoking cessation assistance in pregnant women (grade C). The available data are very inadequate and low level of evidence to assess the impact of varenicline during pregnancy. For this reason, varenicline cannot be recommended for smoking cessation during pregnancy (professional consensus). CONCLUSIONS The prescription of NRT may be offered to any pregnant woman who has failed a spontaneous smoking cessation without NRT, taking into account the lower risks of premature birth in the case of NRT (grade B). This prescription can be initiated by the professional taking care of the pregnant woman in early pregnancy (professional consensus).
Collapse
Affiliation(s)
- J Blanc
- Service de gynécologie-obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA 3279, CEReSS, santé publique, maladies chroniques et qualité de vie, unité de recherche, Aix-Marseille université, 13284 Marseille, France.
| | - A Koch
- Pôle de gynécologie-obstétrique, CHU de Strasbourg, 69000 Strasbourg, France
| |
Collapse
|
46
|
Koch A, Pizanis N, Olberz C, Bäumker H, Rauen U, Ruhparwar A, Aigner C, Falk C, Kamler M. Inflammatory Response after Immediate versus Delayed Ex-Vivo Lung Perfusion in a Porcine Cardiac Arrest Donation Model. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.806] [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
|
47
|
Müller K, Wölfling K, Dickenhorst U, Beutel M, Medenwaldt J, Koch A. Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study. Eur Psychiatry 2020; 43:28-34. [DOI: 10.1016/j.eurpsy.2017.01.326] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/17/2017] [Accepted: 01/19/2017] [Indexed: 01/23/2023] Open
Abstract
AbstractPurpose:Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched.Materials and methods:Patients (n = 270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter.Results:At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder.Discussion:One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient.Conclusions:The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse.
Collapse
|
48
|
Hansel G, Koch A, Wollina U. Dresdner Dermatologische Demonstration 2019 – 6. April 2019. Akt Dermatol 2020. [DOI: 10.1055/a-0970-1529] [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]
Affiliation(s)
- G. Hansel
- Klinik für Dermatologie und Allergologie, Städtisches Klinikum, Akademisches Lehrkrankenhaus der TU Dresden
| | - A. Koch
- Klinik für Dermatologie und Allergologie, Städtisches Klinikum, Akademisches Lehrkrankenhaus der TU Dresden
| | - U. Wollina
- Klinik für Dermatologie und Allergologie, Städtisches Klinikum, Akademisches Lehrkrankenhaus der TU Dresden
| |
Collapse
|
49
|
Höfle L, Biedenkopf D, Werner BT, Shrestha A, Jelonek L, Koch A. Study on the efficiency of dsRNAs with increasing length in RNA-based silencing of the Fusarium CYP51 genes. RNA Biol 2020; 17:463-473. [PMID: 31814508 DOI: 10.1080/15476286.2019.1700033] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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: 10/25/2022] Open
Abstract
Previously, we have demonstrated that transgenic Arabidopsis and barley plants, expressing a 791 nucleotide (nt) dsRNA (CYP3RNA) that targets all three CYP51 genes (FgCYP51A, FgCYP51B, FgCYP51C) in Fusarium graminearum (Fg), inhibited fungal infection via a process designated as host-induced gene silencing (HIGS). More recently, we have shown that spray applications of CYP3RNA also protect barley from fungal infection via a process termed spray-induced gene silencing (SIGS). Thus, RNAi technology may have the potential to revolutionize plant protection in agriculture. Therefore, successful field application will require optimization of RNAi design necessary to maximize the efficacy of the RNA silencing construct for making RNAi-based strategies a realistic and sustainable approach in agriculture. Previous studies indicate that silencing is correlated with the number of siRNAs generated from a dsRNA precursor. To prove the hypothesis that silencing efficiency is correlated with the number of siRNAs processed out of the dsRNA precursor, we tested in a HIGS and SIGS approach dsRNA precursors of increasing length ranging from 400 nt to 1500 nt to assess gene silencing efficiency of individual FgCYP51 genes. Concerning HIGS-mediated disease control, we found that there is no significant correlation between the length of the dsRNA precursor and the reduction of Fg infection on CYP51-dsRNA-expressing Arabidopsis plants. Importantly and in clear contrast to HIGS, we measured a decrease in SIGS-mediated Fg disease resistance that significantly correlates with the length of the dsRNA construct that was sprayed, indicating that the size of the dsRNA interferes with a sufficient uptake of dsRNAs by the fungus.
Collapse
Affiliation(s)
- L Höfle
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - D Biedenkopf
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - B T Werner
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| | - A Shrestha
- Institute for Epidemiology and Pathogen Diagnostics, Julius Kühn-Institute, Braunschweig, Germany
| | - L Jelonek
- Institute of Bioinformatics and Systems Biology, Justus Liebig University, Giessen, Germany
| | - A Koch
- Institute of Phytopathology, Centre for BioSystems, Land Use and Nutrition, Justus Liebig University, Giessen, Germany
| |
Collapse
|
50
|
Kalka K, Keldenich Z, Pizanis N, Carstens H, Reiner G, Ruhparwar A, Kamler M, Koch A. The Isolated Pig Lung from the Slaughtering Process as a Model for Ex Vivo Lung Perfusion: A Comparison in a Model for uDCDD. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705450] [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]
|