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Lüdtke L, Ittermann T, Großjohann R, Jürgens C, Völzke H, Tost F, Stahl A. Risk Factors of Age-Related Macular Degeneration in a Population-Based Study: Results from SHIP-TREND-1 (Study of Health in Pomerania-TREND-1). Med Sci Monit 2024; 30:e943140. [PMID: 38702879 PMCID: PMC11078065 DOI: 10.12659/msm.943140] [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: 11/09/2023] [Accepted: 02/05/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the most common cause of visual impairment in the elderly population in industrialized countries. The Study of Health in Pomerania (SHIP) with its cohort SHIP-TREND was designed to investigate risk factors and clinical disorders in the general population of northeast Germany. This work focused on the first follow-up of SHIP-TREND and determined associated modifiable risk factors of AMD. Modifying risk factors is important to slow the progression of early AMD as there is currently no treatment for the late stage of geographic atrophy. Understanding AMD-associated risk factors also plays an important role in the development of therapeutic concepts. MATERIAL AND METHODS Between 2016 and 2019, data were collected from a total of 2507 initially randomly selected subjects from the general population aged 28 to 89 years. Non-mydriatic fundus photography of the right eye was performed in 2489 subjects. Grading of AMD was performed using the Rotterdam classification system. RESULTS We included 1418 gradable fundus photographs in the analysis. The risk of AMD changes increased with age and was positively correlated with HDL cholesterol, fT3, and low educational level. In men, BMI and cigarette smoking were also positively associated with AMD changes. CONCLUSIONS This study emphasizes the consideration of various metabolic pathways for the development of therapeutic concepts.
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Affiliation(s)
- Lisa Lüdtke
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Rico Großjohann
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
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Vergroesen JE, Jarrar ZA, Weiss S, Frost F, Ansari AS, Nguyen P, Kraaij R, Medina-Gomez C, Völzke H, Tost F, Amin N, van Duijn CM, Klaver CCW, Jürgens C, Hammond CJ, Ramdas WD. Glaucoma Patients Have a Lower Abundance of Butyrate-Producing Taxa in the Gut. Invest Ophthalmol Vis Sci 2024; 65:7. [PMID: 38315494 PMCID: PMC10851784 DOI: 10.1167/iovs.65.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose Glaucoma is an eye disease that is the most common cause of irreversible blindness worldwide. It has been suggested that gut microbiota can produce reactive oxygen species and pro-inflammatory cytokines that may travel from the gastric mucosa to distal sites, for example, the optic nerve head or trabecular meshwork. There is evidence for a gut-eye axis, as microbial dysbiosis has been associated with retinal diseases. We investigated the microbial composition in patients with glaucoma and healthy controls. Moreover, we analyzed the association of the gut microbiome with intraocular pressure (IOP; risk factor of glaucoma) and vertical cup-to-disc ratio (VCDR; quantifying glaucoma severity). Methods The discovery analyses included participants of the Rotterdam Study and the Erasmus Glaucoma Cohort. A total of 225 patients with glaucoma and 1247 age- and sex-matched participants without glaucoma were included in our analyses. Stool samples were used to generate 16S rRNA gene profiles. We assessed associations with 233 genera and species. We used data from the TwinsUK and the Study of Health in Pomerania (SHIP) to replicate our findings. Results Several butyrate-producing taxa (e.g. Butyrivibrio, Caproiciproducens, Clostridium sensu stricto 1, Coprococcus 1, Ruminococcaceae UCG 007, and Shuttleworthia) were less abundant in people with glaucoma compared to healthy controls. The same taxa were also associated with lower IOP and smaller VCDR. The replication analyses confirmed the findings from the discovery analyses. Conclusions Large human studies exploring the link between the gut microbiome and glaucoma are lacking. Our results suggest that microbial dysbiosis plays a role in the pathophysiology of glaucoma.
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Affiliation(s)
- Joëlle E. Vergroesen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Zakariya A. Jarrar
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Stefan Weiss
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Frost
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Abdus S. Ansari
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Picard Nguyen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Robert Kraaij
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Cornelia M. van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Chris J. Hammond
- Department of Ophthalmology, King's College London, London, United Kingdom
- Department of Twins Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Wishal D. Ramdas
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Barth T, Stahl A, Herrmann B, Tost F, Bertram B. [Statement on ophthalmological examination for suspected shaken baby syndrome (SBS). : Statement of the German Society of Ophthalmology (DOG), the German Retina Society (RG), the German Professional Association of Ophthalmologists (BVA) in cooperation with German Society for Child Protection in Medicine (DGKiM). Status: June 2023]. Ophthalmologie 2023; 120:1233-1237. [PMID: 37773527 DOI: 10.1007/s00347-023-01921-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/01/2023]
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Rohrschneider K, Tost F. [Fitness to drive with glaucoma]. Ophthalmologie 2023; 120:1071-1084. [PMID: 37695352 DOI: 10.1007/s00347-023-01917-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
Glaucoma is one of the eye diseases that are particularly relevant to driving in old age. The ophthalmologist often has to take on the task of traffic medical consultation or medical appraisal. It is essential to distinguish between fitness to drive and driving ability or driving safety and driving capability. The medical examination of fitness to drive can only be carried out over long intervals and basically requires an ophthalmological examination in compliance with all the requirements of the driving license ordinance. This is not a healthcare task. In the case of clarification of the fitness to drive in people with known glaucoma on behalf of the test persons themselves or a driving license authority, visual field testing must be performed using manual kinetic perimetry according to Goldmann, especially for all borderline case decisions by traffic experts. The ophthalmologist faces the particular difficulty of maintaining a balance between the legal duty of care and patient-centered care in order not to strain the patient-physician relationship.
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Affiliation(s)
- K Rohrschneider
- Ophthalmologische Rehabilitation und seltene Augenerkrankungen, Augenklinik der Universität Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - F Tost
- Klinik und Poliklinik für Augenheilkunde Universitätsmedizin Greifswald, Ernst-Moritz-Arndt Universität, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
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5
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Lüdtke L, Stahl A, Tost F. [Erratum to: Sudden painless unilateral visual deterioration in a young male patient]. Ophthalmologie 2023; 120:1067-1068. [PMID: 37682329 DOI: 10.1007/s00347-023-01907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
- Lisa Lüdtke
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
| | - Andreas Stahl
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
| | - Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
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6
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Tost F. A Wide Range of Eye Diseases. Dtsch Arztebl Int 2023; 120:488. [PMID: 37661325 PMCID: PMC10487677 DOI: 10.3238/arztebl.m2023.0075] [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] [Indexed: 09/05/2023]
Affiliation(s)
- Frank Tost
- *Klinik und Poliklinik für Augenheilkunde Universitätsmedizin Greifswald
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7
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Tost F, Fries U. [Consider the importance of sonography in multimodal imaging]. Ophthalmologie 2023; 120:740-741. [PMID: 37335391 DOI: 10.1007/s00347-023-01871-z] [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] [Accepted: 04/19/2023] [Indexed: 06/21/2023]
Affiliation(s)
- Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
| | - Ulrich Fries
- Johanniter GmbH Akademische Lehrkrankenhäuser der Rheinischen Friedrich-Wilhelms-Universität Bonn, Bonn, Deutschland
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8
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Tost F, Freißler G. [Ophthalmologic Evaluation of Fitness to Drive]. Klin Monbl Augenheilkd 2023. [PMID: 37236236 DOI: 10.1055/a-1851-6285] [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: 05/28/2023]
Abstract
The ophthalmologist must know the essential principles of the driving fitness assessment. In the case of applications for a driving license renewal, it must always be clarified before the examination whether the fitness to drive is to be checked in accordance with the special regulation for holders of a driving license issued up to December 31, 1998 (see Annex 6 to § 12 of the FeV under 2.2.3 Special regulations for the old German Road Traffic Licensing Regulations). Within the scope of grandfathering, this continues to be valid only for the so-called old holders. A categorization of the manifold concerns regarding fitness to drive or driving ability in everyday practice makes it easier for the ophthalmologist to make a factually justified decision in individual cases. In particular, a distinction must be made between the medical assessment of subjects as applicants for a driving license (first-time applicants or renewal applicants) according to the German Driving License Ordinance (FeV) and the consultation of patients with chronic eye diseases [duty to inform according to the German Patients' Rights Act (PRG) and the German Civil Code (BGB), German Driving License Ordinance (FeV)]. The German Driving License Ordinance contains precise specifications for standardized testing of visual acuity and visual field as the most important partial functions of the eye. A special feature of the identified performance deficits of the eyes is that compensation by other bodily functions or supplementary technical equipment on the vehicle is not yet possible. The ophthalmologist therefore often has the task and responsibility of balancing the individual desire for mobility, in the case of professional drivers even the preservation of their jobs on the one hand, and the general societal need for safety on the other.
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9
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Lüdtke L, Stahl A, Tost F. [Sudden painless unilateral visual deterioration in a young male patient]. Ophthalmologie 2023; 120:437-439. [PMID: 36445476 DOI: 10.1007/s00347-022-01762-9] [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: 09/16/2022] [Revised: 09/16/2022] [Accepted: 10/20/2022] [Indexed: 04/29/2023]
Affiliation(s)
- Lisa Lüdtke
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
| | - Andreas Stahl
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
| | - Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
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10
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Völzke H, Schössow J, Schmidt CO, Jürgens C, Richter A, Werner A, Werner N, Radke D, Teumer A, Ittermann T, Schauer B, Henck V, Friedrich N, Hannemann A, Winter T, Nauck M, Dörr M, Bahls M, Felix SB, Stubbe B, Ewert R, Frost F, Lerch MM, Grabe HJ, Bülow R, Otto M, Hosten N, Rathmann W, Schminke U, Großjohann R, Tost F, Homuth G, Völker U, Weiss S, Holtfreter S, Bröker BM, Zimmermann K, Kaderali L, Winnefeld M, Kristof B, Berger K, Samietz S, Schwahn C, Holtfreter B, Biffar R, Kindler S, Wittfeld K, Hoffmann W, Kocher T. Cohort Profile Update: The Study of Health in Pomerania (SHIP). Int J Epidemiol 2022; 51:e372-e383. [PMID: 35348705 DOI: 10.1093/ije/dyac034] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/25/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Janka Schössow
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Adrian Richter
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - André Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Dörte Radke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Birgit Schauer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Vivien Henck
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Theresa Winter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Frost
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Clinic of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Robin Bülow
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Markus Otto
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Rico Großjohann
- Clinic of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Frank Tost
- Clinic of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Weiss
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Silva Holtfreter
- Department of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Barbara M Bröker
- Department of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Zimmermann
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Lars Kaderali
- Institute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | | | | | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Munster, Munster, Germany
| | - Stefanie Samietz
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Clinic of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Tost F, Rohrschneider K. [Radiation Cataract as an Occupational Disease Due to Cumulative Effects of Chronic Radiation Exposure in Ophthalmological Evaluation]. Klin Monbl Augenheilkd 2022. [PMID: 36368662 DOI: 10.1055/a-1947-5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Frank Tost
- Augenklinik Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald, Deutschland
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12
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Lüdtke L, Großjohann R, Tayar A, Stahl A, Tost F. [Ocular trauma from a vole trap]. Ophthalmologie 2022; 119:1064-1066. [PMID: 35024910 DOI: 10.1007/s00347-021-01566-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 01/26/2023]
Affiliation(s)
- Lisa Lüdtke
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland.
| | - Rico Großjohann
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Allam Tayar
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Andreas Stahl
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Frank Tost
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Paul S, Tost F, Hübner BC. Unilateral Exophthalmos. Dtsch Arztebl Int 2022; 119:618. [PMID: 36507730 PMCID: PMC9756318 DOI: 10.3238/arztebl.m2022.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Sebastian Paul
- *Klinik und Poliklinik für Augenheilkunde der Universitätsmedizin Greifswald,
| | - Frank Tost
- *Klinik und Poliklinik für Augenheilkunde der Universitätsmedizin Greifswald,
| | - Björn-Christian Hübner
- **Klinik für Mund-Kiefer-Gesichtschirurgie/ Plastische Operation der Universitätsmedizin Greifswald
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14
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Tost F, Rohrschneider K. Kommentar zum CME-Fortbildungsbeitrag „Die senile Katarakt“ von Neuhann I et al. Klin Monbl Augenheilkd 2022; 239: 615 – 633. Klin Monbl Augenheilkd 2022. [DOI: 10.1055/a-1863-8777] [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: 10/15/2022]
Affiliation(s)
- Frank Tost
- Augenklinik der Universitätsmedizin Greifswald, Ernst-Moritz-Arndt Universität
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Abstract
Particular importance and diligence must be attached to patient information prior to ocular surgery. A surgical intervention performed without error according to the state of the art in medicine remains exempt from punishment according to § 228 German Criminal Code (StGB) only if effective consent to the treatment is given and only then is there no liability if a risk inherent to the intervention materializes. The patient's consent is only effective if the patient has been properly informed beforehand. In medical malpractice proceedings, a breach of the duty to inform is regularly alleged. From the outset, the physician bears the burden of proof that he has obtained consent in accordance with Section 630d of the German Civil Code (BGB) and provided information in accordance with the requirements of Section 630e of the BGB. The provisions of the Patients' Rights Act also contain formulations that regularly lead to a very detailed individual review of possible errors of disclosure in medical liability proceedings. Apart from the indispensable requirement of an oral clarification discussion by a physician qualified to do so, who informs about "all essential circumstances" of the planned eye operation, the adherence to formal requirements for the clarification discussion and a written documentation with the individual discussion contents are of decisive importance in a lawsuit in order to reduce possible liability risks from the outset. On the one hand, case law sets high requirements for information and on the other hand, every ophthalmologist should also be aware that this effectively counteracts a depersonalization of the physician-patient relationship.
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Affiliation(s)
- F Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald der Ernst-Moritz-Arndt-Universität Greifswald, KöR, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
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16
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Tost F, Fries U, Bülow R. Visual Diagnosis Is not Sufficiently Precise for the Purpose of Differentiation. Dtsch Arztebl Int 2022; 119:370. [PMID: 36017989 PMCID: PMC9472264 DOI: 10.3238/arztebl.m2022.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Frank Tost
- *Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald
| | - Ulrich Fries
- **Johanniter GmbH Akademische Lehrkrankenhäuser der Rheinischen Friedrich-Wilhelms-Universität Bonn
| | - Robin Bülow
- ***Institut für Diagnostische Radiologie und Neuroradiologie Universitätsmedizin Greifswald
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17
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Mielke S, Grundel B, Schmidt SM, Tost F. Keratoconjunctivitis as a Single Entity in X-linked Agammaglobulinemia? Ocul Immunol Inflamm 2022; 31:665-670. [PMID: 35404736 DOI: 10.1080/09273948.2022.2042824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report a case of a male patient with a severe corneal and conjunctival immunopathy likely caused by an X-linked agammaglobulinemia. METHODS A clinical case report with observation results from 2001-2021. RESULTS A severe corneal immunopathy of both eyes is reported in a retrospective long-term observation of nearly twenty years in a 32-year-old male patient with X-linked agammaglobulinemia (XLA). A chronic progressive corneal scarring with a loss of visual acuity and typical symptoms of a phlyctenular keratoconjunctivitis were observed. CONCLUSION Whereas steroid eye drops like dexamethasone could control the symptoms and the corneal scarring progression as short time therapy options, ciclosporin A eye drops showed problems in therapy adherence in long-time use. Antibiotic eye drops supported the anti-inflammatory therapy effects, but no typical pathogen was detected. Antineovascular subconjunctival application did not show any relevant effect in one-time use. Artificial tears were needed as basic therapy.
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Affiliation(s)
- Stefan Mielke
- Department of Ophthalmology, University Medical Center, Greifswald, Germany
| | - Bastian Grundel
- Department of Ophthalmology, University Medical Center, Greifswald, Germany
| | | | - Frank Tost
- Department of Ophthalmology, University Medical Center, Greifswald, Germany
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18
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Hosten N, Bülow R, Völzke H, Domin M, Schmidt CO, Teumer A, Ittermann T, Nauck M, Felix S, Dörr M, Markus MRP, Völker U, Daboul A, Schwahn C, Holtfreter B, Mundt T, Krey KF, Kindler S, Mksoud M, Samietz S, Biffar R, Hoffmann W, Kocher T, Chenot JF, Stahl A, Tost F, Friedrich N, Zylla S, Hannemann A, Lotze M, Kühn JP, Hegenscheid K, Rosenberg C, Wassilew G, Frenzel S, Wittfeld K, Grabe HJ, Kromrey ML. SHIP-MR and Radiology: 12 Years of Whole-Body Magnetic Resonance Imaging in a Single Center. Healthcare (Basel) 2021; 10:33. [PMID: 35052197 PMCID: PMC8775435 DOI: 10.3390/healthcare10010033] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/16/2022] Open
Abstract
The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.
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Affiliation(s)
- Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Carsten Oliver Schmidt
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stephan Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Marcello Ricardo Paulista Markus
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Uwe Völker
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Amro Daboul
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany; (B.H.); (T.K.)
| | - Torsten Mundt
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Karl-Friedrich Krey
- Department of Orthodontics, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17475 Greifswald, Germany; (S.K.); (M.M.)
| | - Maria Mksoud
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17475 Greifswald, Germany; (S.K.); (M.M.)
| | - Stefanie Samietz
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany; (B.H.); (T.K.)
| | - Jean-Francois Chenot
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Andreas Stahl
- Clinic of Ophthalmology, University Medicine Greifswald, 17475 Greifswald, Germany; (A.S.); (F.T.)
| | - Frank Tost
- Clinic of Ophthalmology, University Medicine Greifswald, 17475 Greifswald, Germany; (A.S.); (F.T.)
| | - Nele Friedrich
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stephanie Zylla
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Anke Hannemann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Martin Lotze
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Jens-Peter Kühn
- Institute and Policlinic of Diagnostic and Interventional Radiology, Medical University, Carl-Gustav Carus, 01307 Dresden, Germany;
| | - Katrin Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Christian Rosenberg
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Georgi Wassilew
- Clinic of Orthopedics, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
- German Center of Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Site Greifswald, 17489 Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
- German Center of Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Site Greifswald, 17489 Greifswald, Germany
| | - Marie-Luise Kromrey
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
- Correspondence:
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19
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Gamain J, Herr T, Fleischmann R, Stenner A, Vollmer M, Willert C, Veit B, Lehnert B, Mueller JU, Steigerwald F, Tost F, Kronenbuerger M. Smell and taste in idiopathic blepharospasm. J Neural Transm (Vienna) 2021; 128:1215-1224. [PMID: 34184129 PMCID: PMC8237775 DOI: 10.1007/s00702-021-02366-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/11/2021] [Indexed: 11/22/2022]
Abstract
The pathophysiology of blepharospasm is incompletely understood. Current concepts suggest that blepharospasm is a network disorder, involving basal ganglia, thalamus, cortex, and, possibly, the cerebellum. Tracing, imaging, and clinical studies revealed that these structures are also concerned with olfaction and taste. Because of this anatomical overlap, dysfunction of the chemical senses in blepharospasm is expected. Injections of botulinum toxin into the eyelid muscles are the first-line treatment of blepharospasm. Yet, the effects of botulinum toxin on the chemical senses have not been systematically assessed. To contribute to a better understanding of blepharospasm, olfactory and gustatory abilities were assessed in 17 subjects with blepharospasm and 17 age-/sex-matched healthy controls. Sniffin Sticks were used to assess odor threshold, odor discrimination, and odor identification. Results of these three Sniffin Sticks subtests were added to the composite olfactory score. The Taste Strips were applied to assess taste. In an adjacent study, we assessed the sense of smell and taste in eight subjects with blepharospasm before and 4 weeks after botulinum toxin treatment. Subjects with blepharospasm had significantly lower (= worse) scores for odor threshold and for the composite olfactory score than healthy controls, while odor discrimination, odor identification, and the composite taste score were not different between groups. The adjacent study revealed that botulinum toxin did not impact the chemical senses. In this study, subjects with blepharospasm had a lower (= worse) odor threshold than healthy controls. As olfaction is important in daily life, findings justify further research of olfaction in blepharospasm.
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Affiliation(s)
- Julie Gamain
- Department of Neurology, University of Greifswald, Greifswald, Germany
| | - Thorsten Herr
- Department of Neurology, University of Greifswald, Greifswald, Germany
| | | | - Andrea Stenner
- Department of Neurology, Paracelsus Clinic Zwickau, Zwickau, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University of Greifswald, Greifswald, Germany
| | | | - Birgitt Veit
- Neurology Group Practice, Neubrandenburg, Germany
| | - Bernhard Lehnert
- Department of Otorhinolaryngology, University of Greifswald, Greifswald, Germany
| | - Jan-Uwe Mueller
- Department of Neurosurgery, University of Greifswald, Greifswald, Germany
| | - Frank Steigerwald
- Department of Neurology, University of Greifswald, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University of Greifswald, Greifswald, Germany
| | - Martin Kronenbuerger
- Department of Neurology, University of Greifswald, Greifswald, Germany. .,Department of Neurology, Johns Hopkins University, Baltimore, MD, USA. .,Department of Neurology, Medical School OWL, University of Bielefeld, Bielefeld, Germany.
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20
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Tost F, Stahl A. Contextual Assessment of Retinal Injuries – Tasks of the Ophthalmological Expert. Klin Monbl Augenheilkd 2020; 237:1045-1059. [DOI: 10.1055/a-1178-5031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractThe ophthalmologic assessment of causal relationships is subject to formal guidelines, depending on the legal field (social law in the statutory accident insurance, civil law in the private accident insurance). After determining all objective and subjective findings of the individual case with complete recording of the medical facts, the ophthalmologist has the task of making a summarizing assessment of the existing cause-and-effect relationship. With regard to the distinction between retinal damage caused by an accident or retinal disease not caused by an accident, it is necessary to weigh up the natural causality according to the state of medical experience on the basis of the criteria strength of association, consistency, specificity, temporal sequence, dose dependence, agreement with previous findings, experimental reliability and analogous consideration. All records of medical findings from the patientʼs medical history and the individual description of the accident
must be included in the expert opinion. In the case of several competing causes (often accident and pre-existing damage), the social law in the statutory accident insurance must present the causal contributions with roughly estimated probabilities. In civil law, valid for the private accident insurance, the existence of partial causality (approx. 25, 50, 75%) must be evaluated.
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Affiliation(s)
- Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald
| | - Andreas Stahl
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald
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21
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Katsimpris A, Jürgens C, Lüdtke L, Martin B, Ittermann T, Gläser S, Dörr M, Ewert R, Volaklis K, Felix SB, Tost F, Völzke H, Meisinger C, Baumeister SE. Association between cardiorespiratory fitness and handgrip strength with age-related macular degeneration: a population-based study. Br J Ophthalmol 2020; 105:1127-1132. [PMID: 32859720 DOI: 10.1136/bjophthalmol-2020-316255] [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: 03/26/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
Abstract
AIM To assess whether cardiorespiratory fitness (CRF) and handgrip strength, two objective markers of physical fitness, are associated with age-related macular degeneration (AMD). METHODS We analysed cross-sectional data from the population-based Study of Health in Pomerania (2008-2012) including 1173 adult men and women aged 20-79 years. Fundus photography of the central retina was recorded with a non-mydriatic camera, and images were graded according to an established clinical AMD classification scale by an experienced reader. CRF was measured using peak oxygen uptake (peakVO2), oxygen uptake at the anaerobic threshold (VO2@AT), and maximum power output (Wmax) from standardised cardiopulmonary exercise testing on a bicycle ergometer according to a modified Jones protocol. Handgrip strength was assessed using a handheld dynamometer. Adjusted prevalence ratios (PR) for the associations of peakVO2, VO2@AT, Wmax and handgrip strength with AMD were derived from multivariable Poisson regression models. RESULTS PeakVO2, VO2@AT, Wmax and handgrip strength were not associated with AMD. Adjusted PR for AMD associated with a 1-SD increment in peakVO2, VO2@AT, Wmax and handgrip strength were 1.05 (95% CI 0.82 to 1.34), 0.96 (95% CI 0.78 to 1.18), 1.10 (95% CI 0.86 to 1.41) and 1.01 (95% CI 0.79 to 1.30), respectively. These associations were not modified by age, sex, smoking, body mass index and diabetes. Estimates in sensitivity analysis for confounding, selection bias and missing data were similar. CONCLUSION In our study, CRF and handgrip strength were not associated with AMD. Nevertheless, longitudinal studies with bigger sample sizes are needed to furtherly examine these associations.
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Affiliation(s)
- Andreas Katsimpris
- Chair of Epidemiology, UNIKA-T, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine, Greifswald, Germany
| | - Lisa Lüdtke
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Bahls Martin
- Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases Department, Greifswald University Hospital Clinic and Polyclinic of Internal Medicine B, Greifswald, Germany.,Partner Site Greifswald, German Center for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine, Greifswald, Germany
| | - Sven Gläser
- Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases Department, Greifswald University Hospital Clinic and Polyclinic of Internal Medicine B, Greifswald, Germany
| | - Marcus Dörr
- Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases Department, Greifswald University Hospital Clinic and Polyclinic of Internal Medicine B, Greifswald, Germany.,Partner Site Greifswald, German Center for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Ralf Ewert
- Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases Department, Greifswald University Hospital Clinic and Polyclinic of Internal Medicine B, Greifswald, Germany
| | - Konstantinos Volaklis
- Chair of Epidemiology, UNIKA-T, Ludwig-Maximilians-Universität München, Munich, Germany.,Department of Prevention and Sports Medicine, Technical University of Munich, Munich, Germany
| | - Stephan B Felix
- Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases Department, Greifswald University Hospital Clinic and Polyclinic of Internal Medicine B, Greifswald, Germany.,Partner Site Greifswald, German Center for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine, Greifswald, Germany.,Partner Site Greifswald, German Center for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Christa Meisinger
- Chair of Epidemiology, UNIKA-T, Ludwig-Maximilians-Universität München, Munich, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Sebastian E Baumeister
- Chair of Epidemiology, UNIKA-T, Ludwig-Maximilians-Universität München, Munich, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
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22
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Rohrschneider K, Tost F. Das augenärztliche Gutachten in unterschiedlichen Rechtsgebieten. Klin Monbl Augenheilkd 2020; 237:805-823. [DOI: 10.1055/a-1143-1819] [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: 10/24/2022]
Abstract
ZusammenfassungDie augenärztliche Begutachtung unterscheidet sich in den verschiedenen Rechtsgebieten deutlich, so gelten unterschiedliche Kausalitäten und Beweismaßstäbe, und die Bewertung muss unterschiedlichen Maßstäben folgen. Für die 3 wichtigen Teilbereiche der Privaten und der Gesetzlichen Unfallversicherung sowie dem Schwerbehindertenrecht bzw. dem sozialen Entschädigungsrecht existieren abstrakte tabellarische Vorgaben. Die Grundlagen der Begutachtung in diesen Rechtsgebieten werden vergleichend dargestellt, dabei wird besonders auf die Kausalität eingegangen.
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23
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Rohrschneider K, Tost F. Das augenärztliche Gutachten in unterschiedlichen Rechtsgebieten. Augenheilkunde up2date 2020. [DOI: 10.1055/a-0928-5324] [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: 10/24/2022]
Abstract
ZusammenfassungDie augenärztliche Begutachtung unterscheidet sich in den verschiedenen Rechtsgebieten deutlich, so gelten unterschiedliche Kausalitäten und Beweismaßstäbe, und die Bewertung muss unterschiedlichen Maßstäben folgen. Für die 3 wichtigen Teilbereiche der Privaten und der Gesetzlichen Unfallversicherung sowie dem Schwerbehindertenrecht bzw. dem sozialen Entschädigungsrecht existieren abstrakte tabellarische Vorgaben. Die Grundlagen der Begutachtung in diesen Rechtsgebieten werden vergleichend dargestellt, dabei wird besonders auf die Kausalität eingegangen.
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Mielke S, Tost F. Schwere, bilaterale, medikamenteninduzierte Panuveitis. Klin Monbl Augenheilkd 2020; 237:202-204. [DOI: 10.1055/a-0774-7962] [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: 10/27/2022]
Affiliation(s)
- Stefan Mielke
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ernst-Moritz-Arndt-Universität Greifswald
| | - Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald, Ernst-Moritz-Arndt-Universität Greifswald
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Lüdtke L, Jürgens C, Ittermann T, Völzke H, Tost F. Age-Related Macular Degeneration and Associated Risk Factors in the Population-Based Study of Health in Pomerania (SHIP-Trend). Med Sci Monit 2019; 25:6383-6390. [PMID: 31446436 PMCID: PMC6724561 DOI: 10.12659/msm.915493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Age-related macular degeneration (AMD) is the leading cause of visual impairment in developed countries, especially in the older population. The Study of Health in Pomerania (SHIP) is a population-based study designed to investigate risk factors and clinical disorders in the general population. In the present study, we analysed the AMD prevalence and risk factors in the north-eastern German population. Material/Methods From 2008 to 2012, we collected data among participants ages 29–79 years. The study population consisted of 4420 individuals. Non-mydriatic retinal photographs were taken of 3934 participants. AMD stages were graded according to the Rotterdam Classification System and the International Classification System. Results Photographs from 1854 participants were available for grading. The baseline examinations showed small hard drusen (<63 μm, stage 0b and 0c) were present in 10.7% of the participants (stage 0b in 7.5% and stage 0c in 3.2%). Earliest signs of AMD were detected in 28.68% (stage 0b in 7.5% and stage 1b in 21.18%). Late AMD (geographic atrophy and neovascular AMD, stages 4a and 4b) were identified in 0.43% (stage 4a in 0.16% and stage 4b 0.27%). Risk of AMD increased significantly with age and higher body mass index, waist circumference, hip circumference, and weight-waist-ratio. Smoking, sex, systolic and diastolic blood pressure, HbA1c, cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride were not associated with AMD in this study. Conclusions The prevalence of AMD increases with age and obesity-associated factors. These results must be verified in the follow-up. Data concerning the incidence of AMD will be available after the 5- and 10-year follow-ups.
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Affiliation(s)
- Lisa Lüdtke
- Department of Ophthalmology, University of Medicine, Greifswald, Germany
| | - Clemens Jürgens
- Institute of Community Medicine, University of Medicine, Greifswald, Germany
| | - Till Ittermann
- Institute of Community Medicine, University of Medicine, Greifswald, Germany
| | - Henry Völzke
- Institute of Community Medicine, University of Medicine, Greifswald, Germany.,German Center of Cardiovascular Research, University of Medicine, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University of Medicine, Greifswald, Germany
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Feltgen N, Mele B, Dietlein T, Erb C, Eckstein A, Hager A, Heiligenhaus A, Helbig H, Hoerauf H, Hoffmann E, Pauleikhoff D, Schittkowski M, Seitz B, Sucker C, Suffo S, Schaudig U, Tost F, Thurau S, Walter P, Koscielny J. [Management of anticoagulants in ophthalmic surgery-a survey among ophthalmic surgeons in Germany]. Ophthalmologe 2019; 115:585-591. [PMID: 29770858 DOI: 10.1007/s00347-018-0732-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/22/2022]
Abstract
INTRODUCTION As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo. A questionnaire was sent out and filled out by the different groups of specialists. RESULTS All four divisions of the DOG and four associated organizations returned completed questionnaires. Surgical interventions were listed that are carried out during anticoagulant therapy without exceptions, as well as interventions that were classified to require medical adjustment. Although the assessments varied, general consensus was achieved regarding interventions not requiring adjustments due to anticoagulants (i. e., intravitreal injection, cataract surgery, laser and corneal operations, simple muscle surgery), and those interventions requiring adjustments in medications (glaucoma operations, complex retina surgery, eye socket surgery, complex surgery of the lid). CONCLUSION Main result of this survey was the specification of serious bleeding complications which are permanent vision loss and re-operation. They could serve as endpoint parameters for essential future investigations. Nevertheless, this survey makes clear that the decision about an adjustment of anticoagulant medication in ophthalmic surgery is currently made individually and not based on established standards.
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Affiliation(s)
- N Feltgen
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
| | - B Mele
- DOG Geschäftsstelle, Platenstr. 1, 80336, München, Deutschland
| | - T Dietlein
- Klinik für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland
| | - C Erb
- Augenklinik am Wittenbergplatz, Berlin, Deutschland
| | - A Eckstein
- Klinik für Augenheilkunde, Universitätsklinikum Essen, Essen, Deutschland
| | - A Hager
- Augenarztpraxis am Elsterplatz, Berlin, Deutschland
| | | | - H Helbig
- Klinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - H Hoerauf
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - E Hoffmann
- Klinik für Augenheilkunde, Universitätsklinikum Mainz, Mainz, Deutschland
| | - D Pauleikhoff
- St. Franziskus-Hospital Münster, Münster, Deutschland
| | - M Schittkowski
- Klinik für Augenheilkunde, Universitätsklinikum Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - B Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - C Sucker
- Gerinnungszentrum Berlin Dr. Sucker, Berlin, Deutschland
| | - S Suffo
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - U Schaudig
- Augenklinik, Asklepios Klinik Barmbek, Hamburg, Deutschland
| | - F Tost
- Klinik für Augenheilkunde, Universitätsklinikum Greifswald, Greifswald, Deutschland
| | - S Thurau
- Klinik für Augenheilkunde, Universitätsklinikum München, LMU, München, Deutschland
| | - P Walter
- Klinik für Augenheilkunde, Universitätsklinikum Aachen, Aachen, Deutschland
| | - J Koscielny
- Gerinnungsambulanz und Hämophiliezentrum an der Charité, Berlin, Deutschland
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Radicke F, Schwaneberg T, Meinke-Franze C, Jürgens C, Grabe HJ, Hoffmann W, Tost F, van den Berg N. Prevalence of impaired functional reading ability and its association with quality of life, daily activity, mobility and social participation among general older adults in Germany. BMC Geriatr 2019; 19:176. [PMID: 31238872 PMCID: PMC6593547 DOI: 10.1186/s12877-019-1191-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/17/2019] [Indexed: 12/03/2022] Open
Abstract
Background The prevalence of visual impairment and of impaired functional reading ability rapidly increase with age. However, functional reading ability is essential for an autonomous lifestyle. We analyzed the prevalence of impaired functional reading ability in the general elderly population and the association of impaired functional reading ability with quality of life, daily activities, mobility, and social participation. Methods Cross-sectional data from a population-based cohort were analyzed. Participants aged ≥65 years were tested for their functional reading ability using (1) Nieden charts (cognitive reading ability) and (2) a test in which a telephone number had to be found (reading comprehension). Prevalences of impaired functional reading ability were calculated. In multivariable regression models, the associations of cognitive reading ability (1) with quality of life, daily activities, mobility, and social participation were examined. Results 60 of 780 participants (7.69%) were able to read the third last text of the Nieden test (good cognitive reading ability), whereas 7 participants (0.9%) were unable to read any of the texts. 716 participants (91.8%) identified the phone book entry successfully (good reading comprehension). Multivariable regression models revealed no significant associations of the cognitive reading ability (1) with quality of life, daily activities, social participation, and mobility. Conclusion Our results showed a high prevalence of impaired cognitive reading ability (1). Reading comprehension (2) was slightly affected. The loss of cognitive reading ability usually progresses over years; signs and symptoms might remain unrecognized when compensated by other functions.
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Affiliation(s)
- Franziska Radicke
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1-2, D-17487, Greifswald, Germany
| | | | - Claudia Meinke-Franze
- Department of Study of Health in Pomerania / Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Clemens Jürgens
- Department of Study of Health in Pomerania / Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1-2, D-17487, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1-2, D-17487, Greifswald, Germany.
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Tost F, Freißler G. Fahrtauglichkeit und chronische Augenerkrankungen. Ophthalmologe 2019; 116:479-494. [DOI: 10.1007/s00347-019-0900-8] [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: 11/29/2022]
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Schmidt P, Kempin R, Langner S, Beule A, Kindler S, Koppe T, Völzke H, Ittermann T, Jürgens C, Tost F. Association of anthropometric markers with globe position: A population-based MRI study. PLoS One 2019; 14:e0211817. [PMID: 30730926 PMCID: PMC6366780 DOI: 10.1371/journal.pone.0211817] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/20/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose Exophthalmometry is a common examination in ophthalmology. For example it is relevant for diagnosis or follow-up of thyroid eye disease. However, exophthalmometry is affected by several factors such as ethnicity, sex and age. The purpose of this study was to determine the globe position by magnetic resonance imaging (MRI) and to investigate its correlates among the general Northeast German adult population. Methods A total of 3030 subjects aged between 20 and 89 from the population-based Study of Health in Pomerania (SHIP) underwent a standardised whole-body MRI. Axial length and globe position were determined in axial T1-weighted images of the orbit. The image had to include the corneal apex as well as the optic nerve head. Study participants were excluded from imaging analysis if there was no plane available that included both structures. Further exclusion criterion was a lateral deviation of the subject’s viewing direction. Images with inadequate quality due to motion artefacts or other technical reasons were excluded as well. Globe position was defined as the perpendicular distance between the interzygomatic line and the posterior surface of the cornea (exophthalmometric value). The distance between the posterior surface of the cornea and the posterior pole of the eyeball, at the boundary with orbital fat, was defined as axial length. We used posterior surface of the cornea for our measurements, because it seemed to be less vulnerable for motion artefacts than the anterior one. Moreover body measurements including body mass index (BMI), waist and hip circumferences were determined. Associations between anthropometric measurements with exophthalmometric outcomes were analysed by linear regressions adjusted for age and stratified by sex. P-values <0.05 were considered as statistically significant. To assess intra-reader variability intra-class correlation coefficients (ICC) were computed for repeated measurements of the MRI scans of 25 subjects. Results After considering the exclusion criteria 1926 evaluable subjects remained. There was no significant difference between means of right and left eyes. The mean exophthalmometric value was significantly higher in men (16.5 +/- 2.2 mm) than in women (15.3 +/- 2.1 mm). The mean MRI-axial length was 23.4 +/- 0.8 mm for men and 22.8 +/- 0.9 mm for women. BMI, waist and hip circumferences were positively correlated with exophthalmometric value (p<0.001). Difference of mean MRI-based exophthalmometric value for obese subjects (BMI ≥30 kg/m2) and non-overweight (BMI <25 kg/m2) was 2.1 mm for men and 1.6 mm for women. ICC between 0.97 and 0.99 indicate excellent repeatability of our method. Conclusion We conclude that MRI-based exophthalmometric values are positively correlated with BMI, waist- and hip-circumference among the general Northeast German adult population. This association is independent from age and axial length. Consequently bodyweight of patients should be regarded to interpret exophthalmometric values correctly. MRI-exophthalmometry seems to be a suitable method to determine globe position. Considering the large number of study participants, exophthalmometric values of our study could be used as comparative values for exophthalmometry of people of Western European descent in future.
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Affiliation(s)
- Patrick Schmidt
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Robert Kempin
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Rostock, Rostock, Mecklenburg-Western Pomerania, Germany
| | - Achim Beule
- Department of Otorhinolaryngology, University Clinic Münster, Münster, North Rhine Westphalia, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Thomas Koppe
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
| | - Frank Tost
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany
- * E-mail:
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Paul S, Ribback S, Tost F. [Recognised Occupational Disease and Squamous Cell Carcinoma in Periocular Region]. Klin Monbl Augenheilkd 2018; 236:47-49. [PMID: 30477039 DOI: 10.1055/a-0749-8994] [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: 10/27/2022]
Affiliation(s)
- Sebastian Paul
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald
| | - Silvia Ribback
- Institut für Pathologie, Ernst-Moritz-Arndt-Universität Greifswald
| | - Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald
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Tost F, Freißler G. [Telematics services and telemedicine under ophthalmological legal aspects]. Ophthalmologe 2018; 115:615-630. [PMID: 29797072 DOI: 10.1007/s00347-018-0722-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Telemedical solutions are increasing with respect to diversity, frequency and scope. It should be part of medical practice to remind again and again that telemedicine does not represent a special medical field or even a subspecialty. The concept of telemedicine is more used as a superior term for different medical care concepts, provided across distance and time barriers. Telematic solutions implemented as a new field of service in ophthalmological practice or in hospitals must fulfill the following obligatory requirements in conformity with the law: patients must be informed about the range of telemedical solutions, operators must ensure medical specialist qualifications and all care responsibilities combined with the telemedical services must be guaranteed. The legal assessment standard is always the direct comparison between telemedical measures and the individual patient result of medical treatment in a face to face situation in an ophthalmologists practice as the gold standard. The court makes a targeted examination on whether the individual damage to health of a patient under telemedical care would also have normally occurred under medical treatment within the framework of regular care by a medical specialist in a practice or clinic. If the court has a well-founded doubt, the operator must be able to justify either constraints in individual cases or a better prognosis and success rate (reversal of burden of proof). Especially due to the latter aspect it is important for the operator that the standards for telemedical services of the specific medical fields are predefined by the specialist societies or that corresponding results from healthcare research projects are available.
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Affiliation(s)
- F Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald der Ernst-Moritz-Arndt-Universität Greifswald, KöR, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland.
| | - G Freißler
- Augenarztpraxis Bamberg, Bamberg, Deutschland
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Samietz S, Jürgens C, Ittermann T, Holtfreter B, Pink C, Schipf S, Biffar R, Völzke H, Kocher T, Tost F. Cross-sectional association between oral health and retinal microcirculation. J Clin Periodontol 2018; 45:404-412. [DOI: 10.1111/jcpe.12872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Stefanie Samietz
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Clemens Jürgens
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Till Ittermann
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Christiane Pink
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Sabine Schipf
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Henry Völzke
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Frank Tost
- Department of Ophthalmology; University Medicine Greifswald; Greifswald Germany
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Jürgens C, Ittermann T, Hannemann A, Schmidt C, Völzke H, Tost F. Impact of inexperienced examiners on arterio-venous ratio of static vessel analysis. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1606012] [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: 10/18/2022]
Affiliation(s)
- C Jürgens
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald
| | - T Ittermann
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald
| | - A Hannemann
- Universitätsmedizin Greifswald, Institut für Klinische Chemie und Laboratoriumsmedizin, Greifswald
| | - C Schmidt
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald
| | - H Völzke
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald
| | - F Tost
- Universitätsmedizin Greifswald, Augenklinik, Greifswald
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Tost F, Gramberg-Danielsen B. Richtigstellung und Entgegnung zum Beitrag „Ist die Rententabelle der DOG dem Gutachter noch zuzumuten?“ von H. Burggraf, Klin Monatsbl Augenheilkd 2015; 232: 891–893. Klin Monbl Augenheilkd 2016; 233:753-5. [DOI: 10.1055/s-0041-110398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F. Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald der Ernst-Moritz-Universität Greifswald
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Tost F, Kempin R, Grossjohann R, Herfurth S. [Diabetic retinopathy--Current aspects of therapy]. Med Monatsschr Pharm 2016; 39:148-158. [PMID: 27209895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pathological changes of the small blood vessels are the main risk for diabetic retinopathy. A distinction is made between proliferative and non-proliferative processes. The diabetic macular edema can manifest itself at any stage of the diabetic retinopathy and poses a serious threat to vision and quality of life. Evidence based therapy primarily focuses on laser coagulation. Laser coagulation suspends progression of the disease and is used particularly for extrafoveolar edema. Especially a pathological swelling, such as the cystoid edema, in this central part of the retina, can cause a rapid deterioration of vision. The treatment of cystoid macular edema with intravitreal application of drugs is a widespread therapeutical approach. Invasive therapeutical drug application into the vitreous cavity has to be sterile in order to prevent infection. The usage of VEGF (Vascular endothelial growth factor) antagonists is an effective treatment for the diabetic macular edema. Several drugs are now available for intravitreal injection. Nevertheless a small number of medical drugs regularly administered to patients still have to be approved by the authorities (off-label use). One can distinguish mainly between VEGF antagonist (growth factor antagonist) like ranibizumab, aflibercept and bevacizumab and steroid therapy which includes dexamethasone, fluocinolone and triamcinolone.
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Baumeister SE, Schomerus G, Andersen RM, Tost F, Markus MRP, Völzke H, Jürgens C. Trends of barriers to eye care among adults with diagnosed diabetes in Germany, 1997-2012. Nutr Metab Cardiovasc Dis 2015; 25:906-915. [PMID: 26298427 DOI: 10.1016/j.numecd.2015.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS To study trends of barriers to receiving recommended eye care among subjects with diabetes aged 20-81 years in northeast Germany. METHODS AND RESULTS We analyzed population-based data from two repeated cross-sectional surveys conducted in 1997-2001 and 2008-2012 (Ns of 4308 and 4402). Andersen's Behavioral Model of Health Services Utilization was used to identify individual-level demographic, financial and health-related barriers to annual eye-care utilization in subjects with a self-reported physician's diabetes and to examine population trends in these barriers. The prevalence of diabetes increased from 6.5% to 11.4%. The prevalence of annual eye-care utilization among persons with diabetes decreased from 69.4% to 56.0% (adjusted relative risk = 0.77, p < 0.001). The decline of eye care utilization over the past decade in eye-care use was more pronounced in groups at risk for diabetes-related complications (i.e., lower socio-economic status, >5 years since diagnosis of diabetes, poor glycemic control, obesity, smoking, lack of physical activity, co-existing diseases). We identified relevant predictors of missed annual eye-care use among diabetics. CONCLUSION The increase of diabetes prevalence and downward trend of eye-care visits at the recommended level call for development, implementation and evaluation of continued efforts to improve access to eye specialists, particularly among those with poor diabetic control, co-existing diabetic complications, and comorbidities.
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Affiliation(s)
- S E Baumeister
- Institute of Epidemiology and Preventive Medicine, University of Regensburg, Germany; Institute for Community Medicine, University Medicine Greifswald, Germany.
| | - G Schomerus
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany; Helios Hanseklinikum, Stralsund, Germany
| | - R M Andersen
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, USA
| | - F Tost
- Department of Ophthalmology, University Medicine Greifswald, Germany
| | - M R P Markus
- Institute for Community Medicine, University Medicine Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - C Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Germany
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Abstract
BACKGROUND Epidemiological studies continue to receive growing attention in health services research. OBJECTIVES How can ophthalmological health services research benefit from the Study of Health in Pomerania (SHIP)? METHODS The SHIP is a population-based, epidemiological project conducted in the northeast of Germany. In 1997 a random sample of 6,265 eligible subjects was enrolled for the first SHIP cohort. Between 1997 and 2001 baseline examinations were performed, followed by 5-year follow-up from 2002 to 2006, from 2008 to 2012 and from 2014. A second independent sample of 8,016 eligible subjects was enrolled in 2008. Baseline examinations of this new cohort (SHIP-Trend) were conducted between 2008 and 2012 and the first follow-up is scheduled for 2015. Included in SHIP are a large variety of different assessments including eye examinations. All participants are subjected to non-mydriatic funduscopy and static vessel analysis (SVA). RESULTS A total number of 4,420 subjects participated in the interdisciplinary baseline examinations of SHIP-Trend. Standardized fundus photography was performed with a non-mydriatic camera in 3,934 subjects. CONCLUSION Estimations of the prevalence of major eye diseases may provide valid indicators for healthcare provision within healthcare research. New concepts of prevention with a strengthened integration of ophthalmological diagnostics can be identified from the widespread spectrum of different healthcare examinations. Regional differences in the efficiency of healthcare provision can be evaluated with comparative studies between different German populations.
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Affiliation(s)
- C Jürgens
- Institut für Community Medicine, Study of Health in Pomerania (SHIP), Universitätsmedizin Greifswald, Walter Rathenau Str. 48, 17475, Greifswald, Deutschland,
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Tost F, Kempin R. [Post-surgical management of split-thickness skin grafts in oculoplastic surgery]. Klin Monbl Augenheilkd 2015; 232:27-32. [PMID: 25611496 DOI: 10.1055/s-0034-1396141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Malignant skin tumours in periocular regions often demand ophthalmo-surgical measures. Split-thickness skin grafts still represent an important treatment alternative when plastic-reconstructive covering through local tissue of the facial area is impossible. Essential technical steps to gain viable split-thickness skin grafts are introduced. Current standards in the after-treatment of split-thickness skin grafts at the receiving location as well as in the after-care of the donor area are presented from interdisciplinary points of view referring to the latest publications. Hydrocolloidal dressings are recommended for the after-treatment of removal areas such as the inside of the forearm since they improve post-surgical management for the ophthalmologist significantly and help in abbreviating healing duration. Pain sensation of the patient as well as the rate of infection are minimal. Throughout the early stages, split-thickness skin grafts at reception areas often demand an intensified local massage treatment with hydrocortisone 2.5 % ophthalmic cream. During the later stages follow-up measures should be stopped neither too soon nor abruptly. Ointments with polysiloxane and silicon dioxide preserve skin suppleness and prevent the occurrence of shrinkage as well as hypertrophic scars.
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Affiliation(s)
- F Tost
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt-Universität Greifswald
| | - R Kempin
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt-Universität Greifswald
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Saleh K, Unger V, Dietzel A, Heydenreich D, Großjohann R, Jürgens C, Tost F, Haueisen J. Mechanical eye model for evaluating intraocular pressure measurements. Biomed Eng Lett 2014. [DOI: 10.1007/s13534-014-0159-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ittermann T, Dörr M, Völzke H, Tost F, Lehmphul I, Köhrle J, Jürgens C. High serum thyrotropin levels are associated with retinal arteriolar narrowing in the general population. Thyroid 2014; 24:1473-8. [PMID: 25156414 DOI: 10.1089/thy.2014.0190] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Recent studies have shown associations of hypothyroidism with arterial blood pressure, atherosclerosis, and inflammation. Based on these pathways, there might also be an association between hypothyroidism and retinal arteriolar narrowing (RAN), a marker of microvascular damage from hypertension, atherosclerosis, and inflammation. Against this background, the aim of this study was to investigate the putative association between serum thyrotropin (TSH) levels and RAN defined by arterio-venous ratio (AVR) from static vessel analysis. METHODS We used data from 3189 individuals from the second population-based cohort of the Study of Health in Pomerania (SHIP-TREND-0). Thyroid function was defined according to serum TSH and serum diiodothyronine (3,5-T2) levels. Low and high serum TSH levels were defined by the cutoffs 0.3 mIU/L and 3.0 mIU/L. Fundus photography of the central retina was recorded with a nonmydriatic camera, and images were evaluated by one experienced reader. An AVR <0.8 was defined as decreased. Serum TSH levels, low and high TSH, and serum 3,5-T2 levels were associated with AVR by linear regression and with AVR <0.8 by Poisson regression, both adjusted for age, sex, cigarette smoking, alcohol consumption, and intake of beta-blockers. RESULTS Serum TSH levels were significantly associated with AVR (β=-0.028 [CI -0.049 to -0.007]; p=0.009) and with a decreased AVR <0.8 (relative risk=2.05 [CI 1.13-3.73]; p=0.019). Individuals with high TSH had a 1.43 higher risk for a decreased AVR ([CI 1.04-1.96]; p=0.027) than individuals with serum TSH levels within the reference range. Serum 3,5-T2 levels were also associated with a decreased AVR (relative risk for an increase of 1 nM=0.45 [CI 0.23-0.87]; p=0.017). CONCLUSIONS Our results substantiate evidence for an association between hypothyroidism and RAN. Potential mechanisms explaining this association are long-term hypertension, atherosclerotic processes, and inflammation.
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Affiliation(s)
- Till Ittermann
- 1 Institute for Community Medicine, University Medicine Greifswald , Greifswald, Germany
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Jürgens C, Ittermann T, Völzke H, Tost F. Comparison of Two Non-mydriatic Fundus Cameras to Obtain Retinal Arterio-venous Ratio. Ophthalmic Epidemiol 2014; 21:333-8. [DOI: 10.3109/09286586.2014.949352] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kempin R, Tost F. [Topical chemotherapy for conjunctival tumours - the medical and legal bearings of the case]. Klin Monbl Augenheilkd 2014; 231:594-602. [PMID: 24940757 DOI: 10.1055/s-0034-1368452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The treatment management of malignant tumours is characterised and limited by specific features of the topographical structure of the eye. The anatomic characteristics of the conjunctival sac, the movable tissue structures and the need to take care of corneal transparency and conjunctival stability are the main concerns of the experts. Clinical studies have revealed adjuvant chemotherapy to have a positive effect as a therapeutic treatment for neoplasia of the conjunctiva and cornea. Although mitomycin and interferon are widely used, there are no phase III studies on local adjuvant chemotherapy (interferon, mitomycin, 5-fluorouracil) that evaluate the proof of effectiveness, potential adverse effects or interactions with other drugs. For this reason, the currently available studies fail to comply with the jurisdiction of the German Federal Social Court. Hence, the Medical Service of the Health Insurance Funds (MDK) regionally does not accept the medical preconditions for reimbursement of the costs in adjuvant local chemotherapy. A doctor's unquestioned acceptance of such an MDK decision could have legal consequences. An off-label use is acceptable by law if there is no alternative treatment available with a higher evidence level that conforms to the medical standard. It is therefore recommendable for the Joint Federal Committee commissions the experts in ophthalmology and oncology on off-label use, to review the scientific evidence regarding adjuvant therapy of malignant tumours of the ocular surface. Only in this way can regional disparities in patient care, and intrusions on the doctor-patient relationship, be avoided.
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Affiliation(s)
- R Kempin
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald
| | - F Tost
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald
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44
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Affiliation(s)
- S. Töpel
- Abteilung für Augenheilkunde, Bundeswehr Zentralkrankenhaus, Koblenz
| | - F. Tost
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald
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Töpel S, Tost F. Augenheilkunde im Nationalsozialismus – Das Greifswalder Berufungsverfahren 1938. Klin Monbl Augenheilkd 2013; 230:1146-53. [DOI: 10.1055/s-0032-1328775] [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)
- S. Töpel
- Abteilung für Augenheilkunde, Bundeswehr-Zentralkrankenhaus Koblenz
| | - F. Tost
- Augenklinik der Universitätsmedizin, Ernst-Moritz-Arndt Universität, Greifswald
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Tost F, Großjohann R, Schikorr W, Tesch R, Ekkernkamp A, Lange J, Langner S, Bockholdt B, Frank M. [Mason's lacing cord. Potential danger of severe open ocular injuries]. Ophthalmologe 2013; 111:151-7. [PMID: 23595651 DOI: 10.1007/s00347-013-2800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Introduction of new working equipment or the modification of established working routines could induce new trauma mechanisms. In all of theses cases ophthalmologists are not only responsible for ocular treatment they also have to act as assessors. This might include legal aspects, e.g. to validate the circumstances of an accident. METHODS We present a new trauma mechanism caused by a mason's lacing cord which was fixed with nails. In addition to two case studies we collected experimental data (maximum tension and maximum elongation of various mason's lacing cords) about the triggering event using standard test conditions. RESULTS A tensile force of 96.2 N was needed to achieve maximum elongation of mason's lacing cords. With a cord length of 5 m, an elongation of 0.09 m was enough to cause penetrating injuries (for 10 m cord length the critical elongation was 0.13 m). Under these conditions a nail could be accelerated to a velocity of 18 m/s. This may lead to open eyeball injuries with severe visual loss. CONCLUSIONS Nails fixed to elastic mason's lacing cords are potential risk factors for occupational ocular injuries and severe loss of vision. Caution labels should be attached to the work equipment and proper eye protection should be used to prevent severe occupational ocular injuries.
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Affiliation(s)
- F Tost
- Klinik für Augenheilkunde, Ernst-Moritz-Arndt Universität, Universitätsmedizin Greifswald, Sauerbruchstr., 17475, Greifswald, Deutschland,
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Tost F. [Surgical treatment of upper lid entropion -- selected aspects]. Klin Monbl Augenheilkd 2013; 230:28-35. [PMID: 23345147 DOI: 10.1055/s-0032-1327982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The upper lid entropion is a rare eyelid malposition in which the external lid margin turns inward against the ocular surface. It may be classified as congenital (tarsal malformation, hypoplasia of tarsus, eyelid hyperlaxity) but is more commonly an acquired condition (traumatic, immunopathological, inflammation, involutional forms). Surgery is the treatment of choice for correction of upper lid entropion. Appropriate surgical techniques are available for the respective conditions. This article gives an overview of the most commonly used treatment strategies including non-surgical and surgical procedures. Transcutaneous and intermarginal access routes have proven to be safe methods for minimal or moderate upper lid entropion. Combined surgical procedures (e.g., rotation of tarsoconjunctiva, posterior lamellar graft, everting sutures and autologous cultivated oral mucosal epithelial transplantation and so on) should be applied as treatment strategies for severe upper lid entropion with cicatricial changes in the tarsoconjunctival layer, shortage of posterior lamella and severe ocular surface disease.
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Affiliation(s)
- F Tost
- Augenklinik der Universitätsmedizin KöR, Ernst-Moritz-Arndt Universität, Greifswald.
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Saleh K, Unger V, Dietzel A, Heydenreich D, Großjohann R, Jürgens C, Tost F, Haueisen J. Evaluation of a novel method to measure the intraocular pressure based on a mechanical eye model. BIOMED ENG-BIOMED TE 2012; 57 Suppl 1:/j/bmte.2012.57.issue-s1-P/bmt-2012-4355/bmt-2012-4355.xml. [PMID: 23096344 DOI: 10.1515/bmt-2012-4355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jürgens C, Grossjohann R, Tost F. Distribution of mean, systolic and diastolic ocular perfusion pressure in telemedical homemonitoring of glaucoma patients. Ophthalmic Res 2012; 48:208-11. [PMID: 22890219 DOI: 10.1159/000338234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 03/06/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND To analyze the relation and distribution of mean, systolic and diastolic ocular perfusion pressure (OPP) in telemedical homemonitoring of patients with primary open-angle glaucoma (POAG). METHODS 70 patients with POAG measured intraocular pressure (IOP) and blood pressure at home for a period of 6 months with the Goldmann applanation self-tonometer Ocuton S and the blood pressure device boso medicus PC. Twenty-four-hour profiles were taken every 4 weeks in addition to single measurements in the morning and evening once a week. All measured values were transmitted to an electronic patient record, which calculated OPP by taking systolic, diastolic and mean arterial blood pressure and subtracting IOP. RESULTS We analyzed 3,282 values of mean, systolic and diastolic OPP. The quantity of values below the risk levels of the Barbados Eye Studies was calculated. We found values lower than the risk levels for LE: 49 (1.5%)/RE: 60 (1.8%) systolic OPP, LE: 1,623 (49.5%)/RE: 1,761 (53.7%) diastolic OPP and LE: 687 (20.9%)/RE: 794 (24.2%) mean OPP. The individual average OPP levels of all 70 patients below the risk levels showed the following distribution: LE: 4 (5.7%)/RE: 6 (8.6%) systolic OPP, LE: 19 (27.1%)/RE: 20 (28.6%) diastolic OPP and LE: 10 (14.3%)/RE: 10 (14.3%) mean OPP. CONCLUSION The individual distribution of different OPP values in POAG patients is not easy to interpret for clinical ophthalmologists. Precise practicable guidelines for clinical use still have to be determined.
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Affiliation(s)
- Clemens Jürgens
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany.
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Frank M, Grossjohann R, Schikorr W, Tesch R, Lange J, Ekkernkamp A, Langner S, Bockholdt B, Tost F. Nail projectiles propelled by a mason's lacing cord: an experimental approach. Int J Legal Med 2012; 127:153-8. [PMID: 22562442 DOI: 10.1007/s00414-012-0707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 04/26/2012] [Indexed: 10/28/2022]
Abstract
The recent clinical observation of two unintentional penetrating ocular and cerebral injuries due to 90-mm construction nails gave occasion to an experimental study to check the alleged trauma mechanism for plausibility. Both casualties reported that they had attached a mason's lacing cord to the masonry using a nail as anchoring when suddenly the nail was yanked from its moorings and propelled like a missile by the overstretched lacing cord. As to the best of the authors' knowledge, this mechanism of injury has not yet been reported in any of the literature; it was the aim to find an experimental approach to review the plausibility of the alleged sequence of events leading to the accidents. The tensile strength at break and strain at break of different mason's lacing cords (diameter of 1 and 2 mm) were measured according to DIN EN ISO 2062 by using a tensile testing machine. Based on the maximum spring energy of the lacing cords, which was determined 174.9 J for the 1-mm cord (length 10 m) and 747.4 J for the 2-mm cord (length 10 m), the maximum possible velocity of the nails as projectiles was calculated to be 243.5 m/s for the 1-mm cord and 503.4 m/s for the 2-mm cord. The critical elongation a cord of a certain length has to be stretched to deliver enough kinetic energy to a 90-mm nail to surpass the threshold velocity for skin penetration, which was investigated by Sellier (1977) to be approximately 18 m/s, was also calculated. To conclude, the energy delivered by the cords is high enough to surpass the rather low threshold velocity of nails. The details of how these accidents occurred, which seemed questionable at first, can be reasonably explained by trauma biomechanics.
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Affiliation(s)
- Matthias Frank
- Department of Trauma and Orthopedic Surgery, University Medicine Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany.
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