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Garayzade R, Berlis A, Schiele S, Ertl M, Schneider H, Müller G, Maurer CJ. Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting. Clin Neuroradiol 2024; 34:163-172. [PMID: 37796321 PMCID: PMC10881598 DOI: 10.1007/s00062-023-01350-7] [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: 04/05/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage. AIM OF THE STUDY Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients. METHODS Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality. RESULTS Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort. CONCLUSIONS A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage. For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention.
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Affiliation(s)
- Rana Garayzade
- Department of diagnostic and interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany.
| | - Ansgar Berlis
- Department of diagnostic and interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, Augsburg University, Augsburg, Germany
| | - Michael Ertl
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
| | - Hauke Schneider
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, Augsburg University, Augsburg, Germany
| | - Christoph J Maurer
- Department of diagnostic and interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany
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Behrens L, Adam A, Rubeck A, Schiele S, Müller G, Abrishami Y, Berlis A, Maurer CJ. Safety Aspects and Procedural Characteristics of Ambulatory Diagnostic Cerebral Catheter Angiography. Clin Neuroradiol 2024; 34:155-162. [PMID: 37712974 PMCID: PMC10881604 DOI: 10.1007/s00062-023-01345-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/15/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE Diagnostic cerebral catheter angiography is used to assess a variety of neurovascular pathologies especially in patients before and after endovascular neurointerventional treatment. In many centers diagnostic cerebral angiographies are performed with the patient staying for one night in the hospital because there are not yet sufficient data on the safety of ambulatory cerebral angiography. At the same time hospitals face a growing demand to perform ambulatory medical procedures. METHODS A total of 426 ambulatory diagnostic cerebral angiographies were retrospectively analyzed. Technical details of the angiographies were analyzed to identify procedural risk factors. RESULTS Out of 426 patients 14 (3.3%) had some form of complication, 3 developed minor transient neurological symptoms, 1 patient developed Quincke's edema probably as an adverse reaction to contrast agent, 1 patient had an asymptomatic carotid dissection and 1 had a fall of unknown etiology. Of the 14 complications 8 were puncture site complications with 1 re-bleeding, 1 dissection, and 6 minor complications, 421 punctures were femoral, 3 radial and 2 brachial. Out of 333 patients with magnetic resonance imaging (MRI) after angiography 21 showed focal diffusion-weighted imaging (DWI) lesions but none of these lesions were symptomatic. The rate of DWI lesions was significantly higher in selectively angiography territories than in other territories. The use of a Simmons 2 catheter significantly increased the rate of DWI lesions (p = 0.047), whereas 3D rotational angiography did not (p = 0.55). The rate of DWI lesions per selectively accessed vessel was 4.6% with a higher rate in the anterior than in the posterior circulation. CONCLUSION Diagnostic cerebral catheter angiography can be safely performed in an ambulatory setting.
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Affiliation(s)
- Lars Behrens
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
| | - Andreas Adam
- Department of Radiology, Hospitals Aichach and Friedberg, Friedberg, Germany
| | - Anna Rubeck
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Yalda Abrishami
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Ansgar Berlis
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Christoph J Maurer
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
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Kramer N, Müller G, Zierold S, Röckel M, Fröhlich W, Schefzyk M, Kumbrink J, Hassel JC, Berking C, Ziemer M, Nashan D, French LE, Vera J, Kerl-French KE, Gutzmer R, Heinzerling L. Checkpoint inhibitor-induced bullous pemphigoid differs from spontaneous bullous pemphigoid. J Eur Acad Dermatol Venereol 2024. [PMID: 38400651 DOI: 10.1111/jdv.19860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Affiliation(s)
- N Kramer
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - G Müller
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - S Zierold
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - M Röckel
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - W Fröhlich
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Schefzyk
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Kumbrink
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - J C Hassel
- Department of Dermatology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - C Berking
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Ziemer
- Department of Dermatology, Allergology and Venerology, University Medical Center, Leipzig, Germany
| | - D Nashan
- Department of Dermatology, Hospital Dortmund, Dortmund, Germany
| | - L E French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - J Vera
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - K E Kerl-French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - R Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, Minden, Germany
| | - L Heinzerling
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Vélez González JJ, Berger M, Schiele S, Rubeck A, Müller G, Welzel J, Schuh S. Dynamic optical coherence tomography of chronic venous ulcers. J Eur Acad Dermatol Venereol 2024; 38:223-231. [PMID: 37669869 DOI: 10.1111/jdv.19496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Chronic ulcers, especially venous leg ulcers, are a major burden on the healthcare system. To date there are only few non-invasive established procedures for evaluation of blood perfusion in wounds. Dynamic optical coherence tomography (D-OCT) provides images of the skin's superficial vascularisation. OBJECTIVES This study aims to investigate if and how the D-OCT measurement of chronic wounds can provide new information about the vascularisation during the healing process. METHODS We examined 16 venous ulcers over 16 weeks and evaluated the vessel morphology and density using D-OCT at the wound bed, borders, two centimetres adjacent to the wound und at non-ulcerated skin on the contralateral leg. RESULTS In D-OCT scans clumps were unique and the most common vessel type in the wound area of venous ulcers, whereas lines and serpiginous vessels were the most common in non-ulcerated skin. At the wound border mottle and cluster patterns occurred more frequently. Healthy skin showed a significant increase of mesh pattern. Vessel density significantly increased at the wound area compared to non-ulcerated skin. During the healing process the wound border showed the most vascular changes while only an increase in curves was observed in the wound centre. Non-healing wounds had fewer dots and blobs at the borders, fewer dots, coils, clumps, lines and serpiginous vessels at the centre and fewer dots in adjacent skin. Temperature analysis showed higher temperatures in non-ulcerated skin, followed by the wound margin and centre. Non-healing wounds showed the lowest temperatures in the wound centre. CONCLUSIONS These results highlight the non-invasive use of D-OCT for the examination and monitoring of wound healing in chronic venous ulcers. D-OCT imaging of blood vessels may offer the potential to detect disorders of wound healing at an early stage, differentiate ulcers of different genesis and to tailor more individualized, patient-oriented therapy.
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Affiliation(s)
| | - Maximilian Berger
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Anna Rubeck
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
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Schrempf MC, Zanker J, Arndt TT, Vlasenko D, Anthuber M, Müller G, Sommer F, Wolf S. Immersive Virtual Reality Fitness Games to Improve Recovery After Colorectal Surgery: A Randomized Single Blind Controlled Pilot Trial. Games Health J 2023; 12:450-458. [PMID: 37428543 DOI: 10.1089/g4h.2023.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Introduction: Early mobilization after surgery is crucial for reducing postoperative complications and restoring patients' fitness and ability to care for themselves. Immersive, activity-promoting fitness games in virtual reality (VR) can be used as a low-cost motivational adjunct to standard physiotherapy to promote recovery after surgery. In addition, they have potentially positive effects on mood and well-being, which are often compromised after colorectal surgery. The purpose of this pilot study was to evaluate the feasibility and clinical outcomes of a VR-based intervention that provides additional mobilization. Methods: Patients undergoing curative surgery for colorectal cancer were randomly assigned to an intervention group or a control group. Participants in the intervention group (VR group) received daily bedside fitness exercises using immersive, activity-promoting, virtual reality fitness games in addition to standard care during their postoperative hospital stay. Results: A total of 62 patients were randomized. The feasibility outcomes were in line with the predefined goals. In the VR group, an improvement in overall mood (+0.76 points; 95% confidence interval [CI] 0.39 to 1.12; P < 0.001) and a shift toward positive feelings were observed. The median length of hospital stay was 7.0 days in the VR group compared with 9.0 days in the control group, but the difference (2.0 days) did not reach statistical significance (95% CI -0.0001 to 3.00; P = 0.076). Surgical outcomes, health status, and measures of distress did not differ between groups. Conclusions: The study demonstrated the feasibility of a VR intervention that improved overall mood and showed a desirable effect on feelings and length of hospital stay after colorectal surgery. The results should stimulate further research investigating the potential of VR as an adjunct to physiotherapy to enhance mobilization after surgery.
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Affiliation(s)
- Matthias C Schrempf
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Johannes Zanker
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Tim Tobias Arndt
- Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Dmytro Vlasenko
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Matthias Anthuber
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Gernot Müller
- Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Florian Sommer
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Sebastian Wolf
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Augsburg, Germany
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Garayzade R, Berlis A, Schiele S, Schneider H, Ertl M, Müller G, Maurer CJ. Correction to: Comparison of Safety and Efficacy after Emergency Stenting in Patients Exhibiting Intracranial Atherosclerotic Stenosis Associated with Large-vessel Occlusion with and without Intravenous Infusion of Tirofiban. Cardiovasc Intervent Radiol 2023; 46:547-548. [PMID: 36912988 DOI: 10.1007/s00270-023-03413-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Rana Garayzade
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany.
| | - Ansgar Berlis
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, Augsburg University, Augsburg, Germany
| | - Hauke Schneider
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
| | - Michael Ertl
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, Augsburg University, Augsburg, Germany
| | - Christoph J Maurer
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany
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Kranz S, Brunnmeier G, Yilmaz P, Thamm J, Schiele S, Müller G, Key C, Welzel J, Schuh S. Optical coherence tomography-guided Nd:YAG laser treatment and follow-up of basal cell carcinoma. Lasers Surg Med 2023; 55:257-267. [PMID: 36740365 DOI: 10.1002/lsm.23638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Basal cell carcinoma (BCC) is the most common skin tumor with an annually increasing incidence. Standard care requires several visits for diagnosis and treatment. Optical coherence tomography (OCT) as a diagnostic tool increases the sensitivity (95%) and specificity (77%) of the diagnosis of BCC. Although laser therapy is not the standard of care, the long-pulsed 1064 nm Nd:YAG laser seems to be a promising option. However, data are scarce. The published papers had a short follow-up (FU) time and used to some extent inferior methods to detect complete tumor clearance. To address this research gap, this study evaluates the efficiency of laser treatment by FU OCT. We pursue a patient-focused approach and combine OCT with Nd:YAG laser treatment in one procedure. MATERIALS AND METHODS The study was conducted as a prospective, single-center trial that recruited biopsy-confirmed or OCT-proven BCC with a tumor thickness of less than 1.2 mm. Patients underwent two or three repeated sessions with the Nd:YAG laser (5-6 mm spot, fluence of 120-140 J/cm2 , pulse duration of 8-10 milliseconds). Each BCC was assessed at baseline, and 3 and 12 months after laser treatment by clinical image, dermoscopy, and OCT. Incomplete tumor clearance (ITC) was defined as a clearly detectable BCC on the OCT image or a biopsy-confirmed BCC in the treated area. RESULTS Forty-five patients completed the 12-month FU (46.7% women; median age of 74.0 [52-88] years) with a total number of 78 BCC lesions. At baseline, all patients had their BCC diagnosed by OCT (tumor thickness of 0.6 [0.4; 0.8] mm), 15.4% lesions were additionally diagnosed by histopathology. The most common subtype of BCC was superficial (48.7%), followed by nodular (47.4%) and infiltrative (3.8%). ITC rate after the treatment using Nd:YAG laser was 30.8% (95% CI: 20.8%-42.2%) (24/78) after 3 months and 7.4% (95% CI: 2.1%-17.9%) (4/54) after 12 months. ITC was not associated with histological subtype, tumor thickness, or location. If ITC was detected, the lesion was treated again. Out of 19 lesions with at least one additional laser treatment, 7 lesions (36.8%) suffered from incomplete tumor removal. In 46.7% of the treated lesions, the cosmetic outcome was rated as moderate or severe scarring after 12 months. CONCLUSION Our results demonstrate that the ITC rate of BCC treated with the Nd:YAG laser is much higher (up to one-third) than reported, although the laser settings were identical to prior studies. This is especially evident at the 3-month FU. In addition, we witnessed a larger number of side effects and a worse cosmetic outcome compared to previous studies.
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Affiliation(s)
- Stefanie Kranz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Gisela Brunnmeier
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Pelinsu Yilmaz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Janis Thamm
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Stefan Schiele
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Clara Key
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
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Butea-Bocu M, Müller G. Increase of advanced tumor stages during the corona pandemic? An analysis of 13,228 patients from an uro-oncology outpatient rehabilitation clinic. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00139-2] [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: 02/12/2023]
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Probst A, Ebigbo A, Eser S, Fleischmann C, Schaller T, Märkl B, Schiele S, Geissler B, Müller G, Messmann H. Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center. Clin Endosc 2023; 56:55-64. [PMID: 36634965 PMCID: PMC9902687 DOI: 10.5946/ce.2022.093] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/29/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND/AIMS Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophageal squamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyze long-term survival in a Western center. METHODS Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collected database. RESULTS R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria (M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%) had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It was not performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during a mean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resection was 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overall survival was significantly worse after non-curative resection (p=0.038). CONCLUSION Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited and mainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved.
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Affiliation(s)
- Andreas Probst
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany,Correspondence: Andreas Probst Department of Gastroenterology, University Hospital Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany E-mail:
| | - Alanna Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Eser
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Carola Fleischmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Tina Schaller
- Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, Augsburg, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics and Computational Statistics, University of Augsburg, Augsburg, Germany
| | - Bernd Geissler
- Department of General, Visceral and Transplant Surgery, University Hospital Augsburg, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics and Computational Statistics, University of Augsburg, Augsburg, Germany
| | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
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Schrempf MC, Petzold J, Petersen MA, Arndt TT, Schiele S, Vachon H, Vlasenko D, Wolf S, Anthuber M, Müller G, Sommer F. A randomised pilot trial of virtual reality-based relaxation for enhancement of perioperative well-being, mood and quality of life. Sci Rep 2022; 12:12067. [PMID: 35835944 PMCID: PMC9282619 DOI: 10.1038/s41598-022-16270-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/07/2022] [Indexed: 11/12/2022] Open
Abstract
A cancer diagnosis and subsequent treatment can trigger distress, negatively impact coping resources, and affect well-being as well as quality of life. The aim of this pilot study was to investigate feasibility and clinical effects of a VR intervention on quality of life, well-being and mood in cancer patients undergoing surgery compared to a non-VR intervention and a control group. 54 patients with colorectal cancer or liver metastases from colorectal cancer undergoing elective curatively intended surgery were recruited and randomised to one of two intervention groups or a control group receiving standard treatment. Participants assigned to one of the intervention groups either received a VR-based intervention twice daily or listened to music twice daily. Adherence to the intervention was 64.6% in the music group and 81.6% in the VR group. The VR intervention significantly reduced heart rate (- 1.2 bpm; 95% CI - 2.24 to - 0.22; p = 0.02) and respiratory rate (- 0.7 brpm; 95% CI - 1.08 to - 0.25; p = 0.01). Self-reported overall mood improved in both groups (VR: + 0.79 pts; 95% CI 0.37-1.21; p = 0.001; music: + 0.59 pts; 95% CI 0.22-0.97; p = 0.004). There was no difference in quality of life between the three groups. Both interventions groups reported changes in feelings. Adherence rates favoured the VR intervention over the music group. Observed clinical outcomes showed stronger intragroup effects on mood, feelings, and vital signs in the VR group. The study demonstrated feasibility of a VR intervention in cancer patients undergoing surgery and should encourage further research investigating the potential of VR interventions to positively influence well-being and mood in cancer patients.
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Affiliation(s)
- Matthias C Schrempf
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
| | - Julian Petzold
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Morten Aa Petersen
- Palliative Care Research Unit, Department of Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tim Tobias Arndt
- Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Hugo Vachon
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Dmytro Vlasenko
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Sebastian Wolf
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Matthias Anthuber
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Gernot Müller
- Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Florian Sommer
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
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Lingohr D, Müller G. Continuous‐time threshold autoregressions with jumps: Properties, estimation, and application to electricity markets. Scand Stat Theory Appl 2022. [DOI: 10.1111/sjos.12597] [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: 12/01/2022]
Affiliation(s)
- Daniel Lingohr
- Institute of Mathematics University of Augsburg Augsburg Germany
| | - Gernot Müller
- Institute of Mathematics University of Augsburg Augsburg Germany
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Filippini Velázquez G, Schiele S, Gerken M, Neumaier S, Hackl C, Mayr P, Klinkhammer-Schalke M, Illerhaus G, Schlitt HJ, Anthuber M, Kröncke T, Messmann H, Märkl B, Schmid C, Trepel M, Müller G, Claus R, Hackanson B. Predictive preoperative clinical score for patients with liver-only oligometastatic colorectal cancer. ESMO Open 2022; 7:100470. [PMID: 35461024 PMCID: PMC9271475 DOI: 10.1016/j.esmoop.2022.100470] [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: 11/16/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background Resection of liver metastases from colorectal cancer (CRC) in the oligometastatic stage improves survival and is a potentially curative treatment. Thus, predictive scores that reliably identify those patients who especially benefit from surgery are essential. Patients and methods In this multicenter analysis, 512 patients had undergone surgery for liver metastases from CRC. We investigated distinct cancer-specific risk factors that are routinely available in clinical practice and developed a predictive preoperative score using a training cohort (TC), which was thereafter tested in a validation cohort (VC). Results Inflammatory response to the tumor, a right-sided primary tumor, multiple liver metastases, and node-positive primary tumor were significant adverse variables for overall survival (OS). Patients were stratified in five groups according to the cumulative score given by the presence of these risk factors. Median OS for patients without risk factors was 133.8 months [95% confidence interval (CI) 81.2-not reached (nr)] in the TC and was not reached in the VC. OS decreased significantly for each subsequent group with increasing number of risk factors. Median OS was significantly shorter (P < 0.0001) for patients presenting all four risk factors: 14.3 months (95% CI 10.5 months-nr) in the TC and 16.6 months (95% CI 14.6 months-nr) in the VC. Conclusions Including easily obtainable variables, this preoperative score identifies oligometastatic CRC patients with prolonged survival rates that may be cured, and harbors potential to be implemented in daily clinical practice. We identified four variables of adverse outcome for patients treated with surgical resection of liver metastases from CRC. Adverse variables were inflammatory response to the tumor, multiple metastases, right-sided primary tumor, node-positive primary tumor. We developed a preoperative clinical score according to the number of risk factors present. Using easily obtainable variables, this score identified patients with oligometastatic CRC with good prognosis. Patients without risk factors should strongly be considered for surgical resection of their metastases.
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Affiliation(s)
- G Filippini Velázquez
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - S Schiele
- Faculty of Applied Mathematics and Statistics, University of Augsburg, Augsburg, Germany
| | - M Gerken
- Tumor Center Regensburg, Institute for Quality Assurance and Health Service Research, University of Regensburg, Regensburg, Germany
| | - S Neumaier
- Department of Haematology and Oncology, Katharinen Hospital Stuttgart, Stuttgart, Germany
| | - C Hackl
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - P Mayr
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - M Klinkhammer-Schalke
- Tumor Center Regensburg, Institute for Quality Assurance and Health Service Research, University of Regensburg, Regensburg, Germany
| | - G Illerhaus
- Department of Haematology and Oncology, Katharinen Hospital Stuttgart, Stuttgart, Germany
| | - H J Schlitt
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - M Anthuber
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - T Kröncke
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - H Messmann
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - B Märkl
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - C Schmid
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - M Trepel
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany
| | - G Müller
- Faculty of Applied Mathematics and Statistics, University of Augsburg, Augsburg, Germany
| | - R Claus
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany; General Pathology and Molecular Diagnostics, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - B Hackanson
- Comprehensive Cancer Center Augsburg (CCCA), University Medical Center Augsburg, Augsburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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13
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Jering M, Mayer M, Thölken R, Schiele S, Müller G, Zenk J. Cancer-specific and overall survival of patients with primary and metastatic malignancies of the parotid gland - A retrospective study. J Craniomaxillofac Surg 2022; 50:456-461. [DOI: 10.1016/j.jcms.2022.03.001] [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] [Received: 11/16/2021] [Revised: 01/14/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022] Open
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14
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Neumann F, Kehl T, Plotnicki K, Neumann S, Müller G, Kozlik-Feldmann R, Lang N. Midterm Follow-up Using Lifetech Konar-MF Device for Perimembranous and Muscular Ventricular Septal Defects in Pediatric Patient's. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742977] [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)
- F. Neumann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - T. Kehl
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - K. Plotnicki
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - S. Neumann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - G. Müller
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - R. Kozlik-Feldmann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - N. Lang
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
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15
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Giertzsch T, Kölbel T, Müller G, Kozlik-Feldmann R, Schneider P, Zengin-Sahm E, Sinning C, Lang N, Redlefsen T, Peldschus K, Weinrich J, Krause A, Rickers C. Unentdeckte Aortenisthmusstenosen (CoAs) als Ursache für ungeklärte arterielle Hypertonien bei Jugendlichen und Erwachsenen. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743006] [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)
- T. Giertzsch
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - T. Kölbel
- Vascular Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - G. Müller
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | | | - P. Schneider
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - E. Zengin-Sahm
- University Heart Center Hamburg GmbH, Hamburg, Deutschland, Hamburg, Deutschland
| | - C. Sinning
- Department of Cardiovascular Surgery, University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - N. Lang
- Department of Pediatr Cardiology, Children's Heart Clinic, Univ Med Center Eppendorf, Hamburg, Deutschland
| | - T. Redlefsen
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - K. Peldschus
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - J. Weinrich
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - A. Krause
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - C. Rickers
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
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16
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Heneka L, Neumann S, Schön G, Müller G, Bauer U, Kozlik-Feldmann R, Biermann D, Sachweh J, Hübler M, Rickers C. Complete AV Block, Underestimated and Highly Impacting Complication of Ebstein's Anomaly Surgery. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0041-1741039] [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)
- L. Heneka
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - S. Neumann
- Klinikum Links der Weser Kardiologie - Elektrophysiologie Bremen, Bremen, Deutschland
| | - G. Schön
- Institut für Medizinische Biometrie und Epidemiologie, Hamburg, Deutschland
| | - G. Müller
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - U. Bauer
- Nationales Register Angeborene Herzfehler, Berlin, Deutschland
| | - R. Kozlik-Feldmann
- Department of Pediatr Cardiology, Children's Heart Clinic, Univ Med Center Eppendorf, Hamburg, Deutschland
| | - D. Biermann
- Department of Pediatric Cardiac Surgery, University Heart & Vascular Center, Hamburg, Deutschland
| | - J. Sachweh
- Department of Pediatric Cardiac Surgery, University Heart & Vascular Center, Hamburg, Deutschland
| | - M. Hübler
- Department of Congenital and Pediatric Heart Surgery, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
| | - C. Rickers
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
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17
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Thölken R, Jering M, Mayer M, Schiele S, Müller G, Zenk J. Prospective study on complications using different techniques for parotidectomy for benign tumors. Laryngoscope Investig Otolaryngol 2021; 6:1367-1375. [PMID: 34938876 PMCID: PMC8665421 DOI: 10.1002/lio2.694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/06/2021] [Accepted: 10/25/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Long-term prospective studies on procedure-related complications after parotid surgery for benign neoplasms (BNs) are scarce. This is the first prospective study on the use of extracapsular dissection (ECD) for BNs, and it aimed to examine the incidence of postoperative complications after parotid surgery for BN. METHODS We collected data obtained in a prospective study of parotidectomy for BN at a university hospital and analyzed the transient and long-term complications. RESULTS The incidence rates of transient facial palsy immediately and 18 months after surgery were 15.0% and 3.7%, respectively. The rates of immediate postoperative facial palsy in patients who underwent ECD, partial superficial, superficial, and total parotidectomy were 5.8%, 29.3%, 20.0%, and 44.1%, respectively. Significant risk factors for facial palsy included multiple and larger lesions as well as surgery duration and extension. CONCLUSIONS Postoperative facial palsy remains a common complication after parotidectomy for BN and is associated with the extent of parotidectomy, presence of multiple neoplasms, and operative duration. The results of this study showed that ECD could be a safe technique for avoiding facial palsy. Level of Evidence: 2.
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Affiliation(s)
- Rubens Thölken
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Monika Jering
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Marcel Mayer
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
| | - Stefan Schiele
- Institute of Mathematics, Augsburg UniversityAugsburgGermany
| | - Gernot Müller
- Institute of Mathematics, Augsburg UniversityAugsburgGermany
| | - Johannes Zenk
- Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital AugsburgAugsburgGermany
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Druschke D, Krause F, Müller G, Scharfe J, Hoffmann GF, Schmitt J. Potentials and current shortcomings in the cooperation between German centers for rare diseases and primary care physicians: results from the project TRANSLATE-NAMSE. Orphanet J Rare Dis 2021; 16:494. [PMID: 34819135 PMCID: PMC8611963 DOI: 10.1186/s13023-021-02106-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background The TRANSLATE-NAMSE project with the strengthening of the centers for rare diseases with their affiliation to the European Reference Networks was a major step towards the implementation of the German National Plan of Action for People with Rare Diseases establishing better care structures. As primary care physicians, general practitioners and pediatricians play a central role in the diagnosis of patients with rare disease, as it is usually them referring to specialists and rare disease centers. Therefore, the interface management between primary care physicians and the centers for rare diseases is of particular importance. Methods In a mixed-method-approach an anonymous postal survey of 1,500 randomly selected primary care physicians in Germany was conducted with focus on (1) knowledge about a center for rare diseases and how it works, (2) in case of cooperation, satisfaction with the services provided by centers, and (3) expectations and needs they have with regard to the centers. In addition, in-depth telephone interviews were conducted with physicians who had already referred patients to a center. Results In total, 248 physicians responded to the survey, and 15 primary care physicians were interviewed. We observed a wide lack of knowledge about the existence of (45.6% confirmed to know at least one center) about how to access rare disease centers (50.4% of those who know a center confirmed knowledge) and what the center specializes in. In case of cooperation the evaluation was mostly positive. Conclusion To improve medical care, the interplay between primary care physicians and rare disease centers needs to be strengthened. (1) To improve the communication, the objectives and functioning of the rare disease centers should become more visible. (2) Other projects dealing with the analysis and improvement of interface management between centers and primary care physicians, as described in the National Plan of Action for People with Rare Diseases, need to be implemented immediately. (3) If the project is evaluated positively, the structures of TRANSLATE-NAMSE should be introduced nationwide into the German health care system to ensure comprehensive, quality-assured care for people with rare diseases with special consideration of the key role of primary care physicians—also taking into account the financial expenditures of this new care model.
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Affiliation(s)
- D Druschke
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - F Krause
- Center for Rare Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - G Müller
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - J Scharfe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - G F Hoffmann
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - J Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Martin B, Grosser B, Kempkens L, Miller S, Bauer S, Dhillon C, Banner BM, Brendel EM, Sipos É, Vlasenko D, Schenkirsch G, Schiele S, Müller G, Märkl B. Stroma AReactive Invasion Front Areas (SARIFA)-A New Easily to Determine Biomarker in Colon Cancer-Results of a Retrospective Study. Cancers (Basel) 2021; 13:cancers13194880. [PMID: 34638364 PMCID: PMC8508517 DOI: 10.3390/cancers13194880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/25/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Many studies have used histomorphological features to more precisely predict the prognosis of patients with colon cancer, focusing on tumor budding, poorly differentiated clusters, and the tumor–stroma ratio. Here, we introduce SARIFA: Stroma AReactive Invasion Front Area(s). We defined SARIFA as the direct contact between a tumor gland/tumor cell cluster (≥5 cells) and inconspicuous surrounding adipose tissue in the invasion front. SARIFA shows an excellent interobserver reliability and high prognostic value and is thus a promising histomorphological prognostic indicator for adipose-infiltrative adenocarcinomas of the colon. Abstract Many studies have used histomorphological features to more precisely predict the prognosis of patients with colon cancer, focusing on tumor budding, poorly differentiated clusters, and the tumor–stroma ratio. Here, we introduce SARIFA: Stroma AReactive Invasion Front Area(s). We defined SARIFA as the direct contact between a tumor gland/tumor cell cluster (≥5 cells) and inconspicuous surrounding adipose tissue in the invasion front. In this retrospective, single-center study, we classified 449 adipose-infiltrative adenocarcinomas (not otherwise specified) from two groups based on SARIFA and found 25% of all tumors to be SARIFA-positive. Kappa values between the two pathologists were good/very good: 0.77 and 0.87. Patients with SARIFA-positive tumors had a significantly shorter colon-cancer-specific survival (p = 0.008, group A), absence of metastasis, and overall survival (p < 0.001, p = 0.003, group B). SARIFA was significantly associated with adverse features such as pT4 stage, lymph node metastasis, tumor budding, and higher tumor grade. Moreover, SARIFA was confirmed as an independent prognostic indicator for colon-cancer-specific survival (p = 0.011, group A). SARIFA assessment was very quick (<1 min). Because of low interobserver variability and good prognostic significance, SARIFA seems to be a promising histomorphological prognostic indicator in adipose-infiltrative adenocarcinomas of the colon. Further studies should validate our results and also determine whether SARIFA is a universal prognostic indicator in solid cancers.
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Affiliation(s)
- Benedikt Martin
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Bianca Grosser
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Lana Kempkens
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Silvia Miller
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Svenja Bauer
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Christine Dhillon
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Bettina Monika Banner
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Eva-Maria Brendel
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Éva Sipos
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
| | - Dmytro Vlasenko
- General, Visceral and Transplantation Surgery, University Hospital of Augsburg, 86156 Augsburg, Germany;
| | - Gerhard Schenkirsch
- Tumor Data Management, University Hospital Augsburg, 86156 Augsburg, Germany;
| | - Stefan Schiele
- Institute of Mathematics, Augsburg University, 86156 Augsburg, Germany; (S.S.); (G.M.)
| | - Gernot Müller
- Institute of Mathematics, Augsburg University, 86156 Augsburg, Germany; (S.S.); (G.M.)
| | - Bruno Märkl
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, 86156 Augsburg, Germany; (B.M.); (B.G.); (L.K.); (S.M.); (S.B.); (C.D.); (B.M.B.); (E.-M.B.); (É.S.)
- Correspondence: ; Tel.: +49-8214002150
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Glückstein MI, Dintner S, Arndt TT, Vlasenko D, Schenkirsch G, Agaimy A, Müller G, Märkl B, Grosser B. Comprehensive Immunohistochemical Study of the SWI/SNF Complex Expression Status in Gastric Cancer Reveals an Adverse Prognosis of SWI/SNF Deficiency in Genomically Stable Gastric Carcinomas. Cancers (Basel) 2021; 13:3894. [PMID: 34359794 PMCID: PMC8345509 DOI: 10.3390/cancers13153894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022] Open
Abstract
The SWI/SNF complex has important functions in the mobilization of nucleosomes and consequently influences gene expression. Numerous studies have demonstrated that mutations or deficiency of one or more subunits can have an oncogenic effect and influence the development, progression, and eventual therapy resistance of tumor diseases. Genes encoding subunits of the SWI/SNF complex are mutated in approximately 20% of all human tumors. This study aimed to investigate the frequency, association with clinicopathological characteristics, and prognosis of immunohistochemical expression of proteins of the SWI/SNF complexes, SMARCA2, SMARCA4 SMARCB1, ARID1A, ARID1B, and PBRM1 in 477 adenocarcinomas of the stomach and gastroesophageal junction. Additionally, the tumors were classified immunohistochemically in analogy to The Cancer Genome Atlas (TCGA) classification. Overall, 32% of cases demonstrated aberrant expression of the SWI/SNF complex. Complete loss of SMARCA4 was detected in three cases (0.6%) and was associated with adverse clinical characteristics. SWI/SNF aberration emerged as an independent negative prognostic factor for overall survival in genomically stable patients in analogy to TCGA. In conclusion, determination of SWI/SNF status could be suggested in routine diagnostics in genomically stable tumors to identify patients who might benefit from new therapeutic options.
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Affiliation(s)
- Marie-Isabelle Glückstein
- Institute of General Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany; (M.-I.G.); (S.D.); (T.T.A.); (B.M.)
| | - Sebastian Dintner
- Institute of General Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany; (M.-I.G.); (S.D.); (T.T.A.); (B.M.)
| | - Tim Tobias Arndt
- Institute of General Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany; (M.-I.G.); (S.D.); (T.T.A.); (B.M.)
- Institute of Mathematics and Computational Statistics, University of Augsburg, 86159 Augsburg, Germany;
| | - Dmytro Vlasenko
- Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, 86156 Augsburg, Germany;
| | - Gerhard Schenkirsch
- Tumor Data Management, University Hospital Augsburg, 86156 Augsburg, Germany;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Gernot Müller
- Institute of Mathematics and Computational Statistics, University of Augsburg, 86159 Augsburg, Germany;
| | - Bruno Märkl
- Institute of General Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany; (M.-I.G.); (S.D.); (T.T.A.); (B.M.)
| | - Bianca Grosser
- Institute of General Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany; (M.-I.G.); (S.D.); (T.T.A.); (B.M.)
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Hirschbühl K, Dintner S, Beer M, Wylezich C, Schlegel J, Delbridge C, Borcherding L, Lippert J, Schiele S, Müller G, Moiraki D, Spring O, Wittmann M, Kling E, Braun G, Kröncke T, Claus R, Märkl B, Schaller T. Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach. PLoS One 2021; 16:e0254872. [PMID: 34280238 PMCID: PMC8289110 DOI: 10.1371/journal.pone.0254872] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 04/25/2021] [Accepted: 07/05/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND COVID-19 is only partly understood, and the level of evidence available in terms of pathophysiology, epidemiology, therapy, and long-term outcome remains limited. During the early phase of the pandemic, it was necessary to effectively investigate all aspects of this new disease. Autopsy can be a valuable procedure to investigate the internal organs with special techniques to obtain information on the disease, especially the distribution and type of organ involvement. METHODS During the first wave of COVID-19 in Germany, autopsies of 19 deceased patients were performed. Besides gross examination, the organs were analyzed with standard histology and polymerase-chain-reaction for SARS-CoV-2. Polymerase chain reaction positive localizations were further analyzed with immunohistochemistry and RNA-in situ hybridization for SARS-CoV-2. RESULTS Eighteen of 19 patients were found to have died due to COVID-19. Clinically relevant histological changes were only observed in the lungs. Diffuse alveolar damage in considerably different degrees was noted in 18 cases. Other organs, including the central nervous system, did not show specific micromorphological alterations. In terms of SARS-CoV-2 detection, the focus remains on the upper airways and lungs. This is true for both the number of positive samples and the viral load. A highly significant inverse correlation between the stage of diffuse alveolar damage and viral load was found on a case and a sample basis. Mediastinal lymph nodes and fat were also affected by the virus at high frequencies. By contrast, other organs rarely exhibited a viral infection. Moderate to strong correlations between the methods for detecting SARS-CoV-2 were observed for the lungs and for other organs. CONCLUSIONS The lung is the most affected organ in gross examination, histology and polymerase chain reaction. SARS-CoV-2 detection in other organs did not reveal relevant or specific histological changes. Moreover, we did not find CNS involvement.
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Affiliation(s)
- Klaus Hirschbühl
- Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Sebastian Dintner
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Martin Beer
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Claudia Wylezich
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Jürgen Schlegel
- Department of Neuropathology, School of Medicine, Institute of Pathology, Technical University Munich, Munich, Germany
| | - Claire Delbridge
- Department of Neuropathology, School of Medicine, Institute of Pathology, Technical University Munich, Munich, Germany
| | - Lukas Borcherding
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Jirina Lippert
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Dimitra Moiraki
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Oliver Spring
- Anesthesiology and Operative Intensive Care Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Michael Wittmann
- Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Elisabeth Kling
- Microbiology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Georg Braun
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Thomas Kröncke
- Diagnostic and Interventional Radiology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Rainer Claus
- Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Bruno Märkl
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Tina Schaller
- General Pathology and Molecular Diagnostics, Medical Faculty, University of Augsburg, Augsburg, Germany
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Löhr P, Schiele S, Arndt TT, Grützner S, Claus R, Römmele C, Müller G, Schmid C, Dennehy KM, Rank A. Impact of age and gender on lymphocyte subset counts in patients with COVID-19. Cytometry A 2021; 103:127-135. [PMID: 34125495 PMCID: PMC8426831 DOI: 10.1002/cyto.a.24470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/05/2021] [Accepted: 05/25/2021] [Indexed: 12/15/2022]
Abstract
In symptomatic patients with acute Coronavirus disease 2019 (COVID-19), lymphocytopenia is one of the most prominent laboratory findings. However, to date age and gender have not been considered in assessment of COVID-19-related cell count alterations. In this study, the impact of COVID-19 as well as age and gender on a large variety of lymphocyte subsets was analyzed in 33 COVID-19 patients and compared with cell counts in 50 healthy humans. We confirm that cell counts of total lymphocytes, B, NK, cytotoxic and helper T cells are reduced in patients with severe COVID-19, and this tendency was observed in patients with moderate COVID-19. Decreased cell counts were also found in all subsets of these cell types, except for CD4+ and CD8+ effector memory RA+ (EMRA) and terminal effector CD8+ cells. In multivariate analysis however, we show that in addition to COVID-19, there is an age-dependent reduction of total, central memory (CM), and early CD8+ cell subsets, as well as naïve, CM, and regulatory CD4+ cell subsets. Remarkably, reduced naïve CD8+ cell counts could be attributed to age alone, and not to COVID-19. By contrast, decreases in other subsets could be largely attributed to COVID-19, and only partly to age. In addition to COVID-19, male gender was a major factor influencing lower counts of CD3+ and CD4+ lymphocyte numbers. Our study confirms that cell counts of lymphocytes and their subsets are reduced in patients with COVID-19, but that age and gender must be considered when interpreting the altered cell counts.
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Affiliation(s)
- Phillip Löhr
- Department of Hematology and Oncology, Medical FacultyUniversity of AugsburgAugsburgGermany
| | - Stefan Schiele
- Institute of MathematicsFaculty of Mathematics and Natural Sciences, University of AugsburgAugsburgGermany
| | - Tim Tobias Arndt
- Institute of MathematicsFaculty of Mathematics and Natural Sciences, University of AugsburgAugsburgGermany
| | - Stefanie Grützner
- Institute for Transfusion Medicine and HaemostasisMedical Faculty, University of AugsburgAugsburgGermany
| | - Rainer Claus
- Department of Hematology and Oncology, Medical FacultyUniversity of AugsburgAugsburgGermany
| | - Christoph Römmele
- Department of Gastroenterology and Infectious Diseases, Medical FacultyUniversity of AugsburgAugsburgGermany
| | - Gernot Müller
- Institute of MathematicsFaculty of Mathematics and Natural Sciences, University of AugsburgAugsburgGermany
| | - Christoph Schmid
- Department of Hematology and Oncology, Medical FacultyUniversity of AugsburgAugsburgGermany
| | - Kevin M. Dennehy
- Institute for Laboratory Medicine and MicrobiologyMedical Faculty, University of AugsburgAugsburgGermany
| | - Andreas Rank
- Department of Hematology and Oncology, Medical FacultyUniversity of AugsburgAugsburgGermany
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23
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Schiele S, Arndt TT, Martin B, Miller S, Bauer S, Banner BM, Brendel EM, Schenkirsch G, Anthuber M, Huss R, Märkl B, Müller G. Deep Learning Prediction of Metastasis in Locally Advanced Colon Cancer Using Binary Histologic Tumor Images. Cancers (Basel) 2021; 13:2074. [PMID: 33922988 PMCID: PMC8123276 DOI: 10.3390/cancers13092074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 12/12/2022] Open
Abstract
In this study, we developed the Binary ImaGe Colon Metastasis classifier (BIg-CoMet), a semi-guided approach for the stratification of colon cancer patients into two risk groups for the occurrence of distant metastasis, using an InceptionResNetV2-based deep learning model trained on binary images. We enrolled 291 colon cancer patients with pT3 and pT4 adenocarcinomas and converted one cytokeratin-stained representative tumor section per case into a binary image. Image augmentation and dropout layers were incorporated to avoid overfitting. In a validation collective (n = 128), BIg-CoMet was able to discriminate well between patients with and without metastasis (AUC: 0.842, 95% CI: 0.774-0.911). Further, the Kaplan-Meier curves of the metastasis-free survival showed a highly significant worse clinical course for the high-risk group (log-rank test: p < 0.001), and we demonstrated superiority over other established risk factors. A multivariable Cox regression analysis adjusted for confounders supported the use of risk groups as a prognostic factor for the occurrence of metastasis (hazard ratio (HR): 5.4, 95% CI: 2.5-11.7, p < 0.001). BIg-CoMet achieved good performance for both UICC subgroups, especially for UICC III (n = 53), with a positive predictive value of 80%. Our study demonstrates the ability to stratify colon cancer patients via a semi-guided process on images that primarily reflect tumor architecture.
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Affiliation(s)
- Stefan Schiele
- Institute of Mathematics, Augsburg University, 86159 Augsburg, Germany; (T.T.A.); (G.M.)
| | - Tim Tobias Arndt
- Institute of Mathematics, Augsburg University, 86159 Augsburg, Germany; (T.T.A.); (G.M.)
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Benedikt Martin
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Silvia Miller
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Svenja Bauer
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Bettina Monika Banner
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Eva-Maria Brendel
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Gerhard Schenkirsch
- Tumor Data Management, University Hospital of Augsburg, 86156 Augsburg, Germany;
| | - Matthias Anthuber
- General, Visceral, and Transplantation Surgery, University Hospital of Augsburg, 86156 Augsburg, Germany;
| | - Ralf Huss
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Bruno Märkl
- General Pathology and Molecular Diagnostics, Medical Faculty, 86156 Augsburg, Germany; (B.M.); (S.M.); (S.B.); (B.M.B.); (E.-M.B.); (R.H.); (B.M.)
| | - Gernot Müller
- Institute of Mathematics, Augsburg University, 86159 Augsburg, Germany; (T.T.A.); (G.M.)
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Papachristou I, Akaberi S, Silve A, Navarro-López E, Wüstner R, Leber K, Nazarova N, Müller G, Frey W. Analysis of the lipid extraction performance in a cascade process for Scenedesmus almeriensis biorefinery. Biotechnol Biofuels 2021; 14:20. [PMID: 33446259 PMCID: PMC7807813 DOI: 10.1186/s13068-020-01870-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/27/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Microalgae have attracted considerable interest due to their ability to produce a wide range of valuable compounds. Pulsed Electric Fields (PEF) has been demonstrated to effectively disrupt the microalgae cells and facilitate intracellular extraction. To increase the commercial viability of microalgae, the entire biomass should be exploited with different products extracted and valorized according to the biorefinery scheme. However, demonstrations of multiple component extraction in series are very limited in literature. This study aimed to develop an effective lipid extraction protocol from wet Scenedesmus almeriensis after PEF-treatment with 1.5 MJ·kgDW-1. A cascade process, i.e., the valorization of several products in row, was tested with firstly the collection of the released carbohydrates in the water fraction, then protein enzymatic hydrolysis and finally lipid extraction. Biomass processed with high pressure homogenization (HPH) on parallel, served as benchmark. RESULTS Lipid extraction with ethanol:hexane (1:0.41 vol/vol) offered the highest yields from the different protocols tested. PEF-treatment promoted extraction with almost 70% of total lipids extracted against 43% from untreated biomass. An incubation step after PEF-treatment, further improved the yields, up to 83% of total lipids. Increasing the solvent volume by factor 2 offered no improvement. In comparison, extraction with two other systems utilizing only ethanol at room temperature or elevated at 60 °C were ineffective with less than 30% of total lipids extracted. Regarding cascade extraction, carbohydrate release after PEF was detected albeit in low concentrations. PEF-treated samples displayed slightly better kinetics during the enzymatic protein hydrolysis compared to untreated or HPH-treated biomass. The yields from a subsequent lipid extraction were not affected after PEF but were significantly increased for untreated samples (66% of total lipids), while HPH displayed the lowest yields (~ 49% of total lipids). CONCLUSIONS PEF-treatment successfully promoted lipid extraction from S. almeriensis but only in combination with a polar:neutral co-solvent (ethanol:hexane). After enzymatic protein hydrolysis in cascade processing; however, untreated biomass displayed equal lipid yields due to the disruptive effect of the proteolytic enzymes. Therefore, the positive impact of PEF in this scheme is limited on the improved reaction kinetics exhibited during the enzymatic hydrolysis step.
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Affiliation(s)
- I Papachristou
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany.
| | - S Akaberi
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - A Silve
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - E Navarro-López
- Department of Chemical Engineering, University of Almería, 04120, Almería, Spain
| | - R Wüstner
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - K Leber
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - N Nazarova
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - G Müller
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
| | - W Frey
- Institute for Pulsed Power and Microwave Technology (IHM), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, Bldg 630, 76344, Eggenstein-Leopoldshafen, Germany
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Frenzen FS, Loewe I, Müller G, Schoenlebe J, Tappe D, Teichmann D. Dirofilaria repens infection of the eye with concomitant microfilaremia in a traveller. J Travel Med 2021; 28:5875517. [PMID: 32701137 DOI: 10.1093/jtm/taaa119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 02/04/2023]
Abstract
Dirofilaria repens is the main causative agent of human and canine dirofilariosis. This form of zoonotic parasitosis usually manifests with an involvement of the skin or the eye. Human dirofilariosis is considered as an emerging infectious disease. We report the first case of proven microfilariemic dirofilariosis in peripheral blood in Germany.
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Affiliation(s)
- Frederik Stephan Frenzen
- Center for Infectious Diseases, Travel and Tropical Medicine, Municipal Hospital of Dresden, Saxony, Germany
| | - Ines Loewe
- Clinic for Ophthalmology, Municipal Hospital of Dresden, Saxony, Germany
| | - Gernot Müller
- Center for Infectious Diseases, Travel and Tropical Medicine, Municipal Hospital of Dresden, Saxony, Germany
| | | | - Dennis Tappe
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dieter Teichmann
- Center for Infectious Diseases, Travel and Tropical Medicine, Municipal Hospital of Dresden, Saxony, Germany
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26
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Serbun P, Porshyn V, Müller G, Lützenkirchen-Hecht D. Response to "Comment on 'Advanced field emission measurement techniques for research on modern cold cathode materials and their applications for transmission-type x-ray sources'" [Rev. Sci. Instrum. 91, 107101 (2020)]. Rev Sci Instrum 2020; 91:107102. [PMID: 33138594 DOI: 10.1063/5.0026863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Affiliation(s)
- P Serbun
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - V Porshyn
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - G Müller
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - D Lützenkirchen-Hecht
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
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27
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Serbun P, Porshyn V, Müller G, Lützenkirchen-Hecht D. Advanced field emission measurement techniques for research on modern cold cathode materials and their applications for transmission-type x-ray sources. Rev Sci Instrum 2020; 91:083906. [PMID: 32872899 DOI: 10.1063/5.0018225] [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] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
We report on the functional capabilities of our field emission (FE) measurement systems. The samples are prepared and inserted under clean room conditions and can be precisely xyz-positioned, heat-treated, and investigated in different vacuum environments and temperatures. The FE scanning microscope is a unique microscope being used for the localization of FE sites with high lateral resolution by means of extraction voltage U(x, y) or emission current I(x, y) maps over the cathode area of 25 × 25 mm2 and measuring the FE properties of localized emission sites or individual emitters. In contrast, the integral measurement system with the luminescent screen provides real-time integral information about the distribution of emission sites over the whole cathode during long- and short-term current stability measurements, thus allowing us to investigate the properties of various materials and their applications. Commissioning results with the upgraded systems using a silicon emitter array and a point-type graphene emitter will be given to demonstrate that both FE measurement techniques are very useful for an improved understanding and tailoring of materials for applications. The results showed that point-type graphene emitters are more preferable for practical applications. Using simulation software, a suitable triode configuration for point emitters was designed, and a current transmission ratio of ∼100% was obtained. The FE current stability of graphene emitters at pressures >10-3 Pa can be improved by heating the cathode at 100 °C-300 °C for 1 min-30 min. Finally, point-type graphene film emitters were used for transmission-type x-ray sources, and their applications in imaging and fluorescence spectroscopy are presented.
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Affiliation(s)
- P Serbun
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - V Porshyn
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - G Müller
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
| | - D Lützenkirchen-Hecht
- School of Mathematics and Natural Sciences, University of Wuppertal, Wuppertal D-42119, Germany
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28
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Frenzen F, Müller G, Frenzen K. [The Respiratory Syncytial Virus (RSV) in Adults]. Pneumologie 2020; 74:374-386. [PMID: 32557509 DOI: 10.1055/a-0853-2881] [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
RSV induces an acute viral disease with involvement of the respiratory tract. It can be notably life-threatening for infants but also for older adults. New RSV-subtypes are constantly evolving globally. The knowledge about epidemiology, hygiene measures, diagnostics and clinical feature is essential not only for the paediatrician. Vaccines or specific therapeutics are still missing. This article gives an overview with focus on RSV in adults. In addition, molecular pathological characteristics of the virus are explained, research approaches concerning vaccines and therapeutics are mentioned and current problems in management are discussed.
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29
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Hochstätter R, Schütz A - M, Müller G, Tomasch G, Reif P, Tamussino K, Schöll W. Enhanced Recovery After Surgery (ERAS)-Empfehlungen bei der Kaiserschittentbindung – werden sie in Graz umgesetzt? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - M Schütz A -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - G Müller
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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30
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Hochstätter R, Schütz A - M, Müller G, Tomasch G, Reif P, Tammaa A, Oppelt P, Husslein PW, Hartmann B, Ramoni A, Reisenberger K, Maier B, Mörtl M, Wagner T, Hefler L, Gamper C, Aigmüller T, Tamussino K, Schöll W. Enhanced Recovery After Surgery (ERAS)-Empfehlungen bei der Kaiserschittentbindung – wie weit werden sie in Österreich angewandt? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - M Schütz A -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - G Müller
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - A Tammaa
- Abteilung für Gynäkologie und Geburtshilfe, Krankenhaus Nord Floridsdorf
| | - P Oppelt
- Gynäkologie, Geburtshilfe und Gyn. Endokrinologie, Kepler Universitätsklinikum Linz
| | - P W Husslein
- Univ. Klinik für Frauenheilkunde, AKH – Medizinische Universität Wien
| | - B Hartmann
- Geburtshilflich-Gynäkologische Abteilung, Sozialmedizinisches Zentrum Ost Wien
| | - A Ramoni
- Univ.-Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - K Reisenberger
- Abteilung für Frauenheilkunde und Geburtshilfe, Klinikum Wels-Grieskirchen, Standort Wels
| | - B Maier
- Gynäkologisch-geburtshilfliche Abteilung, Wilhelminenspital Wien
| | - M Mörtl
- Abteilung für Gynäkologie und Geburtshilfe, LKH Klagenfurt
| | - T Wagner
- Gynäkologisch-geburtshilfliche Abteilung, Sozialmedizinisches Zentrum Süd Wien
| | - L Hefler
- Abteilung für Gynäkologie & Geburtshilfe, BHB Linz
| | - C Gamper
- Abteilung für Gynäkologie und Geburtshilfe, Landesklinikum Wiener Neustadt
| | - T Aigmüller
- Abteilung für Frauenheilkunde und Geburtshilfe, Landeskrankenhaus Hochsteiermark, Standort Leoben
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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Papachristou I, Silve A, Jianu A, Wüstner R, Nazarova N, Müller G, Frey W. Evaluation of pulsed electric fields effect on the microalgae cell mechanical stability through high pressure homogenization. ALGAL RES 2020. [DOI: 10.1016/j.algal.2020.101847] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Olfe J, Diaz-Gil D, Von Kodolitsch Y, Kozlik-Feldmann R, Müller G, Stark V, Mir T. Early and Easy Diagnosis of Marfan’s Syndrome in Children: Utility of AV Valve Prolapse at Primary Consultation. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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33
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Diaz-Gil D, Von Kodolitsch Y, Kozlik-Feldmann R, Müller G, Olfe J, Stark V, Wipper SH, Mir T. Neonatal Marfan’s Syndrome in Its Maximum Expression: An Ambitious Course with Multidisciplinary Approach until Adolescence. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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34
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Degener F, Opgen-Rhein B, Wagner R, Boehne M, Boecker D, Reineker K, Wiegand G, Racolta A, Müller G, Kiski D, Rentzsch A, Fischer M, Papakostas K, Ruf B, Hannes T, Khalil M, Kaestner M, Steinmetz M, ÖZcan S, Fischer G, Freudenthal N, Schweigmann U, Pickardt T, Huber C, Messroghli D, Schubert S. Prognostic Parameters for a Severe Disease Course in Pediatric Patients with Suspected Myocarditis: Data from the Prospective Multicenter Registry “MYKKE”. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | | | | | | | - G. Wiegand
- University of Tuebingen, Tuebingen, Germany
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Olfe J, Diaz-Gil D, Von Kodolitsch Y, Kozlik-Feldmann R, Kutsche K, Müller G, Stark V, Mir T. Looks Like Marfan’s Syndrome But It’s Not. Beals–Hecht Syndrome as a Rare Differential Diagnosis. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hatch DJ, Freude G, Martus P, Rose U, Müller G, Potter GG. Age, burnout and physical and psychological work ability among nurses. Occup Med (Lond) 2019; 68:246-254. [PMID: 29590486 DOI: 10.1093/occmed/kqy033] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The ageing of the US labour force highlights the need to examine older adults' physical and psychological ability to work, under varying levels of occupational burnout. Aims To examine how age and burnout interact in predicting physical and psychological work ability. Methods Using a cohort of actively working nurses, we assessed factors on the Work Ability Index at 12-month follow-up and determined how these were related to age and exhaustion-related burnout at baseline. Results The study group consisted of 402 nurses aged 25-67 (mean = 41.7). Results indicated age by burnout interactions in which decrements in physical work ability with greater age were observed at all but the lowest level of burnout (1.5 SD below mean: β = -0.14, 95% CI -0.36, 0.07; 1 SD below: β = -0.23, 95% CI -0.39, -0.06; mean: β = -0.39, 95% CI -0.50, -0.29; 1 SD above: β = -0.56, 95% CI -0.70, -0.42; 1.5 SD above: β = -0.64, 95% CI -0.83, -0.46). In contrast, we observed decrements in psychological work ability with age at higher levels of burnout only (1 SD above: β = -0.20, 95% CI -0.35, -0.05; 1.5 SD above: β = -0.30, 95% CI -0.49, -0.11); at lower levels of burnout, older age was associated with improvements in this (1 SD below: β = 0.19, 95% CI 0.03, 0.35; 1.5 SD below: β = 0.29, 95% CI 0.08, 0.50). Conclusions Findings indicated physical and psychological dimensions of work ability that differed by age and occupational burnout. This emphasizes the need for interventions to reduce burnout and to address age-related strengths and vulnerabilities relating to physical and psychological work ability.
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Affiliation(s)
- D J Hatch
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - G Freude
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - P Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, University Tübingen, Tübingen, Germany
| | - U Rose
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - G Müller
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - G G Potter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Blumentrath CG, Müller G, Teichmann D, Tiesmeier J, Petridou J. Relapse of typhoid fever following delayed response to meropenem: A case report and review of previously published cases indicating limited clinical efficacy of meropenem for the treatment of typhoid fever. Ger Med Sci 2019; 17:Doc01. [PMID: 30837820 PMCID: PMC6388674 DOI: 10.3205/000267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 12/21/2018] [Indexed: 11/30/2022]
Abstract
In times of emerging multi-drug resistance among Gram-negative bacteria (including Salmonella enterica, Serovar Typhi), we observed relapse of typhoid fever following delayed response to treatment with meropenem, suggestive for limited clinical efficacy of the drug. Three previously published cases supported our suspicion. Within this context, we discuss the case details with a focus on potential explanations for insufficient clinical response to meropenem (e.g. limited intracellular penetration, phenomena of tolerance and persistence). Meropenem is a last-resort antimicrobial agent for the treatment of multi-drug resistant Gram-negative infections. Reliable clinical data evaluating the efficacy of meropenem for the treatment of typhoid fever are urgently needed. Future clinical studies evaluating typhoid fever outcome should also investigate the impact of (i) intracellular penetration of antibiotics, and (ii) tolerance and persistence on outcome.
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Affiliation(s)
- Christian G Blumentrath
- Clinic for Cardiology, Angiology and Intensive Care Medicine, Klinikum Lippe Detmold, Germany
| | - Gernot Müller
- Department of Infectious Diseases and Tropical Medicine, Städtisches Klinikum Dresden, Germany
| | - Dieter Teichmann
- Department of Infectious Diseases and Tropical Medicine, Städtisches Klinikum Dresden, Germany
| | - Jens Tiesmeier
- Institute of Anaesthesiology, Intensive Care and Emergency Medicine, General Hospital Lübbecke-Rahden, Germany
| | - Jasmina Petridou
- Institute of Medical Microbiology, University Hospital Minden, Germany
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Pabst A, Klinghuber M, Müller G, Vandersee S, Werkmeister R. Extensive bony metastases from facial metatypical basal cell carcinoma: a case report. Br J Oral Maxillofac Surg 2019; 57:82-84. [DOI: 10.1016/j.bjoms.2018.10.286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
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Müller G, Pfinder M, Clement M, Kaiserauer A, Deis G, Waber T, Rieger S, Schwarz D, Heinzel-Gutenbrunner M, Straif M, Bös K, Kohlmann T. Therapeutic and economic effects of multimodal back exercise: A controlled multicentre study. J Rehabil Med 2019; 51:61-70. [DOI: 10.2340/16501977-2497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Müller G, Rose U. Burnout and work ability and the role of shift work – results from the Study on Mental Health at Work. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.279] [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: 11/12/2022] Open
Affiliation(s)
- G Müller
- Federal Institute for Occupational Safety and Health, Dortmund, Germany
| | - U Rose
- Federal Institute for Occupational Safety and Health, Berlin, Germany
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Frings J, Akoto R, Müller G, Frosch KH. Knöcherne Ausrisse des hinteren Kreuzbandes. Arthroskopie 2018. [DOI: 10.1007/s00142-017-0162-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jacod J, Klüppelberg C, Müller G. Functional Relationships Between Price and Volatility Jumps and Their Consequences for Discretely Observed Data. J Appl Probab 2018. [DOI: 10.1239/jap/1354716647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many prominent continuous-time stochastic volatility models exhibit certain functional relationships between price jumps and volatility jumps. We show that stochastic volatility models like the Ornstein–Uhlenbeck and other continuous-time CARMA models as well as continuous-time GARCH and EGARCH models all exhibit such functional relations. We investigate the asymptotic behaviour of certain functionals of price and volatility processes for discrete observations of the price process on a grid, which are relevant for estimation and testing problems.
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Kreutzer R, Müller G, Leeb T, Brenig B, Moritz A, Baumgärtner W. Ein Gentest für die GM1-Gangliosidose beim Alaskan Husky. Tierarztl Prax Ausg K 2018. [DOI: 10.1055/s-0038-1622617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Zusammenfassung:
Gegenstand und Ziel: Die GM1-Gangliosidose der Alaskan Huskies ist eine angeborene Erkrankung, die durch einen autosomal rezessiv vererbten Defekt des Gens für die saure β-Galaktosidase (GLB1) hervorgerufen wird. Klinisch zeigen die Tiere Minderwuchs sowie, beginnend im Alter von sechs bis acht Wochen, neurologische Ausfallerscheinungen wie Ataxie und Dysmetrie. Zur gezielten Vermeidung dieser Erkrankung ist es für Zuchtentscheidungen wichtig, Anlageträger für den Defekt sicher identifizieren zu können. Material und Methode: Die Spezifität und Sensitivität eines kürzlich beschriebenen Gentests zum direkten Nachweis des genetischen Defekts bei der GM1-Gangliosidose des Alaskan Husky wurde mit der biochemischen Bestimmung der enzymatischen Aktivität der β-Galaktosidase aus isolierten Hautfibroblasten, klinischen und pathologischen Befunden sowie einer Stammbaumanalyse verglichen. Ergebnisse: Die β-Galaktosidase-Enzymaktivitäten von Anlageträgern lagen im Durchschnitt niedriger als die Enzymaktivitäten homozygot gesunder Hunde. Da sich jedoch die Werte der beiden Gruppen überlappten, war eine sichere Identifizierung von Anlageträgern mit der biochemischen Analyse nicht möglich. Demgegenüber erlaubte der Gentest eine eindeutige Unterscheidung zwischen homozygot gesunden Tieren und Anlageträgern. Schlussfolgerung: Der Gentest ist der biochemischen Diagnostik überlegen. Klinische Relevanz: Mithilfe des Gentests können die phänotypisch unauffälligen Anlageträger sicher identifiziert werden. Damit lassen sich Anpaarungen von zwei Anlageträgern verhindern und das Auftreten der GM1-Gangliosidose kann zukünftig vermieden werden.
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Kozlik-Feldmann R, Le T, Lorber A, Sievert H, Ewert P, Jux C, Müller G, Dalla R, Yigitbasi M, Schranz D, Lindinger A, Galal O, Meinertz T. Safety and Effectiveness of the Nit-Occlud Lê VSD Coil System for VSD Occlusion: Long-term Outcome in 93 Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Kozlik-Feldmann
- Klinik f. Kinderkardiologie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - T.P. Le
- Klinik f. Kinderkardiologie, Zentralkrankenhaus Links der Weser, Bremen, Germany
| | - A. Lorber
- Meyer Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Department of Pediatric Cardiology and Adults with Congenital Heart Disease, Haifa, Israel
| | - H. Sievert
- Kardiovaskuläres Zentrum Frankfurt, Sankt Katharinen, Frankfurt, Germany
| | - P. Ewert
- Klinik für Angeborene Herzfehler / Kinderkardiologie, Deutsches Herzzentrum München, München, Germany
| | - C. Jux
- Klinik für Kinderkardiologie und angeborene Herzfehler, Universitätsklinikum Gießen und Marburg GmbH, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - G. Müller
- Klinik f. Kinderkardiologie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - R. Dalla
- Klinikum der Universität München, Großhadern, Abt. f. Kinderkardiologie und päd. Intensivmedizin, München, Germany
| | - M. Yigitbasi
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
| | - D. Schranz
- Klinik für Kinderkardiologie und angeborene Herzfehler, Universitätsklinikum Gießen und Marburg GmbH, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - A. Lindinger
- Member of the Data Safety and Monitoring Board, Westpfalz-Klinikum, Kinderkardiologie, Kaiserslautern, Germany
| | - O. Galal
- Member of the Data Safety and Monitoring Board, King Faisal Specialist Hospital & RC, Pediatric Cardiology, Jeddah, Saudi Arabia
| | - T. Meinertz
- Principal Investigator and Member of the Data Safety and Monitoring Board, Hamburg, Germany
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von Stumm M, Gasser S, Buchholz C, Riso A, Müller G, Kozlik-Feldmann R, Reichenspurner H, Biermann D, Sachweh J. A Novel Technique to Repair Absence of Right Pulmonary Artery. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. von Stumm
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - S. Gasser
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - C. Buchholz
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - A. Riso
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - G. Müller
- Abteilung für Kinderkardiologie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - R. Kozlik-Feldmann
- Abteilung für Kinderkardiologie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - H. Reichenspurner
- Abteilung für Herzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - D. Biermann
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
| | - J.S. Sachweh
- Abteilung für Kinderherzchirurgie, Universitäres Herzzentrum Hamburg, UKE, Hamburg, Germany
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Degener F, Opgen-Rhein B, Böhne M, Weigelt A, Wagner R, Müller G, Racolta A, Rentzsch A, Papakostas K, Reineker K, Kiski D, Ruf B, Wiegand G, Hannes T, Khalil M, Fischer M, Kaestner M, Steinmetz M, Fischer G, Freudenthal N, Pickardt T, Messroghli D, Schubert S. Four-Year Experience of the German Multicenter Registry for Pediatric Patients with Suspected Myocarditis: MYKKE. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F. Degener
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
| | - B. Opgen-Rhein
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Kardiologie, Berlin, Germany
| | - M. Böhne
- Medizinische Hochschule Hannover, Kinderkardiologie, Hannover, Germany
| | - A. Weigelt
- Universitätsklinikum Erlangen, Kinderkardiologie, Erlangen, Germany
| | - R. Wagner
- Herzzentrum Leipzig, Kinderkardiologie, Leipzig, Germany
| | - G. Müller
- Universitäres Herzzentrum Hamburg, Kinderkardiologie, Hamburg, Germany
| | - A. Racolta
- Herz- und Diabeteszentrum NRW, Zentrum für angeborene Herzfehler, Bad Oeynhausen, Germany
| | - A. Rentzsch
- Universität des Saarlandes, Kinderkardiologie, Homburg/Saar, Germany
| | - K. Papakostas
- Klinikum Links der Weser, Strukturelle und angeborene Herzfehler / Kinderkardiologie, Bremen, Germany
| | - K. Reineker
- Universitäts Herzzentrum Freiburg Bad Krozingen, Kinderkardiologie, Freiburg, Germany
| | - D. Kiski
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin/Pädiatrische Kardiologie, Münster, Germany
| | - B. Ruf
- Deutsches Herzzentrum München, Technische Universität München, Angeborene Herzfehler/Kinderkardiologie, München, Germany
| | - G. Wiegand
- Universitätskinderklinik Tübingen, Kinderkardiologie, Tübingen, Germany
| | - T. Hannes
- Uniklinik Köln, Klinik für angeborene Herzfehler und Pädiatrische Kardiologie, Köln, Germany
| | - M. Khalil
- Universitätsklinik Giessen, Abteilung für Kinderkardiologie, Giessen, Germany
| | - M. Fischer
- Klinikum der Universität München, Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, München, Germany
| | - M. Kaestner
- Universitätsklinikum Ulm, Kinderkardiologie, Ulm, Germany
| | - M. Steinmetz
- Universitätsmedizin Göttingen, Klinik für Pädiatrische Kardiologie und Intensivmedizin, Göttingen, Germany
| | - G. Fischer
- Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Germany
| | - N. Freudenthal
- Universitätsklinikum Bonn, Abteilung für Kinderkardiologie, Bonn, Germany
| | - T. Pickardt
- Kompetenznetz Angeborene Herzfehler, Berlin, Germany
| | - D. Messroghli
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Berlin, Berlin, Germany
| | - S. Schubert
- Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
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Aab A, Abreu P, Aglietta M, Al Samarai I, Albuquerque I, Allekotte I, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Anastasi G, Anchordoqui L, Andrada B, Andringa S, Aramo C, Arqueros F, Arsene N, Asorey H, Assis P, Aublin J, Avila G, Badescu A, Balaceanu A, Barbato F, Barreira Luz R, Beatty J, Becker K, Bellido J, Berat C, Bertaina M, Bertou X, Biermann P, Biteau J, Blaess S, Blanco A, Blazek J, Bleve C, Boháčová M, Boncioli D, Bonifazi C, Borodai N, Botti A, Brack J, Brancus I, Bretz T, Bridgeman A, Briechle F, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora K, Caccianiga L, Cancio A, Canfora F, Caramete L, Caruso R, Castellina A, Catalani F, Cataldi G, Cazon L, Chavez A, Chinellato J, Chudoba J, Clay R, Cobos A, Colalillo R, Coleman A, Collica L, Coluccia M, Conceição R, Consolati G, Contreras F, Cooper M, Coutu S, Covault C, Cronin J, D’Amico S, Daniel B, Dasso S, Daumiller K, Dawson B, de Almeida R, de Jong S, De Mauro G, de Mello Neto J, De Mitri I, de Oliveira J, de Souza V, Debatin J, Deligny O, Díaz Castro M, Diogo F, Dobrigkeit C, D’Olivo J, Dorosti Q, dos Anjos R, Dova M, Dundovic A, Ebr J, Engel R, Erdmann M, Erfani M, Escobar C, Espadanal J, Etchegoyen A, Falcke H, Farmer J, Farrar G, Fauth A, Fazzini N, Fenu F, Fick B, Figueira J, Filipčič A, Fratu O, Freire M, Fujii T, Fuster A, Gaior R, García B, Garcia-Pinto D, Gaté F, Gemmeke H, Gherghel-Lascu A, Ghia P, Giaccari U, Giammarchi M, Giller M, Głas D, Glaser C, Golup G, Gómez Berisso M, Gómez Vitale P, González N, Gorgi A, Gorham P, Grillo A, Grubb T, Guarino F, Guedes G, Halliday R, Hampel M, Hansen P, Harari D, Harrison T, Harton J, Haungs A, Hebbeker T, Heck D, Heimann P, Herve A, Hill G, Hojvat C, Holt E, Homola P, Hörandel J, Horvath P, Hrabovský M, Huege T, Hulsman J, Insolia A, Isar P, Jandt I, Johnsen J, Josebachuili M, Jurysek J, Kääpä A, Kambeitz O, Kampert K, Keilhauer B, Kemmerich N, Kemp E, Kemp J, Kieckhafer R, Klages H, Kleifges M, Kleinfeller J, Krause R, Krohm N, Kuempel D, Kukec Mezek G, Kunka N, Kuotb Awad A, Lago B, LaHurd D, Lang R, Lauscher M, Legumina R, Leigui de Oliveira M, Letessier-Selvon A, Lhenry-Yvon I, Link K, Lo Presti D, Lopes L, López R, López Casado A, Lorek R, Luce Q, Lucero A, Malacari M, Mallamaci M, Mandat D, Mantsch P, Mariazzi A, Mariş I, Marsella G, Martello D, Martinez H, Martínez Bravo O, Masías Meza J, Mathes H, Mathys S, Matthews J, Matthews J, Matthiae G, Mayotte E, Mazur P, Medina C, Medina-Tanco G, Melo D, Menshikov A, Merenda KD, Michal S, Micheletti M, Middendorf L, Miramonti L, Mitrica B, Mockler D, Mollerach S, Montanet F, Morello C, Mostafá M, Müller A, Müller G, Muller M, Müller S, Mussa R, Naranjo I, Nellen L, Nguyen P, Niculescu-Oglinzanu M, Niechciol M, Niemietz L, Niggemann T, Nitz D, Nosek D, Novotny V, Nožka L, Núñez L, Ochilo L, Oikonomou F, Olinto A, Palatka M, Pallotta J, Papenbreer P, Parente G, Parra A, Paul T, Pech M, Pedreira F, Pękala J, Pelayo R, Peña-Rodriguez J, Pereira L, Perlin M, Perrone L, Peters C, Petrera S, Phuntsok J, Piegaia R, Pierog T, Pimenta M, Pirronello V, Platino M, Plum M, Porowski C, Prado R, Privitera P, Prouza M, Quel E, Querchfeld S, Quinn S, Ramos-Pollan R, Rautenberg J, Ravignani D, Ridky J, Riehn F, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Fernandez G, Rodriguez Rojo J, Rogozin D, Roncoroni M, Roth M, Roulet E, Rovero A, Ruehl P, Saffi S, Saftoiu A, Salamida F, Salazar H, Saleh A, Salesa Greus F, Salina G, Sánchez F, Sanchez-Lucas P, Santos E, Santos E, Sarazin F, Sarmento R, Sarmiento-Cano C, Sato R, Schauer M, Scherini V, Schieler H, Schimp M, Schmidt D, Scholten O, Schovánek P, Schröder F, Schröder S, Schulz A, Schumacher J, Sciutto S, Segreto A, Shadkam A, Shellard R, Sigl G, Silli G, Sima O, Śmiałkowski A, Šmída R, Smith B, Snow G, Sommers P, Sonntag S, Squartini R, Stanca D, Stanič S, Stasielak J, Stassi P, Stolpovskiy M, Strafella F, Streich A, Suarez F, Suarez Durán M, Sudholz T, Suomijärvi T, Supanitsky A, Šupík J, Swain J, Szadkowski Z, Taboada A, Taborda O, Theodoro V, Timmermans C, Todero Peixoto C, Tomankova L, Tomé B, Torralba Elipe G, Travnicek P, Trini M, Ulrich R, Unger M, Urban M, Valdés Galicia J, Valiño I, Valore L, van Aar G, van Bodegom P, van den Berg A, van Vliet A, Varela E, Vargas Cárdenas B, Varner G, Vázquez R, Veberič D, Ventura C, Vergara Quispe I, Verzi V, Vicha J, Villaseñor L, Vorobiov S, Wahlberg H, Wainberg O, Walz D, Watson A, Weber M, Weindl A, Wiencke L, Wilczyński H, Wileman C, Wirtz M, Wittkowski D, Wundheiler B, Yang L, Yushkov A, Zas E, Zavrtanik D, Zavrtanik M, Zepeda A, Zimmermann B, Ziolkowski M, Zong Z, Zuccarello F. Inferences on mass composition and tests of hadronic interactions from 0.3 to 100 EeV using the water-Cherenkov detectors of the Pierre Auger Observatory. Int J Clin Exp Med 2017. [DOI: 10.1103/physrevd.96.122003] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Tselmin S, Müller G, Schatz U, Julius U, Bornstein S, Hohenstein B. Kinetics of Lipoprotein(a) in patients undergoing weekly lipoprotein apheresis for Lp(a) hyperlipoproteinemia. ATHEROSCLEROSIS SUPP 2017; 30:209-216. [DOI: 10.1016/j.atherosclerosissup.2017.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Erckmann V, Janzen G, Kasparek W, Müller G, Schüller PG, Schwörer K, Thumm M, Wilhelm R. Electron Cyclotron Resonance Heating Experiments in the Wendelstein VII-A Stellarator. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst85-a24543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- V. Erckmann
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - G. Janzen
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - W. Kasparek
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - G. Müller
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - P. G. Schüller
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - K. Schwörer
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - M. Thumm
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
| | - R. Wilhelm
- Institut für Plasmaforschung, Universitat Stuttgart, D-7000 Stuttgart 80 Federal Republic of Germany
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Nübling R, Kaluscha R, Krischak G, Kriz D, Martin H, Müller G, Renzland J, Reuss-Borst M, Schmidt J, Kaiser U, Toepler E. [Outcome Quality in Medical Rehabilitation: Relationship Between "Patient-Reported Outcomes" (PROs) and Social Security Contributions]. REHABILITATION 2017; 56:22-30. [PMID: 28219098 DOI: 10.1055/s-0042-118580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Aim of the Study The outcome quality of medical rehabilitation is evaluated often by "Patient Reported Outcomes" (PROs). It is examined to what extent these PROs are corresponding with "hard" or "objective" outcomes such as payments of contributions to social insurance. Methods The "rehabilitation QM outcome study" includes self-reports of patients as well as data from the Rehabilitation Statistics Database (RSD) of the German pension insurance Baden-Wurttemberg. The sample for the question posed includes N=2 947 insured who were treated in 2011 in 21 clinics of the "health quality network" and who were either employed or unemployed at the time of the rehabilitation application (e. g. the workforce or labour force group, response rate: 55%). The sample turned out widely representative for the population of the insured persons. Results PROs and payment of contributions to pension insurance clearly correspond. In the year after the rehabilitation improved vs. not improved rehabilitees differed clearly with regard to their payments of contributions. Conclusions The results support the validity of PROs. For a comprehensive depiction of the outcome quality of rehabilitation PROs and payments of contributions should be considered supplementary.
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Affiliation(s)
- R Nübling
- Gesellschaft für Qualität im Gesundheitswesen GfQG, Karlsruhe
| | - R Kaluscha
- Institut für Rehabilitationsmedizinische Forschung an der Universität Ulm
| | - G Krischak
- Institut für Rehabilitationsmedizinische Forschung an der Universität Ulm
| | - D Kriz
- Gesellschaft für Qualität im Gesundheitswesen GfQG, Karlsruhe
| | | | | | | | | | - J Schmidt
- Gesellschaft für Qualität im Gesundheitswesen GfQG, Karlsruhe
| | - U Kaiser
- Gesellschaft für Qualität im Gesundheitswesen GfQG, Karlsruhe
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