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Paasch C, Meyer J, Hunger R, Krollmann N, Heisler S, Mantke R. Does the angle of trocar insertion affect the fascial defect caused? A porcine model. Hernia 2024; 28:585-592. [PMID: 38319439 PMCID: PMC10997682 DOI: 10.1007/s10029-023-02952-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/07/2023] [Indexed: 02/07/2024]
Abstract
INTRODUCTION With an incidence of 0-5.2%, trocar site hernias frequently occur following laparoscopy. It is unclear to what extent the angle of trocar insertion affects the size of the fascial defect caused. Hence, we performed a porcine model. METHODS In October 2022, a total of five female pigs were euthanized. In alternating order, three bladeless and two bladed conical 12-mm trocars were inserted at an angle of 45° on each side for 60 min twice each pig. For this purpose, an epoxy resin handmade cuboid with a central channel that runs at an angle of 45° was used. Subsequently, photo imaging and defect size measurement took place. The results were compared with those of our previously conducted and published porcine model, in which the trocars were inserted at an angle of 90°. Effects of trocar type (bladed vs. bladeless) and angle on defect size were analyzed using a mixed model regression analysis. RESULTS The bladeless trocars caused statistically significant smaller defects at the fascia than the bladed (23.4 (SD = 16.9) mm2 vs. 41.3 (SD = 14.8) mm2, p < 0.001). The bladeless VersaOne trocar caused the smallest defect of 16.0 (SD = 6.1) mm2. The bladed VersaOne trocar caused the largest defect of 47.7 (SD = 10.5) mm2. The defect size of the trocars used at a 45° angle averaged 30.5 (SD = 18.3) mm2. The defect size of trocars used at a 90° angle was significantly larger, averaging 58.3 (SD = 20.2) mm2 (p = 0.007). CONCLUSION When conical 12-mm trocars are inserted at a 45° angle, especially bladeless ones, they appear to cause small fascial defects compared with insertion at a 90° angle. This might lead also to a lower rate of trocar hernias. Bladeless trocars might cause smaller fascial defects than bladed trocars.
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Affiliation(s)
- C Paasch
- Department of General and Visceral Surgery, University Hospital Brandenburg an der Havel, Brandenburg Medical University, Clinic for General and Visceral Surgery, Hochstraße 29, 14770, Brandenburg, Germany.
| | - J Meyer
- Department of General and Visceral Surgery, Ameos Hospital Schönebeck, Schönebeck, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - R Hunger
- Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
| | - N Krollmann
- Department of General and Visceral Surgery, University Hospital Brandenburg an der Havel, Brandenburg Medical University, Clinic for General and Visceral Surgery, Hochstraße 29, 14770, Brandenburg, Germany
| | - S Heisler
- Department of General and Visceral Surgery, University Hospital Brandenburg an der Havel, Brandenburg Medical University, Clinic for General and Visceral Surgery, Hochstraße 29, 14770, Brandenburg, Germany
| | - R Mantke
- Department of General and Visceral Surgery, University Hospital Brandenburg an der Havel, Brandenburg Medical University, Clinic for General and Visceral Surgery, Hochstraße 29, 14770, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
- Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany
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De Lange G, Davies J, Toso C, Meurette G, Ris F, Meyer J. Complete mesocolic excision for right hemicolectomy: an updated systematic review and meta-analysis. Tech Coloproctol 2023; 27:979-993. [PMID: 37632643 PMCID: PMC10562294 DOI: 10.1007/s10151-023-02853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/25/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE Complete mesocolic excision improves lymphadenectomy for right hemicolectomy and respects the embryological planes. However, its effect on cancer-free and overall survival is questioned. Therefore, we aimed to determine the potential benefits of the technique by performing a systematic review of the literature and meta-analysis of the available evidence. METHODS Web of Science, PubMed/Medline, and Embase were searched on February 22, 2023. Original studies on short- and long-term oncological outcomes of adult patients undergoing right hemicolectomy with complete mesocolic excision as a treatment for primary colon cancer were considered for inclusion. Outcomes were extracted and pooled using a model with random effects. RESULTS A total of 586 publications were identified through database searching, and 18 from citation searching. Exclusion of 552 articles left 24 articles for inclusion. Meta-analysis showed that complete mesocolic excision increased the lymph node harvest (5 studies, 1479 patients, MD 9.62, 95% CI 5.83-13.41, p > 0.0001, I2 84%), 5-year overall survival (5 studies, 2381 patients, OR 1.88, 95% CI 1.14-3.09, p = 0.01, I2 66%), 5-year disease-free survival (4 studies, 1376 patients, OR 2.21, 95% CI 1.51-3.23, p < 0.0001, I2 0%) and decreased the incidence of local recurrence (4 studies, 818 patients, OR 0.27, 95% CI 0.09-0.79, p = 0.02, I2 0%) when compared to standard right hemicolectomy. Perioperative morbidity was similar between the techniques (8 studies, 3899 patients, OR 1.04, 95% CI 0.89-1.22, p = 0.97, I2 0%). CONCLUSION Meta-analysis of observational and randomised studies showed that right hemicolectomy with complete mesocolic excision for primary right colon cancer improves oncologic results without increasing morbidity/mortality. These results need to be confirmed by high-quality evidence and randomised trials in selected patients to assess who may benefit from the procedure.
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Affiliation(s)
- G De Lange
- Medical School, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
| | - J Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - C Toso
- Medical School, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - G Meurette
- Medical School, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - F Ris
- Medical School, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - J Meyer
- Medical School, University of Geneva, Rue Michel-Servet 1, 1206, Geneva, Switzerland.
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
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Bry V, Landers A, Kim JN, Meyer J. Robustness Analysis of Reference Surfaces for Surface Guided Radiation Therapy of the Breast. Int J Radiat Oncol Biol Phys 2023; 117:e645-e646. [PMID: 37785919 DOI: 10.1016/j.ijrobp.2023.06.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Surface guided radiation therapy (SGRT) implements an optical imaging system in radiation therapy for positioning and motion management. This system projects visible light onto a patient and the reflected light is used to generate 3D positional information so that clinicians can accurately reproduce body positions. Patient setup shifts are calculated with six degrees of freedom by a registration algorithm comparing a reference surface (RS) of the patient to a live surface map of the patient on treatment day. SGRT has been an effective tool in daily localization for the treatment of breast cancer patients. It is common for patients to have multiple RS throughout the course of their treatment to account for anatomical variation between fractions. We sought to evaluate the robustness of reference surfaces and vendor specific algorithms used for SGRT. MATERIALS/METHODS At our institution, positional shift data for five patients treated for right-sided breast cancer were retrospectively analyzed. SGRT performance was compared between RS using bilateral breasts or a single ipsilateral breast. Shift parameters were calculated over the entire treatment course for all patients with a vendor supplied software tool that offers rigid and deformable registration algorithms. The deformable algorithm was used for treatment setups, with the treatment RS encompassing both breasts plus a margin. Two robustness tests were carried out: 1) a trimmed down RS encompassing just the ipsilateral breast and 2) a comparison of deformable vs rigid registration of the clinically used RS. After obtaining translational and angular shift data, the absolute mean differences between shifts were calculated to compare differences between RS size and algorithm performance. RESULTS On average, 1.4 new RS were created per patient guided by weekly radiographic imaging to adjust for anatomical changes. The absolute value of the average of the discrepancies between shifts using the clinical RS subtracted from the trimmed external (89 fractions) were <1mm and 1° and the maximum differences were: Lateral: 2.6mm, Longitudinal: 1.4mm, Vertical: 1.1mm, Yaw: 1.1°, Roll: 1.5°, Pitch: 1.7°. Discrepancies between tracking algorithms (83 fractions) were <1.5mm and 1° and the maximum differences were: Lateral: 3.4mm, Longitudinal: 3.5mm, Vertical: 2.0mm, Yaw: 2.4°, Roll: 2.7°, Pitch: 1.9°. CONCLUSION Clinically negligible mean discrepancies were observed for both robustness tests showing that neither the reference surface size nor the algorithms investigated caused systematic variations in the shifts for this group of patients. Maximum discrepancies of up to 3 mm and 3° were found between the algorithms, which indicate some variation, but within clinical tolerance. Overall, different selection of reference surfaces and algorithms had a minor effect on clinical shifts for SGRT of the breast.
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Affiliation(s)
- V Bry
- University of Washington, Seattle, WA
| | - A Landers
- University of Washington, Seattle, WA
| | - J N Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - J Meyer
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
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Linnemann B, Blank W, Doenst T, Erbel C, Isfort P, Janssens U, Kalka C, Klamroth R, Kotzerke J, Ley S, Meyer J, Mühlberg K, Müller OJ, Noppeney T, Opitz C, Riess H, Solomayer EF, Volk T, Beyer-Westendorf J. Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism. The revised AWMF S2k Guideline. VASA 2023; 52:1-146. [PMID: 37904504 DOI: 10.1024/0301-1526/a001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
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Talcott WJ, Ford EC, Gillespie EF, Wright JL, Lincoln H, Meyer J, Kim JN, Landers A, Moran MS, Hartvigson P, Kishore M, Burmeister JW, Pawlicki T, Evans SB. A Prospective, Multi-Institutional Study of Problematic Plan Detection during Physician Chart Rounds. Int J Radiat Oncol Biol Phys 2023; 117:e445. [PMID: 37785438 DOI: 10.1016/j.ijrobp.2023.06.1625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We performed a multi-institutional prospective study to determine the detection rate of problematic treatment plans (PP) at physician chart rounds (CR), and to identify factors associated with PP detection. MATERIALS/METHODS Curative intent PPs with simulated errors (representative of the most common targets of peer review) were generated. Two breast specialists selected twenty appropriate plans for inclusion and assigned them American Association of Physicists in Medicine (AAPM) Task Group 100 severity and detectability scores. The PPs were blinded and embedded at weekly virtual CR at 2 institutions over 12 months. At site A, both breast and lung cases were reviewed by a mix of breast and lung specialists during CR, and at site B, only breast cases were presented and reviewed by breast specialists. At both sites, breast plans were reviewed via slice-by-slice review in the treatment planning system (TPS), and both used a color-coded tool from the TPS to assess adherence to planning directives. Both sites had systematic approaches to case presentation (without a checklist). Site A was usually prospective CR, while site B was exclusively prospective. The following CR elements were recorded: PP detection, time of detection, length of CR, total number of cases presented, plan elements displayed, number and roles of attendees, and detector's role. Analysis was performed using simple statistics with chi-square testing. RESULTS By PP error type classification, 55.0% pertained to "target volume delineation," 25% to "non-target volume delineation or normal tissue sparing," and 20.0% to "dose prescription or written directives." Detectability was rated ≤5 (<5% likelihood of going undetected) for 60% of PPs, and severity was rated ≥7 ("at least potentially serious toxicity or tumor underdose") for only 30% of PPs. CR lasted a median of 64 minutes at site A (IQR 55-82.5) and 70 minutes at site B (IQR 52.5-81.5). PPs were presented at a median of 34 minutes (IQR 22.5-43, site A) and 41.5 minutes (IQR 23.5-56, site B) after CR start. A median of 16 cases (IQR 13-19) at site A and 32 cases (IQR 25-34.5) at site B were presented per CR session, with a median of 1 PP (site A and B) presented per session (range 1-2). The median time spent per case was 4.0 minutes (Site A) and 2.2 minutes (Site B). The median number of attendings at CR was 4 for site A (range 2-6) and 6.5 for Site B (range 5-10). PP detection rate at site A was 20% (n = 4) and at site B was 70% (n = 14) (p = 0.001). Detections were made by an attending physician in 100% (site A, n = 4) and 92.9% (Site B, n = 13) of PP detections. There were no differences in detection rate by PP error type (p = 0.78), detectability (p = 0.60) or severity score (p = 0.68), or by time PP presented after CR start (p = 0.39). CONCLUSION The effectiveness of PP detection at chart rounds can vary greatly between institutions. The study suggests possible areas for improvement but further study is needed to determine best practices.
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Affiliation(s)
- W J Talcott
- Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY
| | - E C Ford
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - E F Gillespie
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - J L Wright
- Johns Hopkins Medicine, Department of Radiation Oncology, Baltimore, MD
| | - H Lincoln
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - J Meyer
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - J N Kim
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - A Landers
- University of Washington, Seattle, WA
| | - M S Moran
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
| | - P Hartvigson
- University of Washington, Department of Radiation Oncology, Seattle, WA
| | - M Kishore
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR
| | | | - T Pawlicki
- University of California, San Diego, La Jolla, CA
| | - S B Evans
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT
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Erickson DPJ, Saini J, Cao N, Ford EC, Emery R, Kranz M, Goff PH, Meyer J, Wong T, Bloch C, Stewart RD, Sandison GA, Morimoto A, DeLonais-Dick A, Shaver B, Rengan R, Zeng J, Schwarz M. Adaptation of a Clinical Proton Pencil Beam Scanning System for FLASH Experiments. Int J Radiat Oncol Biol Phys 2023; 117:e664. [PMID: 37785966 DOI: 10.1016/j.ijrobp.2023.06.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To characterize a proton pencil beam scanning system for ultra-high dose rate (UHDR) irradiations and validate it with FLASH preclinical experiments. MATERIALS/METHODS After modifications to the beamline to maximize the beam current at isocenter in our gantry room, we characterized the UHDR beam in terms of: 1) Size and shape of the beam spot in three configurations; pristine beam, 75 mm water-equivalent-thickness (WET) range shifter (RS), and custom-built 135 mm WET RS mounted 310 mm upstream of the aperture in the snout housing. These configurations were analyzed to determine which one achieved the highest dose rate; 2) Beam transport efficiency and beam output. We compared the signal in the monitor chambers of the proton system with a Faraday cup and plane parallel ionization chamber (PPC05, IBA dosimetry) for beam current at the cyclotron from 7.5 nA to 800 nA; 3) Dose homogeneity, beam penumbra, and dose rate for the fields to be used in preclinical irradiations. All measurements were performed at isocenter, in air or at 1 cm depth in solid water, using the highest energy (about 230 MeV), which corresponded to a nominal range of 32.9 cm in water. We modeled the UHDR beam in our treatment planning system (TPS) to optimize the dose homogeneity and lateral penumbra of the irradiation fields. We performed the preclinical experiments in single fractions of 19 Gy (RBE), 21 Gy (RBE) and 23 Gy (RBE) (RBE = 1.1), targeting the pelvis of C57BL/6 mice and using survival as the endpoint. Each arm included 6-10 mice. The proton beam was used in transmission mode, positioning the center of the mouse pelvis at isocenter, and irradiating the pelvis with a 2x6 cm^2 field. Apertures were placed at 9cm from the isocenter to sharpen the lateral penumbra. RESULTS The range measurements with a multi-layer ionization chamber were consistent within 1 mm with the nominal range. In UHDR mode, the spot size at the isocenter varied from 4.5 mm for the pristine beam to 9.2 mm for the 135 mm RS. The spot size at isocenter remained constant when the beam intensity varied from 7.5 nA to 800 nA at the cyclotron exit. By employing the configuration with the 135 mm RS and optimizing the fields in the TPS, we achieved a dose rate of 1 Gy (RBE)/s for the conventional regime and 75(RBE) Gy/s for the UHDR regime. The monitor chambers of the proton system were affected by recombination at high dose rates: we observed about 35% higher output for the same number of monitor units delivered at 800 nA vs 7.5 nA. The delivered dose was determined with the PPC05 for each field, as this detector did not show recombination effects. When preclinical irradiations were independently monitored, the delivered dose was typically within 1% of the intended value. In three independent experiments, a dose of 21 Gy (RBE) or higher was associated with an increased survival in the UHDR arm compared to the conventional arm. CONCLUSION We adapted a clinical proton system for preclinical irradiations at UHDR. Our results confirm the presence of the FLASH effect.
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Affiliation(s)
- D P J Erickson
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - J Saini
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - N Cao
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - E C Ford
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - R Emery
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - M Kranz
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - P H Goff
- Department of Radiation Oncology, University of Washington / Fred Hutchinson Cancer Center, Seattle, WA
| | - J Meyer
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - T Wong
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - C Bloch
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - R D Stewart
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - G A Sandison
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - A Morimoto
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - A DeLonais-Dick
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - B Shaver
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - R Rengan
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - J Zeng
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - M Schwarz
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
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Bartzsch S, Ahmed M, Bicher S, Stewart RD, Schmid TE, Combs SE, Meyer J. Equivalent Uniform Dose (EUD) and the Evaluation of Cell Survival in Spatially Fractionated Radiotherapy (SFRT). Int J Radiat Oncol Biol Phys 2023; 117:e642. [PMID: 37785912 DOI: 10.1016/j.ijrobp.2023.06.2053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) SFRT has shown promise as a treatment modality to decrease normal tissue sparing without compromising tumor coverage, i.e., an increase in the therapeutic window compared to more conventional uniform radiation therapy (RT). The aim of this work is to examine and test several alternative bio-dosimetric parameters for the prediction of cell survival for normal-tissue and tumor cell lines irradiated in vitro with uniform and microbeam radiotherapy (MRT). MATERIALS/METHODS A bespoke tungsten collimator with 50 parallel, 50 µm wide slits and 400 µm slit spacing was mounted into an x-ray cabinet. Human fibroblast (MRC5) and two human tumor cell lines (LN18 and A549) were irradiated with a range of doses (< 10 Gy) for uniform and MRT (50um slits, 400um center spacing) using kV X-rays. Average, mean and valley dose as useful predictive metrics of cell survival are compared to the equivalent uniform dose (EUD) with biological parameters estimated from uniform-dose experiments. RESULTS We find that EUD, with linear-quadratic (LQ) model parameters, is more predictive for survival after SFRT than maximum, minimum or average dose. The maximum and average doses are correlated very poorly with in vitro cell survival. The difference in cell survival between uniform and MRT irradiation as a function of EUD is cell-type and dose dependent. The report results suggest that MRT is more effective at cell killing of tumor-cell lines than uniform irradiation for both tumor cell lines. However, MRT is less effective at killing normal tissue cells than uniform irradiation. CONCLUSION EUD is a superior predictor of in vitro cell survival than other metrics sometimes used in the SFRT literature, including mean dose, maximum dose, and valley dose. The reported studies provide some evidence that SFRT may increase the therapeutic ratio by producing spatial dose distributions that effectively reduce normal-tissue damage with little or no change in biological damage to tumor cells. Additional studies are needed to further extend and generalize our results and to test our conclusions against a larger dose range, low and high linear energy transfer (LET) radiations and additional cell lines.
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Affiliation(s)
- S Bartzsch
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute for Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - M Ahmed
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute for Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - S Bicher
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute for Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - R D Stewart
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - T E Schmid
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute for Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - S E Combs
- Department of Radiation Oncology, School of Medicine and Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany; Institute for Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
| | - J Meyer
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
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McCormack KM, Howell BR, Higgins M, Bramlett S, Guzman D, Morin EL, Villongco C, Liu Y, Meyer J, Sanchez MM. The developmental consequences of early adverse care on infant macaques: A cross-fostering study. Psychoneuroendocrinology 2022; 146:105947. [PMID: 36242820 DOI: 10.1016/j.psyneuen.2022.105947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022]
Abstract
Early life adversity/stress (ELA/ELS), particularly adverse caregiving experiences such as child maltreatment (MALT), is a main risk factor for psychopathology, including psychiatric disorders such as anxiety, depression, ADHD, and substance abuse. Yet how these alterations unfold during development and the underlying mechanisms remain poorly understood, as it is difficult to prospectively and longitudinally study early developmental phases in humans, and nearly impossible to disentangle postnatal caregiving effects from heritable traits. This study examined the specific effects of "nurture" (maternal care) versus "nature" (heritable, biological maternal factors) on nonhuman primate infant socioemotional, stress neuroendocrine, and physical development. For this we used a translational and naturalistic macaque model of infant maltreatment by the mother with randomized assignment at birth to either mothers with a history of maltreating their infants (MALT group, n = 22) or to competent mothers (Control group, n = 20). Over the first 6 months of life (roughly equivalent to 2 years in humans), we examined the development of the mother-infant relationship, as well as infants' social behavior and emotional reactivity. In parallel, we assessed hypothalamic-pituitary-adrenal (HPA) axis function longitudinally, using measures of hair cortisol accumulation, and basal morning plasma cortisol. We identified broad impairments in maternal care exhibited by MALT foster mothers, beyond maltreatment (physical abuse, rejection) events, suggesting that MALT foster mothers provide an overall lower quality of care to their infants compared to Controls. MALT infants exhibited alterations in their initiations and breaks of proximity towards their mothers, as well as heightened emotional reactivity in comparison to Controls. Most striking are the HPA axis findings, with MALT infants showing higher levels of plasma cortisol across the first 6 postnatal months as well as higher hair cortisol accumulation from birth through month 6 (a signature of chronic stress) than Controls. No caregiving effects were detected on physical growth, which ruled out confounding effects of maternal nutrition, metabolism, etc. Taken together, these results suggest that the developmental trajectory of MALT and Control infants is different, marked by heightened levels of emotional reactivity, increased HPA activity and alterations in mother-infant interactions in MALT animals. These findings appear to be due to specific effects of postnatal maternal care, and not to biological/ behavioral traits inherited from the mother, or due to prenatal programming caused by prenatal stress, as the cross-fostering design controlled for these potential factors. However, we also detected a couple of interesting biological effects suggesting heritable transmission of some phenotypes. The prolonged HPA axis activation during the first 6 postnatal months of life is expected to have long-term consequences for brain, physiological, and behavioral development in MALT offspring.
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Affiliation(s)
- K M McCormack
- Department of Psychology, Spelman College, Atlanta, GA, USA; Emory National Primate Research Center, Emory University, Atlanta, GA, USA.
| | - B R Howell
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA; Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA; Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, USA
| | - M Higgins
- School of Nursing, Emory University, Atlanta, GA, USA
| | - S Bramlett
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA
| | - D Guzman
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA; Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - E L Morin
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA; Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - C Villongco
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Y Liu
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA
| | - J Meyer
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - M M Sanchez
- Emory National Primate Research Center, Emory University, Atlanta, GA, USA; Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA, USA
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Henkel A, Maracke J, Munke A, Galchenkova M, Rahmani Mashhour A, Reinke P, Domaracky M, Fleckenstein H, Hakanpää J, Meyer J, Tolstikova A, Carnis J, Middendorf P, Gelisio L, Yefanov O, Chapman H, Oberthür D. CFEL TapeDrive 2.0: a conveyor belt-based sample-delivery system for multi-dimensional serial crystallography. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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10
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Gardner L, Dewan A, Meyer J. 397 Characterization of ABCA12 gene variant by electron microscopy in an infant with an ichthyosiform dermatitis and MALT1 deficiency. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Ubels S, Verstegen M, Klarenbeek B, Bouwense S, van Berge Henegouwen M, Daams F, van Det MJ, Griffiths EA, Haveman JW, Heisterkamp J, Koshy R, Nieuwenhuijzen G, Polat F, Siersema PD, Singh P, Wijnhoven B, Hannink G, van Workum F, Rosman C, Matthée E, Slootmans CAM, Ultee G, Schouten J, Gisbertz SS, Eshuis WJ, Kalff MC, Feenstra ML, van der Peet DL, Stam WT, van Etten B, Poelmann F, Vuurberg N, van den Berg JW, Martijnse IS, Matthijsen RM, Luyer M, Curvers W, Nieuwenhuijzen T, Taselaar AE, Kouwenhoven EA, Lubbers M, Sosef M, Lecot F, Geraedts TCM, van Esser S, Dekker JWT, van den Wildenberg F, Kelder W, Lubbers M, Baas PC, de Haas JWA, Hartgrink HH, Bahadoer RR, van Sandick JW, Hartemink KJ, Veenhof X, Stockmann H, Gorgec B, Weeder P, Wiezer MJ, Genders CMS, Belt E, Blomberg B, van Duijvendijk P, Claassen L, Reetz D, Steenvoorde P, Mastboom W, Klein Ganseij HJ, van Dalsen AD, Joldersma A, Zwakman M, Groenendijk RPR, Montazeri M, Mercer S, Knight B, van Boxel G, McGregor RJ, Skipworth RJE, Frattini C, Bradley A, Nilsson M, Hayami M, Huang B, Bundred J, Evans R, Grimminger PP, van der Sluis PC, Eren U, Saunders J, Theophilidou E, Khanzada Z, Elliott JA, Ponten J, King S, Reynolds JV, Sgromo B, Akbari K, Shalaby S, Gutschow CA, Schmidt H, Vetter D, Moorthy K, Ibrahim MAH, Christodoulidis G, Räsänen JV, Kauppi J, Söderström H, Manatakis DK, Korkolis DP, Balalis D, Rompu A, Alkhaffaf B, Alasmar M, Arebi M, Piessen G, Nuytens F, Degisors S, Ahmed A, Boddy A, Gandhi S, Fashina O, Van Daele E, Pattyn P, Robb WB, Arumugasamy M, Al Azzawi M, Whooley J, Colak E, Aybar E, Sari AC, Uyanik MS, Ciftci AB, Sayyed R, Ayub B, Murtaza G, Saeed A, Ramesh P, Charalabopoulos A, Liakakos T, Schizas D, Baili E, Kapelouzou A, Valmasoni M, Pierobon ES, Capovilla G, Merigliano S, Silviu C, Rodica B, Florin A, Cristian Gelu R, Petre H, Guevara Castro R, Salcedo AF, Negoi I, Negoita VM, Ciubotaru C, Stoica B, Hostiuc S, Colucci N, Mönig SP, Wassmer CH, Meyer J, Takeda FR, Aissar Sallum RA, Ribeiro U, Cecconello I, Toledo E, Trugeda MS, Fernández MJ, Gil C, Castanedo S, Isik A, Kurnaz E, Videira JF, Peyroteo M, Canotilho R, Weindelmayer J, Giacopuzzi S, De Pasqual CA, Bruna M, Mingol F, Vaque J, Pérez C, Phillips AW, Chmelo J, Brown J, Han LE, Gossage JA, Davies AR, Baker CR, Kelly M, Saad M, Bernardi D, Bonavina L, Asti E, Riva C, Scaramuzzo R, Elhadi M, Abdelkarem Ahmed H, Elhadi A, Elnagar FA, Msherghi AAA, Wills V, Campbell C, Perez Cerdeira M, Whiting S, Merrett N, Das A, Apostolou C, Lorenzo A, Sousa F, Adelino Barbosa J, Devezas V, Barbosa E, Fernandes C, Smith G, Li EY, Bhimani N, Chan P, Kotecha K, Hii MW, Ward SM, Johnson M, Read M, Chong L, Hollands MJ, Allaway M, Richardson A, Johnston E, Chen AZL, Kanhere H, Prasad S, McQuillan P, Surman T, Trochsler MI, Schofield WA, Ahmed SK, Reid JL, Harris MC, Gananadha S, Farrant J, Rodrigues N, Fergusson J, Hindmarsh A, Afzal Z, Safranek P, Sujendran V, Rooney S, Loureiro C, Leturio Fernández S, Díez del Val I, Jaunoo S, Kennedy L, Hussain A, Theodorou D, Triantafyllou T, Theodoropoulos C, Palyvou T, Elhadi M, Abdullah Ben Taher F, Ekheel M, Msherghi AAA. Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score. Br J Surg 2022. [DOI: https://doi.org/10.1093/bjs/znac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Background
Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.
Methods
This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.
Results
Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.
Conclusion
The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.
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Affiliation(s)
- Sander Ubels
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Moniek Verstegen
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Bastiaan Klarenbeek
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Stefan Bouwense
- Department of Surgery, Maastricht University Medical Centre+ , Maastricht , the Netherlands
| | - Mark van Berge Henegouwen
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Freek Daams
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Marc J van Det
- Department of Surgery, ZGT hospital group , Almelo , the Netherlands
| | - Ewen A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham , Birmingham , UK
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham , Birmingham , UK
| | - Jan W Haveman
- Department of Surgery, University Medical Centre Groningen, University of Groningen , Groningen , the Netherlands
| | - Joos Heisterkamp
- Department of Surgery, Elisabeth-TweeSteden Hospital , Tilburg , the Netherlands
| | - Renol Koshy
- Department of Surgery, Newcastle upon Tyne Hospital NHS Trust , Newcastle upon Tyne , UK
- Department of Surgery, University Hospitals of Coventry and Warwickshire NHS Trust , Coventry , UK
| | | | - Fatih Polat
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Pritam Singh
- Department of Surgery, Nottingham University Hospitals NHS Trust , Nottingham , UK
- Department of Surgery, Regional Oesophago-Gastric Unit, Royal Surrey County Hospital , Guildford , UK
| | - Bas Wijnhoven
- Department of Surgery, Erasmus University Medical Centre , Rotterdam , the Netherlands
| | - Gerjon Hannink
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Frans van Workum
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
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Reddy AV, Hill CS, Sehgal S, He J, Zheng L, Herman JM, Meyer J, Narang AK. Efficacy and Safety of Reirradiation with Stereotactic Body Radiation Therapy for Locally Recurrent Pancreatic Adenocarcinoma. Clin Oncol (R Coll Radiol) 2022; 34:386-394. [PMID: 34974972 DOI: 10.1016/j.clon.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/07/2021] [Accepted: 12/17/2021] [Indexed: 11/03/2022]
Abstract
AIMS The purpose of this study was to report on outcomes of a cohort of patients who were treated with reirradiation with stereotactic body radiation therapy (SBRT) for locally recurrent pancreatic adenocarcinoma. MATERIALS AND METHODS Patients treated with SBRT reirradiation for locally recurrent pancreatic adenocarcinoma from December 2009 to April 2020 were included in the study. Descriptive statistics were used to record patient demographics, tumour and treatment characteristics. Kaplan-Meier analysis was used to evaluate overall survival, local progression-free survival (LPFS), distant metastasis-free survival and progression-free survival (PFS). RESULTS In total, 27 patients were included in the study. The median follow-up time from local recurrence was 19.7 months (range 4.2-43.1 months). Most patients received five-fraction SBRT (26/27, 96%). The median overall survival after local recurrence treatment was 18.3 months (range 3.0-42.6 months), with 6-month, 1-year and 2-year overall survival rates of 88.5%, 73.1% and 33.6%. The median LPFS after local recurrence treatment was 16.2 months (range 2.3-33.6 months), with 6-month, 1-year and 2-year LPFS rates of 95.8%, 62.9% and 27.2%. Peri-SBRT chemotherapy improved LPFS (median 17.5 versus 8.5 months; P = 0.010) and overall survival (median 19.3 versus 5.5 months; P = 0.049). Tumours ≤ 3 cm in the greatest dimension showed better local control (median LPFS 19.2 versus 10.2 months; P = 0.130). There was one case (4%) of acute grade 3 pain and one case (4%) of late grade 3 gastrointestinal toxicity. CONCLUSIONS Reirradiation with five-fraction SBRT is safe, but local control remains suboptimal. Patients with smaller tumours experienced improved outcomes, as did patients whose treatment plan included the administration of peri-SBRT chemotherapy.
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Affiliation(s)
- A V Reddy
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA.
| | - C S Hill
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - S Sehgal
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - J He
- Department of Surgery, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - L Zheng
- Department of Oncology, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - J M Herman
- Department of Radiation Oncology, Northwell Health, New Hyde Park, New York, USA
| | - J Meyer
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - A K Narang
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
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Baatz F, Herbst J, Schambach A, Hust M, Mätzig T, Meyer J, Sauer MG. CRISPR/Cas9-based generation of CAR-expressing natural
killer-like cells against acute myeloid leukemia. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F Baatz
- Department of Pediatric Hematology/Oncology and Blood Stem Cell
Transplantation, Hannover Medical School, Germany
| | - J Herbst
- Department of Pediatric Hematology/Oncology and Blood Stem Cell
Transplantation, Hannover Medical School, Germany
| | - A Schambach
- Institute of Experimental Hematology, Hannover Medical School,
Germany
| | - M Hust
- Department of Biotechnology, Technische Universität
Braunschweig, Germany
| | - T Mätzig
- Institute of Experimental Hematology, Hannover Medical School,
Germany
| | - J Meyer
- Institute of Experimental Hematology, Hannover Medical School,
Germany
| | - MG Sauer
- Department of Pediatric Hematology/Oncology and Blood Stem Cell
Transplantation, Hannover Medical School, Germany
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14
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Andreev V, Arratia M, Baghdasaryan A, Baty A, Begzsuren K, Belousov A, Bolz A, Boudry V, Brandt G, Britzger D, Buniatyan A, Bystritskaya L, Campbell AJ, Cantun Avila KB, Cerny K, Chekelian V, Chen Z, Contreras JG, Cunqueiro Mendez L, Cvach J, Dainton JB, Daum K, Deshpande A, Diaconu C, Eckerlin G, Egli S, Elsen E, Favart L, Fedotov A, Feltesse J, Fleischer M, Fomenko A, Gal C, Gayler J, Goerlich L, Gogitidze N, Gouzevitch M, Grab C, Greenshaw T, Grindhammer G, Haidt D, Henderson RCW, Hessler J, Hladký J, Hoffmann D, Horisberger R, Hreus T, Huber F, Jacobs PM, Jacquet M, Janssen T, Jung AW, Jung H, Kapichine M, Katzy J, Kiesling C, Klein M, Kleinwort C, Klest HT, Kogler R, Kostka P, Kretzschmar J, Krücker D, Krüger K, Landon MPJ, Lange W, Laycock P, Lee SH, Levonian S, Li W, Lin J, Lipka K, List B, List J, Lobodzinski B, Malinovski E, Martyn HU, Maxfield SJ, Mehta A, Meyer AB, Meyer J, Mikocki S, Mondal MM, Morozov A, Müller K, Nachman B, Naumann T, Newman PR, Niebuhr C, Nowak G, Olsson JE, Ozerov D, Park S, Pascaud C, Patel GD, Perez E, Petrukhin A, Picuric I, Pitzl D, Polifka R, Preins S, Radescu V, Raicevic N, Ravdandorj T, Reimer P, Rizvi E, Robmann P, Roosen R, Rostovtsev A, Rotaru M, Sankey DPC, Sauter M, Sauvan E, Schmitt S, Schmookler BA, Schoeffel L, Schöning A, Sefkow F, Shushkevich S, Soloviev Y, Sopicki P, South D, Spaskov V, Specka A, Steder M, Stella B, Straumann U, Sun C, Sykora T, Thompson PD, Traynor D, Tseepeldorj B, Tu Z, Valkárová A, Vallée C, Van Mechelen P, Wegener D, Wünsch E, Žáček J, Zhang J, Zhang Z, Žlebčík R, Zohrabyan H, Zomer F. Measurement of Lepton-Jet Correlation in Deep-Inelastic Scattering with the H1 Detector Using Machine Learning for Unfolding. Phys Rev Lett 2022; 128:132002. [PMID: 35426724 DOI: 10.1103/physrevlett.128.132002] [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: 08/30/2021] [Revised: 12/20/2021] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
The first measurement of lepton-jet momentum imbalance and azimuthal correlation in lepton-proton scattering at high momentum transfer is presented. These data, taken with the H1 detector at HERA, are corrected for detector effects using an unbinned machine learning algorithm (multifold), which considers eight observables simultaneously in this first application. The unfolded cross sections are compared with calculations performed within the context of collinear or transverse-momentum-dependent factorization in quantum chromodynamics as well as Monte Carlo event generators.
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Affiliation(s)
- V Andreev
- Lebedev Physical Institute, Moscow, Russia
| | - M Arratia
- University of California, Riverside, California 92521, USA
| | | | - A Baty
- Rice University, Houston, Texas 77005-1827, USA
| | - K Begzsuren
- Institute of Physics and Technology of the Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
| | - A Belousov
- Lebedev Physical Institute, Moscow, Russia
| | - A Bolz
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - V Boudry
- LLR, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - G Brandt
- II. Physikalisches Institut, Universität Göttingen, Göttingen, Germany
| | - D Britzger
- Max-Planck-Institut für Physik, München, Germany
| | - A Buniatyan
- School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
| | - L Bystritskaya
- Institute for Theoretical and Experimental Physics, Moscow, Russia
| | - A J Campbell
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - K B Cantun Avila
- Departamento de Fisica Aplicada, CINVESTAV, Mérida, Yucatán, México
| | - K Cerny
- Joint Laboratory of Optics, Palacký University, Olomouc, Czech Republic
| | - V Chekelian
- Max-Planck-Institut für Physik, München, Germany
| | - Z Chen
- Shandong University, Shandong, People's Republic of China
| | - J G Contreras
- Departamento de Fisica Aplicada, CINVESTAV, Mérida, Yucatán, México
| | | | - J Cvach
- Institute of Physics, Academy of Sciences of the Czech Republic, Praha, Czech Republic
| | - J B Dainton
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - K Daum
- Fachbereich C, Universität Wuppertal, Wuppertal, Germany
| | - A Deshpande
- Stony Brook University, Stony Brook, New York 11794, USA
| | - C Diaconu
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - G Eckerlin
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - S Egli
- Paul Scherrer Institut, Villigen, Switzerland
| | - E Elsen
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - L Favart
- Inter-University Institute for High Energies ULB-VUB, Brussels and Universiteit Antwerpen, Antwerp, Belgium
| | - A Fedotov
- Institute for Theoretical and Experimental Physics, Moscow, Russia
| | - J Feltesse
- Irfu/SPP, CE Saclay, Gif-sur-Yvette, France
| | - M Fleischer
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - A Fomenko
- Lebedev Physical Institute, Moscow, Russia
| | - C Gal
- Stony Brook University, Stony Brook, New York 11794, USA
| | - J Gayler
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - L Goerlich
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | | | - M Gouzevitch
- Université Claude Bernard Lyon 1, CNRS/IN2P3, Villeurbanne, France
| | - C Grab
- Institut für Teilchenphysik, ETH, Zürich, Switzerland
| | - T Greenshaw
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | | | - D Haidt
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - R C W Henderson
- Department of Physics, University of Lancaster, Lancaster, United Kingdom
| | - J Hessler
- Max-Planck-Institut für Physik, München, Germany
| | - J Hladký
- Institute of Physics, Academy of Sciences of the Czech Republic, Praha, Czech Republic
| | - D Hoffmann
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | | | - T Hreus
- Physik-Institut der Universität Zürich, Zürich, Switzerland
| | - F Huber
- Physikalisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - P M Jacobs
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Jacquet
- IJCLab, Université Paris-Saclay, CNRS/IN2P3, Orsay, France
| | - T Janssen
- Inter-University Institute for High Energies ULB-VUB, Brussels and Universiteit Antwerpen, Antwerp, Belgium
| | - A W Jung
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - H Jung
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - M Kapichine
- Joint Institute for Nuclear Research, Dubna, Russia
| | - J Katzy
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - C Kiesling
- Max-Planck-Institut für Physik, München, Germany
| | - M Klein
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - C Kleinwort
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - H T Klest
- Stony Brook University, Stony Brook, New York 11794, USA
| | - R Kogler
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - P Kostka
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - J Kretzschmar
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - D Krücker
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - K Krüger
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - M P J Landon
- School of Physics and Astronomy, Queen Mary, University of London, London, United Kingdom
| | - W Lange
- Deutsches Elektronen-Synchrotron DESY, Zeuthen, Germany
| | - P Laycock
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S H Lee
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - S Levonian
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - W Li
- Rice University, Houston, Texas 77005-1827, USA
| | - J Lin
- Rice University, Houston, Texas 77005-1827, USA
| | - K Lipka
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - B List
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - J List
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | | | | | - H-U Martyn
- I. Physikalisches Institut der RWTH, Aachen, Germany
| | - S J Maxfield
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - A Mehta
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | - A B Meyer
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - J Meyer
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - S Mikocki
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - M M Mondal
- Stony Brook University, Stony Brook, New York 11794, USA
| | - A Morozov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - K Müller
- Physik-Institut der Universität Zürich, Zürich, Switzerland
| | - B Nachman
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - Th Naumann
- Deutsches Elektronen-Synchrotron DESY, Zeuthen, Germany
| | - P R Newman
- School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
| | - C Niebuhr
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - G Nowak
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - J E Olsson
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - D Ozerov
- Paul Scherrer Institut, Villigen, Switzerland
| | - S Park
- Stony Brook University, Stony Brook, New York 11794, USA
| | - C Pascaud
- IJCLab, Université Paris-Saclay, CNRS/IN2P3, Orsay, France
| | - G D Patel
- Department of Physics, University of Liverpool, Liverpool, United Kingdom
| | | | - A Petrukhin
- Université Claude Bernard Lyon 1, CNRS/IN2P3, Villeurbanne, France
| | - I Picuric
- Faculty of Science, University of Montenegro, Podgorica, Montenegro
| | - D Pitzl
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - R Polifka
- Faculty of Mathematics and Physics, Charles University, Praha, Czech Republic
| | - S Preins
- University of California, Riverside, California 92521, USA
| | - V Radescu
- Department of Physics, Oxford University, Oxford, United Kingdom
| | - N Raicevic
- Faculty of Science, University of Montenegro, Podgorica, Montenegro
| | - T Ravdandorj
- Institute of Physics and Technology of the Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
| | - P Reimer
- Institute of Physics, Academy of Sciences of the Czech Republic, Praha, Czech Republic
| | - E Rizvi
- School of Physics and Astronomy, Queen Mary, University of London, London, United Kingdom
| | - P Robmann
- Physik-Institut der Universität Zürich, Zürich, Switzerland
| | - R Roosen
- Inter-University Institute for High Energies ULB-VUB, Brussels and Universiteit Antwerpen, Antwerp, Belgium
| | - A Rostovtsev
- Institute for Information Transmission Problems RAS, Moscow, Russia
| | - M Rotaru
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), Bucharest, Romania
| | - D P C Sankey
- STFC, Rutherford Appleton Laboratory, Didcot, Oxfordshire, United Kingdom
| | - M Sauter
- Physikalisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - E Sauvan
- LAPP, Université de Savoie, CNRS/IN2P3, Annecy-le-Vieux, France
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - S Schmitt
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - B A Schmookler
- Stony Brook University, Stony Brook, New York 11794, USA
| | | | - A Schöning
- Physikalisches Institut, Universität Heidelberg, Heidelberg, Germany
| | - F Sefkow
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - S Shushkevich
- Lomonosov Moscow State University, Skobeltsyn Institute of Nuclear Physics, Moscow, Russia
| | - Y Soloviev
- Lebedev Physical Institute, Moscow, Russia
| | - P Sopicki
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - D South
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - V Spaskov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - A Specka
- LLR, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - M Steder
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - B Stella
- Dipartimento di Fisica Università di Roma Tre and INFN Roma 3, Roma, Italy
| | - U Straumann
- Physik-Institut der Universität Zürich, Zürich, Switzerland
| | - C Sun
- Shandong University, Shandong, People's Republic of China
| | - T Sykora
- Faculty of Mathematics and Physics, Charles University, Praha, Czech Republic
| | - P D Thompson
- School of Physics and Astronomy, University of Birmingham, Birmingham, United Kingdom
| | - D Traynor
- School of Physics and Astronomy, Queen Mary, University of London, London, United Kingdom
| | - B Tseepeldorj
- Institute of Physics and Technology of the Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
- Ulaanbaatar University, Ulaanbaatar, Mongolia
| | - Z Tu
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Valkárová
- Faculty of Mathematics and Physics, Charles University, Praha, Czech Republic
| | - C Vallée
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - P Van Mechelen
- Inter-University Institute for High Energies ULB-VUB, Brussels and Universiteit Antwerpen, Antwerp, Belgium
| | - D Wegener
- Institut für Physik, TU Dortmund, Dortmund, Germany
| | - E Wünsch
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - J Žáček
- Faculty of Mathematics and Physics, Charles University, Praha, Czech Republic
| | - J Zhang
- Shandong University, Shandong, People's Republic of China
| | - Z Zhang
- IJCLab, Université Paris-Saclay, CNRS/IN2P3, Orsay, France
| | - R Žlebčík
- Faculty of Mathematics and Physics, Charles University, Praha, Czech Republic
| | | | - F Zomer
- IJCLab, Université Paris-Saclay, CNRS/IN2P3, Orsay, France
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Petzuch B, Benardeau A, Hofmeister L, Meyer J, Hartmann E, Pavkovic M, Mathar I, Sandner P, Ellinger-Ziegelbauer H. Urinary miRNA profiles in chronic kidney injury - Benefits of extracellular vesicle enrichment and miRNAs as potential biomarkers for renal fibrosis, glomerular injury and endothelial dysfunction. Toxicol Sci 2022; 187:35-50. [PMID: 35244176 DOI: 10.1093/toxsci/kfac028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Micro-RNAs (miRNAs) are regulators of gene expression and play an important role in physiological homeostasis and disease. In biofluids miRNAs can be found in protein complexes or in extracellular vesicles (EVs). Altered urinary miRNAs are reported as potential biomarkers for chronic kidney disease (CKD). In this context we compared established urinary protein biomarkers for kidney injury with urinary miRNA profiles in obese ZSF1 and hypertensive renin transgenic rats. Additionally, the benefit of urinary EV enrichment was investigated in vivo and the potential association of urinary miRNAs with renal fibrosis in vitro. Kidney damage in both rat models was confirmed by histopathology, proteinuria, and increased levels of urinary protein biomarkers. In total 290 miRNAs were elevated in obese ZSF1 rats compared to lean controls, while 38 miRNAs were altered in obese ZSF1 rats during 14 to 26 weeks of age. These 38 miRNAs correlated better with disease progression than established urinary protein biomarkers. MiRNAs increased in obese ZSF1 rats were associated with renal inflammation, fibrosis, and glomerular injury. Eight miRNAs were also changed in urinary EVs of renin transgenic rats, including one which might play a role in endothelial dysfunction. EV enrichment increased the number and detection level of several miRNAs implicated in renal fibrosis in vitro and in vivo. Our results show the benefit of EV enrichment for miRNA detection and the potential of total urine and urinary EV-associated miRNAs as biomarkers of altered kidney physiology, renal fibrosis and glomerular injury, and disease progression in hypertension and obesity induced CKD.
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Affiliation(s)
- B Petzuch
- Bayer AG, Pharmaceuticals, Investigational Toxicology, 42096 Wuppertal, Germany.,Boehringer Ingelheim Pharma GmbH & Co. KG, Investigative Toxicology, Department of Non-Clinical Drug Safety, 88400 Biberach (Riß), Germany
| | - A Benardeau
- Novo Nordisk A/S,Cardio-Renal Biology, Måløv, Denmark
| | - L Hofmeister
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - J Meyer
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - E Hartmann
- Bayer AG, Pharmaceuticals, Toxicology, Pathology and Clinical Pathology, 42096 Wuppertal, Germany
| | - M Pavkovic
- Bayer AG, Pharmaceuticals, Investigational Toxicology, 42096 Wuppertal, Germany
| | - I Mathar
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany
| | - P Sandner
- Bayer AG, Pharmaceuticals, Cardiovascular Research, 42096 Wuppertal, Germany.,Hannover Medical School, Institute of Pharmacology, 30625 Hannover, Germany
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Roberts J, Marsh S, Moggre A, Meyer J. FLASH in the Clinic Track (Oral Presentations) OPTICAL CALORIMETRY, A PROMISING DOSIMETRY TECHNIQUE FOR FLASH RADIOTHERAPY. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01526-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Retiz K, Althouse A, Meyer J, Arya S, Goodney P. Association of Smoking With Postprocedural Complications Following Open and Endovascular Interventions for Intermittent Claudication. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Meyer J, Thompson M, Ross S. 90: Improving research awareness and engagement in a pediatric cystic fibrosis center. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Elsner P, Meyer J. Elektrokauterisierung eines Compound-Naevus. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1217-1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungBei einer 34-jährigen Patientin wurde von einem Hautarzt eine klinisch als Compound-Naevus diagnostizierte Hautveränderung im Gesichtsbereich auf Wunsch der Patientin aus kosmetischen Gründen mittels Elektrokoagulation operativ entfernt. Im Nachgang kam es zur Entwicklung einer Narbe und Pigmentierung im Exzisionsbereich, sodass durch einen zweiten Hautarzt eine Nachexzision erfolgte, die ein Naevus-Rezidiv ergab.Die Schlichtungsstelle stellte fest, dass die aus kosmetischer Indikation erfolgte elektrochirurgische Therapie des Naevus im Gesicht aufgrund der problembehafteten Tiefensteuerung der Epidermiszerstörung mit zum Teil unvollständiger Gewebedestruktion und somit dem Risiko eines Rezidivnaevus nicht dem Facharztstandard entsprach und damit als fehlerhaftes ärztliches Handeln zu beurteilen sei. Die nach Rezidivoperation verbliebene Narbenbildung sei jedoch nicht als Folge der Elektrokoagulationstherapie zu bewerten.Melanozytäre Compound-Naevi ohne klinische oder auflichtmikroskopische Zeichen der Malignität oder der Dysplasie sind keine medizinische Indikation für eine Behandlung. Falls sie für Patienten kosmetisch störend sind, können sie entfernt werden, wobei die Exzision mit dermatohistologischer Untersuchung des Präparates die Methode der Wahl ist. Gewebsdestruierende Methoden könnten allenfalls dann vertretbar sein, wenn die Patienten über das verbleibende Risiko einer mangelnden Beurteilbarkeit der kompletten Entfernung der Läsion aufgeklärt und dieses in Kauf zu nehmen bereit sind. Der vorliegende Fall zeigt die Notwendigkeit einer umfassenden Aufklärung und ihrer besonderen Dokumentation bei kosmetischen dermatologischen Prozeduren.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Elsner P, Meyer J. Nachexzision eines Basalzellkarzinoms an der falschen Lokalisation. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1345-3738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungEine Patientin stellte sich in der Sprechstunde einer dermatologischen Klinik wegen zweier Hautveränderungen im Bereich der Nase vor. Der behandelnde Dermatologe entfernte diese in Form tangentialer Abtragungen; die histologische Untersuchung ergab das Vorliegen eines Angiofibroms sowie eines Basalzellkarzinoms, welches nicht im Gesunden entfernt worden war. In Absprache mit der Patientin erfolgte eine Nachexzision. Diese wurde von einem zweiten Dermatologen der Klinik auf der Basis einer unklaren Dokumentation der Primärexzision an einer falschen Stelle durchgeführt.Die Patientin bemängelte die operative Behandlung; deshalb sei eine weitere Operation an der Nase erforderlich geworden. Die Schlichtungsstelle bestätigte, dass es fehlerbedingt zu einer nicht notwendigen Exzision an falscher Stelle mit entsprechender Narbenbildung sowie zu einem ohne den Fehler nicht erforderlichen weiteren Eingriff gekommen sei.Der an der falschen Lokalisation durchgeführte dermatochirurgische Eingriff („wrong site surgery“) ist ein in der Dermatochirurgie bekanntes Fehlergeschehen. Als Präventionsmaßnahme hat sich eine sog. „Time-out“ („Auszeit“) bewährt, wobei vor und ggf. während einer Operation diese unterbrochen wird zur Bestätigung des richtigen Patienten, Eingriffs und Ortes. Im vorliegenden Fall wurde die Wahl des falschen Nachexzisionsortes gefördert durch eine unklare Dokumentation der Primärexzision und eine fehlende Kommunikation zwischen den behandelnden Dermatologen über die korrekte Exzisionsstelle. Gemäß § 630 h BGB tritt eine Beweislastumkehr bei der Haftung für Behandlungs- und Aufklärungsfehler ein, wenn es sich um ein sog. „voll beherrschbares Risiko“ handelt; um ein solches handelt es sich bei einer Exzisionsstellenverwechslung. Der berichtete Fall beleuchtet gleichzeitig die Probleme der ärztlichen Arbeitsteilung; nach der sog. „horizontalen Arbeitsteilung“ darf jeder Facharzt zunächst darauf vertrauen, dass ein anderer an der Behandlung beteiligter Facharzt seine Pflichten aus dem Behandlungsvertrag korrekt erfüllt. Entstehen jedoch Zweifel, wie im vorliegenden Fall bzgl. der Dokumentation der korrekten Exzisionsstelle, darf der zweitbehandelnde Arzt nicht unbesehen handeln, sondern muss sich selbstverantwortlich der richtigen Diagnose, in diesem Fall bzgl. der Lokalisation des Basalzellkarzinoms, vergewissern. Durch eine Nachfrage beim erstbehandelnden Dermatologen wäre der Behandlungsfehler zu vermeiden gewesen.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Hanvesakul R, Boccuti A, Meyer J, Rengarajan B, Wu A, Chakrabarti D, Li W. P64.02 EMERGE 402 Phase 4 Observational Study: Safety and Outcomes in Patients With SCLC Receiving Treatment With Lurbinectedin. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Butterworth JW, Butterworth WA, Meyer J, Giacobino C, Buchs N, Ris F, Scarpinata R. A systematic review and meta-analysis of robotic-assisted transabdominal total mesorectal excision and transanal total mesorectal excision: which approach offers optimal short-term outcomes for mid-to-low rectal adenocarcinoma? Tech Coloproctol 2021; 25:1183-1198. [PMID: 34562160 DOI: 10.1007/s10151-021-02515-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Resection of low rectal adenocarcinoma can be challenging in the narrow pelvis of male patients. Transanal total mesorectal excision (TaTME) appears to offer technical advantages for distal rectal tumours, and robotic-assisted transabdominal TME (rTME) was introduced in effort to improve operative precision and ergonomics. However, no study has comprehensively compared these approaches. The aim of the present study was to perform a systematic review of the literature to compare postoperative short-term outcomes in rTME and TaTME. METHODS A systematic online search (1974-July 2020) of MEDLINE, Embase, web of science and google scholar was conducted for trials, prospective or retrospective studies involving rTME, or TaTME for rectal cancer. Outcome variables included: hospital stay; operation duration, blood loss; resection margins; proportion of histologically complete resected specimens; lymph nodes; overall complications; anastomotic leak, and 30-day mortality. RESULTS Sixty-two articles met the inclusion criteria, including 37 studies (3835 patients) assessing rTME resection, 23 studies (1326 patients) involving TaTME and 2 comparing both (165 patients). Operating time was longer in rTME (309.2 min, 95% CI 285.5-332.8) than in TaTME studies (256.2 min, 95% CI 231.5-280.9) (p = 0.002). rTME resected specimens had a larger distal resection margin (2.62 cm, 95% CI 2.35-2.88) than in TaTME studies (2.10 cm, 95% CI 1.83-2.36) (p = 0.007). Other outcome variables did not significantly differ between the two techniques. CONCLUSIONS rTME provides similar pathological and short-term outcomes to TaTME and both are reasonable surgical approaches for patients with mid-to-low rectal cancer. To definitively answer the question of the optimal TME technique, we suggest a prospective trial comparing both techniques assessing long-term survival as a primary outcome.
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Affiliation(s)
- J W Butterworth
- Kings College Hospitals, Princess Royal University Hospital, Farnborough Common, London, BR6 8ND, Kent, UK.
| | | | - J Meyer
- Division of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - C Giacobino
- Division of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - N Buchs
- Division of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - F Ris
- Division of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - R Scarpinata
- Kings College Hospitals, Princess Royal University Hospital, Farnborough Common, London, BR6 8ND, Kent, UK
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23
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Abazov VM, Abbott B, Acharya BS, Adams M, Adams T, Agnew JP, Alexeev GD, Alkhazov G, Alton A, Alves GA, Antchev G, Askew A, Aspell P, Assis Jesus ACS, Atanassov I, Atkins S, Augsten K, Aushev V, Aushev Y, Avati V, Avila C, Badaud F, Baechler J, Bagby L, Baldenegro Barrera C, Baldin B, Bandurin DV, Banerjee S, Barberis E, Baringer P, Barreto J, Bartlett JF, Bassler U, Bazterra V, Bean A, Begalli M, Bellantoni L, Berardi V, Beri SB, Bernardi G, Bernhard R, Berretti M, Bertram I, Besançon M, Beuselinck R, Bhat PC, Bhatia S, Bhatnagar V, Blazey G, Blessing S, Bloom K, Boehnlein A, Boline D, Boos EE, Borchsh V, Borissov G, Borysova M, Bossini E, Bottigli U, Bozzo M, Brandt A, Brandt O, Brochmann M, Brock R, Bross A, Brown D, Bu XB, Buehler M, Buescher V, Bunichev V, Burdin S, Burkhardt H, Buszello CP, Cafagna FS, Camacho-Pérez E, Carvalho W, Casey BCK, Castilla-Valdez H, Catanesi MG, Caughron S, Chakrabarti S, Chan KM, Chandra A, Chapon E, Chen G, Cho SW, Choi S, Choudhary B, Cihangir S, Claes D, Clutter J, Cooke M, Cooper WE, Corcoran M, Couderc F, Cousinou MC, Csanád M, Csörgő T, Cuth J, Cutts D, da Motta H, Das A, Davies G, Deile M, de Jong SJ, De La Cruz-Burelo E, De Leonardis F, Déliot F, Demina R, Denisov D, Denisov SP, De Oliveira Martins C, Desai S, Deterre C, DeVaughan K, Diehl HT, Diesburg M, Ding PF, Dominguez A, Doubek M, Drutskoy A, Druzhkin D, Dubey A, Dudko LV, Duperrin A, Dutt S, Eads M, Edmunds D, Eggert K, Ellison J, Elvira VD, Enari Y, Eremin V, Evans H, Evdokimov A, Evdokimov VN, Fauré A, Feng L, Ferbel T, Ferro F, Fiedler F, Fiergolski A, Filthaut F, Fisher W, Fisk HE, Forthomme L, Fortner M, Fox H, Franc J, Fuess S, Garbincius PH, Garcia F, Garcia-Bellido A, García-González JA, Gavrilov V, Geng W, Georgiev V, Gerber CE, Gershtein Y, Giani S, Ginther G, Gogota O, Golovanov G, Grannis PD, Greder S, Greenlee H, Grenier G, Gris P, Grivaz JF, Grohsjean A, Grünendahl S, Grünewald MW, Grzanka L, Guillemin T, Gutierrez G, Gutierrez P, Haley J, Hammerbauer J, Han L, Harder K, Harel A, Hauptman JM, Hays J, Head T, Hebbeker T, Hedin D, Hegab H, Heinson AP, Heintz U, Hensel C, Heredia-De La Cruz I, Herner K, Hesketh G, Hildreth MD, Hirosky R, Hoang T, Hobbs JD, Hoeneisen B, Hogan J, Hohlfeld M, Holzbauer JL, Howley I, Hubacek Z, Hynek V, Iashvili I, Ilchenko Y, Illingworth R, Isidori T, Ito AS, Ivanchenko V, Jabeen S, Jaffré M, Janda M, Jayasinghe A, Jeong MS, Jesik R, Jiang P, Johns K, Johnson E, Johnson M, Jonckheere A, Jonsson P, Joshi J, Jung AW, Juste A, Kajfasz E, Karev A, Karmanov D, Kašpar J, Katsanos I, Kaur M, Kaynak B, Kehoe R, Kermiche S, Khalatyan N, Khanov A, Kharchilava A, Kharzheev YN, Kiselevich I, Kohli JM, Kopal J, Kozelov AV, Kraus J, Kumar A, Kundrát V, Kupco A, Kurča T, Kuzmin VA, Lami S, Lammers S, Latino G, Lebrun P, Lee HS, Lee SW, Lee WM, Le X, Lellouch J, Li D, Li H, Li L, Li QZ, Lim JK, Lincoln D, Lindsey C, Linhart R, Linnemann J, Lipaev VV, Lipton R, Liu H, Liu Y, Lobodenko A, Lokajicek M, Lokajíček MV, Lopes de Sa R, Losurdo L, Lucas Rodríguez F, Luna-Garcia R, Lyon AL, Maciel AKA, Macrí M, Madar R, Magaña-Villalba R, Malawski M, Malbouisson HB, Malik S, Malyshev VL, Mansour J, Martínez-Ortega J, McCarthy R, McGivern CL, Meijer MM, Melnitchouk A, Menezes D, Mercadante PG, Merkin M, Meyer A, Meyer J, Miconi F, Minafra N, Minutoli S, Molina J, Mondal NK, Mulhearn M, Mundim L, Naaranoja T, Nagy E, Narain M, Nayyar R, Neal HA, Negret JP, Nemes F, Neustroev P, Nguyen HT, Niewiadomski H, Novák T, Nunnemann T, Oguri V, Oliveri E, Oljemark F, Orduna J, Oriunno M, Osman N, Österberg K, Pal A, Palazzi P, Parashar N, Parihar V, Park SK, Partridge R, Parua N, Pasechnik R, Passaro V, Patwa A, Penning B, Perfilov M, Peroutka Z, Peters Y, Petridis K, Petrillo G, Pétroff P, Pleier MA, Podstavkov VM, Popov AV, Prado da Silva WL, Prewitt M, Price D, Procházka J, Prokopenko N, Qian J, Quadt A, Quinn B, Quinto M, Raben TG, Radermacher E, Radicioni E, Rangel M, Ratoff PN, Ravotti F, Razumov I, Ripp-Baudot I, Rizatdinova F, Robutti E, Rodrigues RF, Rominsky M, Ross A, Royon C, Rubinov P, Ruchti R, Ruggiero G, Saarikko H, Sajot G, Samoylenko VD, Sánchez-Hernández A, Sanders MP, Santoro A, Santos AS, Savage G, Savitskyi M, Sawyer L, Scanlon T, Schamberger RD, Scheglov Y, Schellman H, Schott M, Schwanenberger C, Schwienhorst R, Scribano A, Sekaric J, Severini H, Shabalina E, Shary V, Shaw S, Shchukin AA, Shkola O, Simak V, Siroky J, Skubic P, Slattery P, Smajek J, Snoeys W, Snow GR, Snow J, Snyder S, Söldner-Rembold S, Sonnenschein L, Soustruznik K, Stark J, Stefaniuk N, Stefanovitch R, Ster A, Stoyanova DA, Strauss M, Suter L, Svoisky P, Szanyi I, Sziklai J, Taylor C, Tcherniaev E, Titov M, Tokmenin VV, Tsai YT, Tsybychev D, Tuchming B, Tully C, Turini N, Urban O, Uvarov L, Uvarov S, Uzunyan S, Vacek V, Van Kooten R, van Leeuwen WM, Varelas N, Varnes EW, Vasilyev IA, Vavroch O, Verkheev AY, Vertogradov LS, Verzocchi M, Vesterinen M, Vilanova D, Vokac P, Wahl HD, Wang C, Wang MHLS, Warchol J, Watts G, Wayne M, Weichert J, Welti J, Welty-Rieger L, Williams J, Williams MRJ, Wilson GW, Wobisch M, Wood DR, Wyatt TR, Xie Y, Yamada R, Yang S, Yasuda T, Yatsunenko YA, Ye W, Ye Z, Yin H, Yip K, Youn SW, Yu JM, Zennamo J, Zhao TG, Zhou B, Zhu J, Zich J, Zielinski K, Zielinski M, Zieminska D, Zivkovic L. Odderon Exchange from Elastic Scattering Differences between pp and pp[over ¯] Data at 1.96 TeV and from pp Forward Scattering Measurements. Phys Rev Lett 2021; 127:062003. [PMID: 34420329 DOI: 10.1103/physrevlett.127.062003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/19/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
We describe an analysis comparing the pp[over ¯] elastic cross section as measured by the D0 Collaboration at a center-of-mass energy of 1.96 TeV to that in pp collisions as measured by the TOTEM Collaboration at 2.76, 7, 8, and 13 TeV using a model-independent approach. The TOTEM cross sections, extrapolated to a center-of-mass energy of sqrt[s]=1.96 TeV, are compared with the D0 measurement in the region of the diffractive minimum and the second maximum of the pp cross section. The two data sets disagree at the 3.4σ level and thus provide evidence for the t-channel exchange of a colorless, C-odd gluonic compound, also known as the odderon. We combine these results with a TOTEM analysis of the same C-odd exchange based on the total cross section and the ratio of the real to imaginary parts of the forward elastic strong interaction scattering amplitude in pp scattering for which the significance is between 3.4σ and 4.6σ. The combined significance is larger than 5σ and is interpreted as the first observation of the exchange of a colorless, C-odd gluonic compound.
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Affiliation(s)
- V M Abazov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - B Abbott
- University of Oklahoma, Norman, Oklahoma 73019, USA
| | - B S Acharya
- Tata Institute of Fundamental Research, Mumbai-400 005, India
| | - M Adams
- University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - T Adams
- Florida State University, Tallahassee, Florida 32306, USA
| | - J P Agnew
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - G D Alexeev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Alkhazov
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - A Alton
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - G A Alves
- LAFEX, Centro Brasileiro de Pesquisas Físicas, Rio de Janeiro, RJ 22290, Brazil
| | - G Antchev
- INRNE-BAS, Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 1784 Sofia, Bulgaria
| | - A Askew
- Florida State University, Tallahassee, Florida 32306, USA
| | - P Aspell
- CERN, 1211 Geneva 23, Switzerland
| | - A C S Assis Jesus
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - I Atanassov
- INRNE-BAS, Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 1784 Sofia, Bulgaria
| | - S Atkins
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - K Augsten
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - V Aushev
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | - Y Aushev
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | - V Avati
- AGH University of Science and Technology, 30-059 Krakow, Poland
- CERN, 1211 Geneva 23, Switzerland
| | - C Avila
- Universidad de los Andes, Bogotá 111711, Colombia
| | - F Badaud
- LPC, Université Blaise Pascal, CNRS/IN2P3, Clermont, F-63178 Aubière Cedex, France
| | | | - L Bagby
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - B Baldin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D V Bandurin
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - S Banerjee
- Tata Institute of Fundamental Research, Mumbai-400 005, India
| | - E Barberis
- Northeastern University, Boston, Massachusetts 02115, USA
| | - P Baringer
- University of Kansas, Lawrence, Kansas 66045, USA
| | - J Barreto
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - J F Bartlett
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - U Bassler
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - V Bazterra
- University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - A Bean
- University of Kansas, Lawrence, Kansas 66045, USA
| | - M Begalli
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - L Bellantoni
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Berardi
- INFN Sezione di Bari, 70126 Bari, Italy
- Dipartimento Interateneo di Fisica di Bari, 70126 Bari, Italy
| | - S B Beri
- Panjab University, Chandigarh 160014, India
| | - G Bernardi
- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
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- Physikalisches Institut, Universität Freiburg, 79085 Freiburg, Germany
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- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - I Bertram
- Lancaster University, Lancaster LA1 4YB, United Kingdom
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- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - R Beuselinck
- Imperial College London, London SW7 2AZ, United Kingdom
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Florida State University, Tallahassee, Florida 32306, USA
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- University of Nebraska, Lincoln, Nebraska 68588, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- State University of New York, Stony Brook, New York 11794, USA
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- Moscow State University, Moscow 119991, Russia
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- Università degli Studi di Siena and Gruppo Collegato INFN di Siena, 53100 Siena, Italy
- CERN, 1211 Geneva 23, Switzerland
| | - U Bottigli
- Università degli Studi di Siena and Gruppo Collegato INFN di Siena, 53100 Siena, Italy
| | - M Bozzo
- INFN Sezione di Genova, 16146 Genova, Italy
- Università degli Studi di Genova, 16146 Genova, Italy
| | - A Brandt
- University of Texas, Arlington, Texas 76019, USA
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- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | - M Brochmann
- University of Washington, Seattle, Washington 98195, USA
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- Michigan State University, East Lansing, Michigan 48824, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Institut für Physik, Universität Mainz, 55099 Mainz, Germany
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- Moscow State University, Moscow 119991, Russia
| | - S Burdin
- Lancaster University, Lancaster LA1 4YB, United Kingdom
| | | | | | | | | | - W Carvalho
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - B C K Casey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | - S Caughron
- Michigan State University, East Lansing, Michigan 48824, USA
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- State University of New York, Stony Brook, New York 11794, USA
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- University of Notre Dame, Notre Dame, Indiana 46556, USA
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- Rice University, Houston, Texas 77005, USA
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- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
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- University of Kansas, Lawrence, Kansas 66045, USA
| | - S W Cho
- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
| | - S Choi
- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- University of Kansas, Lawrence, Kansas 66045, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Rice University, Houston, Texas 77005, USA
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- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - M-C Cousinou
- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
| | - M Csanád
- Eötvös University, 1117 Budapest, Pázmány P. sétány 1/A, Hungary
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
| | - T Csörgő
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
- MATE Institute of Technology KRC, 3200 Gyöngyös, Hungary
| | - J Cuth
- Institut für Physik, Universität Mainz, 55099 Mainz, Germany
| | - D Cutts
- Brown University, Providence, Rhode Island 02912, USA
| | - H da Motta
- Southern Methodist University, Dallas, Texas 75275, USA
| | - A Das
- Southern Methodist University, Dallas, Texas 75275, USA
| | - G Davies
- Imperial College London, London SW7 2AZ, United Kingdom
| | - M Deile
- CERN, 1211 Geneva 23, Switzerland
| | - S J de Jong
- Nikhef, Science Park, 1098 XG Amsterdam, Netherlands
- Radboud University Nijmegen, 6525 AJ Nijmegen, Netherlands
| | | | - F De Leonardis
- INFN Sezione di Bari, 70126 Bari, Italy
- Dipartimento di Ingegneria Elettrica e dell'Informazione-Politecnico di Bari, 70125 Bari, Italy
| | - F Déliot
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - R Demina
- University of Rochester, Rochester, New York 14627, USA
| | - D Denisov
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S P Denisov
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | | | - S Desai
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Deterre
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - K DeVaughan
- University of Nebraska, Lincoln, Nebraska 68588, USA
| | - H T Diehl
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Diesburg
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P F Ding
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Dominguez
- University of Nebraska, Lincoln, Nebraska 68588, USA
| | - M Doubek
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - A Drutskoy
- Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - D Druzhkin
- Tomsk State University, Tomsk 634050, Russia
- CERN, 1211 Geneva 23, Switzerland
| | - A Dubey
- Delhi University, Delhi-110 007, India
| | - L V Dudko
- Moscow State University, Moscow 119991, Russia
| | - A Duperrin
- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
| | - S Dutt
- Panjab University, Chandigarh 160014, India
| | - M Eads
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - D Edmunds
- Michigan State University, East Lansing, Michigan 48824, USA
| | - K Eggert
- Case Western Reserve University, Department of Physics, Cleveland, Ohio 44106, USA
| | - J Ellison
- University of California Riverside, Riverside, California 92521, USA
| | - V D Elvira
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Y Enari
- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
| | - V Eremin
- Ioffe Physical-Technical Institute of Russian Academy of Sciences, St. Petersburg 194021, Russian Federation
| | - H Evans
- Indiana University, Bloomington, Indiana 47405, USA
| | - A Evdokimov
- University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - V N Evdokimov
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - A Fauré
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - L Feng
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - T Ferbel
- University of Rochester, Rochester, New York 14627, USA
| | - F Ferro
- INFN Sezione di Genova, 16146 Genova, Italy
| | - F Fiedler
- Institut für Physik, Universität Mainz, 55099 Mainz, Germany
| | | | - F Filthaut
- Nikhef, Science Park, 1098 XG Amsterdam, Netherlands
- Radboud University Nijmegen, 6525 AJ Nijmegen, Netherlands
| | - W Fisher
- Michigan State University, East Lansing, Michigan 48824, USA
| | - H E Fisk
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Forthomme
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - M Fortner
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - H Fox
- Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - J Franc
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - S Fuess
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P H Garbincius
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F Garcia
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
| | | | | | - V Gavrilov
- Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - W Geng
- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
- Michigan State University, East Lansing, Michigan 48824, USA
| | - V Georgiev
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - C E Gerber
- University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - Y Gershtein
- Rutgers University, Piscataway, New Jersey 08855, USA
| | - S Giani
- CERN, 1211 Geneva 23, Switzerland
| | - G Ginther
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - O Gogota
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | - G Golovanov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - P D Grannis
- State University of New York, Stony Brook, New York 11794, USA
| | - S Greder
- IPHC, Université de Strasbourg, CNRS/IN2P3, F-67037 Strasbourg, France
| | - H Greenlee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Grenier
- IPNL, Université Lyon 1, CNRS/IN2P3, F-69622 Villeurbanne Cedex, France and Université de Lyon, F-69361 Lyon CEDEX 07, France
| | - Ph Gris
- LPC, Université Blaise Pascal, CNRS/IN2P3, Clermont, F-63178 Aubière Cedex, France
| | - J-F Grivaz
- LAL, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, F-91898 Orsay Cedex, France
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- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - S Grünendahl
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - L Grzanka
- AGH University of Science and Technology, 30-059 Krakow, Poland
| | - T Guillemin
- LAL, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, F-91898 Orsay Cedex, France
| | - G Gutierrez
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Gutierrez
- University of Oklahoma, Norman, Oklahoma 73019, USA
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- Oklahoma State University, Stillwater, Oklahoma 74078, USA
| | - J Hammerbauer
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - L Han
- University of Science and Technology of China, Hefei 230026, People's Republic of China
| | - K Harder
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A Harel
- University of Rochester, Rochester, New York 14627, USA
| | | | - J Hays
- Imperial College London, London SW7 2AZ, United Kingdom
| | - T Head
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - T Hebbeker
- III. Physikalisches Institut A, RWTH Aachen University, 52056 Aachen, Germany
| | - D Hedin
- Northern Illinois University, DeKalb, Illinois 60115, USA
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- LAFEX, Centro Brasileiro de Pesquisas Físicas, Rio de Janeiro, RJ 22290, Brazil
| | | | - K Herner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Hesketh
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M D Hildreth
- University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - R Hirosky
- University of Virginia, Charlottesville, Virginia 22904, USA
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- Florida State University, Tallahassee, Florida 32306, USA
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- State University of New York, Stony Brook, New York 11794, USA
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- Universidad San Francisco de Quito, Quito 170157, Ecuador
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- Rice University, Houston, Texas 77005, USA
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- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - V Hynek
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - I Iashvili
- State University of New York, Buffalo, New York 14260, USA
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- Southern Methodist University, Dallas, Texas 75275, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Isidori
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- LAL, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, F-91898 Orsay Cedex, France
| | - M Janda
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - A Jayasinghe
- University of Oklahoma, Norman, Oklahoma 73019, USA
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- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
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- Imperial College London, London SW7 2AZ, United Kingdom
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- University of Science and Technology of China, Hefei 230026, People's Republic of China
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- University of Arizona, Tucson, Arizona 85721, USA
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- Michigan State University, East Lansing, Michigan 48824, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Imperial College London, London SW7 2AZ, United Kingdom
| | - J Joshi
- University of California Riverside, Riverside, California 92521, USA
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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- Institució Catalana de Recerca i Estudis Avançats (ICREA) and Institut de Física d'Altes Energies (IFAE), 08193 Bellaterra (Barcelona), Spain
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- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
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- CERN, 1211 Geneva 23, Switzerland
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- Moscow State University, Moscow 119991, Russia
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- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
- CERN, 1211 Geneva 23, Switzerland
| | - I Katsanos
- University of Nebraska, Lincoln, Nebraska 68588, USA
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- Panjab University, Chandigarh 160014, India
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- Istanbul University, 34134 Vezneciler, Istanbul, Turkey
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- Southern Methodist University, Dallas, Texas 75275, USA
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- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
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- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Khanov
- Oklahoma State University, Stillwater, Oklahoma 74078, USA
| | - A Kharchilava
- State University of New York, Buffalo, New York 14260, USA
| | - Y N Kharzheev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - I Kiselevich
- Institute for Theoretical and Experimental Physics, Moscow 117259, Russia
| | - J M Kohli
- Panjab University, Chandigarh 160014, India
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- CERN, 1211 Geneva 23, Switzerland
| | - A V Kozelov
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - J Kraus
- University of Mississippi, University, Mississippi 38677, USA
| | - A Kumar
- State University of New York, Buffalo, New York 14260, USA
| | - V Kundrát
- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
| | - A Kupco
- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
| | - T Kurča
- IPNL, Université Lyon 1, CNRS/IN2P3, F-69622 Villeurbanne Cedex, France and Université de Lyon, F-69361 Lyon CEDEX 07, France
| | - V A Kuzmin
- Moscow State University, Moscow 119991, Russia
| | - S Lami
- INFN Sezione di Pisa, 56127 Pisa, Italy
| | - S Lammers
- Indiana University, Bloomington, Indiana 47405, USA
| | - G Latino
- Università degli Studi di Siena and Gruppo Collegato INFN di Siena, 53100 Siena, Italy
| | - P Lebrun
- IPNL, Université Lyon 1, CNRS/IN2P3, F-69622 Villeurbanne Cedex, France and Université de Lyon, F-69361 Lyon CEDEX 07, France
| | - H S Lee
- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
| | - S W Lee
- Iowa State University, Ames, Iowa 50011, USA
| | - W M Lee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - X Le
- University of Arizona, Tucson, Arizona 85721, USA
| | - J Lellouch
- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
| | - D Li
- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
| | - H Li
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - L Li
- University of California Riverside, Riverside, California 92521, USA
| | - Q Z Li
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J K Lim
- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
| | - D Lincoln
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Lindsey
- University of Kansas, Lawrence, Kansas 66045, USA
| | - R Linhart
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - J Linnemann
- Michigan State University, East Lansing, Michigan 48824, USA
| | - V V Lipaev
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - R Lipton
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H Liu
- Southern Methodist University, Dallas, Texas 75275, USA
| | - Y Liu
- University of Science and Technology of China, Hefei 230026, People's Republic of China
| | - A Lobodenko
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - M Lokajicek
- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
| | - M V Lokajíček
- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
| | - R Lopes de Sa
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Losurdo
- Università degli Studi di Siena and Gruppo Collegato INFN di Siena, 53100 Siena, Italy
| | | | | | - A L Lyon
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A K A Maciel
- LAFEX, Centro Brasileiro de Pesquisas Físicas, Rio de Janeiro, RJ 22290, Brazil
| | - M Macrí
- INFN Sezione di Genova, 16146 Genova, Italy
| | - R Madar
- Physikalisches Institut, Universität Freiburg, 79085 Freiburg, Germany
| | | | - M Malawski
- AGH University of Science and Technology, 30-059 Krakow, Poland
| | - H B Malbouisson
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - S Malik
- University of Nebraska, Lincoln, Nebraska 68588, USA
| | - V L Malyshev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - J Mansour
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | | | - R McCarthy
- State University of New York, Stony Brook, New York 11794, USA
| | - C L McGivern
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - M M Meijer
- Nikhef, Science Park, 1098 XG Amsterdam, Netherlands
- Radboud University Nijmegen, 6525 AJ Nijmegen, Netherlands
| | - A Melnitchouk
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Menezes
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - P G Mercadante
- Universidade Federal do ABC, Santo André, SP 09210, Brazil
| | - M Merkin
- Moscow State University, Moscow 119991, Russia
| | - A Meyer
- III. Physikalisches Institut A, RWTH Aachen University, 52056 Aachen, Germany
| | - J Meyer
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | - F Miconi
- IPHC, Université de Strasbourg, CNRS/IN2P3, F-67037 Strasbourg, France
| | - N Minafra
- University of Kansas, Lawrence, Kansas 66045, USA
| | - S Minutoli
- INFN Sezione di Genova, 16146 Genova, Italy
| | - J Molina
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - N K Mondal
- Tata Institute of Fundamental Research, Mumbai-400 005, India
| | - M Mulhearn
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - L Mundim
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - T Naaranoja
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - E Nagy
- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
| | - M Narain
- Brown University, Providence, Rhode Island 02912, USA
| | - R Nayyar
- University of Arizona, Tucson, Arizona 85721, USA
| | - H A Neal
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - J P Negret
- Universidad de los Andes, Bogotá 111711, Colombia
| | - F Nemes
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
- CERN, 1211 Geneva 23, Switzerland
| | - P Neustroev
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - H T Nguyen
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - H Niewiadomski
- Case Western Reserve University, Department of Physics, Cleveland, Ohio 44106, USA
| | - T Novák
- MATE Institute of Technology KRC, 3200 Gyöngyös, Hungary
| | - T Nunnemann
- Ludwig-Maximilians-Universität München, 80539 München, Germany
| | - V Oguri
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | | | - F Oljemark
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - J Orduna
- Brown University, Providence, Rhode Island 02912, USA
| | - M Oriunno
- SLAC National Accelerator Laboratory, Stanford, California 94025, USA
| | - N Osman
- CPPM, Aix-Marseille Université, CNRS/IN2P3, F-13288 Marseille Cedex 09, France
| | - K Österberg
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - A Pal
- University of Texas, Arlington, Texas 76019, USA
| | | | - N Parashar
- Purdue University Calumet, Hammond, Indiana 46323, USA
| | - V Parihar
- Brown University, Providence, Rhode Island 02912, USA
| | - S K Park
- Korea Detector Laboratory, Korea University, Seoul 02841, Korea
| | - R Partridge
- Brown University, Providence, Rhode Island 02912, USA
| | - N Parua
- Indiana University, Bloomington, Indiana 47405, USA
| | - R Pasechnik
- Department of Astronomy and Theoretical Physics, Lund University, SE-223 62 Lund, Sweden
| | - V Passaro
- INFN Sezione di Bari, 70126 Bari, Italy
- Dipartimento di Ingegneria Elettrica e dell'Informazione-Politecnico di Bari, 70125 Bari, Italy
| | - A Patwa
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B Penning
- Imperial College London, London SW7 2AZ, United Kingdom
| | - M Perfilov
- Moscow State University, Moscow 119991, Russia
| | - Z Peroutka
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - Y Peters
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - K Petridis
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - G Petrillo
- University of Rochester, Rochester, New York 14627, USA
| | - P Pétroff
- LAL, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, F-91898 Orsay Cedex, France
| | - M-A Pleier
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - V M Podstavkov
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A V Popov
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - W L Prado da Silva
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - M Prewitt
- Rice University, Houston, Texas 77005, USA
| | - D Price
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - J Procházka
- Institute of Physics, Academy of Sciences of the Czech Republic, 182 21 Prague, Czech Republic
| | - N Prokopenko
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - J Qian
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - A Quadt
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | - B Quinn
- University of Mississippi, University, Mississippi 38677, USA
| | - M Quinto
- INFN Sezione di Bari, 70126 Bari, Italy
- Dipartimento Interateneo di Fisica di Bari, 70126 Bari, Italy
| | - T G Raben
- University of Kansas, Lawrence, Kansas 66045, USA
| | | | | | - M Rangel
- LAFEX, Centro Brasileiro de Pesquisas Físicas, Rio de Janeiro, RJ 22290, Brazil
| | - P N Ratoff
- Lancaster University, Lancaster LA1 4YB, United Kingdom
| | | | - I Razumov
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - I Ripp-Baudot
- IPHC, Université de Strasbourg, CNRS/IN2P3, F-67037 Strasbourg, France
| | - F Rizatdinova
- Oklahoma State University, Stillwater, Oklahoma 74078, USA
| | - E Robutti
- INFN Sezione di Genova, 16146 Genova, Italy
| | - R F Rodrigues
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - M Rominsky
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Ross
- Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - C Royon
- University of Kansas, Lawrence, Kansas 66045, USA
| | - P Rubinov
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Ruchti
- University of Notre Dame, Notre Dame, Indiana 46556, USA
| | | | - H Saarikko
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | - G Sajot
- LPSC, Université Joseph Fourier Grenoble 1, CNRS/IN2P3, Institut National Polytechnique de Grenoble, F-38026 Grenoble Cedex, France
| | - V D Samoylenko
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | | | - M P Sanders
- Ludwig-Maximilians-Universität München, 80539 München, Germany
| | - A Santoro
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550, Brazil
| | - A S Santos
- LAFEX, Centro Brasileiro de Pesquisas Físicas, Rio de Janeiro, RJ 22290, Brazil
| | - G Savage
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Savitskyi
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | - L Sawyer
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - T Scanlon
- Imperial College London, London SW7 2AZ, United Kingdom
| | - R D Schamberger
- State University of New York, Stony Brook, New York 11794, USA
| | - Y Scheglov
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - H Schellman
- Northwestern University, Evanston, Illinois 60208, USA
- Oregon State University, Corvallis, Oregon 97331, USA
| | - M Schott
- Institut für Physik, Universität Mainz, 55099 Mainz, Germany
| | - C Schwanenberger
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - R Schwienhorst
- Michigan State University, East Lansing, Michigan 48824, USA
| | | | - J Sekaric
- University of Kansas, Lawrence, Kansas 66045, USA
| | - H Severini
- University of Oklahoma, Norman, Oklahoma 73019, USA
| | - E Shabalina
- II. Physikalisches Institut, Georg-August-Universität Göttingen, 37073 Göttingen, Germany
| | - V Shary
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - S Shaw
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - A A Shchukin
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - O Shkola
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | - V Simak
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - J Siroky
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - P Skubic
- University of Oklahoma, Norman, Oklahoma 73019, USA
| | - P Slattery
- University of Rochester, Rochester, New York 14627, USA
| | - J Smajek
- CERN, 1211 Geneva 23, Switzerland
| | - W Snoeys
- CERN, 1211 Geneva 23, Switzerland
| | - G R Snow
- University of Nebraska, Lincoln, Nebraska 68588, USA
| | - J Snow
- Langston University, Langston, Oklahoma 73050, USA
| | - S Snyder
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | | | - L Sonnenschein
- III. Physikalisches Institut A, RWTH Aachen University, 52056 Aachen, Germany
| | - K Soustruznik
- Charles University, Faculty of Mathematics and Physics, Center for Particle Physics, 116 36 Prague 1, Czech Republic
| | - J Stark
- LPSC, Université Joseph Fourier Grenoble 1, CNRS/IN2P3, Institut National Polytechnique de Grenoble, F-38026 Grenoble Cedex, France
| | - N Stefaniuk
- Taras Shevchenko National University of Kyiv, Kiev 01601, Ukraine
| | | | - A Ster
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
| | - D A Stoyanova
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - M Strauss
- University of Oklahoma, Norman, Oklahoma 73019, USA
| | - L Suter
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - P Svoisky
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - I Szanyi
- Eötvös University, 1117 Budapest, Pázmány P. sétány 1/A, Hungary
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
| | - J Sziklai
- Wigner Research Centre for Physics, RMI, 1121 Budapest, Hungary
| | - C Taylor
- Case Western Reserve University, Department of Physics, Cleveland, Ohio 44106, USA
| | | | - M Titov
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - V V Tokmenin
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - Y-T Tsai
- University of Rochester, Rochester, New York 14627, USA
| | - D Tsybychev
- State University of New York, Stony Brook, New York 11794, USA
| | - B Tuchming
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - C Tully
- Princeton University, Princeton, New Jersey 08544, USA
| | - N Turini
- Università degli Studi di Siena and Gruppo Collegato INFN di Siena, 53100 Siena, Italy
| | - O Urban
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - L Uvarov
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - S Uvarov
- Petersburg Nuclear Physics Institute, St. Petersburg 188300, Russia
| | - S Uzunyan
- Northern Illinois University, DeKalb, Illinois 60115, USA
| | - V Vacek
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - R Van Kooten
- Indiana University, Bloomington, Indiana 47405, USA
| | | | - N Varelas
- University of Illinois at Chicago, Chicago, Illinois 60607, USA
| | - E W Varnes
- University of Arizona, Tucson, Arizona 85721, USA
| | - I A Vasilyev
- Institute for High Energy Physics, Protvino, Moscow region 142281, Russia
| | - O Vavroch
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - A Y Verkheev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | | | - M Verzocchi
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Vesterinen
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - D Vilanova
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-Sur-Yvette, France
| | - P Vokac
- Czech Technical University in Prague, 116 36 Prague 6, Czech Republic
| | - H D Wahl
- Florida State University, Tallahassee, Florida 32306, USA
| | - C Wang
- University of Science and Technology of China, Hefei 230026, People's Republic of China
| | - M H L S Wang
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Warchol
- University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - G Watts
- University of Washington, Seattle, Washington 98195, USA
| | - M Wayne
- University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - J Weichert
- Institut für Physik, Universität Mainz, 55099 Mainz, Germany
| | - J Welti
- Helsinki Institute of Physics, 00014 University of Helsinki, Helsinki, Finland
- Department of Physics, 00014 University of Helsinki, Helsinki, Finland
| | | | - J Williams
- University of Kansas, Lawrence, Kansas 66045, USA
| | | | - G W Wilson
- University of Kansas, Lawrence, Kansas 66045, USA
| | - M Wobisch
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - D R Wood
- Northeastern University, Boston, Massachusetts 02115, USA
| | - T R Wyatt
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Y Xie
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Yamada
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Yang
- University of Science and Technology of China, Hefei 230026, People's Republic of China
| | - T Yasuda
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Y A Yatsunenko
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - W Ye
- State University of New York, Stony Brook, New York 11794, USA
| | - Z Ye
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H Yin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Yip
- Brookhaven National Laboratory, Upton, New York 11973, USA
| | - S W Youn
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J M Yu
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - J Zennamo
- State University of New York, Buffalo, New York 14260, USA
| | - T G Zhao
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - B Zhou
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - J Zhu
- University of Michigan, Ann Arbor, Michigan 48109, USA
| | - J Zich
- University of West Bohemia, 301 00 Pilsen, Czech Republic
| | - K Zielinski
- AGH University of Science and Technology, 30-059 Krakow, Poland
| | - M Zielinski
- University of Rochester, Rochester, New York 14627, USA
| | - D Zieminska
- Indiana University, Bloomington, Indiana 47405, USA
| | - L Zivkovic
- LPNHE, Universités Paris VI and VII, CNRS/IN2P3, F-75005 Paris, France
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Alaedin M, Ghaffari MH, Sadri H, Meyer J, Dänicke S, Frahm J, Huber K, Grindler S, Kersten S, Rehage J, Muráni E, Sauerwein H. Effects of dietary l-carnitine supplementation on the response to an inflammatory challenge in mid-lactating dairy cows: Hepatic mRNA abundance of genes involved in fatty acid metabolism. J Dairy Sci 2021; 104:11193-11209. [PMID: 34253361 DOI: 10.3168/jds.2021-20226] [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] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/27/2021] [Indexed: 11/19/2022]
Abstract
This study aimed at characterizing the effects of dietary l-carnitine supplementation on hepatic fatty acid (FA) metabolism during inflammation in mid-lactating cows. Fifty-three pluriparous Holstein dairy cows were randomly assigned to either a control (CON, n = 26) or an l-carnitine supplemented (CAR; n = 27) group. The CAR cows received 125 g of a rumen-protected l-carnitine product per cow per day (corresponding to 25 g of l-carnitine/cow per day) from d 42 antepartum (AP) until the end of the trial on d 126 postpartum (PP). Aside from the supplementation, the same basal diets were fed in the dry period and during lactation to all cows. In mid lactation, each cow was immune-challenged by a single intravenous injection of 0.5 μg of LPS/kg of BW at d 111 PP. Blood samples were collected before and after LPS administration. The mRNA abundance of in total 39 genes related to FA metabolism was assessed in liver biopsies taken at d -11, 1, and 14 relative to LPS (d 111 PP) and also on d 42 AP as an individual covariate using microfluidics integrated fluidic circuit chips (96.96 dynamic arrays). In addition to the concentrations of 3 selected proteins related to FA metabolism, acetyl-CoA carboxylase α (ACACA), 5' AMP-activated protein kinase (AMPK), and solute carrier family 25 member 20 (SLC25A20) were assessed by a capillary Western blot method in liver biopsies from d -11 and 1 relative to LPS from 11 cows each of CAR and CON. On d -11 relative to LPS, differences between the mRNA abundance in CON and CAR were limited to acyl-CoA dehydrogenase (ACAD) very-long-chain (ACADVL) with greater mRNA abundance in the CAR than in the CON group. The liver fat content decreased from d -11 to d 1 relative to the LPS injection and remained at the lower level until d 14 in both groups. One day after the LPS challenge, lower mRNA abundance of carnitine palmitoyltransferase 1 (CPT1), CPT2, ACADVL, ACAD short-chain (ACADS), and solute carrier family 22 member 5 (SLC22A5) were observed in the CAR group as compared with the CON group. However, the mRNA abundance of protein kinase AMP-activated noncatalytic subunit gamma 1 (PRKAG1), ACAD medium-chain (ACADM), ACACA, and FA binding protein 1 (FABP1) were greater in the CAR group than in the CON group on d 1 relative to LPS. Two weeks after the LPS challenge, differences between the groups were no longer detectable. The altered mRNA abundance before and 1 d after LPS pointed to increased transport of FA into hepatic mitochondria during systemic inflammation in both groups. The protein abundance of AMPK was lower in CAR than in CON before the LPS administration. The protein abundance of SLC25A20 was neither changing with time nor treatment and the ACACA protein abundance was only affected by time. In conclusion, l-carnitine supplementation temporally altered the hepatic mRNA abundance of some genes related to mitochondrial biogenesis and very-low-density lipoprotein export in response to an inflammatory challenge, but with largely lacking effects before and 2 wk after LPS.
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Affiliation(s)
- M Alaedin
- Institute of Animal Science, Physiology Unit, University of Bonn, Katzenburgweg 7-9, 53115 Bonn, Germany
| | - M H Ghaffari
- Institute of Animal Science, Physiology Unit, University of Bonn, Katzenburgweg 7-9, 53115 Bonn, Germany
| | - H Sadri
- Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, 516616471 Tabriz, Iran
| | - J Meyer
- Institute of Animal Nutrition, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Bundesallee 37, 38116 Braunschweig, Germany
| | - S Dänicke
- Institute of Animal Nutrition, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Bundesallee 37, 38116 Braunschweig, Germany
| | - J Frahm
- Institute of Animal Nutrition, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Bundesallee 37, 38116 Braunschweig, Germany
| | - K Huber
- Institute of Animal Science, Functional Anatomy of Livestock, University of Hohenheim, Fruwirthstraße 35, 70593 Stuttgart, Germany
| | - S Grindler
- Institute of Animal Science, Functional Anatomy of Livestock, University of Hohenheim, Fruwirthstraße 35, 70593 Stuttgart, Germany
| | - S Kersten
- Institute of Animal Nutrition, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Bundesallee 37, 38116 Braunschweig, Germany
| | - J Rehage
- Clinic for Cattle, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany
| | - E Muráni
- Research Institute for the Biology of Farm Animals (FBN), Research Unit Molecular Biology, Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - H Sauerwein
- Institute of Animal Science, Physiology Unit, University of Bonn, Katzenburgweg 7-9, 53115 Bonn, Germany.
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McGillivray E, Jain R, Ramamurthy C, Sheng J, Granina E, Yu D, Lu X, Abbas A, Dotan E, Meyer J, Fang C, Denlinger C. P-103 Associations between quality-of-life, symptom burden, and demographic characteristics in long-term esophageal and gastroesophageal junction cancer survivors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Elsner P, Meyer J. Verzögerte Diagnose und fehlerhafte Therapie von Basalzellkarzinomen. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1205-3242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungEine 68-jährige Patientin wurde von einer dermatologischen Poliklinik unter der klinischen Verdachtsdiagnose von Basaliomen im Bereich der Stirn und des Ohres über 20 Monate topisch mit 5 % Imiquimod-Creme behandelt, ohne dass eine bioptische Sicherung vorgenommen wurde. Die danach erfolgte dermatohistologische Diagnostik ergab ein sklerodermiformes und ein noduläres Basalzellkarzinom. Eine operative Therapie erfolgte wegen mehrfacher mangelnder Tumorfreiheit der Exzisionsränder während multipler stationärer Aufenthalte.Die Schlichtungsstelle bejahte einen ärztlichen Behandlungsfehler. Die Exzision stellt nach Facharztstandard die Therapie der ersten Wahl des Basalzellkarzinoms dar. Auch bei Patientenwunsch nach einer narbenfreien Therapie in kosmetisch sichtbaren Bereichen ist der ärztliche Entscheid zu einer Externatherapie bei klinischer Einordnung als Basalzellkarzinom vom sklerodermiformen bzw. nodulären Typ ohne histopathologische Sicherung als vermeidbare Fehlentscheidung einzuordnen. Spätestens bei Nichtabheilung nach der Erstbehandlung mit Imiquimod-5 %-Creme hätten zwingend eine Probebiopsie und eine histologische Befundsicherung erfolgen müssen. Es lag ein Befunderhebungsmangel vor, der zu einer Umkehr der Beweislast hinsichtlich der Kausalität des Behandlungsfehlers für den eingetretenen Schaden führte. Der klinische Verdacht auf ein Basalzellkarzinom sollte zeitnah durch eine Probebiopsie oder Totalexzision dermatohistologisch bestätigt werden. Eine Therapie des Basalzellkarzinoms mit topischem Imiquimod ist nur für superfizielle Basalzellkarzinome indiziert; bei Nichtansprechen nach 12 Wochen ist eine andere Therapie zu wählen.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Meyer J, Schrenzel J, Balaphas A, Delaune V, Abbas M, Morel P, Puppa G, Rubbia-Brandt L, Bichard P, Frossard JL, Toso C, Buchs N, Ris F. Mapping of aetiologies and clinical presentation of acute colitis: Results from a prospective cohort study in a tertiary centre. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
Our objective was to describe the aetiologies of acute colitis and to identify patients who require diagnostic endoscopy.
Methods
Patients with symptoms of gastrointestinal infection and colonic inflammation on computed tomography were prospectively included. Those immunosuppressed, with history of colorectal cancer or inflammatory bowel disease (IBD) were excluded. Stools were screened with BD-Max and BioFire FilmArray GI panel. Faecal calprotectin was determined. Patients with negative BD-Max underwent colonoscopy. The study was registered into clinicaltrials.gov (NCT02709213).
Results
One hundred and seventy-nine patients were included. BD-Max was positive in 93 patients (52%) and FilmArray in 108 patients (60.3%). Patients with infectious colitis (n = 103, 57.5%) were positive for Campylobacter spp (n = 57, 55.3%), Escherichia coli spp (n = 8, 7.8%), Clostridium difficile (n = 23, 22.3%), Salmonella spp (n = 9, 8.7%), viruses (n = 7, 6.8%), Shigella spp (n = 6, 5.8%), Entamoeba histolytica (n = 2, 1.9%) and others (n = 4, 3.9%). Eighty-six patients underwent colonoscopy, which was compatible with ischemic colitis in 18 patients (10.1%) and IBD in 4 patients (2.2%). Among patients with negative FilmArray, a faecal calprotectin >625μg/g allowed identifying patients with IBD with an area under ROC curve of 85.1%. Introduction of a diagnostic management algorithm including FilmArray and faecal calprotectin could allow decreasing unnecessary colonoscopies from 82 to 29 (corresponding to a decrease of 64.6%).
Conclusion
Computed tomography-proven colitis was mostly of infectious aetiology. Diagnostic management of patients with acute colitis should include broad molecular testing of the stools and, in patients with a calprotectin concentration >625μg/g, colonoscopy to exclude IBD.
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Affiliation(s)
- J Meyer
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - J Schrenzel
- Infectious diseases, Geneva University Hospital, Geneva, Switzerland
| | - A Balaphas
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - V Delaune
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - M Abbas
- Infectious diseases, Geneva University Hospital, Geneva, Switzerland
| | - P Morel
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - G Puppa
- Department of Pathology, Geneva University Hospital, Geneva, Switzerland
| | - L Rubbia-Brandt
- Department of Pathology, Geneva University Hospital, Geneva, Switzerland
| | - P Bichard
- Department of Gastroenterology, Geneva University Hospital, Geneva, Switzerland
| | - J -L Frossard
- Department of Gastroenterology, Geneva University Hospital, Geneva, Switzerland
| | - C Toso
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - N Buchs
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - F Ris
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
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Meyer J, Cirocchi R, Di Saverio S, Ris F, Wheeler J, Davies RJ. Pre-operative iron allows correction of anaemia before abdominal surgery: A systematic review and meta-analysis of randomized controlled trials. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Professional surgical societies recommend the identification and treatment of pre-operative anaemia in patients scheduled for abdominal surgery. However, the evidence supporting this recommendation has been of poor quality until the recent release of several randomized controlled trials (RCT) addressing the question. Our aim was to determine if pre-operative iron allows correction of haemoglobin concentration and decreased incidence of peri-operative blood transfusion in patients undergoing major abdominal surgery.
Methods
MEDLINE, Embase and CENTRAL were searched for RCTs written in English and assessing the effect of pre-operative iron on the incidence of peri-operative allogeneic blood transfusion in patients undergoing major abdominal surgery. Pooled relative risk (RR), risk difference (RD) and mean difference (MD) were obtained using models with random effects. Heterogeneity was assessed using the Q-test and quantified using the I2 value.
Results
Four RCTs were retained for analysis out of 285 eligible articles. MD in haemoglobin concentration between patients with pre-operative iron and patients without pre-operative iron was of 0.81 g/dl (3 RCTs, 95% CI: 0.30 to 1.33, I2: 60%, p = 0.002). Pre-operative iron did not lead to reduction in the incidence of peri-operative blood transfusion in terms of RD (4 RCTs, RD: -0.13, 95% CI: -0.27 to 0.01, I2: 65%, p = 0.07) or RR (4 RCTs, RR: 0.57, 95% CI: 0.30 to 1.09, I2: 64%, p = 0.09).
Conclusion
Pre-operative iron significantly increases haemoglobin concentration by 0.81 g/dl before abdominal surgery but does not reduce the need for peri-operative blood transfusion. Important heterogeneity exists between existing RCTs in terms of populations and interventions. Future trials should target patients suffering from iron-deficiency anaemia and assess the effect of intervention on anaemia-related complications.
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Affiliation(s)
- J Meyer
- Colorectal Unit, Cambridge NHS Foundation Trust, Cambridge, United Kingdom
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - R Cirocchi
- Department of General Surgery and Surgical Oncology, Hospital of Terni, Terni, Italy
| | - S Di Saverio
- General Surgery, Ospedale di Circolo Fondazione Macchi, Varese, Italy
| | - F Ris
- Department of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland
| | - J Wheeler
- Colorectal Unit, Cambridge NHS Foundation Trust, Cambridge, United Kingdom
| | - R J Davies
- Colorectal Unit, Cambridge NHS Foundation Trust, Cambridge, United Kingdom
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Uberoi A, Bartow-McKenney C, Zheng Q, Flowers L, Campbell A, Knight S, Chan N, Wei M, Lovins V, Bugayev J, Horwinski J, Bradley C, Meyer J, Crumrine D, Sutter C, Elias P, Mauldin E, Sutter T, Grice E. 190 Commensal microbiota regulates skin barrier function and repair via signaling through the aryl hydrocarbon receptor. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Elsner P, Meyer J. Kosmetische Laser- und Elektrokautertherapie ohne rechtswirksame Aufklärung. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1345-6891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungBei einer Patientin erfolgte als Selbstzahlerleistung bei einem Hautarzt die Therapie eines Spider-Naevus elektrokaustisch sowie dermaler Naevuszellnaevi mittels Erbiumlaser. Die Patientin war mit dem Behandlungsergebnis unzufrieden und bemängelte bei der zuständigen Schlichtungsstelle die Behandlung; die Laserbehandlung im Gesicht sei fehlerhaft durchgeführt worden. Die Behandlung sei nur für eine Hautveränderung abgesprochen gewesen; während des Eingriffs seien durch den behandelnden Arzt jedoch weitere Bereiche gelasert worden. Erst nach der Behandlung seien ihr mittels Spiegel ärztlicherseits die gelaserten Areale gezeigt worden.Die Schlichtungsstelle verneinte ebenso wie der konsultierte dermatologische Gutachter einen Behandlungsfehler; sowohl die Elektrokaustik als auch die Lasertherapie seien lege artis erfolgt. Die geltend gemachten Ansprüche waren aus Sicht der Schlichtungsstelle jedoch unter dem Gesichtspunkt der mangelhaften Aufklärung begründet. In den Patientenunterlagen des Hautarztes fand sich lediglich ein kursorischer Hinweis über die Möglichkeit der Entfernung der Hautveränderungen mit dem Elektrokauter und dem Erbiumlaser und über den Verlauf und die möglichen Komplikationen. Derartige Hinweise genügten nach Einschätzung der Schlichtungsstelle für die Dokumentation über die geplanten kosmetischen Behandlungsmaßnahmen und in der Folge für die rechtswirksame Einwilligung der Patientin nicht.Auch bei nach Facharztstandard korrekt durchgeführten kosmetischen Eingriffen ist auf eine rechtzeitige, umfassende Aufklärung als Voraussetzung für eine rechtswirksame Einwilligung des Patienten in den Eingriff höchsten Wert zu legen. Ohne Aufklärung und rechtswirksame Einwilligung ist der Eingriff rechtswidrig; unvermeidliche verbleibende kosmetische Beeinträchtigungen nach einem solchen Eingriff sind dann als Gesundheitsschaden zu bewerten und schadensersatzpflichtig. Neben den zivil- und möglicherweise strafrechtlichen Konsequenzen muss der Arzt auch mit berufsrechtlichen Disziplinarmaßnahmen rechnen.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Abstract
ZusammenfassungEine Patientin stellte sich in einer Hautarztpraxis zur Entfernung einer „Aknezyste“ im Bereich der Wange rechts vor. Die Exzision erfolgte in Lokalanästhesie; die histologische Befundung bestätigte die klinische Diagnose. Bei der Nachkontrolle der Exzisionsstelle wurde von der Patientin eine „Zipfelbildung“ an der Narbe bemängelt. Im Folgenden suchte die Patientin einen weiteren Hautarzt auf, der „Dog Ears“ an der Narbe diagnostizierte und eine spätere operative Korrektur empfahl, die schließlich in einer Fachklinik für Plastische und Ästhetische Chirurgie vorgenommen wurde.Die von der Patientin angerufene Schlichtungsstelle stellte fest, dass die nicht korrekte Wahl der Exzisionsstelle exakt nach der Lage der Hautspannungslinien des Gesichtes sowie die Nichteinhaltung eines Winkels von 30° an den jeweiligen Wundenden bei der Schnittführung nicht dem Facharztstandard entsprach und zu den „Dog Ears“ führte. Nach den vorliegenden Fotodokumentationen waren diese aufwerfenden Hautauszipfelungen als kosmetisch beeinträchtigend zu bewerten und bedurften nachfolgend einer Narbenkorrektur.Der vom behandelnden Hautarzt angeführte Wunsch der Patientin nach einer „möglichst kleinen Exzision und Narbe“ veranlasste diesen zu einem zu kleinen Wundverschluss in Abweichung vom Facharztstandard, wonach eine längere, elliptoide Exzision erforderlich gewesen wäre. Besteht ein Patient auf einem Abweichen vom Facharztstandard, sollte dies zur Vermeidung späterer Schadensersatzforderungen nach Aufklärung über die potenziell negativen Folgen schriftlich vereinbart werden.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Meyer J, Schiltz B, Balaphas A, Carvello M, Spinelli A, Toso C, Ris F, Buchs N. How do Swiss surgeons perform fluorescence angiography in colorectal surgery? Tech Coloproctol 2021; 25:657-658. [PMID: 33761031 DOI: 10.1007/s10151-021-02427-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/05/2021] [Indexed: 01/06/2023]
Affiliation(s)
- J Meyer
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland.
| | - B Schiltz
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - A Balaphas
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - M Carvello
- Humanitas Hospital, Via Alessandro Manzoni, 56, 20089 Rozzano, Milano, Italy
| | - A Spinelli
- Humanitas Hospital, Via Alessandro Manzoni, 56, 20089 Rozzano, Milano, Italy
| | - C Toso
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - F Ris
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
| | - N Buchs
- Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
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Alketbi MSG, Meyer J, Robert-Yap J, Scarpa R, Gialamas E, Abbassi Z, Balaphas A, Buchs N, Roche B, Ris F. Levator ani and puborectalis muscle rupture: diagnosis and repair for perineal instability. Tech Coloproctol 2021; 25:923-933. [PMID: 33745102 DOI: 10.1007/s10151-020-02392-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/23/2020] [Accepted: 12/20/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Puborectalis muscle rupture usually arises from peri-partum perineal trauma and may result in anterior, middle compartment prolapses, posterior compartment prolapse which includes rectocele and rectal prolapse, with or without associated anal sphincter damage. Patients with puborectalis muscle and levator ani rupture may present some form of incontinence or evacuation disorder, sexual dysfunction or pelvic organ descent. However, the literature on this subject is scarce. The aim of our study was to evaluate management and treatment of functional disorders associated with puborectalis and/or pubococcygei rupture at the level of the insertion in the pubis in a cohort of patients referred to a tertiary care coloproctology center. METHODS We conducted a prospective cohort study of patients with levator ani and puborectalis muscle avulsion in the Proctology and Pelvic Floor Unit, Division of Digestive Surgery of the University Hospitals of Geneva from January 2001 to November 2018. Clinical examination, anoscopy and ultrasound were performed on a routine basis. Rupture of the levator ani muscle was diagnosed by clinical examination and ultrasound. A Wexner incontinence score was completed before and 6 months after surgery. Levator ani muscle repair was performed using a transvaginal approach. RESULTS Fifty-two female patients (median age 56 ± 11.69 SD years, range 38-86 years) were included in the study. Thirty-one patients (59.6%) had anal incontinence, 25 (48.1%) urinary incontinence, 28 (53.9%) dyschezia (obstructive defecation or excessive straining to defecate), 20 (38.5%) dyspareunia, 17 (32.7%) colpophony, and 13 (25.0%) impaired sensation during sexual intercourse. Deviation of the anus on the side opposite the lesion was observed in 50 patients (96.2%), confirmed with clinical examination and both endoanal and perineal ultrasound. Out of these 52 patients, levator ani rupture (including puborectalis rupture) were categorized into right sided, 43 (82.69%), left sided, 7 (13.46%) and bilateral, 2 (3.85%). Levator ani muscle repair was performed in all patients, associated with posterior repair and levatorplasty in 26 patients (50%) and with sphincteroplasty in 34 patients (63.4%). Four patients (7.7%) experienced postoperative complications: significant postoperative pain (n = 3; 5.77%), urinary retention (n = 2; 3.85%), hematoma (n = 1; 1.92%), and perineal abscess (n = 1; 1.92%). Forty-one patients (78.8%) had full restoration of normal puborectalis muscle function (Wexner score: 0/20) after surgery, and overall, all patients had an improvement in the Wexner score and in sexual function. Dyschezia was reported by 28 patients (53.9%) preoperatively, resolved in 18 (64.3%) and improved by 50% or more in 10 (35.71%). CONCLUSIONS Diagnosis of levator ani and puborectalis muscle rupture requires careful history taking, clinical examination, endoanal and perineal ultrasound. Surgical repair improved anal continence as well as sexual function in all patients. Transvaginal levator ani repair seems to be well tolerated with good short-term results.
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Affiliation(s)
- M S Gh Alketbi
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
| | - J Meyer
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - J Robert-Yap
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - R Scarpa
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - E Gialamas
- Division of Digestive Surgery, Neuchâtel Hospital, Neuchâtel, Switzerland
| | - Z Abbassi
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - A Balaphas
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - N Buchs
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - B Roche
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - F Ris
- Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
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Elsner P, Meyer J. Unterlassene Notfallbehandlung eines akuten allergischen Kontaktekzems. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1160-9478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungBei einer Patientin traten nach der Färbung der Augenbrauen mit einem vermutlich Paraphenylendiamin-haltigen Produkt eine großflächige Gesichtsrötung und eine periorbitale Schwellung auf. Bei der Vorstellung in der interdisziplinären Notaufnahme eines nahegelegenen Klinikums wurde auf eine Therapie verzichtet und die Patientin an einen niedergelassenen Dermatologen verwiesen. Erst mit Verzögerung und nach weiterer Verschlechterung des Hautbefundes wurde in einem anderen von der Patientin konsultierten Klinikum eine allergologische Notfalltherapie mit einem systemischen Glukokortikosteroid und einem Antihistaminikum eingeleitet.Die Schlichtungsstelle beurteilte die Unterlassung der Notfalltherapie als einen ärztlichen Behandlungsfehler. Bei Einbezug der Kenntnis der zeitlichen Entwicklung der Erkrankung durch eine allergische Verursachung, die dem Dienstarzt bekannt war, wäre bei Einsatz einer Kortikoidtherapie das Krankheitsgeschehen wesentlich zu beeinflussen und eine deutliche Verkürzung des Krankheitsverlaufs zu erwarten gewesen.Klinisch schwere akute allergische Kontaktekzeme bedürfen einer medizinischen Notfalltherapie, wozu neben einer Entfernung und Meidung möglicherweise auslösender Allergene auch eine topische und ggf. systemische antiinflammatorische Therapie gehört. Die Unterlassung dieser Notfalltherapie kann eine ärztliche Sorgfaltspflichtverletzung und damit einen Behandlungsfehler darstellen. Die Versorgung dermatologischer Notfälle durch Nichtdermatologen entbindet diese nicht von der Pflicht zu einer Notfallbehandlung, wie sie unabhängig von der Spezialisierung von jedem Arzt erwartet werden muss. Interdisziplinäre Notfallambulanzen sollten Möglichkeiten der konsiliarischen Unterstützung durch Dermatologen vorsehen.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Elsner P, Peckruhn M, Meyer J. Mangelnde Nachexzision eines dermatohistologisch suspekten Poroms. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1182-8855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungVon einem niedergelassenen Hautarzt wurde bei einem Patienten eine Hautveränderung im Bereich des Oberschenkels rechts unter dem Verdacht auf einen epidermalen Naevus exzidiert. Dermatohistologisch wurde die Diagnose „ekkrines Porom“ gestellt. Bei gesteigerter Proliferationsaktivität konnte die Dignität jedoch nicht sicher als gutartig bewertet werden und eine komplette Nachexzision wurde dringend empfohlen. Diese erfolgte weder zeitnah noch nach 11 Monaten, als sich der Patient aufgrund einer Urtikaria erneut vorstellte. Weitere 14 Monate später erfolgte eine Konsultation des Patienten bei einem anderen Hautarzt aufgrund einer plattenförmigen Veränderung im erstbehandelten Bereich des Oberschenkels, wo mittels einer Hautbiopsie ein invasives Porokarzinom gesichert wurde. Eine stationäre Nachexzision sowie ein Tumorstaging wurden in einer dermatologischen Universitätsklinik vorgenommen. 6 Jahre später wurde im Bereich der rechten Leiste eine Lymphknotenmetastase des Porokarzinoms nachgewiesen, die in einer chirurgischen Klinik mittels Lymphknotendissektion sowie adjuvanter Strahlentherapie therapiert wurde.Von der Schlichtungsstelle wurde zwar ein Diagnosefehler verneint, aber eine schuldhafte Unterlassung der Sicherungsaufklärung und der Veranlassung der Folgebehandlung bejaht. Die Unterlassung einer In toto-Entfernung des ekkrinen Poroms mit dadurch erfolgter Zeitverzögerung des malignen Hauttumors war als fehlerhafte massive Fachstandardunterschreitung einzuordnen; bei korrektem Vorgehen wäre nach ärztlicher Erfahrung eine wesentliche Veränderung des Krankheitsverlaufes zu erwarten gewesen.Der dermatohistologische Befund von auf Malignität verdächtigen, unvollständig exzidierten Hauttumoren sollte dem Patienten unverzüglich mitgeteilt, eine Nachexzision, sofern indiziert, eindringlich empfohlen und diese Sicherungsaufklärung in der Patientenakte vermerkt werden. Das Versäumnis dieser Pflicht zur Aufklärung und nachfolgenden Behandlung kann einen groben Behandlungsfehler darstellen, der zur Beweislastumkehr für die Kausalität nachfolgend auftretender Gesundheitsschäden des Patienten führt.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - M. Peckruhn
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Elsner P, Meyer J. Verspätet erkannte Phlegmone bei diabetischem Fußsyndrom. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1205-3180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungEin Patient mit insulinpflichtigem Diabetes mellitus Typ II und diabetischer Polyneuropathie entwickelte akut eine vesikulöse Hautveränderung am linken Fuß, die von einem Dermatologen unter der Diagnose eines Herpes simplex antiviral behandelt wurde. Erst mit 14-tägiger Verzögerung erfolgte die Diagnoseänderung als bakterielle Infektion und nach Wundabstrich eine interne Antibiose. Weitere diagnostische oder therapeutische Maßnahmen, außer Verbandswechsel mit lokaler Anwendung von antibakteriellen Kompressen, wurden nicht durchgeführt. Unter zunehmender Verschlechterung des Befundes und der Diagnose Phlegmone Vorfuß links wurde der Patient in eine chirurgische Praxis und dann in eine Klinik für Gefäßchirurgie überwiesen, wo es nach Amputation der 3. Zehe links sowie Nekrektomie mit offener Wundbehandlung und erregerspezifischer Antibiose über mehrere Monate zur Abheilung kam.Die Schlichtungsstelle stellte einen groben Behandlungsfehler aufgrund des Verkennens der Diagnose, des nicht ausreichenden Einbezuges weiterführender diagnostischer Maßnahmen, einer nicht stadiengerechten Wundtherapie und fehlender Wundkontrollen fest. Nach Einschätzung der Schlichtungsstelle ist von einem schweren Fehler auszugehen. Ein schwerer Behandlungsfehler, der generell geeignet ist, einen Schaden der tatsächlich eingetretenen Art herbeizuführen, führt grundsätzlich zu einer Umkehr der objektiven Beweislast für den ursächlichen Zusammenhang zwischen dem Behandlungsfehler und dem primären Gesundheitsschaden.Infektionen auf dem Boden eines diabetischen Fußsyndroms sind mit einer hohen Morbidität und Mortalität behaftet. Da sie klinisch blande verlaufen können, sollten bei jedem Verdacht eine engmaschige Wundkontrolle sowie eine leitliniengerechte Diagnostik und Therapie erfolgen. In der Zusammenarbeit mit pflegerischen Wundmanagern ist zu klären, ob diese in Delegation des Arztes oder in eigenständiger Verantwortung tätig werden können. Für die ärztliche Dokumentation ist bei der Versorgung von Patienten mit chronischen Wunden der Dermatologe selbst verantwortlich.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Elsner P, Schliemann S, Meyer J. Tod durch Sepsis nach längerfristiger hochdosierter Glukokortikosteroid-Therapie einer Urtikaria. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1169-2190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungEin 80-jähriger Patient mit der Einweisungsdiagnose einer unklaren schweren Urtikaria wurde stationär in einer Klinik für Dermatologie über mehr als 3 Wochen mit systemischen Antihistaminika und intravenös gegebenen Glukokortikosteroiden in höherer Dosis (über 100 mg Prednisolonäquivalenten/Tag) behandelt. Darunter kam es zu einer diabetischen Stoffwechsellage, einer Thrombozytopenie und einer intensivmedizinisch nicht beherrschbaren Staphylokokkensepsis, die schließlich zum Tode führte.Die Schlichtungsstelle beurteilte die längerfristige hochdosierte systemische Glukokortikosteroid-Therapie der Urtikaria als vermeidbaren Behandlungsfehler, da aufgrund der von der Klinik gewählten hohen Glukokortikoid-Dosen und der Behandlungsdauer mit einer ausgeprägten Immunsuppression und entsprechend hoher Infektanfälligkeit zu rechnen war, die sich im konkreten Fall in tragischer Weise realisiert hat.In der Therapie der akuten Urtikaria, aber auch der chronisch-spontanen Urtikaria kann bei Nichtansprechen auf die höherdosierten H1-Antihistaminika die Gabe von systemischen Glukokortikosteroiden notwendig werden; diese sind allerdings bei akuter Urtikaria nur kurzzeitig (für 3 – 4 Tage) mit 40 – 50 mg Predinisolonäquivalent pro Tag empfohlen. Nur wenn assoziierte schwere Angioödeme vorliegen, ergibt sich eine Indikation für eine höherdosierte intravenöse Prednisolontherapie. Die aktuelle internationale Leitlinie zur chronischen Urtikaria äußert sich sehr kritisch gegenüber einer längerfristigen Anwendung von systemischen Glukokortikosteroiden bei der chronisch-spontanen Urtikaria; selbst bei akuten Exazerbationen der chronisch-spontanen Urtikaria sollte die Behandlung auf maximal bis zu 10 Tagen begrenzt werden.Insbesondere im Fall des Off-Label-Einsatzes von Medikamenten, wie es im aktuellen Fall sowohl bez. der Antihistaminika als auch des systemischen Glukokortikosteroids gegeben war, treffen den behandelnden Arzt besondere Aufklärungspflichten, damit der Patient rechtswirksam zustimmen kann („informed consent“). Die Beweislast für die ordnungsgemäße Aufklärung über einen Off-Label-Use obliegt dem Arzt; diese sollte er zur Vermeidung von Aufklärungsrügen nach Möglichkeit schriftlich dokumentieren.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - S. Schliemann
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Heindl F, Fasching PA, Hein A, Hack CC, Heusinger K, Gaß P, Schulz-Wendtland R, Hartmann A, Erber R, Beckmann MW, Meyer J, Häberle L, Jud SM. Mammographische Dichte und Prognose bei Patientinnen mit primärem Mammakarzinom – Risikoverlust durch zunehmendes Alter. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- F Heindl
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - PA Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - A Hein
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - CC Hack
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - K Heusinger
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - P Gaß
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - R Schulz-Wendtland
- Institut für Diagnostische Radiologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - A Hartmann
- Institut für Pathologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - R Erber
- Institut für Pathologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - MW Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - J Meyer
- Biostatistische Einheit, Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - L Häberle
- Biostatistische Einheit, Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
| | - SM Jud
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen, Europäische Metropolregion Nürnberg (CCC ER-EMN), Friedrich Alexander Universität Erlangen-Nürnberg
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Penner T, Meyer J, Dittler A. Relevance of downstream support structure design for oleophilic and oleophobic oil mist filter operating performance. Sep Purif Technol 2020. [DOI: 10.1016/j.seppur.2020.117074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Affiliation(s)
- T. Michaelsen
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
| | - T. Gstir
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
| | - B. Bastian
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | - E. Carrascosa
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
- Laboratory of Molecular Physical Chemistry, Swiss Federal Institute of Technology, Lausanne, Switzerland
| | - A. Ayasli
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
| | - J. Meyer
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
| | - R. Wester
- Institut für Ionenphysik und Angewandte Physik, Universität Innsbruck, Innsbruck, Austria
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Tietz Marques S, Meyer J, Meller Alievi M. A coprological survey of zoonotic tapeworm Bertiella spp. in free living nonhuman primate in Brazil. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Bertiella genus is parasitic tapeworms of non-human primates in nature. B. studeri and B. mucronata have been identified in children and adults with some contact or association with non-human primates. This study aimed to identify zoonotic tapeworms of the genus Bertiella in stool samples from Alouatta guariba clamitans, a primate from the New World, living free in a human community.
Methods
The study of Bertiella spp. comprised a coprological survey of feces collected from 131 brown howler monkeys, male and female, infant and adult, from free-living troops in nine neighborhoods in southern Porto Alegre, including places with increasing anthropization and population pressure, and an estimated population of 83,312 inhabitants. The study lasted four years (2015 to 2018), with stool samples collected from primates under care at the Centre for Wildlife Rehabilitation and Conservation of the Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Brazil. As per usual protocol, all wild animals treated at the Center undergo parasitological examination. Individual freshly collected samples were subjected to the Willis-Mollay method and the Lutz technique.
Results
The average prevalence of Bertiella spp. was 31.3% (41/131). The annual frequencies were 27.3% (6/22), 30% (11/37), 25% (5/20) and 36.5% (19/52), respectively for the years 2015, 2016, 2017 and 2018.
Conclusions
The results demonstrate that Bertiella spp. was present in parasitic fauna over the four years studied and represents a zoonotic potential. Therefore, these methods should be carried out routinely, as they help in the appropriate treatment when necessary. The control and the prevention of this zoonosis are difficult since the intermediate hosts are cosmopolitan. It is suggested that an epidemiological inquiry in humans be performed to ascertain the true prevalence of this parasitosis.
Key messages
Create a schedule of routine test with underserved populations to monitor zoonoses. Poor communities need to be included in government programs.
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Affiliation(s)
- S Tietz Marques
- Clinical Veterinary Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - J Meyer
- Clinical Veterinary Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - M Meller Alievi
- Veterinary Hospital, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Elsner P, Meyer J. Verspätete Aufklärung vor Lasertherapie eines Naevus flammeus. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1158-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungEin Naevus flammeus im Bereich der rechten Wange einer Patientin wurde von einem Dermatologen mit einem Diodenlaser behandelt. In der Folge kam es zu einer Wundheilungsstörung und einer hypertrophen Narbe, die in einer Klinik für plastische Chirurgie mittels Vollhauttransplantation korrigiert wurde. Es verblieben dokumentierte Narbenzustände sowie ein beginnendes Ektropium.Während ein von der Schlichtungsstelle beauftragter Gutachter keinen Behandlungsfehler feststellen konnte, kam die Schlichtungsstelle aufgrund rechtlicher Überlegungen zu dem Schluss, dass der Hautarzt gleichwohl der Patientin gegenüber für die eingetretenen Körperschäden haftbar sei, da keine rechtswirksame Einwilligung für die Laserbehandlung vorgelegen habe. Diese setze eine entsprechende Aufklärung voraus. Die Aufklärung der Patientin erfolgte jedoch am gleichen Tag, an dem ebenfalls die Behandlung durch den Hautarzt stattfand. Eine Aufklärung dürfe auch bei kleineren Eingriffen nicht erst so kurzfristig erfolgen, dass der Patient schon während der Aufklärung mit der anschließenden Durchführung des Eingriffs rechnen muss und deshalb unter Druck steht, sich nicht mehr aus dem bereits in Gang gesetzten Geschehensablauf lösen zu können.Gerade bei dermatologischen Eingriffen im Grenzbereich zwischen medizinischer Notwendigkeit und kosmetischer Indikation kommt einer umfassenden Aufklärung auch über seltene Risiken einer Behandlung als Voraussetzung für eine rechtswirksame Einwilligung in die Durchführung der Behandlung große Bedeutung zu. Diese sollte grundsätzlich mündlich und schriftlich sowie rechtzeitig vor der Behandlung stattfinden, um dem Patienten Bedenkzeit zu geben und die Voraussetzung für eine informierte Einwilligung zu schaffen. Von einer Aufklärung erst kurz vor Durchführung der Laserbehandlung am gleichen Tag ist abzuraten. Nach der umfassenden mündlichen Aufklärung und Beantwortung allfälliger Fragen des Patienten sollten der Umfang der Aufklärung und die Einwilligung schriftlich dokumentiert werden.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Aad G, Abbott B, Abbott D, Abdinov O, Abed Abud A, Abeling K, Abhayasinghe D, Abidi S, AbouZeid O, Abraham N, Abramowicz H, Abreu H, Abulaiti Y, Acharya B, Achkar B, Adachi S, Adam L, Adam Bourdarios C, Adamczyk L, Adamek L, Adelman J, Adersberger M, Adiguzel A, Adorni S, Adye T, Affolder A, Afik Y, Agapopoulou C, Agaras M, Aggarwal A, Agheorghiesei C, Aguilar-Saavedra J, Ahmadov F, Ahmed W, Ai X, Aielli G, Akatsuka S, Åkesson T, Akilli E, Akimov A, Al Khoury K, Alberghi G, Albert J, Alconada Verzini M, Alderweireldt S, Aleksa M, Aleksandrov I, Alexa C, Alexandre D, Alexopoulos T, Alfonsi A, Alhroob M, Ali B, Alimonti G, Alison J, Alkire S, Allaire C, Allbrooke B, Allen B, Allport P, Aloisio A, Alonso A, Alonso F, Alpigiani C, Alshehri A, Alvarez Estevez M, Álvarez Piqueras D, Alviggi M, Amaral Coutinho Y, Ambler A, Ambroz L, Amelung C, Amidei D, Amor Dos Santos S, Amoroso S, Amrouche C, An F, Anastopoulos C, Andari N, Andeen T, Anders C, Anders J, Andreazza A, Andrei V, Anelli C, Angelidakis S, Angerami A, Anisenkov A, Annovi A, Antel C, Anthony M, Antonelli M, Antrim D, Anulli F, Aoki M, Aparisi Pozo J, Aperio Bella L, Arabidze G, Araque J, Araujo Ferraz V, Haddad N, Hadef A, Hageböck S, Hagihara M, Haleem M, Haley J, Halladjian G, Hallewell G, Hamacher K, Hamal P, Araujo Pereira R, Hamano K, Hamdaoui H, Hamity G, Han K, Han L, Han S, Hanagaki K, Hance M, Handl D, Haney B, Arcangeletti C, Hankache R, Hansen E, Hansen J, Hansen J, Hansen M, Hansen P, Hanson E, Hara K, Hard A, Harenberg T, Arce A, Harkusha S, Harrison P, Hartmann N, Hasegawa Y, Hasib A, Hassani S, Haug S, Hauser R, Havener L, Havranek M, Arduh F, Hawkes C, Hawkings R, Hayden D, Hayes C, Hayes R, Hays C, Hays J, Hayward H, Haywood S, He F, Arguin JF, Heath M, Hedberg V, Heelan L, Heer S, Heidegger K, Heidorn W, Heilman J, Heim S, Heim T, Heinemann B, Argyropoulos S, Heinrich J, Heinrich L, Heinz C, Hejbal J, Helary L, Held A, Hellesund S, Helling C, Hellman S, Helsens C, Arling JH, Henderson R, Heng Y, Henkelmann S, Henriques Correia A, Herbert G, Herde H, Herget V, Hernández Jiménez Y, Herr H, Herrmann M, Armbruster A, Herrmann T, Herten G, Hertenberger R, Hervas L, Herwig T, Hesketh G, Hessey N, Higashida A, Higashino S, Higón-Rodriguez E, Armitage L, Hildebrand K, Hill E, Hill J, Hill K, Hiller K, Hillier S, Hils M, Hinchliffe I, Hinterkeuser F, Hirose M, Armstrong A, Hirose S, Hirschbuehl D, Hiti B, Hladik O, Hlaluku D, Hoad X, Hobbs J, Hod N, Hodgkinson M, Hoecker A, Arnaez O, Hoenig F, Hohn D, Hohov D, Holmes T, Holzbock M, Hommels L, Honda S, Honda T, Hong T, Hönle A, Arnold H, Hooberman B, Hopkins W, Horii Y, Horn P, Horyn L, Hostiuc A, Hou S, Hoummada A, Howarth J, Hoya J, Artamonov A, Hrabovsky M, Hrdinka J, Hristova I, Hrivnac J, Hrynevich A, Hryn’ova T, Hsu P, Hsu SC, Hu Q, Hu S, Artoni G, Huang Y, Hubacek Z, Hubaut F, Huebner M, Huegging F, Huffman T, Huhtinen M, Hunter R, Huo P, Hupe A, Artz S, Huseynov N, Huston J, Huth J, Hyneman R, Hyrych S, Iacobucci G, Iakovidis G, Ibragimov I, Iconomidou-Fayard L, Idrissi Z, Asai S, Iengo P, Ignazzi R, Igonkina O, Iguchi R, Iizawa T, Ikegami Y, Ikeno M, Iliadis D, Ilic N, Iltzsche F, Asbah N, Introzzi G, Iodice M, Iordanidou K, Ippolito V, Isacson M, Ishino M, Ishitsuka M, Islam W, Issever C, Istin S, Asimakopoulou E, Ito F, Iturbe Ponce J, Iuppa R, Ivina A, Iwasaki H, Izen J, Izzo V, Jacka P, Jackson P, Jacobs R, Asquith L, Jaeger B, Jain V, Jäkel G, Jakobi K, Jakobs K, Jakobsen S, Jakoubek T, Jamieson J, Janas K, Jansky R, Assamagan K, Janssen J, Janus M, Janus P, Jarlskog G, Javadov N, Javůrek T, Javurkova M, Jeanneau F, Jeanty L, Jejelava J, Astalos R, Jelinskas A, Jenni P, Jeong J, Jeong N, Jézéquel S, Ji H, Jia J, Jiang H, Jiang Y, Jiang Z, Atkin R, Jiggins S, Jimenez Morales F, Jimenez Pena J, Jin S, Jinaru A, Jinnouchi O, Jivan H, Johansson P, Johns K, Johnson C, Atkinson M, Jon-And K, Jones R, Jones S, Jones S, Jones T, Jongmanns J, Jorge P, Jovicevic J, Ju X, Junggeburth J, Atlay N, Juste Rozas A, Kaczmarska A, Kado M, Kagan H, Kagan M, Kahra C, Kaji T, Kajomovitz E, Kalderon C, Kaluza A, Atmani H, Kamenshchikov A, Kanjir L, Kano Y, Kantserov V, Kanzaki J, Kaplan L, Kar D, Kareem M, Karentzos E, Karpov S, Augsten K, Karpova Z, Kartvelishvili V, Karyukhin A, Kashif L, Kass R, Kastanas A, Kataoka Y, Kato C, Katzy J, Kawade K, Avolio G, Kawagoe K, Kawaguchi T, Kawamoto T, Kawamura G, Kay E, Kazanin V, Keeler R, Kehoe R, Keller J, Kellermann E, Avramidou R, Kelsey D, Kempster J, Kendrick J, Kepka O, Kersten S, Kerševan B, Ketabchi Haghighat S, Khader M, Khalil-Zada F, Khandoga M, Ayoub M, Khanov A, Kharlamov A, Kharlamova T, Khoda E, Khodinov A, Khoo T, Khramov E, Khubua J, Kido S, Kiehn M, Azoulay A, Kilby C, Kim Y, Kimura N, Kind O, King B, Kirchmeier D, Kirk J, Kiryunin A, Kishimoto T, Kisliuk D, Azuelos G, Kitali V, Kivernyk O, Kladiva E, Klapdor-Kleingrothaus T, Klassen M, Klein M, Klein M, Klein U, Kleinknecht K, Klimek P, Baca M, Klimentov A, Klingl T, Klioutchnikova T, Klitzner F, Kluit P, Kluth S, Kneringer E, Knoops E, Knue A, Kobayashi D, Bachacou H, Kobayashi T, Kobel M, Kocian M, Kodys P, Koenig P, Koffas T, Köhler N, Koi T, Kolb M, Koletsou I, Bachas K, Komarek T, Kondo T, Kondrashova N, Köneke K, König A, Kono T, Konoplich R, Konstantinides V, Konstantinidis N, Konya B, Backes M, Kopeliansky R, Koperny S, Korcyl K, Kordas K, Koren G, Korn A, Korolkov I, Korolkova E, Korotkova N, Kortner O, Backman F, Kortner S, Kosek T, Kostyukhin V, Kotwal A, Koulouris A, Kourkoumeli-Charalampidi A, Kourkoumelis C, Kourlitis E, Kouskoura V, Kowalewska A, Bagnaia P, Kowalewski R, Kozakai C, Kozanecki W, Kozhin A, Kramarenko V, Kramberger G, Krasnopevtsev D, Krasny M, Krasznahorkay A, Krauss D, Bahmani M, Kremer J, Kretzschmar J, Krieger P, Krieter F, Krishnan A, Krizka K, Kroeninger K, Kroha H, Kroll J, Kroll J, Bahrasemani H, Krstic J, Kruchonak U, Krüger H, Krumnack N, Kruse M, Krzysiak J, Kubota T, Kuchinskaia O, Kuday S, Kuechler J, Bailey A, Kuehn S, 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Bogdanchikov A, Yue X, Yuen S, Zabinski B, Zacharis G, Zaffaroni E, Zahreddine J, Zaitsev A, Zakareishvili T, Zakharchuk N, Zambito S, Bohm C, Zanzi D, Zaripovas D, Zeißner S, Zeitnitz C, Zemaityte G, Zeng J, Zenin O, Ženiš T, Zerwas D, Zgubič M, Boisvert V, Zhang D, Zhang F, Zhang G, Zhang G, Zhang H, Zhang J, Zhang L, Zhang L, Zhang M, Zhang R, Bokan P, Zhang R, Zhang X, Zhang Y, Zhang Z, Zhang Z, Zhao P, Zhao Y, Zhao Z, Zhemchugov A, Zheng Z, Bold T, Zhong D, Zhou B, Zhou C, Zhou M, Zhou M, Zhou N, Zhou Y, Zhu C, Zhu H, Zhu H, Boldyrev A, Zhu J, Zhu Y, Zhuang X, Zhukov K, Zhulanov V, Zieminska D, Zimine N, Zimmermann S, Zinonos Z, Ziolkowski M, Bolz A, Živković L, Zobernig G, Zoccoli A, Zoch K, Zorbas T, Zou R, Zwalinski L, Bomben M, Bona M, Bonilla J, Boonekamp M, Borecka-Bielska H, Borisov A, Borissov G, Bortfeldt J, Bortoletto D, Bortolotto V, Boscherini D, Bosman M, Bossio Sola J, Bouaouda K, Boudreau J, Bouhova-Thacker E, Boumediene D, Boutle S, Boveia A, Boyd J, Boye D, Boyko I, Bozson A, Bracinik J, Brahimi N, Brandt G, Brandt O, Braren F, Brau B, Brau J, Breaden Madden W, Brendlinger K, Brenner L, Brenner R, Bressler S, Brickwedde B, Briglin D, Britton D, Britzger D, Brock I, Brock R, Brooijmans G, Brooks W, Brost E, Broughton J, Bruckman de Renstrom P, Bruncko D, Bruni A, Bruni G, Bruni L, Bruno S, Brunt B, Bruschi M, Bruscino N, Bryant P, Bryngemark L, Buanes T, Buat Q, Buchholz P, Buckley A, Budagov I, Bugge M, Bührer F, Bulekov O, Burch T, Burdin S, Burgard C, Burger A, Burghgrave B, Burr J, Burzynski J, Büscher V, Buschmann E, Bussey P, Butler J, Buttar C, Butterworth J, Butti P, Buttinger W, Buzatu A, Buzykaev A, Cabras G, Cabrera Urbán S, Caforio D, Cai H, Cairo V, Cakir O, Calace N, Calafiura P, Calandri A, Calderini G, Calfayan P, Callea G, Caloba L, Calvente Lopez S, Calvet D, Calvet S, Calvet T, Calvetti M, Camacho Toro R, Camarda S, Camarero Munoz D, Camarri P, Cameron D, Caminal Armadans R, Camincher C, Campana S, Campanelli M, Camplani A, Campoverde A, Canale V, Canesse A, Cano Bret M, Cantero J, Cao T, Cao Y, Capeans Garrido M, Capua M, Cardarelli R, Cardillo F, Carducci G, Carli I, Carli T, Carlino G, Carlson B, Carminati L, Carney R, Caron S, Carquin E, Carrá S, Carter J, Casado M, Casha A, Casper D, Castelijn R, Castillo F, Castillo Gimenez V, Castro N, Catinaccio A, Catmore J, Cattai A, Caudron J, Cavaliere V, Cavallaro E, Cavalli-Sforza M, Cavasinni V, Celebi E, Ceradini F, Cerda Alberich L, Cerny K, Cerqueira A, Cerri A, Cerrito L, Cerutti F, Cervelli A, Cetin S, Chadi Z, Chakraborty D, Chan S, Chan W, Chan W, Chapman J, Chargeishvili B, Charlton D, Charman T, Chau C, Che S, Chegwidden A, Chekanov S, Chekulaev S, Chelkov G, Chelstowska M, Chen B, Chen C, Chen C, Chen H, Chen J, Chen J, Chen S, Chen S, Chen X, Chen Y, Chen YH, Cheng H, Cheng H, Cheplakov A, Cheremushkina E, Cherkaoui El Moursli R, Cheu E, Cheung K, Chevalérias T, Chevalier L, Chiarella V, Chiarelli G, Chiodini G, Chisholm A, Chitan A, Chiu I, Chiu Y, Chizhov M, Choi K, Chomont A, Chouridou S, Chow Y, Chu M, Chu X, Chudoba J, Chuinard A, Chwastowski J, Chytka L, Ciesla K, Cinca D, Cindro V, Cioară I, Ciocio A, Cirotto F, Citron Z, Citterio M, Ciubotaru D, Ciungu B, Clark A, Clark M, Clark P, Clement C, Coadou Y, Cobal M, Coccaro A, Cochran J, Cohen H, Coimbra A, Colasurdo L, Cole B, Colijn A, Collot J, Conde Muiño P, Coniavitis E, Connell S, Connelly I, Constantinescu S, Conventi F, Cooper-Sarkar A, Cormier F, Cormier K, Corpe L, Corradi M, Corrigan E, Corriveau F, Costa M, Costanza F, Costanzo D, Cowan G, Cowley J, Crane J, Cranmer K, Crawley S, Creager R, Crépé-Renaudin S, Crescioli F, Cristinziani M, Croft V, Crosetti G, Cueto A, Cuhadar Donszelmann T, Cukierman A, Czekierda S, Czodrowski P, Da Cunha Sargedas De Sousa M, Da Fonseca Pinto J, Da Via C, Dabrowski W, Dado T, Dahbi S, Dai T, Dallapiccola C, Dam M, D’amen G, D’Amico V, Damp J, Dandoy J, Daneri M, Dang N, Dann N, Danninger M, Dao V, Darbo G, Dartsi O, Dattagupta A, Daubney T, D’Auria S, Davey W, David C, Davidek T, Davis D, Dawson I, De K, De Asmundis R, De Beurs M, De Castro S, De Cecco S, De Groot N, de Jong P, De la Torre H, De Maria A, De Pedis D, De Salvo A, De Sanctis U, De Santis M, De Santo A, De Vasconcelos Corga K, De Vivie De Regie J, Debenedetti C, Dedovich D, Deiana A, Del Gaudio M, Del Peso J, Delabat Diaz Y, Delgove D, Deliot F, Delitzsch C, Della Pietra M, Della Volpe D, Dell’Acqua A, Dell’Asta L, Delmastro M, Delporte C, Delsart P, DeMarco D, Demers S, Demichev M, Demontigny G, Denisov S, Denysiuk D, D’Eramo L, Derendarz D, Derkaoui J, Derue F, Dervan P, Desch K, Deterre C, Dette K, Deutsch C, Devesa M, Deviveiros P, Dewhurst A, Dhaliwal S, Di Bello F, Di Ciaccio A, Di Ciaccio L, Di Clemente W, Di Donato C, Di Girolamo A, Di Gregorio G, Di Micco B, Di Nardo R, Di Petrillo K, Di Sipio R, Di Valentino D, Diaconu C, Dias F, Dias Do Vale T, Diaz M, Dickinson J, Diehl E, Dietrich J, Díez Cornell S, Dimitrievska A, Ding W, Dingfelder J, Dittus F, Djama F, Djobava T, Djuvsland J, Do Vale M, Dobre M, Dodsworth D, Doglioni C, Dolejsi J, Dolezal Z, Donadelli M, Dong B, Donini J, D’onofrio A, D’Onofrio M, Dopke J, Doria A, Dova M, Doyle A, Drechsler E, Dreyer E, Dreyer T, Drobac A, Duan Y, Dubinin F, Dubovsky M, Dubreuil A, Duchovni E, Duckeck G, Ducourthial A, Ducu O, Duda D, Dudarev A, Dudder A, Duffield E, Duflot L, Dührssen M, Dülsen C, Dumancic M, Dumitriu A, Duncan A, Dunford M, Duperrin A, Duran Yildiz H, Düren M, Durglishvili A, Duschinger D, Dutta B, Duvnjak D, Dyckes G, Dyndal M, Dysch S, Dziedzic B, Ecker K, Edgar R, Eifert T, Eigen G, Einsweiler K, Ekelof T, El Jarrari H, El Kacimi M, El Kosseifi R, Ellajosyula V, Ellert M, Ellinghaus F, Elliot A, Ellis N, Elmsheuser J, Elsing M, Emeliyanov D, Emerman A, Enari Y, Epland M, Erdmann J, Ereditato A, Errenst M, Escalier M, Escobar C, Estrada Pastor O, Etzion E, Evans H, Ezhilov A, Fabbri F, Fabbri L, Fabiani V, Facini G, Faisca Rodrigues Pereira R, Fakhrutdinov R, Falciano S, Falke P, Falke S, Faltova J, Fang Y, Fang Y, Fanourakis G, Fanti M, Faraj M, Farbin A, Farilla A, Farina E, Farooque T, Farrell S, Farrington S, Farthouat P, Fassi F, Fassnacht P, Fassouliotis D, Faucci Giannelli M, Fawcett W, Fayard L, Fedin O, Fedorko W, Feickert M, Feigl S, Feligioni L, Fell A, Feng C, Feng E, Feng M, Fenton M, Fenyuk A, Ferrando J, Ferrante A, Ferrari A, Ferrari P, Ferrari R, Ferreira de Lima D, Ferrer A, Ferrere D, Ferretti C, Fiedler F, Filipčič A, Filthaut F, Finelli K, Fiolhais M, Fiorini L, Fischer F, Fisher W, Fleck I, Fleischmann P, Fletcher R, Flick T, Flierl B, Flores L, Flores Castillo L, Follega F, Fomin N, Foo J, Forcolin G, Formica A, Förster F, Forti A, Foster A, Foti M, Fournier D, Fox H, Francavilla P, Francescato S, Franchini M, Franchino S, Francis D, Franconi L, Franklin M, Fray A, Freund B, Freund W, Freundlich E, Frizzell D, Froidevaux D, Frost J, Fukunaga C, Fullana Torregrosa E, Fumagalli E, Fusayasu T, Fuster J, Gabrielli A, Gabrielli A, Gach G, Gadatsch S, Gadow P, Gagliardi G, Gagnon L, Galea C, Galhardo B, Gallardo G, Gallas E, Gallop B, Galster G, Gamboa Goni R, Gan K, Ganguly S, Gao J, Gao Y, Gao Y, García C, García Navarro J, García Pascual J, Garcia-Argos C, Garcia-Sciveres M, Gardner R, Garelli N, Gargiulo S, Garonne V, Gaudiello A, Gaudio G, Gavrilenko I, Gavrilyuk A, Gay C, Gaycken G, Gazis E, Geanta A, Gee C, Geisen J, Geisen M, Geisler M, Gemme C, Genest M, Geng C, Gentile S, George S, Geralis T, Gerlach L, Gessinger-Befurt P, Gessner G, Ghasemi S, Ghasemi Bostanabad M, Ghosh A, Ghosh A, Giacobbe B, Giagu S, Giangiacomi N, Giannetti P, Giannini A, Gibson S, Gignac M, Gillberg D, Gilles G, Gingrich D, Giordani M, Giorgi F, Giraud P, Giugliarelli G, Giugni D, Giuli F, Gkaitatzis S, Gkialas I, Gkougkousis E, Gkountoumis P, Gladilin L, Glasman C, Glatzer J, Glaysher P, Glazov A, Goblirsch-Kolb M, Goldfarb S, Golling T, Golubkov D, Gomes A, Goncalves Gama R, Gonçalo R, Gonella G, Gonella L, Gongadze A, Gonnella F, Gonski J, González de la Hoz S, Gonzalez-Sevilla S, Gonzalvo Rodriguez G, Goossens L, Gorbounov P, Gordon H, Gorini B, Gorini E, Gorišek A, Goshaw A, Gostkin M, Gottardo C, Gouighri M, Goujdami D, Goussiou A, Govender N, Goy C, Gozani E, Grabowska-Bold I, Graham E, Gramling J, Gramstad E, Grancagnolo S, Grandi M, Gratchev V, Gravila P, Gravili F, Gray C, Gray H, Grefe C, Gregersen K, Gregor I, Grenier P, Grevtsov K, Grieco C, Grieser N, Griffiths J, Grillo A, Grimm K, Grinstein S, Grivaz JF, Groh S, Gross E, Grosse-Knetter J, Grout Z, Grud C, Grummer A, Guan L, Guan W, Guenther J, Guerguichon A, Guerrero Rojas J, Guescini F, Guest D, Gugel R, Guillemin T, Guindon S, Gul U, Guo J, Guo W, Guo Y, Guo Z, Gupta R, Gurbuz S, Gustavino G, Gutierrez P, Gutschow C, Guyot C, Gwenlan C, Gwilliam C, Haas A, Haber C, Hadavand H. Search for heavy neutral Higgs bosons produced in association with
b
-quarks and decaying into
b
-quarks at
s=13 TeV
with the ATLAS detector. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.032004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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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Riva T, Meyer J, Theiler L, Obrist D, Bütikofer L, Greif R, Nabecker S. Measurement of airway pressure during high-flow nasal therapy in apnoeic oxygenation: a randomised controlled crossover trial . Anaesthesia 2020; 76:27-35. [PMID: 32776518 DOI: 10.1111/anae.15224] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Abstract
It is recognised that high-flow nasal therapy can prevent desaturation during airway management. Studies in spontaneously breathing patients show an almost linear relationship between flow rate and positive airway pressure in the nasopharynx. Positive airway pressure has been suggested as one of the possible mechanisms explaining how high-flow nasal therapy works. However, data on pressures generated by high-flow nasal therapy in apnoeic adults under general anaesthesia are absent. This randomised controlled crossover trial investigated airway pressures generated by different flow rates during high-flow nasal therapy in anaesthetised and paralysed apnoeic patients, comparing pressures with closed and open mouths. Following induction of anaesthesia and neuromuscular blockade, a continuous jaw thrust was used to enable airway patency. Airway pressure was measured in the right main bronchus, the middle of the trachea and the pharynx, using a fibreoptically-placed catheter connected to a pressure transducer. Each measurement was randomised with respect to closed or open mouth and different flow rates. Twenty patients undergoing elective surgery were included (mean (SD) age 38 (18) years, BMI 25.0 (3.3) kg.m-2 , nine women, ASA physical status 1 (35%), 2 (55%), 3 (10%). While closed mouths and increasing flow rates demonstrated non-linear increases in pressure, the pressure increase was negligible with an open mouth. Airway pressures remained below 10 cmH2 O even with closed mouths and flow rates up to 80 l.min-1 ; they were not influenced by catheter position. This study shows an increase in airway pressures with closed mouths that depends on flow rate. The generated pressure is negligible with an open mouth. These data question positive airway pressure as an important mechanism for maintenance of oxygenation during apnoea.
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Affiliation(s)
- T Riva
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland
| | - J Meyer
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland
| | - L Theiler
- Department of Anaesthesia, Kantonsspital Aarau, Switzerland
| | - D Obrist
- ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
| | | | - R Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland.,School of Medicine, Sigmund Freud University Vienna, Austria
| | - S Nabecker
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland.,Department of Anaesthesia and Pain Management, Sinai Health System, University of Toronto, Canada
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Bailey C, Meyer J, Tangen C, Deane R, Briskin S, Gunstad J, Fastenau P, Smith P, Solomon M, Kelly AW. A-03 SCAT5 Cognitive Screening Normative Data and Reliable Change Indices. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
This study provides normative data on the SCAT5 Cognitive Screening, establishes test-retest reliability, and creates clinically relevant cut points for low performance.
Method
The multisport baseline sample was composed of 727 uninjured college athletes (52% female) at a Division I university who were administered the SCAT5 before the 2017–2018 season. Descriptive statistics, including base rates of low performance, were calculated for SCAT5 indices. Repeat baseline testing was completed by 325 athletes (48% female) at 1 year (days M = 352.56;SD = 56.03) who were included in the test-retest reliability and practice effect analyses. Reliable change indices were calculated.
Results
Descriptive statistics for SCAT5 were computed for both baselines (Baseline 1: SAC total M = 35.15,SD = 4.93; immediate recall total M = 20.01,SD = 3.46; delayed recall total M = 6.43,SD = 1.75). A difference in descriptive statistics and practice effects by sex on the SCAT5 Cognitive Screening has been demonstrated (Bailey, Meyer, Tangen et al., under review). For female athletes, the 1st administration cutoff scores for abnormal performance (<10th%ile) included SAC total score = 33, immediate recall score = 18, and delayed recall score = 6. For male athletes, the 1st administration cutoff scores for abnormal performance (<10th%ile) included SAC total score = 30, immediate recall score = 17, and delayed recall score = 5. Test-retest reliability of the SAC was similar to previous versions but varied by sex. Reliable change indices (RCI) were created with cut points for significant change.
Conclusions
The present study provides clinically relevant normative data for the SCAT5 Cognitive Screening. Cut points for low performance on both reliable chance indices (RCIs) and normative performance reflected meaningful sex differences that could influence clinical interpretation.
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Erber R, Kailayangiri S, Hübner H, Rübner M, Hartmann A, Häberle L, Meyer J, Mackensen A, Landgraf L, Schulz-Wendtland R, Beckmann MW, Fasching PA, Farwick N, Rössig C, Gaß P. Disialogangliosids GD2 beim Mammakarzinom und dessen Einfluss auf die Prognose. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- R Erber
- Institut für Pathologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - S Kailayangiri
- Universitätskinderklinik Münster, Pädiatische Hämatologie und Onkologie, Münster
| | - H Hübner
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - M Rübner
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - A Hartmann
- Institut für Pathologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - L Häberle
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
- Biostatische Einheit, Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - J Meyer
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
- Biostatische Einheit, Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - A Mackensen
- Medizinische Klinik 5, Hämatologie und Onkologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - L Landgraf
- Institut für Pathologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - R Schulz-Wendtland
- Institut für Diagnostische Radiologie, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - M W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
| | - P A Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA
| | - N Farwick
- Universitätskinderklinik Münster, Pädiatische Hämatologie und Onkologie, Münster
| | - C Rössig
- Universitätskinderklinik Münster, Pädiatische Hämatologie und Onkologie, Münster
| | - P Gaß
- Frauenklinik, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander Universität Erlangen–Nürnberg, Erlangen
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Meyer J, Mauro T, Elias P. 224 The lipoxygenase inhibitor ML355 prevents covalent adduction of the corneocyte lipid envelope in a novel preclinical model of congenital ichthyosis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Elsner P, Meyer J. Panzytopenie durch Azathioprin in Kombination mit Allopurinol. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1003-4363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungEin 55-jähriger Patient mit einem seit Jahrzehnten vorbekannten systemischen Lupus erythematodes (SLE) und zahlreichen medikamentös behandelten Komorbiditäten (arterielle Hypertonie, Diabetes mellitus Typ 2, Hyperurikämie, Niereninsuffizienz, Antiphospholipid-Syndrom, venöse Thromboembolien und periphere arterielle Verschlusskrankheit) stellte sich zur Abklärung von Ulcera crurum bei einem Hautarzt vor. Der Dermatologe diagnostizierte eine Immunvaskulitis und verordnete Azathioprin (100 mg/Tag). In der Folge kam es zu einer deutlichen Verschlechterung des Allgemeinbefindens sowie zu einem Abszess am Oberschenkel; als Ursache stellte sich eine schwere Panzytopenie heraus. Während des nachfolgenden stationären Aufenthaltes wurde der Patient dialysepflichtig, entwickelte eine Pneumonie, Gerinnungsstörungen und zerebrale Infarkte mit Entwicklung einer kortikalen Blindheit. In zeitlichem Abstand traten eine akute Cholecystitis bei Cholelithiasis, eine Sepsis und zunehmende Ischämien im Bereich der hirnzuführenden Arterien mit motorischen Ausfällen, Sprachstörungen und rezidivierenden Krampfanfällen auf, die schließlich zum Tode führten.Gutachterlich festgestellt und von der Schlichtungsstelle bestätigt wurde als Ursache der Panzytopenie die behandlungsfehlerhafte Komedikation von Azathioprin mit der vorbestehenden Medikation mit Allopurinol ohne Dosisanpassung. Xanthinoxidasehemmer wie Allopurinol können die Myelotoxizität von Azathioprin erhöhen; sollte im Einzelfall eine entsprechende Kombination unvermeidbar sein, ist laut Fachinformation eine Dosisreduktion von Azathioprin auf 25 % erforderlich sowie eine engmaschige Kontrolle von Blutbild und Thrombozyten.Gerade bei multimorbiden, multimedikamentös vorbehandelten Patienten sollten bei Neuansetzen einer medikamentösen Therapie mögliche Arzneimittelinteraktionen sorgfältig überprüft werden.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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Kerstein-Staehle A, Leinung N, Meyer J, Pitann S, Müller A, Riemekasten G, Lamprecht P. FRI0001 NEUTROPHILS IN GRANULOMATOSIS WITH POLYANGIITIS DISPLAY FEATURES OF PYROPTOSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Granulomatosis with polyangiitis (GPA) is characterized by extravascular necrotizing granulomatous inflammation and systemic ANCA – associated (AAV) vasculitis with neutrophils as a key player in the pathogenesis (1). We and others have shown that neutrophil-related cell death mechanisms contribute to chronic inflammatory processes in AAV (2, 3). Recently, another form of inflammatory cell death primarily described in monocytes called pyroptosis was also discovered in neutrophils (4). A cardinal feature of pyroptosis is the activation of the NLRP3 inflammasome, a sensor of different pathogen- and damage-associated molecular patterns (PAMP, DAMP), following caspase-1-mediated processing and secretion of IL-1beta (5).Objectives:The aim of this study was to investigate, if neutrophils from GPA patients express pyroptosis-related components NLRP3, active caspase 1 and cleaved IL-1beta.Methods:Polymorphonuclear leukocytes (PMN) were isolated from peripheral blood of GPA patients and healthy controls (HC) (n = 10 each). Expression of NLRP3, inactive/active caspase 1 and active IL-1beta was determined by western blot. In addition, peripheral blood mononuclear cells (PBMC) were isolated from GPA and HC. mRNA expression ofnlrp3andil1bwas determined by qPCR. To exclude false-positive results by contamination with monocytes we performed flow cytometry analysis of whole blood samples with markers CD3, CD14, CD15, CD66b and NLRP3.Results:PMN from GPA patients showed markedly increased expression of NLRP3, active caspase 1 and active IL-1beta compared to HC. In contrast, there was no difference between GPA and HC on the mRNA level of neithernlrp3noril1bin PBMC. In addition, we confirmed by flow cytometry increased expression of NLRP3 in PMN from GPA, but not in monocytes.Conclusion:Here we provide evidence, that neutrophils from GPA undergo pyroptosis, demonstrated by increased NLRP3, active caspase 1 expression as well as IL-1beta processing. Neutrophils are present in high numbers at the site of granulomatous lesions of inflamed tissue in GPA and IL-1beta is increased in GPA sera (2). Therefore, neutrophils represent a potential source of IL-1beta in GPA. Given the fact that GPA-associated features such as massive release of necrosis-related DAMP or microbial agents such asStaphylococcus aureus(6) can activate the NLRP3-inflammasome, we identified here a potential relevant mechanism of neutrophils contributing to chronic inflammation of GPA.References:[1]Jennette, J.C., and Falk, R.J. (2014). Pathogenesis of antineutrophil cytoplasmic autoantibody-mediated disease. Nat. Rev. Rheumatol.10, 463–473.[2]Millet, A., Martin, K.R., Bonnefoy, F., Saas, P., Mocek, J., Alkan, M., Terrier, B.,Kerstein,A., Tamassia, N., Satyanarayanan, S.K., et al. (2015). Proteinase 3 on apoptotic cells disrupts immune silencing in autoimmune vasculitis. J. Clin. Invest. 125, 4107–4121.[3]Schreiber, A., Rousselle, A., Becker, J.U., von Mässenhausen, A., Linkermann, A., and Kettritz, R. (2017). Necroptosis controls NET generation and mediates complement activation, endothelial damage, and autoimmune vasculitis. Proc. Natl. Acad. Sci. 201708247.[4]Tourneur, L., and Witko-Sarsat, V. (2019). Inflammasome activation: Neutrophils go their own way. J. Leukoc. Biol.105, 433–436.[5]Bergsbaken, T., Fink, S.L., and Cookson, B.T. (2009). Pyroptosis: Host cell death and inflammation. Nat. Rev. Microbiol.7, 99–109.[6]Lamprecht, P.,Kerstein, A., Klapa, S., Schinke, S., Karsten, C.M., Yu, X., Ehlers, M., Epplen, J.T., Holl-Ulrich, K., Wiech, T., et al. (2018). Pathogenetic and Clinical Aspects of Anti-Neutrophil Cytoplasmic Autoantibody-Associated Vasculitides. Front. Immunol.9, 1–10.Disclosure of Interests:Anja Kerstein-Staehle: None declared, Nadja Leinung: None declared, Jannik Meyer: None declared, Silke Pitann: None declared, Antje Müller: None declared, Gabriela Riemekasten Consultant of: Cell Trend GmbH, Janssen, Actelion, Boehringer Ingelheim, Speakers bureau: Actelion, Novartis, Janssen, Roche, GlaxoSmithKline, Boehringer Ingelheim, Pfizer, Peter Lamprecht: None declared
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Elsner P, Peckruhn M, Meyer J. Fehldiagnose eines genitalen Morbus Paget als Lichen sclerosus et atrophicus aufgrund verspäteter histologischer Diagnosesicherung. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1002-9728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungEine Patientin mit Hautveränderungen im Bereich der Vulva wurde von einer Dermatologin unter der Diagnose eines Lichen sclerosus et atrophicus behandelt. Zum Ausschluss eines malignen Prozesses erfolgte die Überweisung an eine Gynäkologin zwecks Biopsie, die diese jedoch nicht vornahm. Die Dermatologin behandelte die Patientin über weitere dreieinhalb Jahre antientzündlich, bis durch eine bei einem anderen Gynäkologen durchgeführte Biopsie die Diagnose eines extramammären Morbus Paget gestellt wurde. Aufgrund des zwischenzeitlich ausgedehnten Befundes waren in der Folge wiederholte Vulvektomien mit erheblichen Residualschäden erforderlich.Von der Schlichtungsstelle wurde ein schuldhafter Befunderhebungsfehler bejaht. Die Übertragung der Durchführung der histopathologischen Diagnostik ohne Einforderung des Befundergebnisses bzw. die histologisch unkontrollierte Aufrechterhaltung der Diagnose bei regelmäßiger Befundkontrolle und Therapie über mehr als 3 Jahre waren als Fehler ärztlichen Handelns einzuordnen. Da es sich bei dem Biopsieauftrag um eine bloße Delegation einer genuin dermatologischen Leistung handelte, konnte sich die Dermatologin auch nicht auf den rechtlichen Grundsatz der „horizontalen Arbeitsteilung“ berufen. Indem sie die Patientin gleichwohl weiterbehandelte, bestand der Behandlungsvertrag, der sie persönlich zu einer Behandlung nach dermatologischem Facharztstandard verpflichtete, unverändert fort. Dermatologen sollten bei der Delegation diagnostischer Leistungen an andere Fachgebiete sicherstellen, dass diese Leistungen auch tatsächlich erbracht werden.Da Vulvakarzinome klinisch uncharakteristisch sein könnten, sollte bei dem geringsten Verdacht eine bioptische dermatohistologische Befundsicherung angestrebt werden.
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Affiliation(s)
- P. Elsner
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - M. Peckruhn
- Klinik für Hautkrankheiten, Universitätsklinikum Jena
| | - J. Meyer
- Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern, Hannover
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