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Groten T, Lehmann T, Städtler M, Komar M, Winkler JL, Condic M, Strizek B, Seeger S, Jäger Y, Pecks U, Eckmann-Scholz C, Kagan KO, Hoopmann M, von Kaisenberg CS, Hertel B, Tauscher A, Schrey-Petersen S, Friebe-Hoffmann U, Lato K, Hübener C, Delius M, Verlohren S, Sroka D, Schlembach D, de Vries L, Kraft K, Seliger G, Schleußner E. Pentaerythrityl tetranitrate improves the outcome of children born to mothers with compromised uterine perfusion-12-months follow-up and safety data of the double-blind randomized PETN trial. Am J Obstet Gynecol MFM 2024; 6:101332. [PMID: 38460823 DOI: 10.1016/j.ajogmf.2024.101332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/06/2024] [Accepted: 02/27/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND This is a follow-up study to the pentaerythrityl tetranitrate randomized controlled multicenter trial that reports neonatal outcome data of newborns admitted to neonatal intensive care units and outcome data of the offspring at 12 months of age. OBJECTIVE We present data on adverse events reported during the study to document the safety of pentaerythrityl tetranitrate treatment during pregnancy. To further evaluate the effects of pentaerythrityl tetranitrate on neonatal and long-term outcomes, we present follow up data from of 240 children at 12 months of age, including information on height, weight, head circumference, developmental milestones, and the presence of chronic disease and of 144 newborns admitted to the neonatal intensive care unit during the trial. STUDY DESIGN The pentaerythrityl tetranitrate trial was a randomized, double-blind, placebo-controlled study designed to assess the efficacy and safety of the nitric oxide-donor pentaerythrityl tetranitrate in the prevention of fetal growth restriction and perinatal death in pregnancies complicated by abnormal placental perfusion. RESULTS Results at 12 months demonstrated that significantly more children were age appropriately developed without impairments in the pentaerythrityl tetranitrate group (P=.018). In addition, the presence of chronic disease was lower in the pentaerythrityl tetranitrate group (P=.041). Outcome data of the 144 newborns admitted to the neonatal intensive care unit did not reveal differences between the treatment and placebo groups. There were no differences in the number or nature of reported adverse events between the study groups. CONCLUSION The analysis shows that study children born in the pentaerythrityl tetranitrate cohort have a clear advantage compared with the placebo group at the age of 12 months, as evidenced by the increased incidence of normal development without the presence of chronic disease. Although safety has been proven, further follow-up studies are necessary to justify pentaerythrityl tetranitrate treatment during pregnancies complicated by impaired uterine perfusion.
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Affiliation(s)
- Tanja Groten
- Department of Obstetrics, Jena University Hospital (Prof. Groten and Prof. Schleußner), Jena, Germany.
| | - Thomas Lehmann
- Institute of Medical Statistics and Computer Science, Jena University Hospital (Dr Lehmann), Jena, Germany; Center for Clinical Studies, Jena University Hospital (Dr Lehmann and Mrs Städtler), Jena, Germany
| | - Mariann Städtler
- Center for Clinical Studies, Jena University Hospital (Dr Lehmann and Mrs Städtler), Jena, Germany
| | - Matej Komar
- Department of Gynecology and Obstetrics, Technische Universität Dresden (Dr Komar and Dr Winkler), Dresden, Germany
| | - Jennifer Lucia Winkler
- Department of Gynecology and Obstetrics, Technische Universität Dresden (Dr Komar and Dr Winkler), Dresden, Germany
| | - Mateja Condic
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn (Dr Condic and Prof. Strizek), Germany
| | - Brigitte Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn (Dr Condic and Prof. Strizek), Germany
| | - Sven Seeger
- Department of Gynaecology and Obstetrics, Perinatal Centre, St. Elisabeth and St. Barbara Halle (Drs Seeger and Jäger), Halle (Saale), Germany
| | - Yvonne Jäger
- Department of Gynaecology and Obstetrics, Perinatal Centre, St. Elisabeth and St. Barbara Halle (Drs Seeger and Jäger), Halle (Saale), Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynaecology and Department of Maternal Health and Midwifery, University Medical Centre Würzburg (Prof. Pecks), Würzburg, Germany
| | - Christel Eckmann-Scholz
- Department of Obstetrics, Christian-Albrechts-University of Kiel (Dr Eckmann-Scholz), Kiel, Germany
| | - Karl Oliver Kagan
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen (Profs Kagan and Hoopmann), Tübingen, Germany
| | - Markus Hoopmann
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen (Profs Kagan and Hoopmann), Tübingen, Germany
| | - Constantin S von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School (Prof. von Kaisenberg and Dr. Hertel), Hannover, Germany
| | - Bettina Hertel
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School (Prof. von Kaisenberg and Dr. Hertel), Hannover, Germany
| | - Anne Tauscher
- Department of Obstetrics and Gynecology, University of Leipzig (Drs Tauscher and Schrey-Petersen), Leipzig, Germany
| | - Susanne Schrey-Petersen
- Department of Obstetrics and Gynecology, University of Leipzig (Drs Tauscher and Schrey-Petersen), Leipzig, Germany
| | - Ulrike Friebe-Hoffmann
- Department of Gynecology and Obstetrics, Ulm University Hospital (Prof. Friebe-Hoffmann and Dr. Lato), Ulm, Germany
| | - Krisztian Lato
- Department of Gynecology and Obstetrics, Ulm University Hospital (Prof. Friebe-Hoffmann and Dr. Lato), Ulm, Germany
| | - Christoph Hübener
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, LMU Munich (Prof. Hübener and Dr. Delius), Munich, Germany
| | - Maria Delius
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, LMU Munich (Prof. Hübener and Dr. Delius), Munich, Germany
| | - Stefan Verlohren
- Department of Obstetrics, Charité - Universitätsmedizin Berlin (Prof. Verlohren and Dr. Sroka), Berlin, Germany
| | - Dorota Sroka
- Department of Obstetrics, Charité - Universitätsmedizin Berlin (Prof. Verlohren and Dr. Sroka), Berlin, Germany
| | - Dietmar Schlembach
- Vivantes Network of Health GmbH, Clinicum Neukoelln, Clinic for Obstetric Medicine (Dr Schlembach), Berlin, Germany
| | - Laura de Vries
- Department of Obstetrics and Gynecology Städtisches Klinikum Harlaching Munich (Dr de Vries), Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein (Dr Kraft), Lübeck, Germany
| | - Gregor Seliger
- Center for Reproductive Medicine and Andrology, University Medical Center Halle (Saale) (Prof. Seliger), Halle (Saale), Germany
| | - Ekkehard Schleußner
- Department of Obstetrics, Jena University Hospital (Prof. Groten and Prof. Schleußner), Jena, Germany
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Longardt AC, Zöllkau J, Mand N, Wowretzko F, Büchel J, Andresen K, Hoyer BF, Kraft K, Pecks U. Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data from the CRONOS Registry. Z Geburtshilfe Neonatol 2024; 228:88-96. [PMID: 38330963 DOI: 10.1055/a-2222-6491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
SARS-CoV-2 infection and COVID-19 disease are thought to have an impact on breastfeeding rate - besides other known peripartal issues. Data of the national CRONOS registry regarding breastfeeding behavior in 6,746 women was analyzed regarding the time window between maternal SARS-CoV-2 infection and time of delivery. In addition, other influencing factors like the predominant viral variant, maternal disease severity, and gestational age at delivery were taken into account. Our data suggest that within the variables analyzed, in the case of acute maternal infection (<14 days before birth), breastfeeding behavior improved with increasing gestational age at birth (p<0.0001), with less severe maternal illness (p<0.0001) and as the pandemic progressed with less virulent viral variants (p=0.01). When adjusting for COVID-19-associated and non-associated factors, rooming-in remains the most important factor positively influencing breastfeeding behavior. With regards to the benefits for mother and infants from breastfeeding, a separation of mother and child even in case of infectious settings should be avoided.
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Affiliation(s)
- Ann Carolin Longardt
- Klinik für Kinder- und Jugendmedizin I / Neonatologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Nadine Mand
- Neonatology and Pediatric Intensive Care, University of Marburg, Marburg, Germany
| | - Feline Wowretzko
- Obstetrics and Gynaecology, Buchholz Hospital, Buchholz in der Nordheide, Germany
| | - Johanna Büchel
- Department of Obstetrics and Gynecology, LMU, München, Germany
| | - Kristin Andresen
- Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany
| | | | - Katrina Kraft
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lubeck, Germany
| | - Ulrich Pecks
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany
- Maternal Health and Midwifery Science, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
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Hachenberg J, Guenther J, Steinkasserer L, Brodowski L, Dueppers AL, Delius M, Chiaie LD, Lobmaier S, Sourouni M, Richter MF, Manz J, Parchmann O, Schmidt S, Winkler J, Werring P, Kraft K, Kunze M, Manz M, Eichler C, Schaefer V, Berghaeuser M, Schlembach D, Seeger S, Schäfer-Graf U, Kyvernitakis I, Bohlmann MK, Ramsauer B, Morfeld CA, Ruediger M, Pecks U, von Kaisenberg C. Evolution of Fetal Growth in Symptomatic Sars-Cov-2 Pregnancies. Z Geburtshilfe Neonatol 2024; 228:57-64. [PMID: 38330960 DOI: 10.1055/a-2224-2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
INTRODUCTION SARS-CoV-2 is a viral disease with potentially devastating effects. Observational studies of pregnant women infected with SARS-CoV-2 report an increased risk for FGR. This study utilizes data from a prospective SARS-CoV-2 registry in pregnancy, investigating the progression of fetuses to fetal growth restriction (FGR) at birth following maternal SARS-CoV-2 and evaluating the hypothesis of whether the percentage of SGA at birth is increased after maternal SARS-CoV-2 taking into account the time interval between infection and birth. MATERIALS & METHODS CRONOS is a prospective German registry enrolling pregnant women with confirmed SARS-CoV-2 infection during their pregnancy. SARS-CoV-2 symptoms, pregnancy- and delivery-specific information were recorded. The data evaluated in this study range from March 2020 until August 2021. Women with SARS-CoV-2 were divided into three groups according to the time of infection/symptoms to delivery: Group I<2 weeks, Group II 2-4 weeks, and Group III>4 weeks. FGR was defined as estimated and/or birth weight<10% ile, appropriate for gestational age (AGA) was within 10 and 90%ile, and large for gestational age (LGA) was defined as fetal or neonatal weight>90%ile. RESULTS Data for a total of 2,650 SARS-CoV-2-positive pregnant women were available. The analysis was restricted to symptomatic cases that delivered after 24+0 weeks of gestation. Excluding those cases with missing values for estimated fetal weight at time of infection and/or birth weight centile, 900 datasets remained for analyses. Group I consisted of 551 women, Group II of 112 women, and Group III of 237 women. The percentage of changes from AGA to FGR did not differ between groups. However, there was a significantly higher rate of large for gestational age (LGA) newborns at the time of birth compared to the time of SARS-CoV-2 infection in Group III (p=0.0024), respectively. CONCLUSION FGR rates did not differ between symptomatic COVID infections occurring within 2 weeks and>4 weeks before birth. On the contrary, it presented a significant increase in LGA pregnancies in Group III. However, in this study population, an increase in the percentage of LGA may be attributed to pandemic measures and a reduction in daily activity.
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Affiliation(s)
- Jens Hachenberg
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Julia Guenther
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Lena Steinkasserer
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Lars Brodowski
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Frauenklinik, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Maria Delius
- Obstetrics and Gynecology, LMU, München, Germany
| | - Loredana Delle Chiaie
- Department of Gynecology and Obstetrics, City of Stuttgart Hospitals, Stuttgart, Germany
| | - Silvia Lobmaier
- Frauenheilkunde und Geburtshilfe, Klinikum rechts der Isar der Technischen Universitat München, München, Germany
| | - Marina Sourouni
- Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | | | - Jula Manz
- Department of Gynecology and Obstetrics, Darmstadt Hospital, Darmstadt, Germany
| | - Olaf Parchmann
- Department of Gynecology and Obstetrics, HELIOS Klinik Sangerhausen, Sangerhausen, Germany
| | - Saskia Schmidt
- Department of Gynecology and Obstetrics, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Jennifer Winkler
- Department of Gynecology and Obstetrics, Dresden University Hospital, Dresden, Germany
| | - Pia Werring
- Department of Gynecology and Obstetrics, Christophorus-Kliniken GmbH Betriebsstätte Sankt-Vincenz-Hospital Coesfeld, Coesfeld, Germany
| | - Katrina Kraft
- Department of Gynecology and Obstetrics, München Klinik Harlaching, München, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinik Freiburg, Freiburg, Germany
| | - Maike Manz
- Department of Obstetrics and Gynaecology, Klinikum Darmstadt, Darmstadt, Germany
| | - Christian Eichler
- Department of Obstetrics and Gynecology, St Franziskus-Hospital Münster GmbH, Münster, Germany
| | - Viola Schaefer
- Department of Gynecology and Obstetrics, University Hospital Marburg Department of Gynaecology and Obstetrics, Marburg, Germany
| | - Martin Berghaeuser
- Department of Gynecology and Obstetrics, Florence-Nightingale-Krankenhaus, Düsseldorf, Germany
| | | | - Sven Seeger
- KH St. Elisabeth und St. Barbara Halle, Klinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum, Halle/Saale, Germany
| | - Ute Schäfer-Graf
- Klinik für Geburtshilfe, St Joseph Krankenhaus Berlin-Tempelhof, Berlin, Germany
| | - Ioannis Kyvernitakis
- Dept. of Obstetrics and Gynecology, Philipps-University of Marburg, Marburg, Germany
| | - Michael K Bohlmann
- Frauenheilkunde und Geburtshilfe, St Elisabethen-Krankenhaus Lörrach gGmbH, Lörrach, Germany
| | - Babette Ramsauer
- Department of Gynecology and Obstetrics, Vivantes Klinikum Neukölln, Berlin, Germany
| | | | - Mario Ruediger
- Department of Neonatology, Dresden University Hospital, Dresden, Germany
| | - Ulrich Pecks
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany
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Zöllkau J, Heimann Y, Hagenbeck C, Pecks U, Abou-Dakn M, Schlösser R, Schohe A, Dressler-Steinbach I, Manz M, Banz-Jansen C, Reuschel E, Iannaccone A, Bohlmann MK, Kraft K, Fill Malfertheiner S, Wimberger P, Kolben T, Bartmann C, Longardt AC. Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS). J Hum Lact 2023; 39:625-635. [PMID: 37712573 DOI: 10.1177/08903344231190623] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic and its influence on peripartum processes worldwide led to issues in breastfeeding support. RESEARCH AIM The aim of this study was to describe breastfeeding behavior and peripartum in-hospital management during the pandemic in Germany and Austria. METHODS This study was a descriptive study using a combination of secondary longitudinal data and a cross-sectional online survey. Registry data from the prospective multicenter COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS) cohort study (longitudinal, medical records of 1,815 parent-neonate pairs with confirmed SARS-CoV-2 infection during pregnancy) and a cross-sectional online survey of CRONOS hospitals' physicians (N = 67) were used for a descriptive comparison of feeding outcomes and postpartum management. RESULTS In 93.7% (n = 1700) of the cases in which information on the neonate's diet was provided, feeding was with the mother's own milk. Among neonates not receiving their mother's own milk, 24.3% (n = 26) reported SARS-CoV-2 infection as the reason. Peripartum maternal SARS-CoV-2 infection, severe maternal COVID-19 including the need for intensive care unit (ICU) treatment or invasive ventilation, preterm birth, mandatory delivery due to COVID-19, and neonatal ICU admission were associated with lower rates of breastfeeding. Rooming-in positively influenced breastfeeding without affecting neonatal SARS-CoV-2 frequency (4.2% vs. 5.6%). CRONOS hospitals reported that feeding an infant their mother's own milk continued to be supported during the pandemic. In cases of severe COVID-19, four of five hospitals encouraged breastfeeding. CONCLUSION Maintaining rooming-in and breastfeeding support services in the CRONOS hospitals during the pandemic resulted in high breastfeeding rates.
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Affiliation(s)
- Janine Zöllkau
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Yvonne Heimann
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Michael Abou-Dakn
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | - Rolf Schlösser
- Hospital for Children and Adolescents, University Hospital of Frankfurt, Frankfurt, Germany
| | - Anna Schohe
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | | | - Maike Manz
- Department of Obstetrics and Gynecology, Darmstadt City Hospital, Darmstadt, Germany
| | - Constanze Banz-Jansen
- Department of Gynecology and Obstetrics, Protestant Hospital of Bethel Foundation, Bielefeld, Germany
| | - Edith Reuschel
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | | | - Michael K Bohlmann
- Department of Obstetrics and Gynecology, St. Elisabeth' Hospital, Loerrach, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, Munich Municipal Hospital, Harlaching, Munich, Germany
| | - Sara Fill Malfertheiner
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, TU Dresden, Dresden, Germany
| | - Thomas Kolben
- Department for Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Catharina Bartmann
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
| | - Ann - Carolin Longardt
- Clinic for Pediatrics and Adolescent Medicine I / Neonatology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
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Groten T, Lehmann T, Städtler M, Komar M, Winkler JL, Condic M, Strizek B, Seeger S, Jäger Y, Pecks U, Eckmann-Scholz C, Kagan KO, Hoopmann M, von Kaisenberg CS, Brodowski L, Tauscher A, Schrey-Petersen S, Friebe-Hoffmann U, Lato K, Hübener C, Delius M, Verlohren S, Sroka D, Schlembach D, de Vries L, Kraft K, Seliger G, Schleußner E. Effect of pentaerythritol tetranitrate (PETN) on the development of fetal growth restriction in pregnancies with impaired uteroplacental perfusion at midgestation-a randomized trial. Am J Obstet Gynecol 2023; 228:84.e1-84.e12. [PMID: 35931132 DOI: 10.1016/j.ajog.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Fetal growth restriction is strongly associated with impaired placentation and abnormal uteroplacental blood flow. Nitric oxide donors such as pentaerythritol tetranitrate are strong vasodilators and protect the endothelium. Recently, we demonstrated in a randomized controlled pilot study a 38% relative risk reduction for the development of fetal growth restriction or perinatal death following administration of pentaerythritol tetranitrate to pregnant women at risk, identified by impaired uterine perfusion at midgestation. Results of this monocenter study prompted the hypothesis that pentaerythritol tetranitrate might have an effect in pregnancies with compromised placental function as a secondary prophylaxis. OBJECTIVE This study aimed to test the hypothesis that the nitric oxide donor pentaerythritol tetranitrate reduces fetal growth restriction and perinatal death in pregnant women with impaired placental perfusion at midgestation in a multicenter trial. STUDY DESIGN In this multicenter, randomized, double-blind, placebo-controlled trial, 2 parallel groups of pregnant women presenting with a mean uterine artery pulsatility index >95th percentile at 19+0 to 22+6 weeks of gestation were randomized to 50-mg Pentalong or placebo twice daily. Participants were assigned to high- or low-risk groups according to their medical history before randomization was performed block-wise with a fixed block length stratified by center and risk group. The primary efficacy endpoint was the composite outcome of perinatal death or development of fetal growth restriction. Secondary endpoints were neonatal and maternal outcome parameters. RESULTS Between August 2017 and March 2020, 317 participants were included in the study and 307 were analyzed. The cumulative incidence of the primary outcome was 41.1% in the pentaerythritol tetranitrate group and 45.5% in the placebo group (unadjusted relative risk, 0.90; 95% confidence interval, 0.69-1.17; adjusted relative risk, 0.90; 95% confidence interval, 0.69-1.17; P=.43). Secondary outcomes such as preterm birth (unadjusted relative risk, 0.73; 95% confidence interval, 0.56-0.94; adjusted relative risk, 0.73; 95% confidence interval, 0.56-0.94; P=.01) and pregnancy-induced hypertension (unadjusted relative risk, 0.65; 95% confidence interval, 0.46-0.93; adjusted relative risk, 0.65; 95% confidence interval, 0.46-0.92; P=0.01) were reduced. CONCLUSION Our study failed to show an impact of pentaerythritol tetranitrate on the development of fetal growth restriction and perinatal death in pregnant women with impaired uterine perfusion at midgestation. Pentaerythritol tetranitrate significantly reduced secondary outcome parameters such as the incidence of preterm birth and pregnancy-induced hypertension in these pregnancies.
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Affiliation(s)
- Tanja Groten
- Department of Obstetrics, Jena University Hospital, Jena, Germany.
| | - Thomas Lehmann
- Institute of Medical Statistics and Computer Science, Jena University Hospital, Jena, Germany; Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Mariann Städtler
- Center for Clinical Studies, Jena University Hospital, Jena, Germany
| | - Matej Komar
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Jennifer Lucia Winkler
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | - Mateja Condic
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Sven Seeger
- Department of Gynaecology and Obstetrics, Perinatal Centre, Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany
| | - Yvonne Jäger
- Department of Gynaecology and Obstetrics, Perinatal Centre, Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany
| | - Ulrich Pecks
- Department of Obstetrics, Christian-Albrecht University of Kiel, Kiel, Germany
| | | | - Karl Oliver Kagan
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany
| | - Markus Hoopmann
- Department of Feto-Maternal Medicine, Women's University Hospital Tübingen, Tübingen, Germany
| | | | - Lars Brodowski
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Anne Tauscher
- Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany
| | | | | | - Krisztian Lato
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Christoph Hübener
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany
| | - Maria Delius
- Department of Obstetrics and Gynecology, Perinatal Center, University Hospital, Campus Grosshadern, Ludwig Maximilian University of Munich, Munich, Germany
| | - Stefan Verlohren
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dorota Sroka
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dietmar Schlembach
- Vivantes Network for Health GmbH, Klinikum Neukölln, Clinic for Obstetric Medicine, Berlin, Germany
| | - Laura de Vries
- Department of Obstetrics and Gynecology, München Klinik Harlaching, Munich, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, München Klinik Harlaching, Munich, Germany
| | - Gregor Seliger
- Center for Reproductive Medicine and Andrology, University Medical Center Halle (Saale), Halle (Saale), Germany
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Kraft K, Schütze S, Essers J, Tschürtz AK, Hüner B, Janni W, Reister F. Pre-viable Preterm Premature Rupture of Membranes under 20 weeks of Pregnancy: A Retrospective Cohort Analysis for Potential Outcome Predictors. Eur J Obstet Gynecol Reprod Biol 2022; 278:177-182. [DOI: 10.1016/j.ejogrb.2022.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/04/2022]
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7
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Kuenz S, Thurner S, Hoffmann D, Kraft K, Wiltafsky-Martin M, Damme K, Windisch W, Brugger D. Effects of gradual differences in trypsin inhibitor activity on the estimation of digestible amino acids in soybean expellers for broiler chickens. Poult Sci 2022; 101:101740. [PMID: 35245805 PMCID: PMC8892013 DOI: 10.1016/j.psj.2022.101740] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/16/2021] [Accepted: 01/13/2022] [Indexed: 12/04/2022] Open
Abstract
The present study investigated the effect of varying trypsin inhibitor activity (TIA) in differently processed soybean expellers on apparent prececal amino acid (AA) digestibility in male broiler chickens. Two different raw soybean batches were treated using varying processing techniques and intensities. In this way, 45 expeller extracted soybean meal (ESBM) variants were created. The processed soybean variants were then merged into a basal diet (160 g/kg crude protein [CP]) at 2 inclusion levels (15%, 30%) resulting in 90 different diets plus one basal diet (0.4 mg/g-8.5 mg/g TIA). All diets contained 0.5% titanium dioxide. A total of 5,460-day-old male broilers (Ross 308) were allocated on d 14 to 546 pens (10 birds/pen) after a starter phase (CP 215 g/kg, 14 g/kg Lysine, 12.5 MJ ME/kg). The 91 experimental diets were fed ad libitum until d 22. Subsequently, birds were euthanized and digesta of the terminal ileum was collected for determination of AA digestibility. TIA depressed the prececal digestibility of every single AA significantly in a straight linear fashion (P < 0.001). Sulfur-containing AA expressed the strongest suppression by TIA with cystine showing the lowest apparent prececal digestibility measured (10.6% at 23.6 mg/g TIA in raw ESBM). The present data demonstrate that TIA severely depresses digestibility of essential and nonessential AA in a straight linear fashion. On the one hand, this questions the usefulness of defined upper limits of TIA in soy products whereas on the other hand, TIA must be considered when testing raw components for their feed protein value in vivo.
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Affiliation(s)
- S Kuenz
- Technical University of Munich (TUM), TUM School of Life Sciences, Chair of Animal Nutrition, 85354 Freising, Germany
| | - S Thurner
- Bavarian State Research Center for Agriculture, Institute for Agricultural Engineering and Animal Husbandry, 85354 Freising, Germany
| | - D Hoffmann
- Technical University of Munich (TUM), TUM School of Life Sciences, Chair of Animal Nutrition, 85354 Freising, Germany; Bavarian State Research Center for Agriculture, Institute for Agricultural Engineering and Animal Husbandry, 85354 Freising, Germany
| | - K Kraft
- Bavarian State Research Center for Agriculture, Institute for Agricultural Engineering and Animal Husbandry, 85354 Freising, Germany; Bavarian State Research Center for Agriculture, Department for Education and Poultry Research, 97318 Kitzingen, Germany
| | | | - K Damme
- Bavarian State Research Center for Agriculture, Department for Education and Poultry Research, 97318 Kitzingen, Germany
| | - W Windisch
- Technical University of Munich (TUM), TUM School of Life Sciences, Chair of Animal Nutrition, 85354 Freising, Germany
| | - D Brugger
- Technical University of Munich (TUM), TUM School of Life Sciences, Chair of Animal Nutrition, 85354 Freising, Germany; University of Zurich, Vetsuisse-Faculty, Institute of Animal Nutrition and Dietetics, 8057 Zurich, Switzerland.
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8
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Schütze S, Hohlfeld B, Friedl TWP, Otto S, Kraft K, Hancke K, Hüner B, Janni W, Deniz M. Fishing for (in)continence: long-term follow-up of women with OASIS-still a taboo. Arch Gynecol Obstet 2020; 303:987-997. [PMID: 33258994 PMCID: PMC7985110 DOI: 10.1007/s00404-020-05878-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/04/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Obstetric anal sphincter injuries (OASIS) increase the risk for pelvic floor dysfunctions. The goal of this study was to examine the long-term outcomes after OASIS on pelvic floor functions and quality of life. MATERIAL AND METHODS Between 2005 and 2013, 424 women had an OASIS at the Women University Hospital Ulm. Out of these 71 women completed the German pelvic floor questionnaire, which includes questions regarding prolapse symptoms as well as bladder, bowel and sexual function. In addition, 64 women were physically examined, including a speculum examination to evaluate the degree of prolapse, a cough test to evaluate urinary stress incontinence (SI) and an evaluation of both pelvic floor sphincter (modified Oxford score) and anal sphincter contraction. RESULTS A high rate of pelvic floor disorders after OASIS was found, as 74.6% of women reported SI, 64.8% flatus incontinence and 18.3% stool incontinence, respectively. However, only few women stated a substantial negative impact on quality of life. The clinical examination showed that a positive cough test, a weak anal sphincter tone and a diagnosed prolapse correlated with the results of the self-reported questionnaire. CONCLUSION On one hand, OASIS has an influence on pelvic floor function going along with lots of complaints, while on the other hand, it still seems to be a taboo topic, as none of the participants spoke about the complaints after OASIS with a doctor. Therefore, the gynecologist should actively address these issues and offer therapy options for the women with persisting problems.
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Affiliation(s)
- Sabine Schütze
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Benedikt Hohlfeld
- Kbo-Lech-Mangfall Clinic Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
| | - Thomas W P Friedl
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Stephanie Otto
- Comprehensive Cancer Center Ulm (CCCU), Ulm University Hospital, Ulm, Germany
| | | | - Katharina Hancke
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Beate Hüner
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Miriam Deniz
- Department of Gynaecology and Obstetrics, Ulm University Hospital, Ulm, Germany.
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Sommer S, Decker Y, Oberhoffer R, Grab D, Scholz C, Kraft K. Fallbericht einer 31-jährigen GII/PI Gravida mit fetaler Aortenbogenhypoplasie und Aortenisthmusstenose. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718320] [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)
- S Sommer
- München Klinik Harlaching, Frauenklinik
| | - Y Decker
- München Klinik Harlaching, Frauenklinik
| | - R Oberhoffer
- Technische Universität München, Präventive Pädiatrie
| | - D Grab
- München Klinik Harlaching, Frauenklinik
| | - C Scholz
- München Klinik Harlaching, Frauenklinik
| | - K Kraft
- München Klinik Harlaching, Frauenklinik
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Kraft K, Friedl T, Schlanstedt P, Bode H, Janni W, Scholz C, Reister F. Das Timing der antenataler Kortikosteroidgabe beeinflusst neonatale Outcome nach Frühgeburt. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Kraft
- München Klinik Harlaching, Frauenklinik
| | | | | | - H Bode
- Uniklinikum Ulm, Sozialpädiatrisches Zentrum
| | - W Janni
- Unifrauenklinik Ulm, Frauenklinik
| | - C Scholz
- München Klinik Harlaching, Frauenklinik
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Decker Y, Sommer S, Oberhoffer R, Grab D, Scholz C, Kraft K. Fallbericht einer 36-jährigen IVG/IP mit Rhabdomyom des II. Fetus bei Di-Di Geminigravidität. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718256] [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)
- Y Decker
- München Klinik Harlaching, Gynäkologie und Geburtshilfe
| | - S Sommer
- München Klinik Harlaching, Gynäkologie und Geburtshilfe
| | - R Oberhoffer
- Technische Universität München, Präventive Pädiatrie
| | - D Grab
- München Klinik Harlaching, Gynäkologie und Geburtshilfe
| | - C Scholz
- München Klinik Harlaching, Gynäkologie und Geburtshilfe
| | - K Kraft
- München Klinik Harlaching, Gynäkologie und Geburtshilfe
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12
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Affiliation(s)
- C Vollbracht
- University Medicine Rostock, Rostock
- Address correspondence to C. Vollbracht, University Medicine Rostock, Rostock, Germany.
| | | | - K Kraft
- University Medicine Rostock, Rostock
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Kersten M, Hancke K, Janni W, Kraft K. Pregnancy induced Cushing's syndrome and primary aldosteronism: a case report. BMC Pregnancy Childbirth 2020; 20:421. [PMID: 32711486 PMCID: PMC7382848 DOI: 10.1186/s12884-020-03117-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 07/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background First manifestation of Cushing’s syndrome during pregnancy is rare. The diagnosis of both Cushing’s and primary aldosteronism within a pregnancy has not been previously documented. Diagnosis is especially challenging due to the normal physiological changes that occur during pregnancy. Consequently, many tests that are normally used for diagnosis are not reliable. Tumor based etiologies can be surgically removed. Etiologies that are not tumor based are challenging to treat during pregnancy. Case presentation A 25 year old G1P0 was admitted in the 22 5/7 week of pregnancy with elevated blood pressure (200/100 mm Hg), acne, moon facies, abdominal striae and hirsutism. With five antihypertensive medications her blood pressure remained 190/100 mm Hg. The patient was admitted to the ICU for intravenous medications and monitoring. She was diagnosed with Cushing’s syndrome and primary aldosteronism. In spite of therapy with spironolactone and metyrapone she developed preeclampsia and was delivered in the 26 0/7 week of pregnancy. At her follow up visit eight weeks postpartum she had blood pressure within normal limits, no clinical signs or symptoms, and all medications had been discontinued. Conclusions Early diagnosis of pregnancy induced Cushing’s syndrome and primary aldosteronism requires an interdisciplinary approach. Late detection has been associated with increased perinatal morbidity and mortality including but not limited to placental abruption and intrauterine demise. Collaboration is essential in the optimization of maternal and fetal outcomes.
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Affiliation(s)
- Maria Kersten
- Department of Obstetrics and Gynecology, University of Ulm (Universitätsklinikum Ulm), Ulm, Germany
| | - Katharina Hancke
- Department of Obstetrics and Gynecology, University of Ulm (Universitätsklinikum Ulm), Ulm, Germany
| | - Wolfgang Janni
- Department of Obstetrics and Gynecology, University of Ulm (Universitätsklinikum Ulm), Ulm, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, Munich Klinik Harlaching (München Klinik Harlaching), Munich, Germany.
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Puhl A, Weiss C, Schneid A, Zahn E, Kraft K, Pretscher J, Faschingbauer F, Beckmann MW, Kehl S. [Does Induction of Labor for Preterm Premature Rupture of Membranes at 34 Weeks of Gestation Increase the Risk for Cesarean Section?]. Z Geburtshilfe Neonatol 2020; 224:269-274. [PMID: 32120446 DOI: 10.1055/a-1110-1132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE Induction of labor at 34 weeks of gestation is often linked to increased risk for cesarean section. Recently, the PPROMT trial demonstrated a higher cesarean section rate when labor was induced for preterm premature rupture of membranes (PPROM). The purpose of this study was therefore to evaluate the success rate of induction of labor for PPROM at 34 and 35 weeks of gestation in comparison with a higher gestational age. MATERIAL AND METHODS In this historic cohort study, cases with labor inductions for PPROM ≥ 34 weeks of gestation were included. Induction of labor at 34 and 35 weeks of gestation (group 1) were compared with those performed at 36 weeks (group 2) and 37 weeks (group 3). Induction of labor was started 12 to 24 hours after (preterm) premature rupture of membranes. Antibiotics were given routinely. The primary outcome was the rate of cesarean section. RESULTS There were significantly more cesarean sections in group 3 in comparison with group 2 (7 vs. 25%, p=0.0136). However, univariable and multiple logistic regression analysis of the primary outcome measure showed that there was no impact of the group affiliation on cesarean section rate. Significant parameters influencing the risk of cesarean section were body mass index and Bishop score. CONCLUSION Induction of labor for PPROM at 34 weeks of gestation is not associated with an increased rate of cesarean section.
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Affiliation(s)
- Alexander Puhl
- Frauenklinik, Klinikverbund Kempten-Oberallgäu gGmbH, Kempten
| | - Christel Weiss
- Medizinische Statistik, Biomathematik und Informationsverarbeitung, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim
| | - Anna Schneid
- Frauenklinik, Klinikverbund Kempten-Oberallgäu gGmbH, Kempten
| | - Eva Zahn
- Frauenklinik, Klinikverbund Kempten-Oberallgäu gGmbH, Kempten
| | | | - Jutta Pretscher
- Gynäkologie und Geburtshilfe, Universitätsklinikum Erlangen Frauenklinik, Erlangen
| | | | | | - Sven Kehl
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
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Lippke S, Wienert J, Keller FM, Derksen C, Welp A, Kötting L, Hofreuter-Gätgens K, Müller H, Louwen F, Weigand M, Ernst K, Kraft K, Reister F, Polasik A, Huener Nee Seemann B, Jennewein L, Scholz C, Hannawa A. Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study. BMC Health Serv Res 2019; 19:908. [PMID: 31779620 PMCID: PMC6883614 DOI: 10.1186/s12913-019-4579-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. Methods The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). Discussion This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users’ motivation. Insights gained from this study can inform other patient safety interventions and health policy developments. Trial registration ClinicalTrials.gov Identifier: NCT03855735; date of registration: February 27, 2019.
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Affiliation(s)
- Sonia Lippke
- Jacobs University Bremen gGmbH, Germany Campus Ring 1, 28759, Bremen, Germany.
| | - Julian Wienert
- Jacobs University Bremen gGmbH, Germany Campus Ring 1, 28759, Bremen, Germany
| | | | - Christina Derksen
- Jacobs University Bremen gGmbH, Germany Campus Ring 1, 28759, Bremen, Germany
| | - Annalena Welp
- Jacobs University Bremen gGmbH, Germany Campus Ring 1, 28759, Bremen, Germany
| | - Lukas Kötting
- Jacobs University Bremen gGmbH, Germany Campus Ring 1, 28759, Bremen, Germany
| | - Kerstin Hofreuter-Gätgens
- Die Techniker; Unternehmenszentrale, Fachbereich Versorgungsmanagement, Bramfelder Str. 140, 22305, Hamburg, Germany
| | - Hardy Müller
- Die Techniker; Unternehmenszentrale, Fachbereich Versorgungsmanagement, Bramfelder Str. 140, 22305, Hamburg, Germany.,Aktionsbündnis Patientensicherheit, Am Zirkus 2, 10117, Berlin, Germany
| | - Frank Louwen
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt Goethe-Universität, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Marcel Weigand
- Aktionsbündnis Patientensicherheit, Am Zirkus 2, 10117, Berlin, Germany
| | - Kristina Ernst
- Universitätsklinikum Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Katrina Kraft
- Universitätsklinikum Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Frank Reister
- Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89070, Ulm, Germany
| | - Arkadius Polasik
- Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89070, Ulm, Germany
| | | | - Lukas Jennewein
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt Goethe-Universität, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Christoph Scholz
- Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89070, Ulm, Germany
| | - Annegret Hannawa
- Center for the Advancement of Healthcare Quality and Patient Safety (CAHQS), Faculty of CommunicationSciences, Università della Svizzera Italiana, Lugano, Switzerland
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16
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Kyvernitakis I, Maul H, Rath W, Kraft K, Kuon R, Hamza A, Reuschel E, Filsinger B, Abele H, Garnier Y, Bahlmann F, Schleußner E, Berger R. Position Paper of the Task Force for Obstetrics and Prenatal Medicine (AGG - Section Preterm Birth) on the Placement, Removal and Surveillance of the Arabin Cervical Pessary in Patients at Risk for Spontaneous Preterm Birth. Geburtshilfe Frauenheilkd 2019; 79:1171-1175. [PMID: 31736505 PMCID: PMC6846727 DOI: 10.1055/a-1007-8613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023] Open
Abstract
This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training. This training is essential for proper pessary placement in patients in emergency situations to prevent preterm delivery and optimize neonatal outcomes. Consequently, pessaries should only be applied by healthcare professionals who are not only familiar with the clinical implications of preterm birth as a syndrome but are also trained in the practical application of the devices. The following statements on the clinical use of pessary application and its removal serve as an addendum to the recently published German S2-consensus guideline on the prevention and treatment of preterm birth.
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Affiliation(s)
- Ioannis Kyvernitakis
- Section of Prenatal Diagnostics and Therapy, Dept. of Obstetrics and Prenatal Medicine, Asklepios Center of Excellence Hamburg, Campus Barmbek, Heidberg-Nord and Wandbek, Hamburg, Germany
| | - Holger Maul
- Dept. of Obstetrics and Prenatal Medicine, Asklepios Center of Excellence Hamburg, Campus Barmbek, Heidberg-Nord and Wandbek, Hamburg, Germany
| | - Werner Rath
- Dept. of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Katrina Kraft
- Dept. of Obstetrics and Gynecology, Harlaching Hospital Munich, Munich, Germany
| | - Ruben Kuon
- Dept. of Gynecological Endocrinology and Fertility Disorders, University Hospital of Heidelberg, Heidelberg, Germany
| | - Amr Hamza
- Dept. of Obstetrics and Gynecology, University Hospital Saarland, Homburg, Germany
| | - Edith Reuschel
- Dept. of Obstetrics and Gynecology, University of Regensburg, Hospital of the Barmherzige Brueder, Clinic St Hedwig, Regensburg, Germany
| | - Barbara Filsinger
- Dept. of Obstetrics and Gynecology, Diakonissen Hospital Speyer, Speyer, Germany
| | - Harald Abele
- Center for Mother and Child, University-Hospital Tübingen, Tübingen, Germany
| | - Yves Garnier
- Dept. of Obstetrics and Gynecology, Osnabrück Hospital, Osnabrück, Germany
| | - Franz Bahlmann
- Dept. of Obstetrics and Gynecology, Buergerhospital and Clementine Children's Hospital Frankfurt a. M., Frankfurt a. M., Germany
| | - Ekkehard Schleußner
- Dept. Of Obstetrics and Prenatal Medicine, University of Jena, Jena, Germany
| | - Richard Berger
- Dept. of Obstetrics and Gynecology, Marienhospital Neuwied, Neuwied, Germany
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Kraft K, Alum A, Abbaszadegan M. Environmental algal phage isolates and their impact on production potential for food and biofuel applications. J Appl Microbiol 2019; 128:182-190. [PMID: 31606918 DOI: 10.1111/jam.14487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/11/2019] [Revised: 08/07/2019] [Accepted: 09/14/2019] [Indexed: 11/28/2022]
Abstract
AIMS The United States Department of Energy is aiming to bring microalgal biofuels into commercial use by 2030 at the price of $3 per gasoline gallon equivalent. Large-scale production of biofuel faces many challenges including naturally occurring algal phages; and characterizing this threat is the aim of this study. METHODS AND RESULTS Bench-scale experiments were performed to study the impact of viral infectivity on the production of microalgal in bioreactors. All environmental samples were tested positive for algal phages which showed various levels of infectivity against Synechocystis PCC 6803 and the environmental isolates of microalgae. The viral attachment to algal cells was observed under transmission electron microscopy (TEM) and to determine the shape and size of the viral particles. All the viruses detected were c. 50-60 nm icosahedral particles. Viral infection resulted in 48% reduction in the biomass of the infected algal culture in 22 days. CONCLUSIONS This study has lead to the conclusion that the microalgal phages prevalent in natural environment may cause infections in broad range of microalgae used for biofuel production. SIGNIFICANCE AND IMPACT OF THE STUDY This study has detected and quantified the phages that can infect algal populations in natural freshwater habitats and laboratory cultures of microalgal strains. The impact of viral threat to health of commercial algal production operations has been identified in this study.
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Affiliation(s)
- K Kraft
- Civil, Environmental & Sustainable Engineering, School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
| | - A Alum
- Civil, Environmental & Sustainable Engineering, School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
| | - M Abbaszadegan
- Civil, Environmental & Sustainable Engineering, School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
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Holman A, Haydar B, Kraft K, Park J. Infant spinal anesthesia: a safe, efficient, and worthwhile collaboration. J Pediatr Urol 2019; 15:583-584. [PMID: 31401223 DOI: 10.1016/j.jpurol.2019.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 11/20/2022]
Affiliation(s)
- A Holman
- Department of Anesthesiology, Division of Pediatric Anesthesiology, University of Michigan, C. S. Mott Children's Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA.
| | - B Haydar
- Department of Anesthesiology, Division of Pediatric Anesthesiology, University of Michigan, C. S. Mott Children's Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA
| | - K Kraft
- Department of Urology, Division of Pediatric Urology, University of Michigan, C. S. Mott Children's Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA
| | - J Park
- Department of Urology, Division of Pediatric Urology, University of Michigan, C. S. Mott Children's Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA
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Kraft K, Handke-Vesely A, Stuck D, Bauer E, Hüner B, Janni W, Reister F. „Sekundäre Präeklampsie“: Fallbericht eine atypische Präsentation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- K Kraft
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | | | - D Stuck
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - E Bauer
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - B Hüner
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - W Janni
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - F Reister
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
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Kraft K, Hüner B, Handke-Vesely A, Janni W, Reister F. Geburtsmodus bei Frühgeborenen: Eine retrospektive Single Center Erhebung. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- K Kraft
- Universitätsfrauenklinik Ulm, Geburtshilfe und Gynäkologie, Ulm, Deutschland
| | - B Hüner
- Universitätsfrauenklinik Ulm, Geburtshilfe und Gynäkologie, Ulm, Deutschland
| | - A Handke-Vesely
- Universitätsfrauenklinik Ulm, Geburtshilfe und Gynäkologie, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Geburtshilfe und Gynäkologie, Ulm, Deutschland
| | - F Reister
- Universitätsfrauenklinik Ulm, Geburtshilfe und Gynäkologie, Ulm, Deutschland
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Puhl A, Weiss C, Schneid A, Zahn E, Kraft K, Pretscher J, Faschingbauer F, Beckmann MW, Kehl S. Vergleich der Geburtseinleitung wegen einem frühen vorzeitigen Blasensprung und einem vorzeitigen Blasensprung. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Puhl
- Klinikverbund Kempten-Oberallgäu gGmbH, Klinik für Frauenheilkunde und Geburtshilfe, Kempten, Deutschland
| | - C Weiss
- Universitätsmedizin Mannheim, Universität Heidelberg, Medizinische Statistik, Biomathematik und Informationsverarbeitung, Mannheim, Deutschland
| | - A Schneid
- Klinikverbund Kempten-Oberallgäu gGmbH, Klinik für Frauenheilkunde und Geburtshilfe, Kempten, Deutschland
| | - E Zahn
- Klinikverbund Kempten-Oberallgäu gGmbH, Klinik für Frauenheilkunde und Geburtshilfe, Kempten, Deutschland
| | - K Kraft
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Pretscher
- Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
| | - F Faschingbauer
- Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
| | - MW Beckmann
- Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
| | - S Kehl
- Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
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Kraft K, Hüner B, Handke-Vesely A, Janni W, Reister F. Vorzeitiger Blasensprung vor der 20. Schwangerschaftswoche: Eine Analyse von 29 Fällen über 3 Jahre. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1660650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- K Kraft
- Universitätsfrauenklinik Ulm
| | - B Hüner
- Universitätsfrauenklinik Ulm
| | | | - W Janni
- Universitätsfrauenklinik Ulm
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Kraft K. The WHO traditional medicine strategy – a way to better medical care. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K Kraft
- Center for Internal Medicine, Universitätsmedizin Rostock, Rostock, Germany
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Müller J, Fink C, Rabini S, Kelber O, Nieber K, Kraft K, Storr MA. The herbal medicine STW 5 is efficacious in functional dyspepsia also in the elderly – a meta-analysis of randomized controlled trials. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Müller
- Medical and Clinical Affairs Phytomedicines, Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany, Darmstadt, Germany
| | - C Fink
- Medical and Clinical Affairs Phytomedicines, Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany, Darmstadt, Germany
| | - S Rabini
- Medical and Clinical Affairs Phytomedicines, Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany, Darmstadt, Germany
| | - O Kelber
- Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany, Darmstadt, Germany
| | - K Nieber
- Pharmaceutical Institute, Leipzig University, Leipzig, Germany, Leipzig, Germany
| | - K Kraft
- Chair for Naturopathy, Center for Internal Medicine, University Medicine Rostock, Rostock, Germany, Rostock, Germany
| | - MA Storr
- Center for Endoscopy, Starnberg, Germany
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Fink C, Müller J, Kelber O, Nieber K, Kraft K. Dry cough associated with pharyngeal irritation: Survey on Althea officinalis L. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Fink
- Medical and Clinical Affairs Phytomedicines, Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - J Müller
- Medical and Clinical Affairs Phytomedicines, Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - O Kelber
- Innovation and Development, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - K Nieber
- Pharmaceutical Institute, Leipzig University, Leipzig, Germany
| | - K Kraft
- Chair for Naturopathy, Center for Internal Medicine, University Medicine Rostock, Rostock, Germany
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Kraft K, Mooz H, Puhl A, Graf M, Renz H, Haller M, Karch M, Felberbaum R. Tako-Tsubo cardiomyopathy after cardiopulmonary resuscitation during emergency Cesarean section in a 28 year old patient in the 31st week of pregnancy. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593213] [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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Kraft K. 59-jährige Frau mit Karzinosarkom (Müller-Mischtumor). Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1580665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lorenz KJ, Kraft K, Graf F, Pröpper C, Steinestel K. [Importance of cellular tight junction complexes in the development of periprosthetic leakage after prosthetic voice rehabilitation]. HNO 2015; 63:171-2, 174-8, 180-1. [PMID: 25515126 DOI: 10.1007/s00106-014-2951-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The use of voice prostheses is currently the gold standard in voice rehabilitation after total laryngectomy. This method combines low complication rates and excellent rehabilitation results; however, approximately 30% of patients show periprosthetic leakage or severe fistula enlargement after laryngectomy and prosthetic voice restoration within the first 4 years. The development of this enlargement is controversially discussed in the literature but recently published studies have shown that high esophageal reflux plays a key role in this process, which leads to an inflammatory reaction and disturbs the intercellular tight junctions in the sense of an epithelial mesenchymal transition (EMT). MATERIAL AND METHODS A total of 44 patients underwent 24 h pH monitoring, a sample biopsy from the region of the fistula and a subsequent biomolecular examination for intracellular junction proteins as well as a correlation between the severity of reflux and tracheoesophageal fistula problems before and after antireflux therapy with proton pump inhibitors (PPI). RESULTS Immunohistochemical staining revealed decreases in membrane E-cadherin and β-catenin and a significant increase in the cytoplasmic fraction, depending on the severity of inflammation in the fistula tissue. In patients with an improvement of clinical fistula problems under oral PPI treatment an increase of membrane E-cadherin could be shown, whereas patients with persisting fistula enlargement demonstrated a further decrease of E-cadherin. CONCLUSION The data indicate a central role of EMT in the development of fistula enlargement after total laryngectomy. Patients with periprosthetic leakage showed a loss of membrane bound E-cadherin and β-catenin with an up-regulation of vimentin expression. In patients with mild or no leakage problems EMT could be resolved by aggressive antireflux treatment, whereas patients without any effect of PPI treatment on the fistula showed no reversal of EMT. These data contribute to the understanding of treatment resistant fistula enlargement after total laryngectomy.
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Affiliation(s)
- K J Lorenz
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Chirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland,
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Capsec J, Lefebvre C, Chupe F, Heitzmann P, Raveneau C, Giraud VD, Sauger C, Lagasse J, Kraft K, Linassier C, Dorval E. 2136 Non-organizational factors associated with delayed adjuvant chemotherapy (AC) in colon cancer (CC): An epidemiological study in “Region Centre”, France. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31057-7] [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: 11/17/2022]
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Mühlmeier G, Hausch R, Arndt A, Kraft K, Danz B, Maier H. [Respiratory epithelial adenomatoid hamartoma of the nose and nasal sinuses : a rare differential diagnosis of nasal polyposis]. HNO 2015; 62:813-7. [PMID: 25312591 DOI: 10.1007/s00106-014-2914-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Hamartomas are benign tumor-like lesions resulting from incorrectly differentiated germplasm and can manifest in different organ systems. In the nasal cavity and the sinuses these lesions are rare. Only few data on etiology, epidemiology and clinical significance of these tumors exist to date. MATERIALS AND METHODS In a retrospective study, material from patients treated in the Clinic for Otorhinolaryngology, Head and Neck Surgery of the Ulm Military Hospital was screened on the incidence and clinical courses of respiratory epithelial adenomatoid hamartomas (REAH) of the nose and nasal cavity. Furthermore, for cases of REAH, formalin-fixated paraffin-embedded tissue samples were re-evaluated and examined for human papillomavirus (HPV) DNA by PCR. RESULTS Tissue samples from 8145 surgical interventions on the nose and nasal sinuses from 2003 to 2012 were included. A total of 22 patients (3 female, 19 male; median age 57.5 years) diagnosed with REAH could be identified. Major complaints were nasal blockage (91 %), sinusitis (82 %), rhinorrhea (36 %) and cephalgia (23 %). Nasal endoscopy showed polyps in 68 % of patients. Native nasal sinus CT scans revealed no indications of REAH. Intraoperatively, hamartomas were found in 12 patients originating from the ethmoid bone, in 8 from the middle meatus or infundibulum and in 2 from the olfactory cleft. Macroscopic and histological examination showed compact lesions sized between 4 and 25 mm in the largest diameter containing homologous tissue, without signs of dysplasia or malignancy. HPV DNA was not identified in any case. CONCLUSION REAH of the nasal cavity and sinuses are rare benign local tissue lesions, usually without any autonomous proliferation. Clinical signs and findings correspond to those in polypoid pansinusitis. Only with single-sided or olfactory cleft location might CT scans provide indication of a tumorous lesion. For differentiation from true neoplasms, surgical resection and histopathological clarification is indicated. On the basis of current knowledge, complete surgical resection is adequate therapy.
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Affiliation(s)
- G Mühlmeier
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland,
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Affiliation(s)
- K Kraft
- Bundeswehrzentralkrankenhaus, Abteilung Pathologie, Koblenz, BRD
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Gretz N, Lasserre J, Kraft K, Waldherr R, Weidler B, Meisinger E, Strauch M. Efficacy and side effects of erythropoietin used in the treatment of anemia of uremic rats. Contrib Nephrol 2015; 60:236-44. [PMID: 3345672 DOI: 10.1159/000414808] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- N Gretz
- Clinic of Nephrology, Klinikum Mannheim, University of Heidelberg, FRG
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Giovannetti S, Barsotti G, Gretz N, Kraft K. Treatment and prevention of uremic osteodystrophy. Contrib Nephrol 2015; 72:66-72. [PMID: 2743774 DOI: 10.1159/000417321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Kraft K, Merom D, Steel K, Olson R, MacMillan F. Older adults’ views on sports and physical activity complexity: The match and mismatch to the professional's taxonomy. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.304] [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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Maier M, Kraft K, Steinestel K, Schramm A, Lorenz KJ, Tisch M, Schwerer M, Maier H. [Human papillomavirus in squamous cell cancer of the head and neck. A study at the Ulm Military Hospital, Germany]. HNO 2014; 61:593-601. [PMID: 23842698 DOI: 10.1007/s00106-013-2676-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There is increasing evidence worldwide that human papillomavirus is a major risk factor for head and neck cancer. Only few studies on this association have been performed in Germany to date. For the purposes of the present study, tumor specimens from 223 patients with squamous cell cancer of the oral cavity, oropharynx, hypopharynx and larynx were analyzed for HPV DNA and p16INK4a expression. The prevalence of HPV genotype 16 (HPV16) DNA in the study population was 17.5%. Further high-risk HPV types were not detected. All HPV16-positive tumors showed intense p16INK4a expression. HPV16 prevalence was highest in tonsillar carcinoma (37.5%) and lowest in laryngeal cancer (2.8%). We observed a significantly higher incidence of cervical lymph node metastases in patients with HPV16-positive tonsillar carcinoma in comparison to HPV-negative tumors (p < 0.016). Tobacco and/or alcohol consumption was significantly lower in patients with HPV-positive tumors (p < 0.0001).
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Affiliation(s)
- M Maier
- Univ.-HNO-Klinik Heidelberg.
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Kraft K, Reese S, Maierl J, Fiedler A. Einfluss eines neuartigen Biozids auf die Prävalenz von Dermatitis digitalis bei Milchkühen. Tierarztl Prax Ausg G Grosstiere Nutztiere 2013. [DOI: 10.1055/s-0038-1623179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Zusammenfassung
Gegenstand und Ziel: Es wurde untersucht, ob der Einsatz des Biozidprodukts T-Hexx Dragonhyde HBC (Fa. Hydromer, Branchburg, NJ, USA) die Prävalenz der Dermatitis digitalis (DD) beeinflusst. Material und Methoden: In einem Milchviehbetrieb (110 melkende Kühe) wurden 48 lahmheitsfreie Tiere randomisiert Versuchs- und Kontrollgruppe zugeteilt. Die mit 70–80% hohe Prävalenz der DD wurde 2 Monate lang vier Mal im Abstand von je 16–21 Tagen erfasst. Ein Punkteschema diente zur Dokumentation des Grades der DD-Läsionen an den Hinterklauen. Die Kühe der Versuchsgruppe wurden zweimal wöchentlich für zwei Melkzeiten nach Vorreinigung der Klauen mit Wasser durch ein Klauenbad mit T-Hexx-Dragonhyde geleitet, bei den Kontrolltieren erfolgte nur eine Klauenreinigung. Die Spritzer der Biozidlösung an Tieren und Umgebung wurden fotografisch dokumentiert und beurteilt. Wasser- und Biozidbad wurden nach Nutzung durch steigende Tierzahlen bakteriologisch untersucht. Ergebnisse: Statistisch signifikante Unterschiede der Prävalenzen der DD zwischen und innerhalb der beiden Gruppen waren nicht festzustellen. Die Punktebewertung der Läsionen differierte zwischen beiden Gruppen nicht. Im Wasserbad nahm mit steigender Zahl der Durchgänge die Zahl der koloniebildenden Einheiten (KBE) pro Milliliter sowie die der Enterobacteriaceae deutlich zu. Im T-Hexx-Dragonhyde-Bad ließen sich zu keinem Zeitpunkt KBE oder Enterobacteriaceae bestimmen. Die auffälligen Spritzer der Lösung waren bis in Höhe des Euters sichtbar. Schlussfolgerung und klinische Relevanz: Ein Einfluss des Biozidprodukts bei 4%- und 2%iger Badkonzentrationen auf die Prävalenz der DD konnte nicht nachgewiesen werden. Die hygienische Wirkung der Lösung war nicht gleichbedeutend mit einer erfolgreichen Keimreduktion an der Klaue. Eine mögliche Prävention der DD durch veterinärhygienische Maßnahmen könnte zukünftig bei geringerer Prävalenz und größerem Stichprobenumfang überprüft werden. Bei Anwendung von Klauenbädern besteht grundsätzlich die Gefahr einer Kontamination der Milch bzw. einer Mastitis durch Spritzer der Lösung.
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Fiedler A, Kraft K, Reese S, Maierl J. [Influence of a new biocidal product on the prevalence of digital dermatitis in dairy cows]. Tierarztl Prax Ausg G Grosstiere Nutztiere 2013; 41:207-216. [PMID: 23959616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 02/20/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE It was investigated whether usage of the biocidal product T-Hexx Dragonhyde (Hydromer, Branchburg, NJ, USA) could influence the prevalence of digital dermatitis (DD). MATERIAL AND METHODS On a dairy farm (110 milking cows) 48 dairy cows without lameness were selected randomly for a test group or a control (negative) group, respectively. A high prevalence of DD (70-80%) was documented over a period of 2 months, during which four examinations were made, with an interval of 16-21 days between each examination. The respective grade of the DD-lesion on the hind hoofs was documented according to a scoring scheme. After precleaning the claws with water, the test group passed through a hoof bath containing T-Hexx Dragonhyde on 2 days per week at two milking times on each day, whereas the claws of control animals were cleaned using only a water bath. Splashes contaminating the animals and the environment were documented photographically and evaluated. Bacteriological examinations of the water bath and the T-Hexx-bath were performed after increasing numbers of animals had passed through the baths. RESULTS Between and within groups no statistically significant differences in the prevalence of DD were found. DD-lesion scoring did not show any difference between the groups. With increasing numbers of animals having passed through the water bath, there was a significant increase in colony-forming units per millilitre and of enterobacteriaceae. In the T-Hexx Dragonhyde footbath, bacterial contamination remained below the detection limit at all times. The coloured splashes of the footbath were visible up to the level of the udder and teats. CONCLUSION AND CLINICAL RELEVANCE The prevalence of DD was not influenced by the 2% or 4% concentration of the biocidal product in the footbath. Thus the microbiocidal effect of the solution did not lead to an efficient reduction in bacteria on the hoof. To demonstrate a potential preventive effect on DD, future studies would require herds with lower prevalence and a higher sample size. However, when applying footbaths there is the general risk of milk contamination or causing mastitis.
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Affiliation(s)
- A Fiedler
- Dr. Andrea Fiedler, Heerstraße 3, 81247 München, E-Mail:
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Janik H, Mau C, Kraft K. P02.104. Nonlinear parameters of heart rate variability (HRV) – suitable measures to observe physiological outcome during a peat bath in rehabilitation. Altern Ther Health Med 2012. [PMCID: PMC3373320 DOI: 10.1186/1472-6882-12-s1-p160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mariette C, Messager M, Lefevre JH, Pichot V, Souadka A, Thibot T, Brachet D, Carrere N, Fernandez M, Guiramand J, Tsilividis B, Flamein R, Kraft K, Balon JM, Borie F, Glaise A, d'Journo X, Peschaud F, Vandois F, Piessen G. Effect of neoadjuvant chemotherapy on survival in patients with gastric signet ring cell adenocarcinoma: A multicentric comparative study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4036] [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: 11/20/2022] Open
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Reichling J, Kraft K, Gome R, Kelber O, Wegener T. Letter to the Editor Subject: Contribution of Maistro et al. in Genetics and Molecular Research (2010); 9(4): 2114-2122. Genet Mol Res 2011; 10:1092-4; author reply 1095-7. [DOI: 10.4238/vol10-2gmr1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kraft K, Delibasic M, Janik H. Evaluation of the effect of dynamic electro-neuro-stimulation (DENS)-therapy in patients with chronic neck pain in two rehabilitation hospitals. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.09.044] [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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Kiene H, Brinkhaus B, Fischer G, Girke M, Hahn E, Hoppe H, Jütte R, Kraft K, Klitzsch W, Matthiessen P, Meister P, Michalsen A, Teut M, Willich S, Heimpel H. Professional treatment in the context of medical pluralism—A German perspective. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Janik H, Mau C, Kraft K. Influence of a peat bath series on heart rate variability (HRV) measures of patients with prolapse of the nucleus pulposus during an inpatient orthopaedic rehabilitation. Eur J Integr Med 2009. [DOI: 10.1016/j.eujim.2009.08.125] [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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Kraft K, Balushev L. Deficits in the knowledge of relaxation techniques in German medical and economics students. Eur J Integr Med 2008. [DOI: 10.1016/j.eujim.2008.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Richter H, Kraft K, Kleinwechter H, Demandt N, Meincke G, Dabelstein A, Weisser B. [Effects of a telephone intervention in patients with type 2 diabetes]. Dtsch Med Wochenschr 2008; 133:2203-8. [PMID: 18924053 DOI: 10.1055/s-0028-1091262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE While there are evermore therapeutic options, a continuous rise in the prevalence of type 2 diabetes mellitus has been demonstrated in epidemiological studies and is leading to an increasing financial burden on health care systems. It has been shown in a number of studies that health-related lifestyle may be influenced by a telephone intervention program. PATIENTS AND METHODS The effect of a telephone intervention on physical activity and other important cardiovascular risk factors was investigated over a period of three months in patients with type 2 diabetes. Those in the intervention group (n=22) were phoned once weekly and only matters concerning their physical activity were discussed. The patients in a matching control group (n=20) were not phoned. RESULTS Physical activity increased in the intervention group with a significant difference when compared to the control group at the end of the three months' intervention. At the end of the intervention weight, body mass index, waist circumference, systolic blood pressure, triglycerides and fasting blood sugar where either significantly different between the intervention and control groups (absolute values) or showed a significantly greater decrease in the intervention group. In addition there was a tendency (not statistically significant) towards an improvement in the intervention group regarding other risk factors (body fat, diastolic blood pressure, total cholesterol, LDL, HDL, HbA1c). CONCLUSIONS These results demonstrate that a telephone intervention can increase physical activity and reduce cardiovascular risk factors. As a result it may reduce health care-related costs.
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Affiliation(s)
- H Richter
- Abteilung Sportmedizin, Institut für Sport und Sportwissenschaften der CAU zu Kiel, 24098 Kiel
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Maier H, Mühlmeier G, Kraft K, Blumstein NM, Tisch M. [Primary malignant melanoma of the parotid gland: a case report and review of the literature]. HNO 2008; 56:627-32. [PMID: 18066514 DOI: 10.1007/s00106-007-1634-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Malignant melanomas (MMs) of the parotid gland are relatively uncommon. They occur almost invariably as metastases from a primary tumour located in the region of the scalp or the mucous membranes of the nose, paranasal sinuses, or throat. Primary MMs arising in the parotid gland are extremely rare. It is assumed that they originate in the glandular tissue or in intraglandular lymph nodes. We present a case report and review of the literature on the diagnosis, treatment, and prognosis of intraparotid malignant melanoma. Diagnosis is based primarily on B-scan ultrasonography and fine-needle aspiration cytology. Patients with a cytological diagnosis of MM are further evaluated by magnetic resonance imaging and positron emission tomography and receive a thorough ear-nose-throat and dermatological examination. The treatment of choice is total parotidectomy and selective neck dissection. The effectiveness of adjuvant treatments such as radiotherapy, chemotherapy, or immunotherapy remains controversial. Patients with primary MMs of the parotid gland appear to have a better prognosis than those with parotid metastases from melanomas of the skin or mucous membranes.
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Affiliation(s)
- H Maier
- Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm.
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Kraft K. Cimicifuga, Johanniskraut und andere Phytotherapeutika im Klimakterium. Gynäkologische Endokrinologie 2008. [DOI: 10.1007/s10304-008-0256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Eisele R, Vogelsang E, Kraft K, Baumgarten U, Schick RR. Screening for colorectal lesions with high-resolution video colonoscopes in a German male average-risk population at 40 to 59 years of age. Z Gastroenterol 2007; 45:952-7. [PMID: 17874357 DOI: 10.1055/s-2007-963477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Prevalence data for colorectal neoplastic lesions obtained from screening colonoscopies have recently been reported for a U. S. American and a Polish average-risk population. However, prevalence data for a German average-risk population have not been published. METHODS From 1998 until 2003 a screening colonoscopy was offered to all male participants of a health assessment program. In a total of 618 volunteers with an average risk for colorectal cancer, polypoid lesions were identified and removed using high-resolution video colonoscopes. The histological features of the lesions were categorised according to those of the most advanced one. An advanced lesion was defined as an adenoma of at least 1 cm in diameter, a polyp with villous histological features or high-grade intraepithelial neoplasms or a cancer. Data were analysed in two groups: age 40 - 49 years (group A) and age 50 - 59 years (group B). RESULTS In group A (age 40 - 49 years, n = 285), 133 subjects (47 %) had polypoid lesions. Histological findings revealed that 57 subjects (20 %) had non-neoplastic and 76 subjects (27 %) had neoplastic lesions. In nine cases (3.2 %) polyps were classified as advanced lesions with a maximal diameter of 35 mm. In group B (age 50 - 59, n = 333), 183 subjects (55 %) had polypoid lesions. Histological findings revealed that 64 subjects (19 %) had non-neoplastic and 119 subjects (36 %) had neoplastic lesions. Among those, 34 (10.2 %) had advanced lesions with a maximal diameter of 55 mm. In neither group was an invasive cancer detected. The difference in the prevalence of neoplastic lesions between the two age groups was statistically significant (chi (2) = 5.85). An exceptionally high rate of 27 % neoplastic lesions was detected in subjects at 40 to 49 years of age. The rate of detected lesions in the group of older subjects was 36 %. CONCLUSION By using high-resolution endoscopes we found an unexpectedly large number of neoplastic lesions in the colon even in a relatively young average-risk population. The question whether screening colonoscopy should therefore not only aim at detecting early colorectal cancer but also at identifying and removing precursor adenomas at younger ages clearly deserves further attention.
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Affiliation(s)
- R Eisele
- Department of Internal Medicine, Federal Armed Forces Hospital Ulm, Ulm, Germany.
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Völker HU, Mühlmeier G, Maier H, Kraft K, Müller-Hermelink HK, Zettl A. True malignant mixed tumour (carcinosarcoma) of submandibular gland--a rare neoplasm of monoclonal origin? Histopathology 2007; 50:795-8. [PMID: 17376173 DOI: 10.1111/j.1365-2559.2007.02646.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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