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Aksakal T, Mader M, Erdsiek F, Annac K, Padberg D, Yılmaz-Aslan Y, Razum O, Brzoska P. [Supporting rehabilitation facilities in implementing diversity-sensitive care: Development of the DiversityKAT manual]. Rehabilitation (Stuttg) 2024; 63:23-30. [PMID: 37722412 DOI: 10.1055/a-2138-9199] [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] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND Expectations regarding health care including rehabilitation differ depending on age, gender, and also the migration history of the patient population. To meet the diverse expectations, health care needs to be diversity-sensitive, which can have a positive effect on the utilization and outcomes of care. Diversity-sensitive care, however, should take into consideration not only the expectations of diverse patient groups but also the opportunities and challenges offered by diversity of staff. Managers of health care facilities and health care staff in Germany are well aware of the need for diversity-sensitive care, but corresponding measures, so far, have been applied rarely and only unsystematically. The aim of the study was to develop a manual consisting of a catalogue of instruments and a guideline that can support rehabilitation facilities in implementing diversity-sensitive care. METHODS A mixed methods approach was used for the study. Based on a scoping review, suitable instruments (n=34) were identified that can be used for the implementation of diversity-sensitive health care. Consensus on a draft of the manual was then reached in seven focus group discussions with health care staff (n=44) and a discussion circle consisting of n=5 representatives of the rehabilitation providers. RESULTS The DiversityKAT manual, which was developed in a participatory manner, presents diversity-sensitive tools, including instructions, questionnaires, checklists and concepts that can be used to take into account the diversity of needs and expectations in everyday health care. In line with the feedback from health care staff, the manual includes information that can be used as a step-by-step guide to select and implement appropriate tools. At the request of the staff and the rehabilitation providers, exemplary case descriptions were added to present the use of selected instruments in specific situations. A matrix was developed for purposes of quick orientation and pre-selection of suitable instruments. DISCUSSION Through practice-oriented advice and low-threshold guidance, the DiversityKAT-manual can increase user orientation in rehabilitation but needs to be further examined in future evaluation studies.
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Affiliation(s)
- Tuğba Aksakal
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Maria Mader
- AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Fabian Erdsiek
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Kübra Annac
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Dennis Padberg
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Yüce Yılmaz-Aslan
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
- AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Oliver Razum
- AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Patrick Brzoska
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
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Schäfer G, Lübke R, Degen O, Mader M, Scheiter R, Wolski A, Addo MM, Schulze Zur Wiesch J, Pischke S. Lack of evidence of acute HEV infections as a sexually transmitted disease: Data from a German cohort of PrEP users. Braz J Infect Dis 2024; 28:103720. [PMID: 38365184 PMCID: PMC10885309 DOI: 10.1016/j.bjid.2024.103720] [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: 08/31/2023] [Revised: 12/26/2023] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND While the sexual transmissibility of HAV in MSM has been extensively described, the potential for sexual transmission of HEV has not been definitively established. Although HEV has been detected in the ejaculate of chronically infected men, studies among MSM PrEP users in France did not observe an elevated anti-HEV seroprevalence as an indicator of increased exposure risk by sexual intercourse. PATIENTS AND METHODS A total of 111 unselected PrEP users and 111 age- and sex-matched blood donors were tested for anti-HEV IgG, IgM and HEV (PCR). Of the participants 79/111 (71 %) responded to a questionnaire covering topics as sexual preferences, previous sexually transmitted diseases, profession, food consumption, and pet ownership. RESULTS The anti-HEV IgG seroprevalence in PrEP users (22 %) did not differ significantly from the rate in controls (17 %). While one PrEP user and three controls tested positive for anti-HEV IgM, all PrEP users and controls tested PCR negative. CONCLUSION In immunocompetent individuals with frequent changes of sexual partners, the epidemiology of Hepatitis E Virus does not significantly involve the sexual transmission route.
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Affiliation(s)
- Guido Schäfer
- ICH Hamburg, Hamburg, Germany; Ambulanzentrum des UKE, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rabea Lübke
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf Degen
- Ambulanzentrum des UKE, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Mader
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robin Scheiter
- Ambulanzentrum des UKE, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annika Wolski
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marylyn M Addo
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany
| | - Julian Schulze Zur Wiesch
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany
| | - Sven Pischke
- First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner sites, Hamburg, Germany.
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Pischke S, Ashouri MM, Peters U, Shiprov A, Schulze Zur Wiesch J, Sterneck M, Fischer F, Huebener P, Mader M, Fischer L, Fründt T, Aarabi G, Beikler T. High incidence of periodontitis in patients with ascitic decompensated cirrhosis. World J Hepatol 2023; 15:1325-1332. [PMID: 38223419 PMCID: PMC10784813 DOI: 10.4254/wjh.v15.i12.1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/27/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Periodontitis has been associated with various liver diseases. However, the relevance of periodontitis in the progression of decompensated cirrhosis remains inconclusive. In particular, it is unclear whether the common periodontitis pathogens, Porphyromonas gingivalis (P. gingivalis) and Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), can be detected not only in the oral mucosa but also in ascites and stool. AIM To investigate the significance of periodontitis, P. gingivalis, and A. actinomycetemcomitans in cirrhosis patients with ascitic decompensation. METHODS This prospective study was conducted at the University Hospital Hamburg-Eppendorf, a tertiary center in Northern Germany. A cohort of 27 patients with ascitic decompensated liver cirrhosis underwent dental examinations to assess the association between periodontitis and various clinical parameters of cirrhosis, as well as patient outcomes. PCR was used to test gingival samples, ascites, and stool for the presence of P. gingivalis and A. actinomycetemcomitans. Gingival samples were collected by probing the deepest gum pocket of a sextant and wiping them on a cotton swab. RESULTS Periodontitis was diagnosed in 22 out of 27 (82%) ascite patients, which is significantly more common than in a control cohort of 100 unselected patients (59%, P = 0.04). P. gingivalis was detected in the gingiva of six patients, and one of them also had P. gingivalis in their stool. However, P. gingivalis was not found in the ascites of any patient. Five out of six patients with P. gingivalis had periodontitis (83%). A. actinomycetemcomitans was not detected in any sample. Patients without periodontitis had a significantly higher mortality rate compared to those with periodontitis, and survival (Kaplan-Meier analysis) was longer in patients with periodontitis (P = 0.02). Transplant-free survival was also more common in patients with periodontitis compared to those without (63% vs 0%, P = 0.02). CONCLUSION Decompensated cirrhotic patients frequently suffer from periodontitis. However, there was no evidence of the translocation of P. gingivalis or A. actinomycetemcomitans into ascites. The survival of cirrhotic patients with periodontitis was not reduced.
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Affiliation(s)
- Sven Pischke
- First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg 20246, Germany.
| | - Mohamad Motee Ashouri
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
- Periodontics, Preventive and Restorative Dentistry, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Anita Shiprov
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
- Periodontics, Preventive and Restorative Dentistry, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | | | - Martina Sterneck
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Frank Fischer
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Peter Huebener
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Maria Mader
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Lutz Fischer
- Department of Visceral Transplantation, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Thorben Fründt
- First Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - G Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
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Pischke S, Knoop EV, Mader M, Kling L, Wolski A, Wagner A, Mueller K, Horvatits T, Stiller J, Wisnewski K, Kohn B, Schulze Zur Wiesch J, Groschup MH, Eiden M. Author Correction: Anti-HEV seroprevalence and rate of viremia in a German cohort of dogs, cats, and horses. Sci Rep 2023; 13:20651. [PMID: 38001248 PMCID: PMC10673996 DOI: 10.1038/s41598-023-47523-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023] Open
Affiliation(s)
- S Pischke
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany.
| | | | - M Mader
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Kling
- SYNLAB.Vet GmbH, Berlin, Germany
| | - A Wolski
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Wagner
- Vetambulanz Hamburg, Hamburg, Germany
| | - K Mueller
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - T Horvatits
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Stiller
- Small Animal Clinic, University of Leipzig, Leipzig, Germany
| | - K Wisnewski
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
| | - B Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - J Schulze Zur Wiesch
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
| | - M H Groschup
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
| | - M Eiden
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
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Pischke S, Knoop EV, Mader M, Kling L, Wolski A, Wagner A, Mueller K, Horvatits T, Stiller J, Wisnewski K, Kohn B, Schulze Zur Wiesch J, Groschup MH, Eiden M. Anti-HEV seroprevalence and rate of viremia in a German cohort of dogs, cats, and horses. Sci Rep 2023; 13:19240. [PMID: 37935733 PMCID: PMC10630430 DOI: 10.1038/s41598-023-46009-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
Hepatitis E virus (HEV) genotype 3 infections in Germany are mainly transmitted zoonotically through the consumption of swine meat. Furthermore, there is evidence that pets might come into contact with HEV, but the relevance of companion animals as possible sources of HEV transmission in Germany still needs to be defined. A monitoring study was therefore carried out on dogs, cats, and horses from Germany. In total 365 serum samples from pets (124 dogs, 119 cats, and 122 horses) were tested for HEV by PCR and for anti-HEV antibodies by a commercial ELISA. The HEV seroprevalence determined by the sero-assay varied significantly between dogs (10%), cats (6%), and horses (2%). Liver injury-related enzymes, alanine transaminase (ALT), and aspartate transaminase (AST) showed no differences between HEV-positive or negative animals. None of the pet serum samples tested positive for PCR. This serological study suggests that dogs and cats are significantly exposed to HEV in Germany, while horses are of minor relevance.
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Affiliation(s)
- S Pischke
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany.
| | | | - M Mader
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Kling
- SYNLAB.Vet GmbH, Berlin, Germany
| | - A Wolski
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Wagner
- Vetambulanz Hamburg, Hamburg, Germany
| | - K Mueller
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - T Horvatits
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Stiller
- Small Animal Clinic, University of Leipzig, Leipzig, Germany
| | - K Wisnewski
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
| | - B Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - J Schulze Zur Wiesch
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
| | - M H Groschup
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
| | - M Eiden
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Hamburg, Germany
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493, Greifswald-Insel Riems, Germany
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Westphal T, Mader M, Karsten H, Cords L, Knapp M, Schulte S, Hermanussen L, Peine S, Ditt V, Grifoni A, Addo MM, Huber S, Sette A, Lütgehetmann M, Pischke S, Kwok WW, Sidney J, Schulze zur Wiesch J. Evidence for broad cross-reactivity of the SARS-CoV-2 NSP12-directed CD4 + T-cell response with pre-primed responses directed against common cold coronaviruses. Front Immunol 2023; 14:1182504. [PMID: 37215095 PMCID: PMC10196118 DOI: 10.3389/fimmu.2023.1182504] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction The nonstructural protein 12 (NSP12) of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has a high sequence identity with common cold coronaviruses (CCC). Methods Here, we comprehensively assessed the breadth and specificity of the NSP12-specific T-cell response after in vitro T-cell expansion with 185 overlapping 15-mer peptides covering the entire SARS-CoV-2 NSP12 at single-peptide resolution in a cohort of 27 coronavirus disease 2019 (COVID-19) patients. Samples of nine uninfected seronegative individuals, as well as five pre-pandemic controls, were also examined to assess potential cross-reactivity with CCCs. Results Surprisingly, there was a comparable breadth of individual NSP12 peptide-specific CD4+ T-cell responses between COVID-19 patients (mean: 12.82 responses; range: 0-25) and seronegative controls including pre-pandemic samples (mean: 12.71 responses; range: 0-21). However, the NSP12-specific T-cell responses detected in acute COVID-19 patients were on average of a higher magnitude. The most frequently detected CD4+ T-cell peptide specificities in COVID-19 patients were aa236-250 (37%) and aa246-260 (44%), whereas the peptide specificities aa686-700 (50%) and aa741-755 (36%), were the most frequently detected in seronegative controls. In CCC-specific peptide-expanded T-cell cultures of seronegative individuals, the corresponding SARS-CoV-2 NSP12 peptide specificities also elicited responses in vitro. However, the NSP12 peptide-specific CD4+ T-cell response repertoire only partially overlapped in patients analyzed longitudinally before and after a SARS-CoV-2 infection. Discussion The results of the current study indicate the presence of pre-primed, cross-reactive CCC-specific T-cell responses targeting conserved regions of SARS-CoV-2, but they also underline the complexity of the analysis and the limited understanding of the role of the SARS-CoV-2 specific T-cell response and cross-reactivity with the CCCs.
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Affiliation(s)
- Tim Westphal
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Maria Mader
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik Karsten
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leon Cords
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Knapp
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Schulte
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lennart Hermanussen
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vanessa Ditt
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Marylyn Martina Addo
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Institute of Infection Research and Vaccine Development, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Samuel Huber
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Marc Lütgehetmann
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Pischke
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - William W. Kwok
- Benaroya Research Institute at Virginia Mason, Seattle, WA, United States
| | - John Sidney
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, United States
| | - Julian Schulze zur Wiesch
- Infectious Diseases Unit I, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Infection Research Deutsches Zentrum für Infektionsforschung (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
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Pischke S, Shiprov A, Peters U, Schulze Zur Wiesch J, Kluwe J, Westphal T, Fischer F, Mader M, Fründt T, Horvatits K, Horvatits T, Aarabi G, Beikler T. High prevalence of periodontal disease in patients with NASH- possible association of poor dental health with NASH severity. Ann Hepatol 2023; 28:100887. [PMID: 36646168 DOI: 10.1016/j.aohep.2022.100887] [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] [Received: 08/30/2022] [Revised: 11/28/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION AND OBJECTIVES Recent translational research indicated a bidirectional relationship between NASH (non-alcoholic steatohepatitis) and periodontitis; however, few clinical cohorts have studied this in detail. Thus we investigated this assumed association in a well-defined cohort. MATERIALS AND METHODS Data were generated prospectively for 132 patients (32 patients with NASH and 100 unselected, consecutively collected, anonymized controls from a local dental practice): detailed periodontal parameters, i.e., pocket-probing-depths (PPD), bleeding-on-probing (BOP), plaque-index, and utilization of dental care were assessed and correlated with relevant hepatic parameters (liver stiffness via fibroscan, AST, ALT, bilirubin, and MELD-score). Gingiva samples were tested for Porphyromonas gingvalis (P.g.) and Actinobacillus actinomyctemcomitans (A.a.) by PCR. RESULTS 87.5% of NASH patients and 47% of controls suffered from moderate to severe periodontitis (p=0.01). Liver stiffness was significantly correlated with elevated PPD (p=0.02) and BOP (p=0.03). 34 % of the NASH patients did not make use of regular dental health care. In these patients, AST (p=0.04), MELD score (p<0.01), and liver stiffness (p=0.01) were significantly elevated compared to those who see a dentist regularly. The severity of NASH was not associated with the intraoral detection of P.g. and A.a. CONCLUSIONS The present study suggests that NASH might be associated with periodontitis, irrespective of the intraoral presence of P.g. and A.a. Moreover, regular dental care utilization might mitigate the course of NASH, and patients should be reminded by their hepatologists of the importance of regular dental visits. Future studies should investigate the role of regular dental care and additional anti-inflammatory treatments of the oral cavity.
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Affiliation(s)
- Sven Pischke
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Germany.
| | - Anita Shiprov
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Periodontics, Preventive and Restorative Dentistry, University Medical Centre Hamburg-Eppendorf, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Centre Hamburg-Eppendorf, Germany
| | - Julian Schulze Zur Wiesch
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel and Heidelberg Partner Sites, Germany
| | - Johannes Kluwe
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Westphal
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Fischer
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Centre Hamburg-Eppendorf, Germany
| | - Maria Mader
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thorben Fründt
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karoline Horvatits
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Horvatits
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Centre Hamburg-Eppendorf, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Centre Hamburg-Eppendorf, Germany
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Aksakal T, Erdsiek F, Yılmaz-Aslan Y, Mader M, Padberg D, Razum O, Brzoska P. [Implementation Strategies of Diversity-Sensitive Health Care and Administration - A Nationwide Postal Survey of Inpatient Rehabilitation Facilities]. Rehabilitation (Stuttg) 2023; 62:40-47. [PMID: 35764298 DOI: 10.1055/a-1819-1968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Diversity characteristics such as disability, gender, age or migration background are associated with different expectations towards health care. If these are not sufficiently considered in rehabilitative care, this may have a negative impact on the satisfaction with and outcomes of health care. Sensitivity towards the diversity of patients can promote patient-centered health care by helping to address different needs and expectations. The aim of the present study was to examine what measures inpatient rehabilitation facilities in Germany use to provide diversity-sensitive health care and which barriers prevent their proper implementation. METHODS Between May and August 2019, administrative managers of rehabilitation facilities were invited to participate in a nationwide postal questionnaire survey (n=1,233). The questionnaire included questions on addressing the diversity of employees and rehabilitation patients. Responses were received from a total of 223 inpatient rehabilitation facilities (response rate: 18.9%). Results were analyzed descriptively. RESULTS The survey shows that diversity-sensitive health care is a relevant topic for many rehabilitation facilities. It is regarded particularly important for the satisfaction of rehabilitation patients, treatment outcomes and employee satisfaction. Obstacles to the implementation of diversity-sensitive care comprise a lack of incentives on the part of health care organization, a lack of financial resources and organizational difficulties. DISCUSSION The majority of the administrative managers surveyed acknowledge the relevance of diversity-sensitive care. Instruments enabling it, however, are used only sparingly and unsystematically. To promote diversity-sensitive care, health care facilities need support in competence building and in selecting and implementing appropriate measures. A handbook with instructions on how diversity-sensitive care can be implemented can contribute to that goal.
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Affiliation(s)
- Tuğba Aksakal
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Fabian Erdsiek
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Yüce Yılmaz-Aslan
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten.,AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld.,AG6 Versorgungsforschung und Pflegewissenschaft, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Maria Mader
- AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Dennis Padberg
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
| | - Oliver Razum
- AG3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Patrick Brzoska
- Lehrstuhl für Versorgungsforschung, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten
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Erdsiek F, Aksakal T, Mader M, Idris M, Yılmaz-Aslan Y, Razum O, Brzoska P. Diversity-sensitive measures in German hospitals - attitudes, implementation, and barriers according to administration managers. BMC Health Serv Res 2022; 22:689. [PMID: 35606740 PMCID: PMC9128136 DOI: 10.1186/s12913-022-08058-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
Background Populations have varying needs and expectations concerning health care that result from diversity characteristics such as a migrant background, gender identity, disability, and age. These needs and expectations must be considered to ensure adequate utilization and quality of health services. Approaches to address diversity do exist, however, little is known about the extent to which they are implemented by health care facilities. The present study aims to examine, which measures and structures hospitals in Germany employ to address diversity, as well as which barriers they encounter in doing so. Methods A mixed-mode survey among administration managers of all registered German hospitals (excluding rehabilitation hospitals; n = 1125) was conducted between May and October 2019 using pen-and-paper and online questionnaires. Results were analyzed descriptively. Results Data from n = 112 hospitals were available. While 57.1% of hospitals addressed diversity in their mission statement and 59.9% included diversity considerations in quality management, dedicated working groups and diversity commissioners were less prevalent (15.2% each). The majority of hospitals offered multi-lingual admission and exit interviews (59.8%), treatments or therapies (57.1%), but only few had multi-lingual meal plans (12.5%) and seminars or presentations (11.6%). While 41.1% of the hospitals offered treatment and/or nursing exclusively by staff of the same sex, only 17.0% offered group therapies for both sexes separately. According to the managers, the main barriers were a lack of financial resources (54.5%), a lack of incentives from the funding providers (49.1%), and organizational difficulties (45.5%). Other reported barriers were a lack of conviction of the necessity among decision makers (28.6%) and a lack of motivation among staff members (19.6%). Conclusions Administration managers from only a small proportion of hospitals participated in our survey on diversity sensitivity. Even hospitals of those who did are currently not adequately addressing the diversity of staff members and patients. Most hospitals address diversity on an ideational level, practical measures are not widely implemented. Existing measures suggest that most hospitals have no overarching concept to address diversity in a broader sense. The main reported barriers relate to economic aspects, a lack of support in organizing and implementing corresponding measures and a lack of awareness or motivation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08058-3.
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Affiliation(s)
- Fabian Erdsiek
- Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany.
| | - Tuğba Aksakal
- Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany
| | - Maria Mader
- Bielefeld University, School of Public Health, AG 3: Epidemiology and International Public Health, Bielefeld, Germany
| | - Munzir Idris
- Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany
| | - Yüce Yılmaz-Aslan
- Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany.,Bielefeld University, School of Public Health, AG 3: Epidemiology and International Public Health, Bielefeld, Germany.,Bielefeld University, School of Public Health, AG 6: Health Services Research and Nursing Science, Bielefeld, Germany
| | - Oliver Razum
- Bielefeld University, School of Public Health, AG 3: Epidemiology and International Public Health, Bielefeld, Germany
| | - Patrick Brzoska
- Witten/Herdecke University, Faculty of Health, School of Medicine, Health Services Research, Alfred-Herrhausen-Strasse 50, 58448, Witten, Germany
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Brzoska P, Erdsiek F, Aksakal T, Mader M, Ölcer S, Idris M, Altinok K, Wahidie D, Padberg D, Yilmaz-Aslan Y. Pictorial Assessment of Health-Related Quality of Life. Development and Pre-Test of the PictoQOL Questionnaire. Int J Environ Res Public Health 2022; 19:ijerph19031620. [PMID: 35162642 PMCID: PMC8835013 DOI: 10.3390/ijerph19031620] [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] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/03/2022]
Abstract
The aim of the present study was to develop a pictorial questionnaire for the assessment of health-related quality of life (PictoQOL) and to examine its content validity and usability across three exemplary population groups of different origin residing in Germany (non-migrants, Turkish migrants and Arabic-speaking migrants). A mixed-methods design combining qualitative and quantitative methods was used, comprising 6 focus group discussions with a total of 17 participants, 37 cognitive interviews and a quantitative pretest with 15 individuals. The PictoQOL consists of a pictorial representation of a total of 15 different situations. Using a visual Likert scale, respondents indicate how much each situation applies to them. Some representations proved to be culturally sensitive and were adapted. Respondents found the use of an additional graphic layer in the form of symbols in addition to pictures helpful for interpretation. The PictoQOL is considered to allow a more accessible assessment and better comparability of HRQOL across different population groups regardless of their literacy level. It is therefore considered to be superior to existing instruments for routine use in health research and practice. Future studies need to examine its convergent and factorial validity.
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Affiliation(s)
- Patrick Brzoska
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Correspondence:
| | - Fabian Erdsiek
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Tuğba Aksakal
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Maria Mader
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
| | - Sabahat Ölcer
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Munzir Idris
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Kübra Altinok
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Diana Wahidie
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Dennis Padberg
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Yüce Yilmaz-Aslan
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
- Department of Nursing and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
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Robinson N, Kirchbichler A, Banuls O, Mader M, Aikin R, Sottas PE, D'Onofrio G. Validation of a Blood Stability Score as an easy-to-use blood sample quality index. Int J Lab Hematol 2016; 38:685-693. [DOI: 10.1111/ijlh.12557] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/21/2016] [Indexed: 01/08/2023]
Affiliation(s)
- N. Robinson
- Swiss Laboratory for Doping Analyses; University Center of Legal Medicine, Lausanne and Geneva; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Epalinges, VD Switzerland
| | | | - O. Banuls
- Cycling Anti-Doping Foundation; Aigle Switzerland
| | - M. Mader
- Nationale Anti-Doping Agentur Austria; Vienna Austria
| | - R. Aikin
- World Anti-Doping Agency; Lausanne Switzerland
| | | | - G. D'Onofrio
- Research Center for Automated Methods in Hematology; Catholic University of Sacred Hearth; Rome Italy
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Luff J, Rowland P, Mader M, Orr C, Yuan H. Two Canine Papillomaviruses Associated With Metastatic Squamous Cell Carcinoma in Two Related Basenji Dogs. Vet Pathol 2016; 53:1160-1163. [DOI: 10.1177/0300985816630795] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Papillomaviruses (PV) are associated with benign mucosal and cutaneous epithelial proliferations. In dogs, PV-associated pigmented plaques and papillomas can undergo malignant transformation, but this is rare, and most cases of canine squamous cell carcinoma do not arise from PV-induced precursor lesions. We describe herein the progression of pigmented plaques to invasive and metastatic squamous cell carcinoma associated with 2 canine papillomaviruses (CPV) in 2 related Basenji dogs. Immunohistochemistry for PV antigen revealed strong nuclear immunoreactivity within keratinocytes from pigmented plaques from both dogs, consistent with a productive viral infection. Polymerase chain reaction (PCR) using degenerate primers for the L1 gene revealed PV DNA sequences from 2 different CPVs. In situ hybridization for CPV revealed strong hybridization signals within the pigmented plaques and neoplastic squamous epithelial cells from both dogs. We report here progression of PV-associated pigmented plaques to metastatic squamous cell carcinoma within 2 Basenji dogs associated with 2 different CPVs.
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Affiliation(s)
- J. Luff
- North Carolina State University, Raleigh, NC, USA
| | - P. Rowland
- Histopath Consulting, Worcester, MA, USA
| | - M. Mader
- North Carolina State University, Raleigh, NC, USA
| | - C. Orr
- Animal Clinic of East Avenue, Rochester, NY, USA
| | - H. Yuan
- Georgetown University Medical School, Washington, DC, USA
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Oelze M, Kröller-Schön S, Mader M, Zinßius E, Stamm P, Hausding M, Mayoux E, Wenzel P, Schulz E, Münzel T, Daiber A. Effects of empagliflozin on oxidative stress and endothelial dysfunction in STZ-induced Type 1 diabetic rat. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bender A, Beckers J, Schneider I, Hölter SM, Haack T, Ruthsatz T, Vogt-Weisenhorn DM, Becker L, Genius J, Rujescu D, Irmler M, Mijalski T, Mader M, Quintanilla-Martinez L, Fuchs H, Gailus-Durner V, de Angelis MH, Wurst W, Schmidt J, Klopstock T. Creatine improves health and survival of mice. Neurobiol Aging 2007; 29:1404-11. [PMID: 17416441 DOI: 10.1016/j.neurobiolaging.2007.03.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2006] [Revised: 02/13/2007] [Accepted: 03/02/2007] [Indexed: 02/07/2023]
Abstract
The supplementation of creatine (Cr) has a marked neuroprotective effect in mouse models of neurodegenerative diseases. This has been assigned to the known bioenergetic, anti-apoptotic, anti-excitotoxic, and anti-oxidant properties of Cr. As aging and neurodegeneration share pathophysiological pathways, we investigated the effect of oral Cr supplementation on aging in 162 aged C57Bl/6J mice. Outcome variables included "healthy" life span, neurobehavioral phenotyping, as well as morphology, biochemistry, and expression profiling from brain. The median healthy life span of Cr-fed mice was 9% higher than in control mice, and they performed significantly better in neurobehavioral tests. In brains of Cr-treated mice, there was a trend towards a reduction of reactive oxygen species and significantly lower accumulation of the "aging pigment" lipofuscin. Expression profiling showed an upregulation of genes implicated in neuronal growth, neuroprotection, and learning. These data show that Cr improves health and longevity in mice. Cr may be a promising food supplement to promote healthy human aging.
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Affiliation(s)
- A Bender
- Department of Neurology, University of Munich, Klinikum Grosshadern, Marchioninistr. 15, Munich D-81377, Germany
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Haack T, Bender A, Beckers J, Hölter SM, Ruthsatz T, Vogt-Weisenhorn D, Becker L, Genius J, Rujescu D, Irmler M, Mijalski T, Mader M, Quintanilla-Martinez L, Fuchs H, Gailus-Durner V, Hrabé de Angelis M, Wurst W, Schmidt J, Schneider I, Klopstock T. Creatine improves health and survival in mice. Akt Neurol 2007. [DOI: 10.1055/s-2007-987803] [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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Elstner M, Morris C, Metha D, Mader M, Klopstock T, Prokisch H, Turnbull D. Genexpressionsanalyse dopaminerger Zellen der Substantia nigra im Parkinson-Syndrom. Akt Neurol 2007. [DOI: 10.1055/s-2007-987907] [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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Specht K, Smida J, Nährig J, Reich U, Schnitzbauer U, Mader M, Budczies J, Tornow S, Harbeck N, Kiechle M, Höfler H. Predictive array analysis of breast cancer. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80574-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Sister Mary Joseph nodules are metastatic deposits in the periumbilical area. The purpose of this review is to demonstrate umbilical anatomy, discuss modes of metastatic spread, the various imaging appearances and their relevance to the radiologist.
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Affiliation(s)
- D M Coll
- Department of Radiology, Cleveland Clinic Foundation, OH 44195, USA
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Possover M, Mader M, Zielinski J, Pietrzak K, Hettenbach A. Is laparotomy for staging early ovarian cancer an absolute necessity? J Am Assoc Gynecol Laparosc 1995; 2:285-8. [PMID: 9050572 DOI: 10.1016/s1074-3804(05)80110-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVE To demonstrate that palpation of the omentum, mesentery, and intestine can be omitted from the laparoscopic staging of stage I carcinoma of the ovary. DESIGN Retrospective analysis of 223 women with stages III and IV ovarian cancer treated by laparotomy. SETTING Gynecological Oncology Clinic, M. Sklodowska-Curie Memorial Cancer Institute of Oncology, Warsaw, Poland. INTERVENTIONS Observation of macroscopic spread of tumor to areas accessible to laparoscopic inspection versus spread to areas inaccessible to laparoscopic evaluation. MEASUREMENTS AND MAIN RESULTS Macroscopically detectable disease in the areas easily accessible to laparoscopic inspection was present in all cases of metastases to the mesentery, omentum, or intestine. CONCLUSION The diagnosis of FIGO stage I ovarian cancer can be made with confidence if laparoscopic inspection of certain areas reveals no evidence of metastases.
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Affiliation(s)
- M Possover
- Frauenklinik, Klinik am Eichert, Postgraduate Clinic of University Ulm, 73006 Göppingen, Germany
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Weintraub WS, Weimann G, Teichholz LE, Swartz MH, Cohl J, Mader M, Kupersmith J. Rapid on-line drug information system for intensive care units. Mt Sinai J Med 1981; 48:315-21. [PMID: 6975881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Deysine M, Mader M. Thoracic duct lymph flow changes secondary to alterations in serum calcium levels: a proposed mechanism of action. Lymphology 1980; 13:1-8. [PMID: 7366247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Deysine M, Mader M, Rosario E, Mandell C, Klavins JV. Lymphatic flow alterations secondary to changes total serum calcium levels. Proc Soc Exp Biol Med 1974; 147:158-61. [PMID: 4438318 DOI: 10.3181/00379727-147-38303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Deysine M, Mraovitch S, Mader M, Koch M. Serum calcium alterations produced by enterectomy in normal and parathyroidectomized dogs. Surg Gynecol Obstet 1973; 136:421-4. [PMID: 4631851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Deysine M, Mraovitch S, Mader M, Wilder JR. Isolated bone perfusion. Surg Gynecol Obstet 1971; 132:204-6. [PMID: 5547399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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