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Rodacki M, Calliari LE, Ramalho AC, Vianna AGD, Franco DR, Melo KFS, Araujo LR, Krakauer M, Scharf M, Minicucci W, Ziegler R, Gabbay M. Using trend arrows in continuous glucose monitoring systems for insulin adjustment in clinical practice: Brazilian Diabetes Society Position Statement. Diabetol Metab Syndr 2021; 13:2. [PMID: 33390180 PMCID: PMC7780381 DOI: 10.1186/s13098-020-00607-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/03/2020] [Indexed: 11/24/2022] Open
Abstract
This manuscript reports the Brazilian Diabetes Society Position Statement for insulin adjustments based on trend arrows observed in continuous glucose monitoring systems. The Brazilian Diabetes Society supports the utilization of trend arrows for insulin dose adjustments in patients with diabetes on basal-bolus insulin therapy, both with multiple daily insulin doses or insulin pumps without closed-loop features. For those on insulin pumps with predictive low-glucose suspend feature, we suggest that only upward trend arrows should be used for adjustments. In this paper, tables for insulin adjustment based on sensitivity factors are provided and strategies to optimize the use of trend arrows in clinical practice are discussed.
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Affiliation(s)
- M Rodacki
- Department of Internal Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
| | - L E Calliari
- Pediatric Endocrinology Unit, Pediatric Department, Santa Casa de São Paulo School of Mediccal Sciences, São Paulo, Brazil
| | - A C Ramalho
- Department of Endocrinology, Federal University of Bahia, Salvador, BA, Brazil
| | - A G D Vianna
- Curitiba Diabetes Center, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | - D R Franco
- CPCLIN/DASA Clinical Research Center, São Paulo, Brazil
| | - K F S Melo
- Diabetes Secion, Hospital das Clinicas, University of São Paulo (USP), Quasar Telemedicine (Glic), São Paulo, Brazil
| | - L R Araujo
- Endocrinology Section, School of Medical Sciences, Belo Horizonte, MG, Brazil
| | - M Krakauer
- Diabetes and Endocrinology, Science Valley Research Institute, Santo André, SP, Brazil
| | - M Scharf
- Curitiba Diabetes Center, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | - W Minicucci
- Endocrinology Section, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - R Ziegler
- Diabetes Clinic for Children and Adolescents, Munster, Germany
| | - M Gabbay
- Diabetes Centre-UNIFESP, Federal University of São Paulo, São Paulo, Brazil
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Hemmer CJ, Bierhaus A, Riedesel JV, Gabat S, Liliensiek B, Pitronik P, Lin J, Grauer A, Amiral J, Ziegler R, Schieffer S, Kern P, Seitz R, Egbring R, Dietrich M, Nawroth PP. Elevated Thrombomodulin Plasma Levels as a Result of Endothelial Involvement in Plasmodium falciparum Malaria. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648889] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryWe used thrombomodulin (TM) to assess the participation of the vascular endothelium in human Plasmodium falciparum (P. F.) malaria. Before therapy TM plasma levels were elevated in P. F. malaria and fell to normal values during therapy. Parasitemia, TNFα, elastase and TAT levels correlated directly with TM. Elevated TM levels can not be explained by increased synthesis, since incubating HUVEC with pretherapy serum of patients with P. F. malaria, but not reconvalescence serum, suppressed TM transcription. This was partially prevented by adding a TNFα neutralizing antibody to patient serum before incubation with HUVEC. However, TNFα does not release TM from cultured HUVEC in vitro. Coincubation of HUVEC with pretherapy serum together with neutrophils resulted in endothelial cell destruction, which could be partly prevented by a TNFα neutralizing antibody. Hence the increase of TM during P. F. malaria might reflect the concerted action of cytokines and neutrophils on HUVEC.
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Affiliation(s)
- Christoph J Hemmer
- The Department of Medicine, Bernhard-Nocht-lnstitute for Tropical Medicine, Hamburg, Germany
| | - A Bierhaus
- Department of Medicine, University of Heidelberg, Germany
| | - J v Riedesel
- Department of Medicine, University of Heidelberg, Germany
| | - S Gabat
- Department of Medicine, University of Heidelberg, Germany
| | - B Liliensiek
- Department of Medicine, University of Heidelberg, Germany
| | - P Pitronik
- Department of Medicine, University of Heidelberg, Germany
| | - J Lin
- Department of Medicine, University of Heidelberg, Germany
| | - A Grauer
- Department of Medicine, University of Heidelberg, Germany
| | - J Amiral
- SERBIO Research Laboratories, Gennevilliers, France
| | - R Ziegler
- Department of Medicine, University of Heidelberg, Germany
| | - S Schieffer
- Infectious Diseases and Clinical Immunology Section, University of Ulm
| | - P Kern
- Infectious Diseases and Clinical Immunology Section, University of Ulm
| | - R Seitz
- Department of Hematology, Hemostaseology Section, University of Marburg, Germany
| | - R Egbring
- Department of Hematology, Hemostaseology Section, University of Marburg, Germany
| | - M Dietrich
- The Department of Medicine, Bernhard-Nocht-lnstitute for Tropical Medicine, Hamburg, Germany
| | - P P Nawroth
- Department of Medicine, University of Heidelberg, Germany
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Bierhaus A, Hemmer CJ, Mackman N, Kutob R, Ziegler R, Dietrich M, Nawroth PP. Antiparasitic Treatment of Patients with P. falciparum Malaria Reduces the Ability of Patient Serum to Induce Tissue Factor by Decreasing NF-κB Activation. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummarySerum from patients with P. falciparum malaria at day 1 (pretherapy) induces tissue factor (TF) in cultured endothelial cells. TF induction depends on de novo transcription as shown in Nuclear Run On assays. Electrophoretic mobility shift assays demonstrated binding of AP-1 and NF- κB/Rel proteins to their recognition sites in the TF promotor. After therapy (day 28), stimulation of TF antigen by patient serum is reduced by 70%. When serum obtained before and after therapy was compared, a decrease of NF-κB activation was evident. Activation of NF-κB-like proteins was in part dependent on TNFα in patient serum, since a TNFα neutralizing antibody reduced induction of TF transcription and translation and induction of NF-κB-like proteins. Induction of TF activity was suppressed by pDTC, an inhibitor of NF-κB activation. When different promotor constructs of the TF gene were tested, induction was dependent upon the presence of the intact NF-κB-like binding site in the TF promotor. A mutant with deleted NF-κB, but intact AP-1 sites was not inducible. Mutation of the AP-1 sites did not prevent induction, but reduced inducibility by pretherapy serum. Therefore, NF-κB/Rel proteins are responsible for induction of TF transcription by pretherapy serum, but AP-1 is needed for highest inducibility. The effect of antiparasitic therapy on the induction of TF by serum from patients with complicated P. falciparum malaria is dependent on a therapy-mediated loss of activation of NF-κB-like proteins in post-treatment patient serum.
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Affiliation(s)
- A Bierhaus
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
| | - Ch J Hemmer
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - N Mackman
- The Dept. of Immunol., Scripps Res. Clinic, La Jolla, USA
| | - R Kutob
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - R Ziegler
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
| | - M Dietrich
- The Dept. of Medicine, Bernhard Nocht Inst. for Tropical Medicine, Hamburg, Germany
| | - P P Nawroth
- The Dept. of Medicine I, Univ. of Heidelberg, Germany
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Böckenholt J, Schneider F, Urlichs F, Böswald M, Ziegler R, Oesingmann-Weirich S. Erfolgreiche Therapie eines transienten neonatalen Diabetes mellitus aufgrund einer UPD6pat-Mutation bei einem hypotrophen Frühgeborenen (34+2 SSW) mit oralen Sulfonylharnstoffen. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Böckenholt
- St. Franziskus-Hospital Münster, Allgemeine Kinder- und Jugendmedizin, Pädiatrische Diabetologie, Münster, Germany
| | - F Schneider
- St. Franziskus-Hospital Münster, Neonatologie und pädiatrische Intensivmedizin, Münster, Germany
| | - F Urlichs
- St. Franziskus-Hospital Münster, Neonatologie und pädiatrische Intensivmedizin, Münster, Germany
| | - M Böswald
- St. Franziskus-Hospital Münster, Allgemeine Kinder- und Jugendmedizin, Pädiatrische Diabetologie, Münster, Germany
| | - R Ziegler
- St. Franziskus-Hospital Münster, Allgemeine Kinder- und Jugendmedizin, Pädiatrische Diabetologie, Münster, Germany
| | - S Oesingmann-Weirich
- St. Franziskus-Hospital Münster, Allgemeine Kinder- und Jugendmedizin, Pädiatrische Diabetologie, Münster, Germany
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Elser H, Haufe S, Ziegler R, Georgi P, Pfeilschifter J. Einfluß prätherapeutischer Variablen auf die Wirkung einer standardisierten 131J-Therapie mit 150 Gray beim Morbus Basedow. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel: Bei 61 Patienten mit einem Morbus Basedow haben wir den Einfluß prätherapeutischer Variablen auf die Funktion und das Volumen der Schilddrüse ein Jahr nach einer 131J-Therapie mit 150 Gray untersucht. Methoden: FT3, FT4, und TSH wurden vor Therapie und eineinhalb, 3, 6 und 12 Monate nach Therapie gemessen. Das Schilddrüsenvolumen wurde vor Therapie und ein Jahr nach Therapie sonographisch und szin-tigraphisch bestimmt. Ergebnisse: Ein Jahr nach Therapie waren 30% der Patienten latent oder manifest hyperthyreot, 24% euthyreot, und 46% latent oder manifest hypothyreot. Lebensalter und Ausgangsvolumen der Schilddrüse waren die Hauptprädiktoren der posttherapeutischen Schilddrüsenfunktion. Der Anteil an persistierenden Hyperthyreosen war bei älteren Patienten mit einem Schilddrüsenvolumen größer 50 ml mit über 70% besonders hoch. Bei fast allen Patienten kam es zu einer deutlichen Verkleinerung der Schilddrüse. Ausgangsvolumen und Lebensalter waren auch hier die Hauptprädiktoren der posttherapeutischen Schilddrüsengröße. Bei allen Patienten jünger als 50 Jahre kam es sogar unabhängig von der Ausgangsgröße zu einer Normalisierung des Schilddrüsenvolumens. Schlußfolgerung: Eine Radiojodtherapie mit 150 Gray führt bei den meisten Patienten mit einem Morbus Basedow zu einer deutlichen Verkleinerung der Schilddrüse. Alter und initiales Volumen haben einen wesentlichen Einfluß auf die Funktion und Größe der Schilddrüse nach Therapie und sollten bei der Dosisfestlegung berücksichtigt werden.
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-111213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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Neu A, Bürger-Büsing J, Danne T, Dost A, Holder M, Holl R, Holterhus PM, Kapellen T, Karges B, Kordonouri O, Müller S, Raile K, Schweizer R, von Sengbusch S, Stachow R, Wagner V, Wiegand S, Ziegler R. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter – AWMF-Registernummer 057–016. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-100779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - J. Bürger-Büsing
- Bund diabetischer Kinder und Jugendlicher e.V., Diabeteszentrum, Kaiserslautern
| | - T. Danne
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - A. Dost
- Universitätsklinikum Jena, Klinik für Kinder- und Jugendmedizin
| | | | - R. Holl
- Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm
| | - P.-M. Holterhus
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Allgemeine Pädiatrie
| | - T. Kapellen
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Kinder- und Jugendmedizin
| | - B. Karges
- RWTH Aachen, Universitätsklinikum, Sektion Endokrinologie und Diabetologie
| | - O. Kordonouri
- Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S. Müller
- Praxis für Ernährungsberatung, Ennepetal
| | - K. Raile
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Schweizer
- Universität Tübingen, Klinik für Kinder- und Jugendmedizin
| | - S. von Sengbusch
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Kinder- und Jugendmedizin
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - V. Wagner
- Gemeinschaftspraxis für Kinder- und Jugendmedizin, Rostock
| | - S. Wiegand
- Charité, Universitätsmedizin Berlin, Virchow-Klinikum
| | - R. Ziegler
- Praxis für Kinder- und Jugendmedizin, Diabetologische Schwerpunktpraxis, Münster
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Berger A, Meinel DM, Schaffer A, Ziegler R, Pitteroff J, Konrad R, Sing A. A case of pharyngeal diphtheria in Germany, June 2015. Infection 2016; 44:673-5. [PMID: 26883545 DOI: 10.1007/s15010-016-0882-2] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND In June 2015, a 45-year-old man suffering from acute necrotic tonsillitis and throat phlegmon was hospitalized in Nuremberg, Germany. After emergency surgery the patient was initially treated with antibiotics. RESULTS A throat swab grew a toxigenic Corynebacterium diphtheriae biovar mitis strain. The patient's vaccination status was not documented and the patient was tested serologically for anti-diphtheria antibodies showing no protective immunity. Extensive control investigations were performed by the local health department showing no likely source of his infection. CONCLUSION No secondary cases were found and the patient completely recovered.
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Affiliation(s)
- A Berger
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany.,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - D M Meinel
- Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - A Schaffer
- Public Health Authority, City of Nuremberg, Nuremberg, Germany
| | - R Ziegler
- Institute for Clinical Hygiene, Microbiology and Infectiology, Klinikum Nürnberg, Nuremberg, Germany
| | - J Pitteroff
- Otorhinolaryngology Clinic, Klinikum Nürnberg, Nuremberg, Germany
| | - R Konrad
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany.,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - Andreas Sing
- National Consiliary Laboratory for Diphtheria, 85764, Oberschleißheim, Germany. .,Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany.
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Veith N, Braun B, Fritz T, Pohlemann T, Tschernig T, Ziegler R, Mörsdorf P, Knopp W. Sägeverletzungen der Hand – epidemiologische Aspekte. Zentralbl Chir 2015; 142:194-198. [DOI: 10.1055/s-0041-107435] [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: 10/22/2022]
Affiliation(s)
- N. Veith
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - B. Braun
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - T. Fritz
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - T. Pohlemann
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - T. Tschernig
- Universität des Saarlandes, Institut für Anatomie und Zellbiologie, Homburg, Deutschland
| | - R. Ziegler
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - P. Mörsdorf
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
| | - W. Knopp
- Universitätsklinikum des Saarlandes, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Homburg, Deutschland
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553882] [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: 10/22/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Zöllner YF, Ziegler R, Stueve M, Krumreich J, Schauf M. Event and cost offsets of a partial switch from multiple daily injections to continuous subcutaneous insulin infusion in type 1 diabetes patients in Germany: a four-year simulation model. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1556577] [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: 10/23/2022]
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Abstract
BACKGROUND Valgus high tibial osteotomy (HTO) increases the pressure in the lateral tibiofemoral compartment. OBJECTIVE The purpose of this work is to provide an overview about current knowledge on the effect of HTO on the lateral tibiofemoral osteochondral unit and lateral meniscus. MATERIALS AND METHODS Studies in translational models on the effect of medial opening wedge HTO on the lateral tibiofemoral osteochondral unit and lateral meniscus are reviewed and placed in the clinical perspective. Emphasis is placed on specific correlations between topographical alterations of the cartilage, subchondral bone, and meniscus in the lateral tibiofemoral compartment. DISCUSSION Specific topographical relationships exist in the central region between the articular cartilage and subchondral bone plate thickness, and in the submeniscal periphery between the articular cartilage and lateral meniscus, emphasizing the important protective role of the lateral meniscus. Following standard correction, the pressure increase in the lateral compartment following valgus HTO does not induce significant structural changes in the lateral tibiofemoral compartment. A higher increase in pressure following valgus overcorrection induces adaptive changes in the lateral compartment, reflected by an increased specific bone surface (BS/BV) in the subarticular spongiosa compared with unloading by varisation. Valgus overcorrection also leads to a decrease in the number of cells in the red-red (peripheral) zone of the middle third of the lateral menisci, without structural changes. RESULTS In conjunction with the clinical data these results show that opening wedge HTO is a safe procedure for the lateral tibial osteochondral unit and the lateral meniscus.
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Affiliation(s)
- H Madry
- Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung, Universität des Saarlandes und Zentrum für Experimentelle Orthopädie, Universitätsklinikum des Saarlandes, Kirrbergerstraße 1, Gebäude 37, 66421, Homburg, Deutschland,
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Danne T, Bollow E, Schwandt A, Heidtmann B, Kordonouri O, Rami-Merhar B, Ziegler R, Holl RW. Charakteristika der 1279 Patchpumpen-Nutzer im deutsch-östereichischen DPV-Register*. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549734] [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: 10/23/2022]
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14
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Frank K, Ding G, Raue F, Ziegler R. Can the routine treatment of Graves' orbitopathy be efficiently supplemented by the administration of Venalot? Dev Ophthalmol 2015; 20:127-9. [PMID: 2687048 DOI: 10.1159/000417928] [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]
Affiliation(s)
- K Frank
- Abteilung Innere Medizin I, Universitätsklinik, Heidelberg, FRG
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15
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Thiel M, Schilling T, Gey DC, Ziegler R, Collery P, Keppler BK. Tris(8-quinolinolato)gallium(III), a Novel Orally Applied Antitumor Gallium Compound. ACTA ACUST UNITED AC 2015. [DOI: 10.1159/000425857] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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16
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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Wiedebusch S, Wehmöller A, Ziegler R, Brewe F, Büsing S, Lohmann A. Der Betreuungsbedarf von Kindern mit Typ-1-Diabetes in Kindertageseinrichtungen. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1385205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | - R. Ziegler
- Diabetologische Schwerpunktpraxis für Kinder und Jugendliche, Münster
| | - F. Brewe
- Diabetologische Schwerpunktpraxis, Praxis für Kinderheilkunde und Jugendmedizin, Osnabrück
| | - S. Büsing
- Fachabteilung für Pädiatrische Diabetologie, Christliches Kinderhospital Osnabrück
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18
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Chan DV, Kartono F, Ziegler R, Abdulwahab N, DiPaola N, Flynn J, Wong HK. Absence of HLA-DR1 positivity in 2 familial cases of frontal fibrosing alopecia. J Am Acad Dermatol 2014; 71:e208-10. [PMID: 25437995 DOI: 10.1016/j.jaad.2014.05.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 05/28/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Derek V Chan
- Division of Dermatology, Department of Medicine, Wexner Medical Center at the Ohio State University, Columbus, Ohio
| | - Francisca Kartono
- Division of Dermatology, Department of Medicine, Wexner Medical Center at the Ohio State University, Columbus, Ohio
| | - Rebecca Ziegler
- Division of Dermatopathology, Department of Pathology, Wexner Medical Center at the Ohio State University, Columbus, Ohio
| | - Nebila Abdulwahab
- Clinical Histocompatibility Laboratory, Wexner Medical Center at the Ohio State University, Columbus, Ohio
| | - Nicholas DiPaola
- Clinical Histocompatibility Laboratory, Wexner Medical Center at the Ohio State University, Columbus, Ohio
| | - Joseph Flynn
- Division of Hematology, Department of Medicine, Wexner Medical Center at the Ohio State University, Columbus, Ohio; James Cancer Center at the Ohio State University, Columbus, Ohio
| | - Henry K Wong
- Division of Dermatology, Department of Medicine, Wexner Medical Center at the Ohio State University, Columbus, Ohio; James Cancer Center at the Ohio State University, Columbus, Ohio.
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Geier F, Greve Y, Popp S, Achterberg A, Glöckner E, Ziegler R, Heppner H, Mang H, Christ M. Versorgungsprozesse von Patienten mit Verdacht auf Sepsis in einer deutschen Notaufnahme. Dtsch Med Wochenschr 2014; 139:1869-75. [DOI: 10.1055/s-0034-1387236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- F. Geier
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - Y. Greve
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - S. Popp
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - A. Achterberg
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - E. Glöckner
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
| | - R. Ziegler
- Institut für Mikrobiologie und Hygiene, Klinikum Nürnberg
| | - H. Heppner
- Lehrstuhl für Geriatrie, Universität Witten/Herdecke
| | - H. Mang
- Masterstudiengang M.Sc. Medical Process Management, Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - M. Christ
- Klinik für Notfall- und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Nürnberg
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnosis, Therapy and Control of Diabetes Mellitus in Children and Adolescents. Exp Clin Endocrinol Diabetes 2014; 122:425-34. [DOI: 10.1055/s-0034-1366384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | - B. Karges
- Sektion Endokrinologie und Diabetologie, RWTH Aachen
| | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - A. Podeswik
- Bundesverband Bunter Kreis e. V., Institut für Sozialmedizin in der Pädiatrie, Augsburg
| | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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21
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Barnard KD, Lloyd CE, Dyson PA, Davies MJ, O'Neil S, Naresh K, Lawton J, Ziegler R, Holt RIG. Kaleidoscope model of diabetes care: time for a rethink? Diabet Med 2014; 31:522-30. [PMID: 24506524 DOI: 10.1111/dme.12400] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/03/2013] [Accepted: 01/28/2014] [Indexed: 01/02/2023]
Abstract
National Audit Data highlight persistent sub-optimum control among increasing numbers of people living with diabetes, with severe consequences for the individual and the NHS. The aim of the present review was to introduce a new cohesive, holistic model of care, tailored to individual needs to support optimum diabetes outcomes. This model of diabetes is necessary in order to understand the driving forces behind behaviour and their impact on diabetes management. Feelings (an emotional state or reaction) and beliefs (an acceptance that something is true or real) are fundamental behavioural drivers and influence diabetes self-management choices. Individually, these explain some of the complexities of behaviour and, collectively, they impact on personal motivation (rationale/desire to act) to achieve a specific outcome. Inevitably, they independently affect diabetes self-management and the environment in which individuals live. A model of care that proposes the encompassing of environment, intrinsic thought and therapy regimens to provide tailored, personalized healthcare should support enhanced diabetes self-management and outcomes from diagnosis. The Kaleidoscope model of care could be deliverable in routine care, incorporating each of the influences on diabetes self-management, and should benefit both individuals with diabetes and healthcare professionals.
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Affiliation(s)
- K D Barnard
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
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22
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1350564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A. Neu
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen
| | - P. Beyer
- Klinik für Kinder und Jugendliche, Evangelisches Krankenhaus GmbH, Oberhausen
| | | | - T. Danne
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | | | - B. Heidtmann
- Kindermedizinisches Versorgungszentrum am Wilhelmstift, Hamburg
| | - R. Holl
- Abt. Epidemiologie, Universitätsklinikum Ulm
| | | | - W. Kiess
- Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig
| | - I. Knerr
- Kinder- und Jugendklinik des Universitätsklinikums Erlangen
| | - O. Kordonouri
- Diabetes-Zentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover
| | - K. Lange
- Medizinische Hochschule, Medizinische Psychologie, Hannover
| | - R. Lepler
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - W. Marg
- Klinikum Bremen-Mitte gGmbH, Zentrum für Kinderheilkunde und Jugendmedizin, Bremen
| | - A. Näke
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M. Petersen
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | | | - R. Stachow
- Fachklinik Sylt für Kinder und Jugendliche, Westerland
| | - S. von Sengbusch
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - V. Wagner
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
| | - R. Ziegler
- Diabetologische Schwerpunktpraxis, Münster
| | - P. Holterhus
- Klinik für allgemeine Pädiatrie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
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23
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Ziegler R, Tubili C, Chico A, Guerci B, Lundberg E, Borchert M, Loeffler A, Bloethner S, Weissmann J, Pfuetzner A. ProAct Studie: Neue Funktionen von Insulinpumpen verbessern Diabetes-Management und glykämische Kontrolle bei Patienten mit Typ 1 Diabetes mellitus nach Umstellung von CSII Systemen unter täglichen Routinebedingungen. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341845] [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: 10/26/2022]
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24
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Ziegler R, Schulz B, Fröhlich H, Schmutzler H. Akzeptanz, Anwendung und Stoffwechseleinfluss eines kombinierten Blutzucker-/β-Keton-Messgerätes im Praxisalltag: Ergebnisse der nicht-interventionellen Studie GOLD Plus. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341934] [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: 10/26/2022]
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25
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Ziegler R, Cavan DA, Cranston I, Barnard K, Vogel C, Ryder J, Parkin CG, Köhler W, Vesper I, Petersen B, Schweitzer MA, Wagner R. Einsatz eines Bolusrechners verbessert die glykämische Stoffwechseleinstellung ohne Erhöhung des Hypoglykämie-Risikos bei unbefriedigend eingestellten Patienten mit Diabetes mellitus Typ1 und Typ2 behandelt mit ICT: Erste Ergebnisse der „Automated Bolus Advisor Control and Utility Study (ABACUS)“. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341849] [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: 10/26/2022]
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26
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325581] [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: 10/27/2022]
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27
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Ziegler R, Just HM, Castell S, Diel R, Gastmeier P, Haas W, Hauer B, Loytved G, Mielke M, Moser I, Nienhaus A, Richter E, Rüden H, Rüsch-Gerdes S, Schaberg T, Wischnewski N, Loddenkemper R. [Tuberculosis infection control - recommendations of the DZK]. Gesundheitswesen 2012; 74:337-50. [PMID: 22723258 DOI: 10.1055/s-0032-1306680] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
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Affiliation(s)
- R Ziegler
- Institut für Klinikhygiene, Med. Mikrobiologie u. Klin. Infektiologie, Klinikum Nürnberg
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Castell S, Ziegler R, Just HM, Loddenkemper R. Empfehlungen zur Infektionsprävention bei Tuberkulose. Gesundheitswesen 2012. [DOI: 10.1055/s-0032-1307285] [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: 10/28/2022]
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29
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Ziegler R, Just HM, Castell S, Diel R, Gastmeier P, Haas W, Hauer B, Loytved G, Mielke M, Moser I, Nienhaus A, Richter E, Rüden H, Rüsch-Gerdes S, Schaberg T, Wischnewski N, Loddenkemper R. [Tuberculosis infection control--recommendations of the DZK]. Pneumologie 2012; 66:269-82. [PMID: 22294284 DOI: 10.1055/s-0031-1291582] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.
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Affiliation(s)
- R Ziegler
- Institut für Klinikhygiene, Med. Mikrobiologie u. Klin. Infektiologie, Klinikum Nürnberg, Germany
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Reiser J, Rieth M, Dafferner B, Baumgärtner S, Ziegler R, Hoffmann A. Deep drawing of tungsten plates for structural divertor applications in future fusion devices. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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31
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283769] [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: 10/15/2022]
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32
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Mathison J, Corrow S, Platt M, King K, Ziegler R, Chatterjee G, Nakayama K, Yonas A. Developmental Prosopagnosia: A childhood case study. J Vis 2011. [DOI: 10.1167/11.11.571] [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: 11/24/2022] Open
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Meyer E, Ziegler R, Mattner F, Schwab F, Gastmeier P, Martin M. Increase of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase-producing Enterobacteriaceae. Infection 2011; 39:501-6. [PMID: 21710119 DOI: 10.1007/s15010-011-0154-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 06/16/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the incidence of patients co-colonised or co-infected with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium or extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in four German tertiary care hospitals. METHODS This study was conducted at four tertiary care hospitals (all with >1,000 beds) in different geographic regions in Germany (Berlin in the east, Luebeck in the north, Freiburg in the southwest and Nuernberg in the southeast). Routine surveillance data on MRSA, vancomycin-resistant enterococci (VRE) and ESBL-producing bacteria were analysed from 2007 to 2009. Co-colonisation or co-infection was defined as a patient having positive cultures for at least two of the following resistant pathogens: MRSA, VRE faecium or different species of ESBL-producing Enterobacteriaceae within one calendar year. RESULTS A total of 896,822 patients were analysed, of which 10,066 patients harboured MRSA, VRE faecium and/or ESBL-producing Enterobacteriaceae, and 542 patients co-harboured at least two of those resistant pathogens. In 2009, 7.6% of the MRSA patients, 13.7% of the VRE faecium patients and even 16.1% of the ESBL-producing Enterobacteriaceae patients were co-colonised or co-infected. The incidence of patients with co-infection or co-colonisation increased steadily from 5 (2007) to 7 per 10,000 patients (2009). CONCLUSIONS Patients harbouring ESBL-producing Enterobacteriaceae or VRE faecium had a higher risk of being co-colonised or co-infected compared to what was to be extrapolated from their overall incidence. This might be linked to their gastrointestinal reservoir and impracticality to decolonise the gut of resistant VRE and ESBL-producing Enterobacteriaceae.
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Affiliation(s)
- E Meyer
- Institute of Hygiene and Environmental Medicine, Charité University Medicine, Hindenburgdamm 27, 12203 Berlin, Germany.
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34
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Kapellen T, Bartelt H, Prettin C, Marg W, Ziegler R, Grulich-Henn J, Hungele A, Labitzke B, Kiess W, Holl RW. Transition von Jugendlichen in die Erwachsenen-Diabetologie. Repräsentativer Survey in Deutschland. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277530] [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: 10/18/2022]
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35
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Wiedebusch S, Ziegler R. Transition - Erwartungen und Wünsche von Jugendlichen mit Typ-1-Diabetes. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1271437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Beckmann L, Hüsing A, Setiawan VW, Amiano P, Clavel-Chapelon F, Chanock SJ, Cox DG, Diver R, Dossus L, Feigelson HS, Haiman C, Hallmans G, Hayes RB, Henderson BE, Hoover RN, Hunter DJ, Khaw K, Kolonel LN, Kraft P, Lund E, Le Marchand L, Peeters PHM, Riboli E, Stram D, Thomas G, Thun MJ, Tumino R, Trichopoulos D, Vogel U, Willett WC, Yeager M, Ziegler R, Hankinson SE, Kaaks R. Comprehensive analysis of hormone and genetic variation in 36 genes related to steroid hormone metabolism in pre- and postmenopausal women from the breast and prostate cancer cohort consortium (BPC3). J Clin Endocrinol Metab 2011; 96:E360-7. [PMID: 21177793 PMCID: PMC3048330 DOI: 10.1210/jc.2010-0912] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Sex steroids play a central role in breast cancer development. OBJECTIVE This study aimed to relate polymorphic variants in 36 candidate genes in the sex steroid pathway to serum concentrations of sex steroid hormones and SHBG. DESIGN Data on 700 genetic polymorphisms were combined with existing hormone assays and data on breast cancer incidence, within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nurses' Health Study (NHS) cohorts; significant findings were reanalyzed in the Multiethnic Cohort (MEC). SETTING AND PARTICIPANTS We analyzed data from a pooled sample of 3852 pre- and postmenopausal Caucasian women from EPIC and NHS and 454 postmenopausal women from MEC. MAIN OUTCOME MEASURES Outcome measures were SHBG, testosterone, dehydroepiandrosterone (DHEAS), androstenedione, estrone (E1), and estradiol (E2) as well as breast cancer risk. RESULTS Globally significant associations were found among pre- and postmenopausal women combined between levels of SHBG and the SHBG gene and between DHEAS and the FSHR and AKR1C3 genes. Among postmenopausal women, serum E1 and E2 were significantly associated with the genes CYP19 and FSHR, and E1 was associated with ESR1. None of the variants related to serum hormone levels showed any significant association with breast cancer risk. CONCLUSIONS We confirmed associations between serum levels of SHBG and the SHBG gene and of E1 and E2 and the CYP19 and ESR1 genes. Novel associations were observed between FSHR and DHEAS, E1, and E2 and between AKR1C3 and DHEAS.
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Affiliation(s)
- L Beckmann
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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Ziegler R, Isoe J, Moore W, Riehle MA, Wells MA. The putative AKH receptor of the tobacco hornworm, Manduca sexta, and its expression. J Insect Sci 2011; 11:40. [PMID: 21529255 PMCID: PMC3281483 DOI: 10.1673/031.011.0140] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 08/10/2010] [Indexed: 05/30/2023]
Abstract
Adipokinetic hormones are peptide hormones that mobilize lipids and/or carbohydrates for flight in adult insects and activate glycogen Phosphorylase in larvae during starvation and during molt. We previously examined the functional roles of adipokinetic hormone in Manduca sexta L. (Lepidoptera: Sphingidae). Here we report the cloning of the full-length cDNA encoding the putative adipokinetic hormone receptor from the fat body of M. sexta. The sequence analysis shows that the deduced amino acid sequence shares common motifs of G protein-coupled receptors, by having seven hydrophobic transmembrane segments. We examined the mRNA expression pattern of the adipokinetic hormone receptor by quantitative Real-Time PCR in fat body during development and in different tissues and found the strongest expression in fat body of larvae two days after molt to the fifth instar. We discuss these results in relation to some of our earlier results. We also compare the M. sexta adipokinetic hormone receptor with the known adipokinetic hormone receptors of other insects and with gonadotropin releasing hormone-like receptors of invertebrates.
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Affiliation(s)
- R. Ziegler
- Department of Entomology, The University of Arizona, Tucson, AZ 85721 USA
| | - J. Isoe
- Department of Chemistry and Biochemistry, The University of Arizona, Tucson, AZ 85721 USA
| | - W. Moore
- Department of Entomology, The University of Arizona, Tucson, AZ 85721 USA
| | - M. A. Riehle
- Department of Entomology, The University of Arizona, Tucson, AZ 85721 USA
| | - M. A. Wells
- Department of Chemistry and Biochemistry, The University of Arizona, Tucson, AZ 85721 USA
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, von Sengbusch S, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1262636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Meyer E, Ziegler R, Mattner F, Schwab F, Martin M. P24.01 Patients with multiple multiresistant pathogens (MRSA, VRE, ESBL). J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Ziegler R, Wiedebusch S. Transition – Wie wünschen sich Jugendliche mit Typ 1 Diabetes den Übergang von der Kinderdiabetologie in die Erwachsenendiabetologie? DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253862] [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: 10/19/2022]
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41
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Ogmen H, Breitmeyer BG, Kafaligonul H, Todd S, Mardon L, Ziegler R. Temporal aspects of contour and brightness processing in meta- and paracontrast. J Vis 2010. [DOI: 10.1167/6.6.122] [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: 11/24/2022] Open
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Ziegler R, Fuhrman B, Xu X, Gail M, Keefer L, Veenstra T, Hoover R. In Asian-American Women, Westernization Influences Estrogen Metabolism, but Not Total Endogenous Estrogen Production. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Historically, breast cancer incidence rates were 4-7 times higher in the United States than in China and Japan. When Asian women migrate to the U.S., their risk rises over several generations and approaches that in U.S. Whites. Endogenous estrogen has been postulated to explain these international differences. Methods: In a population-based case-control study in Chinese, Japanese, and Filipino women living in San Francisco-Oakland, CA; Los Angeles, CA; or Oahu, HI, we documented a six-fold gradient in breast cancer risk with Westernization. Using 12-h, overnight urines from 263 premenopausal mid-luteal and 168 postmenopausal control subjects, we investigated associations of estrogens and estrogen metabolites (EM) with Westernization, particularly birthplace in the East or West. Fifteen EM were measured concurrently by liquid chromatography-tandem mass spectrometry with high accuracy, precision, and sensitivity. Log-transformed EM measures, adjusted for age and ethnicity, were compared by robust linear regression. Results: Total urinary EM (pmol/mg creatinine) was not associated with birthplace in premenopausal or postmenopausal women. When the three estrogen hydroxylation pathways were expressed as percent of total EM, the relative difference by birthplace, West compared to East, was 15% lower for 2-pathway EM (p=0.009), 7% lower for 4-pathway EM (p=0.37), and 10% higher for 16-pathway EM (p=0.008). Similar results were observed for individual EM in each pathway, premenopausal and postmenopausal women, and the three ethnicities. In both menopausal groups, 2-pathway EM concentration decreased steadily with increasing risk across six categories of Westernization. Conclusions: Our results do not indicate that total estrogen production explains the increased breast cancer risk in Western societies. However, estrogen metabolism patterns, especially reduced 2-hydroxylation, may contribute to the elevated risk; and underlying mechanisms merit further exploration.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3063.
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Affiliation(s)
| | | | - X. Xu
- 2SAIC-Frederick, Inc., MD,
| | - M. Gail
- 1National Cancer Institute, MD,
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Pepene CE, Seck T, Diel I, Minne HW, Ziegler R, Pfeilschifter J. Effect of glucocorticoid-, parathyroid- and thyroid hormones excess on human iliac crest bone matrix insulin-like growth factor (IGF)-I in patients with osteoporosis. Exp Clin Endocrinol Diabetes 2009; 118:310-4. [PMID: 19998242 DOI: 10.1055/s-0029-1224124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Insulin-like growth factor-I (IGF-I) is a well documented bone-active growth factor. Clinical studies reported that circulating hormones may affect serum IGF-I levels, with potential consequences on bone remodeling. However, no data on bone matrix concentrations of IGF-I in subjects with endocrine dysfunction is available in humans. Bone mineral density and cancellous bone matrix IGF-I levels were assessed in iliac crest biopsies from 38 patients with low bone mass related to glucocorticoid- (n=10), parathyroid- (n=14) or thyroid (n=14) hormones excess. Results were compared to those of sex- and age-matched patients with primary osteoporosis. Bone matrix extraction was performed based on a guanidine-chlorhidric acid/ethylendiamine-tetraacetic acid method. Long-term glucocorticoid therapy (> or =24 months) led to significantly lower cancellous bone matrix IGF-I levels in comparison to age-matched controls (p=0.03). Although higher trabecular bone IGF-I levels were seen in hyperparathyroid subjects, the difference was not significant in comparison to controls (p=0.24). Likewise, no difference was noticed in cancellous bone matrix IGF-I concentrations between subjects with low bone mass and sub-clinical or overt thyrotoxicosis and euthyroid controls. Neither parathyroid hormone (PTH) nor thyroxin (T (4)) concentrations were associated with bone matrix IGF-I levels. To conclude, our study documented that in vivo long-term corticotherapy is associated with low trabecular human bone matrix IGF-I. In contrast, no influence of increased circulating parathyroid- or thyroid hormones levels on human iliac crest skeletal IGF-I concentrations was observed.
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Affiliation(s)
- C E Pepene
- University of Medicine and Pharmacy Cluj-Napoca, Endocrinology, Cluj-Napoca, Romania
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44
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Neu A, Beyer P, Bürger-Büsing J, Danne T, Etspüler J, Heidtmann B, Holl R, Karges B, Kiess W, Knerr I, Kordonouri O, Lange K, Lepler R, Marg W, Näke A, Petersen M, Podeswik A, Stachow R, Sengbusch SV, Wagner V, Ziegler R, Holterhus P. Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Kindes- und Jugendalter. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1224581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Blind E, Raue F, Knappe V, Schroth J, Ziegler R. Cyclic AMP formation in rat bone and kidney cells is stimulated equally by parathyroid hormone-related protein (PTHrP) 1-34 and PTH 1-34. Exp Clin Endocrinol 2009; 101:150-5. [PMID: 8223983 DOI: 10.1055/s-0029-1211222] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Parathyroid hormone-related protein (PTHrP) plays a major role in the pathogenesis of humoral hypercalcemia of malignancy. It interacts with the PTH receptor and has therefore a nearly identical effect on bone cells as PTH. However, PTHrP is thought to be less potent than PTH in stimulating adenylate cyclase in canine renal membranes, leading to the hypothesis of a differential efficiency in signal transduction by PTHrP with respect to bone vs kidney. In a homologous model with intact osteoblast-like cells (UMR 106) and primary kidney cells, both from the rat, we have tested N-terminal peptide fragments, based on the rat amino acid sequence 1-34, of PTH and PTHrP. Compared with PTHrP(1-34), rat PTH(1-34) had a similar relative potency in bone cells (85%) and in kidney cells (140%) in its ability to stimulate adenylate cyclase. Human PTH(1-34) was 5.6- to 6.5-fold less potent than rat PTH(1-34) in both cell types. In human osteoblast-like cells (SaOS-2), rat and human PTH were essentially equally potent compared to PTHrP(1-34) (identical sequence in rat and human) in stimulating cAMP accumulation. In conclusion, our study revealed the equipotency of rat PTH(1-34) and PTHrP(1-34) in stimulating intracellular cAMP formation in a homologous system of rat bone and kidney cells. There seemed to be no unique signal transduction mechanism of PTHrP to the adenylate cyclase in rat kidney cells compared with bone cells.
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Affiliation(s)
- E Blind
- Department of Internal Medicine I, Endocrinology and Metabolism, University of Heidelberg, Germany
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Abstract
Calcitonin (CT) inhibits osteoclast-mediated bone resorption and is being used to treat Paget's disease of bone, hypercalcemia of malignancy and postmenopausal osteoporosis. The formation of antibodies against heterologuous calcitonins like salmon calcitonin (sCT) is common and occurs in 40-70% of the patients treated for more than 4 months. Not all of these patients, however, develop a secondary resistance to sCT, therefore the clinical significance of sCT antibodies is discussed controversially. In vivo and in vitro approaches demonstrate a neutralizing effect in 35 to 60% of the patient sera with antibodies against sCT. These neutralizing antibodies appear to explain most cases of clinically relevant secondary resistance to sCT treatment, which occurs in 25-45% of the patients after treatment periods of 6 months and longer. A positive treatment response to human CT after development of secondary resistance to sCT proves the diagnosis of antibody related resistance. Few cases develop secondary resistance in the absence of sCT binding antibodies, the mechanism of this phenomenon is unclear. Antibody related resistance is a significant problem in long term treatment with sCT. Especially in conditions like postmenopausal osteoporosis, where no readily accessable marker of treatment response is available, the development of sCT antibodies and their possible neutralizing effect has to be considered.
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Affiliation(s)
- A Grauer
- Department of Internal Medicine I, University of Heidelberg, Germany
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47
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Scharla SH, Minne HW, Lempert UG, Leidig G, Hauber M, Raedsch R, Ziegler R. Bone mineral density and calcium regulating hormones in patients with inflammatory bowel disease (Crohn's disease and ulcerative colitis). Exp Clin Endocrinol 2009; 102:44-9. [PMID: 8005208 DOI: 10.1055/s-0029-1211264] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Inflammatory bowel disease (Crohn's disease and ulcerative colitis) is associated with decreased bone mineral density and increased risk of osteoporosis. However, the pathogenesis of this bone loss is not yet fully understood. In the present study we measured lumbar bone mineral density (by dual photon absorptiometry), serum levels of parathyroid hormone (PTH) and vitamin D metabolites, and serum markers of bone turnover (alkaline phosphatase and osteocalcin) in 15 patients with Crohn's disease and in 4 patients with ulcerative colitis. The median duration of the disease was 4 years and the median lifetime steroid dose was 10g of prednisone. We compared our results to a control group of 19 normal persons, who were matched for age and sex to the patients. We found that lumbar bone density was reduced by 11% in patients compared with control persons (Z-score -0.6 +/- 0.6 versus -0.1 +/- 0.8; p < 0.05). In patients, the serum levels of PTH, 25-hydroxyvitamin D3, and calcitriol (1,25(OH)2D3) were significantly reduced compared with control persons. Serum alkaline phosphatase activity (AP) was significantly higher in the patients and was inversely related to lumbar bone density. Osteocalcin values were not different between patients and control persons. There was also no difference in serum levels of calcium between the two groups, whereas phosphorus levels were higher in patients. We conclude that malabsorption of calcium was not a primary cause of bone loss in our patients, because we did not find secondary hyperparathyroidism. Accordingly, we did not find a severe vitamin D deficiency, since 25-hydroxyvitamin D3 levels were within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S H Scharla
- Department of Internal Medicine I (Endocrinology & Metabolism), University of Heidelberg, Germany
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Frank-Raue K, Höppner W, Buhr H, Herfarth C, Ziegler R, Raue F. Application of genetic screening in families with hereditary medullary thyroid carcinoma. Exp Clin Endocrinol Diabetes 2009; 104 Suppl 4:108-10. [PMID: 8981015 DOI: 10.1055/s-0029-1211715] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In 34 families out of 35 with hereditary medullary thyroid cancer a mutation in the RET proto-ongene could be identified. In 84 family members gene carrier state could be proven, in 75 family members gene carrier state could be excluded. The majority of gene carriers (67 out of 84) were symptomatic while 17 gene carriers were diagnosed in a presymptomatic state. 9 of the 17 presymptomatic gene carriers had prophylactic thyroidectomy. On histological examination C-cell hyperplasia or multifocal microcarcinomas could be proven. In one of our families with familial MTC no germline mutation in the RET gene could be detected. In this family pentagastrintests and indirect genotyping are necessary. Four family members of MEN 2A families have had thyroidectomy on the basis of pentagastrin testing and now proved not to be gene carriers. The application of genetic testing in families with hereditary thyroid carcinoma has further improved management in these families - it is the first step in the evaluation of family members at risk.
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Affiliation(s)
- K Frank-Raue
- Endokrinologische Gemeinschaftspraxis, Heidelberg, Germany
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Scharla SH, Scheidt-Nave C, Leidig G, Woitge H, Wüster C, Seibel MJ, Ziegler R. Lower serum 25-hydroxyvitamin D is associated with increased bone resorption markers and lower bone density at the proximal femur in normal females: a population-based study. Exp Clin Endocrinol Diabetes 2009; 104:289-92. [PMID: 8817249 DOI: 10.1055/s-0029-1211456] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Subclinical vitamin D deficiency is considered to be a risk factor for osteoporosis. Therefore, we studied vitamin D status and bone mineral density (BMD) in an age- and sex-stratified population based sample (209 males and 206 females aged between 50 and 80 years). In addition, urinary excretion of pyridinium crosslinks of collagen was determined in order to monitor bone resorption. We found a seasonal variation of serum 25-hydroxyvitamin D (25(OH)D) levels with higher values detected in the summer (27 +/ - 10 ng/ml) and lower values measured in the winter (17 +/- 9 ng/ml). Further analyses were performed separately for winter and summer, respectively. We also excluded subjects taking osteotropic medication. In men, we found no significant relationship between vitamin D status and bone density or pyridinium crosslinks. In women, we found significant positive correlations between 25(OH)D and proximal femur BMD in winter (r = 0.21, p < 0.05) and in summer (r = 0.36, p < 0.01). The association between 25(OH)D and proximal femur BMD persisted after correction for age and body mass index. Serum 25(OH)D and urinary pyridinium crosslinks were inversely correlated in females in winter (r = -0.24, p < 0.02) and in summer (r = -0.32, p < 0.02). Our data support the hypothesis that already moderately low serum levels of 25(OH)D within the "normal" range lead to osteopenia via increased bone resorption.
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Affiliation(s)
- S H Scharla
- Universitätsklinik Heidelberg (Innere Medizin I), Germany
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Janott J, Hallner D, Pfeiffer A, Abendroth K, Banzer D, Felsenberg D, Franke J, Kriiskemper GM, Matthis H, Raspe H, Reisinger W, Schatz H, Scheldt-Nave C, Ziegler R. Risk Factors of Osteoporosis: Results of EVOS in Germany. Scand J Rheumatol 2009. [DOI: 10.3109/03009749609103770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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