1
|
Neumann S, Hamilton MCK, Hart EC, Brooks JCW. Pain perception during baroreceptor unloading by lower body negative pressure. Eur J Pain 2024. [PMID: 38623884 DOI: 10.1002/ejp.2273] [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] [Received: 07/03/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND People with high blood pressure have reduced sensitivity to pain, known as blood pressure hypoalgesia. One proposed mechanism for this is altered baroreceptor sensitivity. In healthy volunteers, stimulating the carotid baroreceptors causes reduced sensitivity to acute pain; however, this effect may be confounded by a rise in blood pressure due to baroreflex stimulation. The present study tests whether baroreceptor unloading contributes to the physiological mechanism of blood pressure-related hypoalgesia. METHODS In the present study, pain perception to thermal stimulation of the forearm was studied in 20 healthy volunteers during baroreceptor unloading by lower body negative pressure (LBNP) at -5 and -20 mmHg. Blood pressure and heart rate were measured continuously throughout. To address issues relating to stimulation order, the sequence of LBNP stimulation was counterbalanced across participants. RESULTS Increased heart rate was observed at a LBNP of -20 mmHg, but not -5 mmHg, but neither stimulus had an effect on blood pressure. There was no change in warm or cold sensory detection thresholds, heat or cold pain thresholds nor perceived pain from a 30s long thermal heat stimulus during LBNP. CONCLUSION Therefore, baroreceptor unloading with maintained systemic blood pressure did not alter pain perception. The current study does not support the hypothesis that an altered baroreflex may underlie the physiological mechanism of blood pressure-related hypoalgesia. SIGNIFICANCE This work provides evidence that, when measured in normotensive healthy young adults, the baroreflex response to simulated hypovolaemia did not lead to reduced pain sensitivity (known as blood pressure hypoalgesia).
Collapse
Affiliation(s)
- S Neumann
- Clinical Trials Unit, University of Bristol, Bristol, UK
| | - M C K Hamilton
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - E C Hart
- School of Physiology Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - J C W Brooks
- School of Psychology, University of East Anglia, Norwich, UK
| |
Collapse
|
2
|
Neumann S, Bauer CM, Nastasi L, Läderach J, Thürlimann E, Schwarz A, Held JPO, Easthope CA. Accuracy, concurrent validity, and test-retest reliability of pressure-based insoles for gait measurement in chronic stroke patients. Front Digit Health 2024; 6:1359771. [PMID: 38633383 PMCID: PMC11021704 DOI: 10.3389/fdgth.2024.1359771] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Wearables are potentially valuable tools for understanding mobility behavior in individuals with neurological disorders and how it changes depending on health status, such as after rehabilitation. However, the accurate detection of gait events, which are crucial for the evaluation of gait performance and quality, is challenging due to highly individual-specific patterns that also vary greatly in movement and speed, especially after stroke. Therefore, the purpose of this study was to assess the accuracy, concurrent validity, and test-retest reliability of a commercially available insole system in the detection of gait events and the calculation of stance duration in individuals with chronic stroke. Methods Pressure insole data were collected from 17 individuals with chronic stroke during two measurement blocks, each comprising three 10-min walking tests conducted in a clinical setting. The gait assessments were recorded with a video camera that served as a ground truth, and pressure insoles as an experimental system. We compared the number of gait events and stance durations between systems. Results and discussion Over all 3,820 gait events, 90.86% were correctly identified by the insole system. Recall values ranged from 0.994 to 1, with a precision of 1 for all measurements. The F1 score ranged from 0.997 to 1. Excellent absolute agreement (Intraclass correlation coefficient, ICC = 0.874) was observed for the calculation of the stance duration, with a slightly longer stance duration recorded by the insole system (difference of -0.01 s). Bland-Altmann analysis indicated limits of agreement of 0.33 s that were robust to changes in walking speed. This consistency makes the system well-suited for individuals post-stroke. The test-retest reliability between measurement timepoints T1 and T2 was excellent (ICC = 0.928). The mean difference in stance duration between T1 and T2 was 0.03 s. We conclude that the insole system is valid for use in a clinical setting to quantitatively assess continuous walking in individuals with stroke.
Collapse
Affiliation(s)
- Saskia Neumann
- DART, Lake Lucerne Institute, Vitznau, Switzerland
- Cereneo Foundation, Vitznau, Switzerland
| | | | - Luca Nastasi
- DART, Lake Lucerne Institute, Vitznau, Switzerland
- Cereneo Foundation, Vitznau, Switzerland
| | | | - Eva Thürlimann
- Vascular Neurology and Neurorehabilitation, University of Zurich, Zurich, Switzerland
| | - Anne Schwarz
- Vascular Neurology and Neurorehabilitation, University of Zurich, Zurich, Switzerland
| | - Jeremia P. O. Held
- Vascular Neurology and Neurorehabilitation, University of Zurich, Zurich, Switzerland
| | - Chris A. Easthope
- DART, Lake Lucerne Institute, Vitznau, Switzerland
- Cereneo Foundation, Vitznau, Switzerland
| |
Collapse
|
3
|
Brolund-Napier CN, Ffrench-Constant AE, Neumann S, Paull JC, Fenton NK, Jones CA, Lyen S, Manghat NE, Hamilton MCK. CT pulmonary angiography: optimising acute thoracic imaging by fixed-timing contrast medium delivery with a modified breathing instruction. Clin Radiol 2023; 78:e237-e242. [PMID: 36588065 DOI: 10.1016/j.crad.2022.11.007] [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] [Received: 06/30/2022] [Revised: 11/03/2022] [Accepted: 11/13/2022] [Indexed: 12/31/2022]
Abstract
AIM To compare the thoracic vascular opacification achieved using the standard bolus-tracking protocol (BTP) with a fixed-timing protocol (FTP) with a modified breathing instruction during computed tomography pulmonary angiography (CTPA) examinations. MATERIALS AND METHODS A single-centre review of CTPA examinations performed between July 2018 and January 2019 using the BTP or FTP and weight-based contrast dosing of 20 mg iodine/kg body weight/s for 20 seconds at 100 kV tube potential. Radiodensity (in Hounsfield units) was analysed in the right ventricle, main pulmonary artery (MPA), left atrium, left ventricle, and ascending and descending thoracic aorta (DTA). A p-value of <0.05 was considered significant. RESULTS Of 782 examinations, 88 BTP and 90 FTP examinations were included. Mean attenuation of the MPA was similar in the FTP (396 ± 106 HU) and BTP (362 ± 119 HU; p=0.06); however, good-quality (≥250 HU) MPA opacification was achieved in more FTP examinations (87/90, 96.7%) compared to the BTP (73/88, 82.9%; p=0.002). Mean attenuation of the DTA was better in the FTP (325 ± 72 HU) than the BTP (228 ± 75 HU; p <0.0001), with good-quality opacification (≥250 HU) in 76/90 (84.4%) FTP examinations compared with 36/88 (40.9%) BTP examinations (p <0.001). CONCLUSION The FTP achieves better opacification of the MPA and DTA compared to the BTP.
Collapse
Affiliation(s)
- C N Brolund-Napier
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - A E Ffrench-Constant
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - S Neumann
- University of Bristol, Faculty of Health Sciences, Queens Road, Bristol BS8 1QU, UK
| | - J C Paull
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - N K Fenton
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - C A Jones
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - S Lyen
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - N E Manghat
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - M C K Hamilton
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
| |
Collapse
|
4
|
Komber HMEI, Neumann S, Paull J, Andrade MG, Lyen SM, Manghat NE, Hamilton MCK. A quality-improvement project to enhance systemic arterial contrast opacification in CT for trans-catheter aortic valve implantation. Clin Radiol 2022; 77:e697-e704. [PMID: 35717408 DOI: 10.1016/j.crad.2022.05.017] [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] [Received: 03/04/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
AIM To assess improvement in arterial opacification by optimising the contrast medium dosing protocol for computed tomography (CT) prior to trans-catheter aortic valve implantation (TAVI). MATERIALS AND METHODS A wide variation in arterial opacification was observed in the initial CT TAVI protocol (standard protocol). The practice was optimised by considering the time required for the examination and optimising contrast medium flux. This became the optimised protocol with a 30-second contrast medium bolus of iodine flux 15-19 mg iodine/kg body weight/second (mg/kg/s). Attenuation (mean HU) in (a) the ascending aorta (gated systolic acquisition) and (b) the ascending, descending thoracic (at carina), infra-renal abdominal aorta, and right common iliac artery (non-gated acquisition) was measured. Thirty-one sequential optimised examinations were compared to 31 prior standard protocol examinations. RESULTS There was no difference between the standard and optimised groups regarding age, sex, weight, body mass index (BMI), or voltage. The mean bolus durations were 24.9±4.4 seconds for the standard and 30±0.3 seconds for the optimised protocols (p<0.001). Although there was no difference in the attenuation in the gated ascending aorta (p>0.99), there was improvement at all other anatomical points in the non-gated examinations of the optimised protocol (p<0.002). CONCLUSION Optimising contrast medium flux and matching bolus duration to the CT technology dramatically improves the vascular access component of TAVI planning and provides a reliable method to achieve objectively enhanced arterial opacification. This work highlights how to obtain good arterial contrast medium opacification in haemodynamically fragile patients without excessive contrast medium volumes.
Collapse
Affiliation(s)
- H M E I Komber
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
| | - S Neumann
- Faculty of Life Sciences, School of Physiology, Pharmacology and Neuroscience, University of Bristol, Senate House, Tyndall Ave, Bristol BS8 1TH, UK
| | - J Paull
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - M Gesteira Andrade
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - S M Lyen
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - N E Manghat
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - M C K Hamilton
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK
| |
Collapse
|
5
|
Neumann F, Kehl T, Plotnicki K, Neumann S, Müller G, Kozlik-Feldmann R, Lang N. Midterm Follow-up Using Lifetech Konar-MF Device for Perimembranous and Muscular Ventricular Septal Defects in Pediatric Patient's. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F. Neumann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - T. Kehl
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - K. Plotnicki
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - S. Neumann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - G. Müller
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - R. Kozlik-Feldmann
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| | - N. Lang
- Department of Pediatr Cardiology, Children's Heart Clinic, University Med Center Eppendorf, Hamburg, Deutschland
| |
Collapse
|
6
|
Heneka L, Neumann S, Schön G, Müller G, Bauer U, Kozlik-Feldmann R, Biermann D, Sachweh J, Hübler M, Rickers C. Complete AV Block, Underestimated and Highly Impacting Complication of Ebstein's Anomaly Surgery. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0041-1741039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- L. Heneka
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| | - S. Neumann
- Klinikum Links der Weser Kardiologie - Elektrophysiologie Bremen, Bremen, Deutschland
| | - G. Schön
- Institut für Medizinische Biometrie und Epidemiologie, Hamburg, Deutschland
| | - G. Müller
- Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - U. Bauer
- Nationales Register Angeborene Herzfehler, Berlin, Deutschland
| | - R. Kozlik-Feldmann
- Department of Pediatr Cardiology, Children's Heart Clinic, Univ Med Center Eppendorf, Hamburg, Deutschland
| | - D. Biermann
- Department of Pediatric Cardiac Surgery, University Heart & Vascular Center, Hamburg, Deutschland
| | - J. Sachweh
- Department of Pediatric Cardiac Surgery, University Heart & Vascular Center, Hamburg, Deutschland
| | - M. Hübler
- Department of Congenital and Pediatric Heart Surgery, University Heart & Vascular Center Hamburg, Hamburg, Deutschland
| | - C. Rickers
- University Heart Center Hamburg GmbH, Hamburg, Deutschland
| |
Collapse
|
7
|
Neumann S, Taylor J, Bamford A, Metcalfe C, Gaunt DM, Whone A, Steeds D, Emmett SR, Hollingworth W, Ben-Shlomo Y, Henderson EJ. Cholinesterase inhibitor to prevent falls in Parkinson's disease (CHIEF-PD) trial: a phase 3 randomised, double-blind placebo-controlled trial of rivastigmine to prevent falls in Parkinson's disease. BMC Neurol 2021; 21:422. [PMID: 34715821 PMCID: PMC8556953 DOI: 10.1186/s12883-021-02430-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falls are a common complication of Parkinson's disease. There is a need for new therapeutic options to target this debilitating aspect of the disease. Cholinergic deficit has been shown to contribute to both gait and cognitive dysfunction seen in the condition. Potential benefits of using cholinesterase inhibitors were shown during a single centre phase 2 trial. The aim of this trial is to evaluate the effectiveness of a cholinesterase inhibitor on fall rate in people with idiopathic Parkinson's disease. METHODS This is a multi-centre, double-blind, randomised placebo-controlled trial in 600 people with idiopathic Parkinson's disease (Hoehn and Yahr stages 1 to 4) with a history of a fall in the past year. Participants will be randomised to two groups, receiving either transdermal rivastigmine or identical placebo for 12 months. The primary outcome is the fall rate over 12 months follow-up. Secondary outcome measures, collected at baseline and 12 months either face-to-face or via remote video/telephone assessments, include gait and balance measures, neuropsychiatric indices, Parkinson's motor and non-motor symptoms, quality of life and cost-effectiveness. DISCUSSION This trial will establish whether cholinesterase inhibitor therapy is effective in preventing falls in Parkinson's disease. If cost-effective, it will alter current management guidelines by offering a new therapeutic option in this high-risk population. TRIAL REGISTRATION REC reference: 19/SW/0043. EudraCT: 2018-003219-23. ISCRTN 41639809 (registered 16/04/2019). ClinicalTrials.gov Identifier: NCT04226248 PROTOCOL AT TIME OF PUBLICATION: Version 7.0, 20th January 2021.
Collapse
Affiliation(s)
- S Neumann
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - J Taylor
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - A Bamford
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - C Metcalfe
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - D M Gaunt
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - A Whone
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - D Steeds
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - S R Emmett
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - W Hollingworth
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - Y Ben-Shlomo
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK
| | - E J Henderson
- University of Bristol, Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, Bristol, UK.
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.
| |
Collapse
|
8
|
Neumann S, Bamford A, Lithander FE, Tenison E, Henderson EJ. Public attitudes to the use of remote data collection in clinical research. Contemp Clin Trials 2021; 111:106595. [PMID: 34653652 PMCID: PMC8511885 DOI: 10.1016/j.cct.2021.106595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/28/2022]
Abstract
Background/aims Coronavirus Disease 2019 (COVID-19) has presented an unprecedented challenge for delivering clinical research. The use of technology-assisted data collection for clinical research is desirable for many practitioners, but the acceptability of use in the general population has not been assessed. The aim of the study was to assess attitudes towards using technology-assisted remote methods in the delivery of clinical research in the UK and to understand the barriers to taking part in research with respect to both remote assessments and traditional research methods across different age ranges. Methods The study was conducted as an online anonymous survey with a 4-part questionnaire, between August 2020 and December 2020. Participants living in the UK aged 18 years and above were eligible to take part. Results A total 351 completed the survey and are included in the data analysis. In all age groups, participants identified that use of online assignments, video calls and telephone calls would make them more likely to take part in clinical research. Overall, the largest barrier to taking part in research was time commitments and timing of the appointment. COVID-19 has had a small, positive influence on the confidence of using technology in the general population. Conclusions The study found that there is a large interest in taking part in research using online, telephone and video call appointments, which could facilitate research delivery in light of ongoing COVID-19-related restrictions and also improve the accessibility and inclusivity of research.
Collapse
Affiliation(s)
- S Neumann
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK.
| | - A Bamford
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK
| | - F E Lithander
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK
| | - E Tenison
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK; Royal United Hospitals Bath NHS Foundation Trust, Older Peoples Unit, Bath, UK
| | - E J Henderson
- University of Bristol, Faculty of Health Sciences, Bristol Medical School, Population Health Sciences, Bristol, UK; Royal United Hospitals Bath NHS Foundation Trust, Older Peoples Unit, Bath, UK
| |
Collapse
|
9
|
Hamilton MCK, Neumann S, Szantho G, Rydon L, Lawton CB, Hart E, Manghat NE, Turner MS. The design and use of a simple device for the MRI assessment of changes in cardiovascular function by lower-body negative-pressure-simulated reduction of central blood volume. Clin Radiol 2021; 76:471.e9-471.e16. [PMID: 33637308 DOI: 10.1016/j.crad.2021.01.016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022]
Abstract
AIM To use a locally designed and simple lower-body negative-pressure (LBNP) device and 1.5 T magnetic resonance imaging (MRI) to demonstrate the ability to assess changes in cardiovascular function during preload reduction. These effects were evaluated on ventricular volumes and great vessel flow in healthy volunteers, for which there are limited published data. MATERIAL AND METHODS After ethical review, 14 volunteers (mean age 33.9 ± 7 years, mean body mass index [BMI] 23.1 ± 2.5) underwent LBNP prospectively at 0, -5, -10, and -20 mmHg pressure, using a locally designed LBNP box. Expiratory breath-hold biventricular volumes, and free-breathing flow imaging of the ascending aorta and main pulmonary artery were acquired at each level of LBNP. RESULTS At -5 mmHg, there was no change in aortic flow or left ventricular volumes versus baseline. Right ventricular output (p=0.013) and pulmonary net flow (p=0.026) decreased. At -20 mmHg, aortic and pulmonary net flow (p<0.001) decreased, as were left and right ventricular end diastolic volume (p<0.001) and left and right end systolic volumes (p=0.038 and p=0.003 respectively). CONCLUSIONS Use of a MRI-compatible LBNP device is feasible to measure changes in ventricular volume and great arterial flow in the same experiment. This may enhance further research into the effects of preload reduction by MRI in a wide range of important cardiovascular pathologies.
Collapse
Affiliation(s)
- M C K Hamilton
- Department of Clinical Radiology, Bristol Royal Infirmary, Bristol BS28HW, UK.
| | - S Neumann
- School of Physiology, Pharmacology and Neurosciences, University of Bristol, Bristol BS8 1TD, UK
| | - G Szantho
- Department of Cardiology, Bristol Heart Institute, Bristol BS28HW, UK
| | - L Rydon
- MEMO Clinical Engineering, Bristol Royal Infirmary, Bristol BS28HW, UK
| | - C B Lawton
- Department of Clinical Radiology, Bristol Royal Infirmary, Bristol BS28HW, UK
| | - E Hart
- School of Physiology, Pharmacology and Neurosciences, University of Bristol, Bristol BS8 1TD, UK
| | - N E Manghat
- Department of Clinical Radiology, Bristol Royal Infirmary, Bristol BS28HW, UK
| | - M S Turner
- Department of Cardiology, Bristol Heart Institute, Bristol BS28HW, UK
| |
Collapse
|
10
|
Kamp F, Hager L, Proebstl L, Schreiber A, Riebschläger M, Neumann S, Straif M, Schacht-Jablonowsky M, Falkai P, Pogarell O, Manz K, Soyka M, Koller G. 12- and 18-month follow-up after residential treatment of methamphetamine dependence: Influence of treatment drop-out and different treatment concepts. J Psychiatr Res 2020; 129:103-110. [PMID: 32652338 DOI: 10.1016/j.jpsychires.2020.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
This study investigates the effects of two different residential treatments and of treatment drop-out in a German methamphetamine (MA) dependent sample. 108 subjects from two addiction treatment concepts were recruited at treatment begin and followed-up at 12 (T2) and 18 (T3) months after treatment. Based on follow-up samples (n = 38 at T2, n = 25 at T3), 77.1% at T2 and 68.0% at T3 were MA abstinent. Classifying everyone, who did not participate at follow-ups as having had a relapse, showed MA-abstinence rates of 25.0% (at T2) and 15.7% (at T3). There was no difference in MA-use between treatment conditions nor between treatment completers and drop-outs. Having injected any substance predicted MA-use at T2 (p = .03). The median time of relapse was 1.5 days after hospital release. Depression scores at T2 predicted MA-use at T3 (p = .02). T2 participants that dropped out of treatment had higher craving scores at T2, than T2 subjects who completed treatment (p = .03). The results show positive effects of current inpatient treatment programs without differences between different concepts. More research is needed to clarify the impact of treatment drop-out. Attention should be paid to a successful transition from residential to outpatient services and to a reduction of study attrition.
Collapse
Affiliation(s)
- F Kamp
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - L Hager
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany.
| | - L Proebstl
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - A Schreiber
- District Hospital Hochstadt, Hauptstraße 13, 96272, Hochstadt Am Main, Germany
| | - M Riebschläger
- MEDIAN Clinic Mecklenburg, Blumenstraße 3, 19217, Rehna OT Parber, Germany
| | - S Neumann
- MEDIAN Clinic Mecklenburg, Blumenstraße 3, 19217, Rehna OT Parber, Germany
| | - M Straif
- District Hospital Hochstadt, Hauptstraße 13, 96272, Hochstadt Am Main, Germany
| | | | - P Falkai
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - K Manz
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany
| | - M Soyka
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - G Koller
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| |
Collapse
|
11
|
Komber H, Neumann S, Paull J, Andrade M, Lyen S, Manghat N, Hamilton M. Improving Arterial Opacification In Computed Tomography For Trans-catheter Aortic Valve Replacement. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.174] [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: 11/30/2022]
|
12
|
Kamp F, Proebstl L, Hager L, Schreiber A, Riebschläger M, Neumann S, Straif M, Schacht-Jablonowsky M, Manz K, Soyka M, Koller G. Effectiveness of methamphetamine abuse treatment: Predictors of treatment completion and comparison of two residential treatment programs. Drug Alcohol Depend 2019; 201:8-15. [PMID: 31154239 DOI: 10.1016/j.drugalcdep.2019.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is an increasing demand of evidence-based treatment options for methamphetamine users, but research in this field is limited. This study therefore evaluates the efficacy of two residential treatment programs for methamphetamine users. METHOD A total of 108 patients with a history of methamphetamine abuse from two inpatient rehabilitation centers were studied for psychiatric symptoms, craving, psychosocial resources, and cognitive functioning at the start and end of therapy. Patients from one center ("amphetamine type stimulant group") received conventional group therapy plus an additional 10 h of group therapy focusing on stimulant use. Patients from the other center ("treatment as usual") received conventional group therapy only. Predictors of drop-out were estimated. RESULTS A drop-out rate of 40.7% was observed without a significant difference between both centers. Patients remained significantly longer in treatment as usual compared to amphetamine type stimulant treatment. Irrespective of treatment program, craving and psychiatric symptoms significantly decreased while psychosocial resources, processing speed, and cognitive flexibility improved over time. Other cognitive measures yielded mixed results. History of injection drug use was a significant predictor for treatment drop-out. CONCLUSIONS Existing treatments are effective in reducing craving and psychiatric symptoms. Additional stimulant specific groups do not appear to influence treatment completion and secondary outcome measures. Institutions should therefore offer treatment for methamphetamine users, even if they do not provide a therapy content focusing on methamphetamine. History of injection drug use should receive attention in treatment to prevent drop-out. Changes in cognitive functioning need to be further explored.
Collapse
Affiliation(s)
- F Kamp
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany.
| | - L Proebstl
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - L Hager
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| | - A Schreiber
- District Hospital Hochstadt, Hauptstraße 13, 96272, Hochstadt am Main, Germany
| | - M Riebschläger
- MEDIAN Clinic Mecklenburg, Blumenstraße 3, Rehna OT Parber, 19217, Germany
| | - S Neumann
- MEDIAN Clinic Mecklenburg, Blumenstraße 3, Rehna OT Parber, 19217, Germany
| | - M Straif
- District Hospital Hochstadt, Hauptstraße 13, 96272, Hochstadt am Main, Germany
| | | | - K Manz
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany
| | - M Soyka
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany; Medical Parc Chiemseeblick, Rathausstraße 8, 83233, Bernau am Chiemsee, Germany
| | - G Koller
- Department of Psychiatry and Psychotherapy University Hospital Munich, LMU Munich, Nussbaumstraße 7, 80336, Munich, Germany
| |
Collapse
|
13
|
Neumann S, Sophocleous F, Kobetic MD, Hart EC, Nightingale AK, Parker KH, Hamilton MK, Biglino G. Wave intensity analysis in the internal carotid artery of hypertensive subjects using phase-contrast MR angiography and preliminary assessment of the effect of vessel morphology on wave dynamics. Physiol Meas 2018; 39:104003. [PMID: 30192235 PMCID: PMC6372132 DOI: 10.1088/1361-6579/aadfc5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Hypertension is associated with reduced cerebral blood flow, but it is not known how this impacts on wave dynamics or potentially relates to arterial morphology. Given the location of the internal carotid artery (ICA) and risks associated with invasive measurements, wave dynamics in this artery have not been extensively assessed in vivo. This study explores the feasibility of studying wave dynamics in the internal carotid artery non-invasively. Approach: Normotensive, uncontrolled and controlled hypertensive participants were recruited (daytime ambulatory blood pressure <135/85 mmHg and >135/85 mmHg, respectively; n = 38). Wave intensity, reservoir pressure and statistical shape analyses were performed on the right ICA and ascending aorta high-resolution phase-contrast magnetic resonance angiography data. Main results: Wave speed in the aorta was significantly lower in normotensive compared to hypertensive participants (6.7 ± 1.8 versus 11.2 ± 6.2 m s−1 for uncontrolled and 11.8 ± 4.6 m s−1 for controlled hypertensives, p = 0.02), whilst there were no differences in wave speed in the ICA. There were no significant differences between the groups for the wave intensity or reservoir pressure. Interestingly, a significant association between the anatomy of the ICA and wave energy (FCW and size, r2 = 0.12, p = 0.04) was found. Significance: This study shows it is feasible to study wave dynamics in the ICA non-invasively. Whilst changes in aortic wave speed confirmed an expected increase in arterial stiffness, this was not observed in the ICA. This might suggest a protective mechanism in the cerebral circulation, in conjunction with the effect of vessel tortuosity. Furthermore, it was observed that ICA shape correlated with wave energy but not wave speed.
Collapse
Affiliation(s)
- S Neumann
- University of Bristol, Bristol, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Neumann S, Franke AG. „Cognitive Enhancement“ mit Psychostimulanzien: Kognitive Leistungssteigerung zwischen Lifestyle-Phänomen und therapeutischer Indikation. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667963] [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)
- S Neumann
- Ludwigs-Maximilians-Universität München, Klinik und Poliklinik für Psychiatrie und Psychotherapie, München, Deutschland
| | - AG Franke
- Hochschule der Bundesagentur für Arbeit, Mannheim, Deutschland
| |
Collapse
|
15
|
Tetta C, Segoloni G, Camussi G, Neumann S, Griva S, Piva S, Pacitti A, Vercellone A. In vitro Complement-Independent Activation of Human Neutrophils by Hemodialysis Membranes: Role of the Net Electric Charge. Int J Artif Organs 2018. [DOI: 10.1177/039139888701000204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Polymethylmethacrylate (PMMA) membranes with different net electric charges and percentage water contents (anionic 71%, neutral 70%, cationic 75%) were evaluated for their ability to stimulate plasma-free human polymorphonuclear neutrophils (PMN), and compared for potency to cuprophan (Cu), already described as being a potent trigger of PMN. The release of lysozyme, β-glucuronidase, lactic dehydrogenase (LDH), and the generation of a platelet aggregating activity were studied in the supernatants from plasma-free human PMN incubated with different membranes. The PMN intracellular content of neutrophil cationic proteins (NCP), elastase, and cathepsin G were also studied by immunofluorescence using specific antisera on smears of PMN before and after incubation with each membrane. Only cationic, but not anionic or neutral PMMA induced a marked release of lysozyme (range 20-25% of the sonicated control, assumed as 100%), and β-glu-coronidase (40-43%), and marked depletion of the intracellular content of NCP, elastase, and cathepsin G, suggesting a degranulation process. Platelet aggregating activity was generated and referred to the release of platelet activating factor (PAF) only in the supernatants from PMN incubated with cationic, but not with anionic, or neutral PMMA membranes. These results indicate that modification of the net electric charge can per se turn PMMA, commonly recognized as inert, into a material with marked PMN activating effects, comparable to those of Cu, a highly reactive polymer.
Collapse
Affiliation(s)
- C. Tetta
- Laboratorio di Immunopatologia, Ospedale Maggiore S.G. Battista - Molinette, Torino
- Cattedra di Nefrologia Università di Torino and Divisione di Nefrologia e Dialisi, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - G. Segoloni
- Cattedra di Nefrologia Università di Torino and Divisione di Nefrologia e Dialisi, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - G. Camussi
- Laboratorio di Immunopatologia, Ospedale Maggiore S.G. Battista - Molinette, Torino
- Cattedra di Nefrologia Università di Torino and Divisione di Nefrologia e Dialisi, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - S. Neumann
- Biochemical Research Institute, E. Merck, Darmstadt, West Germany
| | - S. Griva
- Laboratorio di Immunopatologia, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - S. Piva
- Laboratorio di Immunopatologia, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - A. Pacitti
- Cattedra di Nefrologia Università di Torino and Divisione di Nefrologia e Dialisi, Ospedale Maggiore S.G. Battista - Molinette, Torino
| | - A. Vercellone
- Laboratorio di Immunopatologia, Ospedale Maggiore S.G. Battista - Molinette, Torino
- Cattedra di Nefrologia Università di Torino and Divisione di Nefrologia e Dialisi, Ospedale Maggiore S.G. Battista - Molinette, Torino
| |
Collapse
|
16
|
Beyes M, Nause N, Bleyer M, Kaup FJ, Neumann S. Description of post-implantation embryonic stages in European roe deer (Capreolus capreolus
) after embryonic diapause. Anat Histol Embryol 2017; 46:582-591. [DOI: 10.1111/ahe.12315] [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] [Received: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 11/28/2022]
Affiliation(s)
- M. Beyes
- Institute of Veterinary Medicine; Georg-August-Universität; Göttingen Germany
| | - N. Nause
- Platform Degenerative Diseases; German Primate Center; Göttingen Germany
| | - M. Bleyer
- Pathology Unit; German Primate Center; Göttingen Germany
| | - F.-J. Kaup
- Pathology Unit; German Primate Center; Göttingen Germany
| | - S. Neumann
- Institute of Veterinary Medicine; Georg-August-Universität; Göttingen Germany
| |
Collapse
|
17
|
Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld-Toal M, Cornely OA, Einsele H, Karthaus M, Link H, Mahlberg R, Neumann S, Ostermann H, Penack O, Ruhnke M, Sandherr M, Schiel X, Vehreschild JJ, Weissinger F, Maschmeyer G. Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 2017; 96:1775-1792. [PMID: 28856437 PMCID: PMC5645428 DOI: 10.1007/s00277-017-3098-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/06/2017] [Indexed: 02/07/2023]
Abstract
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade. Stratification into a high-risk versus low-risk patient population is recommended. In high-risk patients, initial empirical antimicrobial therapy should be active against pathogens most commonly involved in microbiologically documented and most threatening infections, including Pseudomonas aeruginosa, but excluding coagulase-negative staphylococci. In patients whose expected duration of neutropenia is more than 7 days and who do not respond to first-line antibacterial treatment, specifically in the absence of mold-active antifungal prophylaxis, further therapy should be directed also against fungi, in particular Aspergillus species. With regard to antimicrobial stewardship, treatment duration after defervescence in persistently neutropenic patients must be critically reconsidered and the choice of anti-infective agents adjusted to local epidemiology. This guideline updates recommendations for diagnosis and empirical therapy of fever of unknown origin in adult neutropenic cancer patients in light of the challenges of antimicrobial stewardship.
Collapse
Affiliation(s)
- W J Heinz
- Department of Internal Medicine II, University of Würzburg Medical Center, Würzburg, Germany
| | - D Buchheidt
- Department of Internal Medicine-Hematology and Oncology, Mannheim University Hospital, Mannheim, Germany
| | - M Christopeit
- Department of Stem Cell Transplantation, University Hospital UKE, Hamburg, Germany
| | | | - O A Cornely
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany.,Clinical Trials Centre Cologne, ZKS Köln, Cölogne, Germany.,Center for Integrated Oncology CIO Köln-Bonn, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Medical Faculty, University of Cologne, Cologne, Germany
| | - H Einsele
- Department of Internal Medicine II, University of Würzburg Medical Center, Würzburg, Germany
| | - M Karthaus
- Department of Hematology, Oncology and Palliative Care, Klinikum Neuperlach and Klinikum Harlaching, München, Germany.,Department of Hematology, Oncology and Palliative Care, Klinikum Harlaching, Munich, Germany
| | - H Link
- Hematology and Medical Oncology Private Practice, Kaiserslautern, Germany
| | - R Mahlberg
- Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
| | - S Neumann
- Medical Oncology, AMO MVZ, Wolfsburg, Germany
| | - H Ostermann
- Department of Hematology and Oncology, University of Munich, Munich, Germany
| | - O Penack
- Internal Medicine, Hematology, Oncology and Tumor Immunology, University Hospital Charité, Campus Virchow Klinikum, Berlin, Germany
| | - M Ruhnke
- Department of Hematology and Oncology, Paracelsus-Klinik, Osnabrück, Germany
| | - M Sandherr
- Hematology and Oncology Practice, Weilheim, Germany
| | - X Schiel
- Department of Hematology, Oncology and Palliative Care, Klinikum Harlaching, Munich, Germany
| | - J J Vehreschild
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - F Weissinger
- Department of Internal Medicine, Hematology, Oncology and Palliative Care, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.
| |
Collapse
|
18
|
Neumann S, Franke AG, Soyka M. Frauen und „Crystal Meth“ – Gendersensible Ergebnisse einer systematischen Literaturrecherche zu bio-psycho-sozialen Aspekten und Therapie. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1606051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Neumann
- Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Psychiatrie und Psychotherapie, München
| | - AG Franke
- Hochschule Neubrandenburg (University of Applied Sciences), Fachbereich Soziale Arbeit, Bildung und Erziehung, Neubrandenburg
| | - M Soyka
- Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Psychiatrie und Psychotherapie, München
| |
Collapse
|
19
|
Neumann S, Franke AG. Psychosozialer Stress im ländlichen Raum: Problemlagen, subjektive Belastung und Inanspruchnahme von Hilfen. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Neumann
- Hochschule Neubrandenburg (University of Applied Sciences), Fachbereich Soziale Arbeit, Bildung und Erziehung, Neubrandenburg
| | - AG Franke
- Hochschule Neubrandenburg (University of Applied Sciences), Fachbereich Soziale Arbeit, Bildung und Erziehung, Neubrandenburg
| |
Collapse
|
20
|
Steffen U, Tomsing O, Korsch A, Hoppe N, Richter M, Neumann S. Palliativ-Management massiver Pleuraergüsse mit dem Pleurx – System 2008 – 2015: Wie hoch ist die Pleurodese-Rate? Pneumologie 2016. [DOI: 10.1055/s-0036-1572292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
21
|
Neumann S, Hüser L, Ondreka K, Auler N, Haverkamp S. Cell type-specific bipolar cell input to ganglion cells in the mouse retina. Neuroscience 2016; 316:420-32. [PMID: 26751712 DOI: 10.1016/j.neuroscience.2015.12.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 12/21/2015] [Accepted: 12/30/2015] [Indexed: 10/22/2022]
Abstract
Many distinct ganglion cell types, which are the output elements of the retina, were found to encode for specific features of a visual scene such as contrast, color information or movement. The detailed composition of retinal circuits leading to this tuning of retinal ganglion cells, however, is apart from some prominent examples, largely unknown. Here we aimed to investigate if ganglion cell types in the mouse retina receive selective input from specific bipolar cell types or if they sample their synaptic input non-selectively from all bipolar cell types stratifying within their dendritic tree. To address this question we took an anatomical approach and immunolabeled retinae of two transgenic mouse lines (GFP-O and JAM-B) with markers for ribbon synapses and type 2 bipolar cells. We morphologically identified all green fluorescent protein (GFP)-expressing ganglion cell types, which co-stratified with type 2 bipolar cells and assessed the total number of bipolar input synapses and the proportion of synapses deriving from type 2 bipolar cells. Only JAM-B ganglion cells received synaptic input preferentially from bipolar cell types other than type 2 bipolar cells whereas the other analyzed ganglion cell types sampled their bipolar input most likely from all bipolar cell terminals within their dendritic arbor.
Collapse
Affiliation(s)
- S Neumann
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany
| | - L Hüser
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany
| | - K Ondreka
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany
| | - N Auler
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany
| | - S Haverkamp
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany.
| |
Collapse
|
22
|
Abstract
The achievement of self-healing (SH) under ambient conditions (low temperature, no external input of energy) still presents a significant area of research, and is enabledvia“click”-type crosslinking reactions.
Collapse
Affiliation(s)
- S. Neumann
- Chair of Macromolecular Chemistry
- Institute of Chemistry
- Division of Technical and Macromolecular Chemistry
- Faculty of Natural Science II (Chemistry
- Physics and Mathematics)
| | - D. Döhler
- Chair of Macromolecular Chemistry
- Institute of Chemistry
- Division of Technical and Macromolecular Chemistry
- Faculty of Natural Science II (Chemistry
- Physics and Mathematics)
| | - D. Ströhl
- Chair of Macromolecular Chemistry
- Institute of Chemistry
- Division of Technical and Macromolecular Chemistry
- Faculty of Natural Science II (Chemistry
- Physics and Mathematics)
| | - W. H. Binder
- Chair of Macromolecular Chemistry
- Institute of Chemistry
- Division of Technical and Macromolecular Chemistry
- Faculty of Natural Science II (Chemistry
- Physics and Mathematics)
| |
Collapse
|
23
|
Abstract
Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.
Collapse
Affiliation(s)
- S Neumann
- Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, USA
| | - R F Place
- Nova Therapeutics LLC, E Foothill Blvd, Pasadena, USA
| | - C C Krieger
- Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, USA
| | - M C Gershengorn
- Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, USA
| |
Collapse
|
24
|
Neumann S, Webendörfer S, Lang S, Germann C, Oberlinner C. [Diabetes screening and prevention in a large chemical company]. Dtsch Med Wochenschr 2015; 140:e94-100. [PMID: 25970421 DOI: 10.1055/s-0041-101873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Diabetes is with 6 million cases in Germany one of the most common and most expensive chronic diseases. Studies presume a high number of unreported cases. Early detection of diabetes with a specific screening method is very important. In Germany family physicians offer a preventive check-up starting at the age of 35 years but only 19% males participate. From this background the BASF department for Occupational Medicine and Health Protection introduced for all 35.000 employees at the headquarter, in Ludwigshafen a general health check focused on the early detection of lifestyle diseases. METHODS From April 2011 to June 2013 12.114 employees participated in the general health check offered by the medical department (2.530 women, 9.584 men). All participants filled out a questionnaire named "Findrisk" a scientifically validated questionnaire which focuses on risk factors for diabetes. Furthermore, the blood glucose and the HbA1c of the participants have also been checked in a laboratory test RESULTS Following the Findrisk criteria the results are: 1.368 employees had an elevated risk of 17%, 854 employees a risk factor of 33% and 131 employees a risk factor of 33%. In 1.533 employees (13,2% of all participants) we diagnosed a prediabetes with an elevated HbA1c-parameter between 5.7 to 6,4%. In 243 employees a manifest diabetes disease with HbA1c of > than 6,5% was diagnosed. DISCUSSION We found out that diabetes prevention within the workplace setting is helpful to detect prediabetes and diabetes earlier than family doctors outside the company are able to do.Occupational physicians have the opportunity to inform the employees on risks for lifestyle diseases at an early stage when they are still healthy (primary prevention).For secondary prevention surveillance and clearance examination can be easily combined with screening tests for diabetes. For further diagnostics and therapy the family doctors will be addressed. This system helps individuals to prevent negative health effects, it helps the employer to reduce incapacity time and it also helps the state health system to safe money for therapy and rehabilitation.
Collapse
Affiliation(s)
- S Neumann
- Abteilung Arbeitsmedizin und Gesundheitsschutz, GUA / B, BASF SE, Ludwigshafen
| | - S Webendörfer
- Abteilung Arbeitsmedizin und Gesundheitsschutz, GUA / B, BASF SE, Ludwigshafen
| | - S Lang
- Abteilung Arbeitsmedizin und Gesundheitsschutz, GUA / B, BASF SE, Ludwigshafen
| | - C Germann
- Abteilung Arbeitsmedizin und Gesundheitsschutz, GUA / B, BASF SE, Ludwigshafen
| | - C Oberlinner
- Abteilung Arbeitsmedizin und Gesundheitsschutz, GUA / B, BASF SE, Ludwigshafen
| |
Collapse
|
25
|
Kreuter M, Vansteenkiste J, Fischer J, Eberhardt W, Zabeck H, Kollmeier J, Serke M, Frickhofen N, Reck M, Engel-Riedel W, Neumann S, Thomer M, Schuhmann C, De Leyn P, Graeter T, Stamatis G, Griesinger F, Thomas M. Langzeit Ergebnisse der randomisierten Phase 2 Studie zur Verbesserung der adjuvanten Chemotherapie beim frühen NSCLC – Vergleich Cisplatin/Pemetrexed (CPx) mit Cisplatin/Vinorelbine (CVb) (TREAT). Pneumologie 2015. [DOI: 10.1055/s-0035-1544765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
26
|
Maschmeyer G, Carratalà J, Buchheidt D, Hamprecht A, Heussel CP, Kahl C, Lorenz J, Neumann S, Rieger C, Ruhnke M, Salwender H, Schmidt-Hieber M, Azoulay E. Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): updated guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol 2015; 26:21-33. [PMID: 24833776 PMCID: PMC4269340 DOI: 10.1093/annonc/mdu192] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/29/2014] [Accepted: 05/02/2014] [Indexed: 12/13/2022] Open
Abstract
Up to 25% of patients with profound neutropenia lasting for >10 days develop lung infiltrates, which frequently do not respond to broad-spectrum antibacterial therapy. While a causative pathogen remains undetected in the majority of cases, Aspergillus spp., Pneumocystis jirovecii, multi-resistant Gram-negative pathogens, mycobacteria or respiratory viruses may be involved. In at-risk patients who have received trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis, filamentous fungal pathogens appear to be predominant, yet commonly not proven at the time of treatment initiation. Pathogens isolated from blood cultures, bronchoalveolar lavage (BAL) or respiratory secretions are not always relevant for the etiology of pulmonary infiltrates and should therefore be interpreted critically. Laboratory tests for detecting Aspergillus galactomannan, β-D-glucan or DNA from blood, BAL or tissue samples may facilitate the diagnosis; however, most polymerase chain reaction assays are not yet standardized and validated. Apart from infectious agents, pulmonary side-effects from cytotoxic drugs, radiotherapy or pulmonary involvement by the underlying malignancy should be included into differential diagnosis and eventually be clarified by invasive diagnostic procedures. Pre-emptive treatment with mold-active systemic antifungal agents improves clinical outcome, while other microorganisms are preferably treated only when microbiologically documented. High-dose TMP/SMX is first choice for treatment of Pneumocystis pneumonia, while cytomegalovirus pneumonia is treated primarily with ganciclovir or foscarnet in most patients. In a considerable number of patients, clinical outcome may be favorable despite respiratory failure, so that intensive care should be unrestrictedly provided in patients whose prognosis is not desperate due to other reasons.
Collapse
Affiliation(s)
- G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.
| | - J Carratalà
- Department of Infectious Diseases, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain
| | - D Buchheidt
- Department of Hematology and Oncology, Mannheim University Hospital, Mannheim
| | - A Hamprecht
- Institution for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne, Cologne
| | - C P Heussel
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University Hospital, Heidelberg
| | - C Kahl
- Department of Hematology and Oncology, Klinikum Magdeburg, Magdeburg
| | - J Lorenz
- Department of Pneumology, Infectious Diseases, Sleep Medicine and Intensive Care, Klinikum Lüdenscheid, Lüdenscheid
| | - S Neumann
- Medical Oncology, AMO MVZ, Wolfsburg
| | - C Rieger
- Department of Medicine III, University Hospital Großhadern, München
| | - M Ruhnke
- Department of Medical Oncology and Hematology, Charité University Medicine Campus Mitte, Berlin
| | - H Salwender
- Department of Hematology, Oncology, Stem Cell Transplantation, Asklepios Klinik Altona, Hamburg
| | - M Schmidt-Hieber
- Department of Hematology, Oncology and Tumor Immunology, Helios-Klinikum Berlin-Buch, Berlin, Germany
| | - E Azoulay
- AP-HP, Hopital Saint-Louis, Service de Réanimation Médicale, Université Paris-Diderot, Sorbonne Paris-Cité, Faculté de Médecine, Paris, France
| |
Collapse
|
27
|
Fink SEK, Gandhi MK, Nourse JP, Keane C, Jones K, Crooks P, Jöhrens K, Korfel A, Schmidt H, Neumann S, Tiede A, Jäger U, Dührsen U, Neuhaus R, Dreyling M, Borchert K, Südhoff T, Riess H, Anagnostopoulos I, Trappe RU. A comprehensive analysis of the cellular and EBV-specific microRNAome in primary CNS PTLD identifies different patterns among EBV-associated tumors. Am J Transplant 2014; 14:2577-87. [PMID: 25130212 DOI: 10.1111/ajt.12858] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/19/2014] [Accepted: 05/26/2014] [Indexed: 01/25/2023]
Abstract
Primary central nervous system (pCNS) posttransplant lymphoproliferative disorder (PTLD) is a complication of solid organ transplantation characterized by poor outcome. In contrast to systemic PTLD, Epstein-Barr virus (EBV)-association of pCNS PTLD is almost universal, yet viral and cellular data are limited. To identify differences in the pattern of EBV-association of pCNS and systemic PTLD, we analyzed the expression of latent and lytic EBV transcripts and the viral and cellular microRNAome in nine pCNS (eight EBV-associated) and in 16 systemic PTLD samples (eight EBV-associated). Notably although 15/16 EBV-associated samples exhibited a viral type III latency pattern, lytic transcripts were also strongly expressed. Members of the ebv-miR-BHRF1 and ebv-miR-BART clusters were expressed in virtually all EBV-associated PTLD samples. There were 28 cellular microRNAs differentially expressed between systemic and pCNS PTLD. pCNS PTLD expressed lower hsa-miR-199a-5p/3p and hsa-miR-143/145 (implicated in nuclear factor kappa beta and c-myc signaling) as compared to systemic PTLD. Unsupervised nonhierarchical clustering of the viral and cellular microRNAome distinguished non-EBV-associated from EBV-associated samples and identified a separate group of EBV-associated pCNS PTLD that displayed reduced levels of B cell lymphoma associated oncomiRs such as hsa-miR-155, -21, -221 and the hsa-miR-17-92 cluster. EBV has a major impact on viral and cellular microRNA expression in EBV-associated pCNS PTLD.
Collapse
Affiliation(s)
- S E K Fink
- Clinical Immunohaematology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Department of Hematology and Oncology, Charité - Universitätsmedizin Berlin, Campus Virchow Clinic, Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Lange B, Neumann S, Hirsch H, Kern W. Infektionsprophylaxe bei Immunsuppression. Dtsch Med Wochenschr 2014; 139:1999-2002. [DOI: 10.1055/s-0034-1387287] [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)
- B. Lange
- IFB-Zentrum für Chronische Immundefizienz (CCI)
| | - S. Neumann
- Interdisziplinäres ambulantes Onkologiezentrum, Wolfsburg
| | - H. Hirsch
- Klinik für Infektiologie und Spitalhygiene, Universitätsspital Basel
| | - W. Kern
- Abteilung Infektiologie, Universitätsklinikum Freiburg
| |
Collapse
|
29
|
Chappell A, Seagly K, Okwara L, Bayan S, Sayegh P, Neumann S. B-69 * Cognitive Performance as a Function of Low-Frequency, Repetitive Transcranial Magnetic Stimulation Administration to the Right Dorsolateral Prefrontal Cortex and Supplementary Motor Area. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.157] [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: 11/14/2022] Open
|
30
|
Broeckling CD, Afsar FA, Neumann S, Ben-Hur A, Prenni JE. RAMClust: a novel feature clustering method enables spectral-matching-based annotation for metabolomics data. Anal Chem 2014; 86:6812-7. [PMID: 24927477 DOI: 10.1021/ac501530d] [Citation(s) in RCA: 164] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Metabolomic data are frequently acquired using chromatographically coupled mass spectrometry (MS) platforms. For such datasets, the first step in data analysis relies on feature detection, where a feature is defined by a mass and retention time. While a feature typically is derived from a single compound, a spectrum of mass signals is more a more-accurate representation of the mass spectrometric signal for a given metabolite. Here, we report a novel feature grouping method that operates in an unsupervised manner to group signals from MS data into spectra without relying on predictability of the in-source phenomenon. We additionally address a fundamental bottleneck in metabolomics, annotation of MS level signals, by incorporating indiscriminant MS/MS (idMS/MS) data implicitly: feature detection is performed on both MS and idMS/MS data, and feature-feature relationships are determined simultaneously from the MS and idMS/MS data. This approach facilitates identification of metabolites using in-source MS and/or idMS/MS spectra from a single experiment, reduces quantitative analytical variation compared to single-feature measures, and decreases false positive annotations of unpredictable phenomenon as novel compounds. This tool is released as a freely available R package, called RAMClustR, and is sufficiently versatile to group features from any chromatographic-spectrometric platform or feature-finding software.
Collapse
Affiliation(s)
- C D Broeckling
- Proteomics and Metabolomics Facility, Colorado State University , Fort Collins, Colorado 80523, United States
| | | | | | | | | |
Collapse
|
31
|
Hentrich M, Schalk E, Schmidt-Hieber M, Chaberny I, Mousset S, Buchheidt D, Ruhnke M, Penack O, Salwender H, Wolf HH, Christopeit M, Neumann S, Maschmeyer G, Karthaus M. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol 2014; 25:936-47. [PMID: 24399078 DOI: 10.1093/annonc/mdt545] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer patients are at increased risk for central venous catheter-related infections (CRIs). Thus, a comprehensive, practical and evidence-based guideline on CRI in patients with malignancies is warranted. PATIENTS AND METHODS A panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) has developed a guideline on CRI in cancer patients. Literature searches of the PubMed, Medline and Cochrane databases were carried out and consensus discussions were held. RESULTS Recommendations on diagnosis, management and prevention of CRI in cancer patients are made, and the strength of the recommendation and the level of evidence are presented. CONCLUSION This guideline is an evidence-based approach to the diagnosis, management and prevention of CRI in cancer patients.
Collapse
Affiliation(s)
- M Hentrich
- Department of Hematology, Oncology and Palliative Care, Harlaching Hospital and Neuperlach Hospital, Munich
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Schumacher M, Neumann S. [Clinical use of the U-shaped external fixator with enhanced threadplate (UFEG®)]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2014; 42:5-12. [PMID: 24518942] [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] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 07/08/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE In this retrospective case study a new reusable device for external skeletal fixation (UFEG®) that has been especially designed for use in veterinary medicine was evaluated in a case series. MATERIAL AND METHODS In total, 20 patients from three different species (13 cats, five dogs, two rabbits) with a bodyweight between 1.8 and 33.0 kg were treated with the new device. The patients suffered from fractures, luxations and ruptures of tendons at diffe- rent localizations. All injuries were treated using the UFEG® alone or in association with an internal fixation. RESULTS The duration of the healing process of 3-12 weeks and the success rate with respect to fracture and joint stability were comparable to other clinically used external skeletal fixation systems. In comparison to other devices weighing 14-64 g, the UFEG® has a low net weight of 18 g while still providing high rigidity. Additional advantages are the relatively low price, the easy application without the need for specific instruments and the possibility to anchor many Kirschner pins of different gauges in the bone. CONCLUSION AND CLINICAL RELEVANCE The results support the clinical usefulness of the UFEG® device. It is highly suitable for treating different limb injuries.
Collapse
Affiliation(s)
- M Schumacher
- Dr. Manfred Schumacher, Kreuzgasse 27, 88677 Markdorf, E-Mail:
| | | |
Collapse
|
33
|
Neumann S, Korenstein R, Barenholz Y, Ottolenghi M. Photoinduced Charge Separation and Recombination in Exciplex Systems in Lipid Bilayer Vesicles. Isr J Chem 2013. [DOI: 10.1002/ijch.198200024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
34
|
Neumann S, Krause SW, Maschmeyer G, Schiel X, von Lilienfeld-Toal M. Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematological malignancies and solid tumors : guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2013; 92:433-42. [PMID: 23412562 PMCID: PMC3590398 DOI: 10.1007/s00277-013-1698-0] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 02/02/2013] [Indexed: 01/09/2023]
Abstract
Bacterial infections are the most common cause for treatment-related mortality in patients with neutropenia after chemotherapy. Here, we discuss the use of antibacterial prophylaxis against bacteria and Pneumocystis pneumonia (PCP) in neutropenic cancer patients and offer guidance towards the choice of drug. A literature search was performed to screen all articles published between September 2000 and January 2012 on antibiotic prophylaxis in neutropenic cancer patients. The authors assembled original reports and meta-analysis from the literature and drew conclusions, which were discussed and approved in a consensus conference of the Infectious Disease Working Party of the German Society of Hematology and Oncology (AGIHO). Antibacterial prophylaxis has led to a reduction of febrile events and infections. A significant reduction of overall mortality could only be shown in a meta-analysis. Fluoroquinolones are preferred for antibacterial and trimethoprim–sulfamethoxazole for PCP prophylaxis. Due to serious concerns about an increase of resistant pathogens, only patients at high risk of severe infections should be considered for antibiotic prophylaxis. Risk factors of individual patients and local resistance patterns must be taken into account. Risk factors, choice of drug for antibacterial and PCP prophylaxis and concerns regarding the use of prophylactic antibiotics are discussed in the review.
Collapse
Affiliation(s)
- S Neumann
- Department of Hematology and Oncology, Georg August University Göttingen, Robert Koch Str. 40, 37075, Göttingen, Germany.
| | | | | | | | | | | | | |
Collapse
|
35
|
Vehreschild MJGT, Vehreschild JJ, Hübel K, Hentrich M, Schmidt-Hieber M, Christopeit M, Maschmeyer G, Schalk E, Cornely OA, Neumann S. Diagnosis and management of gastrointestinal complications in adult cancer patients: evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Oncol 2013; 24:1189-202. [PMID: 23401037 DOI: 10.1093/annonc/mdt001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cancer patients frequently suffer from gastrointestinal complications. However, a comprehensive, practical and evidence-based guideline on this issue is not yet available. PATIENTS AND METHODS An expert group was put together by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO) to develop a guideline on gastrointestinal complications in cancer patients. For each subtopic, a literature search was carried out in PubMed, Medline and Cochrane databases and the strength of recommendation and the quality of the published evidence for major therapeutic strategies were categorized using a modification of the 'Infectious Diseases Society of America' criteria. Consensus discussions were held on each of the topics. RESULTS Recommendations were made with respect to non-infectious and infectious gastrointestinal complications. For all recommendations, the strength of the recommendation and the level of evidence are presented. CONCLUSION This guideline is an evidence-based approach to the diagnosis and management of gastrointestinal complications in cancer patients.
Collapse
|
36
|
Kreuter M, Vansteenkiste J, Fischer JR, Eberhardt W, Zabeck H, Kollmeier J, Serke M, Frickhofen N, Reck M, Engel-Riedel W, Neumann S, Thomeer M, Schumann C, De Leyn P, Graeter T, Stamatis G, Zuna I, Griesinger F, Thomas M. Randomized phase 2 trial on refinement of early-stage NSCLC adjuvant chemotherapy with cisplatin and pemetrexed versus cisplatin and vinorelbine: the TREAT study. Ann Oncol 2012; 24:986-92. [PMID: 23161898 DOI: 10.1093/annonc/mds578] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adjuvant chemotherapy is beneficial in non-small-cell lung cancer (NSCLC). However, balancing toxicity and efficacy mandates improvement. PATIENTS AND METHODS Patients with completely resected stages IB-pT3N1 NSCLC were randomly assigned to either four cycles cisplatin (C: 50 mg/m(2) day (d)1 + 8) and vinorelbine (V: 25 mg/m(2) d1, 8, 15, 22) q4 weeks or four cycles cisplatin (75 mg/m(2) d1) and pemetrexed (Px: 500 mg/m(2) d1) q3 weeks. Primary objective was the clinical feasibility rate (no grade (G)4 neutropenia/thrombocytopenia or thrombocytopenia with bleeding, no G3/4 febrile neutropenia or non-hematological toxicity; no premature withdrawal/death). Secondary objectives were drug delivery and efficacy. RESULTS One hundred and thirty two patients were randomized (stages: 38% IB, 10% IIA, 47% IIB, 5% pT3pN1; histology: 43% squamous, 57% non-squamous). The feasibility rates were 95.5% (cisplatin and pemetrexed, CPx) and 75.4% (cisplatin and vinorelbine, CVb) (P = 0.001); hematological G3/4 toxic effects were 10% (CPx) and 74% (CVb) (P < 0.001), non-hematological toxic effects were comparable (33% and 31%, P = 0.798). Delivery of total mean doses was 90% of planned with CPx, but 66% (cisplatin) and 64% (vinorelbine) with CVb (P < 0.0001). The median number of cycles [treatment time (weeks)] was 4 for CPx (11.2) and 3 for CVb (9.9). Time to withdrawal from therapy differed significantly between arms favoring CPx (P < 0.001). CONCLUSION Adjuvant chemotherapy with CPx is safe and feasible with less toxicity and superior dose delivery compared with CVb.
Collapse
Affiliation(s)
- M Kreuter
- Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Amalienstr. 5, 69126 Heidelberg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Schoenenberger AW, Stortecky S, Neumann S, Moser A, Juni P, Carrel T, Huber C, Gandon M, Bischoff S, Schoenenberger CM, Stuck AE, Windecker S, Wenaweser P. Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI). Eur Heart J 2012; 34:684-92. [DOI: 10.1093/eurheartj/ehs304] [Citation(s) in RCA: 236] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
38
|
Kreuter M, Vansteenkiste J, Fischer JR, Eberhardt W, Zabeck H, Kollmeier J, Serke M, Frickhofen N, Reck M, Engel-Riedel W, Neumann S, Thomeer M, Schumann C, De Leyn P, Graeter T, Stamatis G, Zuna I, Griesinger F, Thomas M. Randomisierte Phase 2 Studie zur Verbesserung der adjuvanten Chemotherapie beim frühen NSCLC – Vergleich Cisplatin/Pemetrexed (CPx) mit Cisplatin/Vinorelbine (CVb) – erweiterte Ergebnisse der TREAT Studie. Pneumologie 2012. [DOI: 10.1055/s-0032-1302560] [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]
|
39
|
Neumann S, Haverkamp S, Auferkorte ON. Intrinsically photosensitive ganglion cells of the primate retina express distinct combinations of inhibitory neurotransmitter receptors. Neuroscience 2011; 199:24-31. [PMID: 22044923 DOI: 10.1016/j.neuroscience.2011.10.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/27/2011] [Accepted: 10/17/2011] [Indexed: 10/16/2022]
Abstract
Intrinsically-photosensitive retinal ganglion cells (ipRGCs) express the photopigment melanopsin and function as irradiance detectors, responsible for crucial non-image forming visual functions. In addition to their intrinsic photosensitivity, ipRGCs are also activated by synaptic inputs originating at the classical photoreceptors, rods and cones. Little is known about inhibition through these retinal pathways, despite ipRGCs receiving massive synaptic inputs from inhibitory amacrine interneurons. We performed a wide anatomical screening for neurotransmitter receptors possibly involved in the inhibitory modulation of ipRGCs in the macaque retina. We investigated both subtypes of primate ipRGCs described so far and report that outer-stratifying (M1) cells possess mainly GlyR α2 and GABA(A)R α3 subunits, while inner-stratifying (M2) cells are overall subject to less inhibitory modulation. Our results suggest that M1 and M2 ipRGC subtypes are modulated via distinct inhibitory intraretinal circuits.
Collapse
Affiliation(s)
- S Neumann
- Department of Neuroanatomy, Max-Planck-Institute for Brain Research, D-60528 Frankfurt a.M., Germany
| | | | | |
Collapse
|
40
|
Abstract
BACKGROUND Transarterial catheter embolization of the kidneys (TAE) is a minimally invasive, image-guided procedure. In this study outcome and TAE-related complications of the patients who underwent TAE of the kidneys were evaluated retrospectively. PATIENTS AND METHODS Between August 2003 and August 2009, 11 patients underwent selective percutaneous transarterial renal embolization for end stage renal disease associated with uncontrolled hypertension, nephrotic syndrome, bleeding or malignancy. TAE of renal arteries was performed using different embolization agents. RESULTS Successful renal embolization was possible in all 21 kidneys. All patients became anuric. Non-target embolization was not detectable. Nevertheless, all patients developed some degree of postembolization symptoms including nausea, vomiting, fever or pain. A typical finding after embolization was an increase in the C-reactive protein. CONCLUSIONS Renal embolization is rarely done but should be considered as an alternative to surgical nephrectomy in patients with end stage renal disease due to the lesser invasiveness. Our study confirms the safety and effectivity of percutaneous renal embolization in patients with ESRD. We were able to control the hypertension, nephrotic syndrome, and bleeding caused by ESRD.
Collapse
Affiliation(s)
- A Hansch
- Friedrich Schiller University, Jena, Germany.
| | | | | | | | | | | |
Collapse
|
41
|
Kreuter M, Vansteenkiste JF, Fischer JR, Eberhardt WEE, Zabeck H, Kollmeier J, Serke MH, Frickhofen N, Reck M, Engel-Riedel W, Neumann S, Thomeer M, Schumann C, Deleyn P, Graeter T, Stamatis G, Zuna I, Griesinger F, Thomas M. Randomized phase II trial on refinement of early-stage NSCLC adjuvant chemotherapy with cisplatin and pemetrexed (CPx) versus cisplatin and vinorelbine (CVb): TREAT. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
42
|
Abstract
TSH activates the TSH receptor (TSHR) thereby stimulating the function of thyroid follicular cells (thyrocytes) leading to biosynthesis and secretion of thyroid hormones. Because TSHR is involved in several thyroid pathologies, there is a strong rationale for the design of small molecule "drug-like" ligands. Recombinant human TSH (rhTSH, Thyrogen(®)) has been used in the follow-up of patients with thyroid cancer to increase the sensitivity for detection of recurrence or metastasis. rhTSH is difficult to produce and must be administered by injection. A small molecule TSHR agonist could produce the same beneficial effects as rhTSH but with greater ease of oral administration. We developed a small molecule ligand that is a full agonist at TSHR. Importantly for its clinical potential, this agonist elevated serum thyroxine and stimulated thyroidal radioiodide uptake in mice after its absorption from the gastrointestinal tract following oral administration. Graves' disease (GD) is caused by persistent, unregulated stimulation of thyrocytes by thyroid-stimulating antibodies (TSAbs) that activate TSHR. We identified the first small molecule TSHR antagonists that inhibited TSH- and TSAb-stimulated signalling in primary cultures of human thyrocytes. Our results provide proof-of-principle for effectiveness of small molecule agonists and antagonists for TSHR. We suggest that these small molecule ligands are lead compounds for the development of higher potency ligands that can be used as probes of TSHR biology with therapeutic potential.
Collapse
Affiliation(s)
- S Neumann
- National Institutes of Health, NIDDK, CEB, Receptor and Hormone Action Section, MD 20892, Bethesda, USA.
| | | |
Collapse
|
43
|
Noonan K, Martin P, Scott A, Kuhn G, Neumann S. Do Anti-inflammatory Agents Promote Linear Ablation Lesion Discontinuities? An Electrophysiological Examination. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
44
|
Kiewnick S, Neumann S, Sikora RA, Frey JE. Effect of Meloidogyne incognita inoculum density and application rate of Paecilomyces lilacinus strain 251 on biocontrol efficacy and colonization of egg masses analyzed by real-time quantitative PCR. Phytopathology 2011; 101:105-112. [PMID: 20822430 DOI: 10.1094/phyto-03-10-0090] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The fungal biocontrol agent, Paecilomyces lilacinus strain 251 (PL251), was evaluated for its potential to control the root-knot nematode Meloidogyne incognita on tomato at varying application rates and inoculum densities. Conversely to previous studies, significant dose-response relationships could not be established. However, we demonstrated that a preplanting soil treatment with the lowest dose of commercially formulated PL251 (2 × 10(5) CFU/g soil) was already sufficient to reduce root galling by 45% and number of egg masses by 69% when averaged over inoculum densities of 100 to 1,600 eggs and infective juveniles per 100 cm(3) of soil. To determine the role of colonization of M. incognita egg masses by PL251 for biocontrol efficacy, a real-time quantitative polymerase chain reaction (PCR) assay with a detection limit of 10 CFU/egg mass was used. Real-time PCR revealed a significant relationship between egg mass colonization by PL251 and the dose of product applied to soil but no correlation was found between fungal density and biocontrol efficacy or nematode inoculum level. These results demonstrate that rhizosphere competence is not the key mode of action for PL251 in controlling M. incognita on tomato.
Collapse
Affiliation(s)
- S Kiewnick
- Research Station Agroscope Changins-Waedenswil ACW, Plant Protection and Extension Fruit and Vegetables, Schloss P.O. Box, 8820 Waedenswil, Switzerland.
| | | | | | | |
Collapse
|
45
|
Wiedemann M, John S, Schlüter M, Kutschera D, Riener FX, Döring W, Neumann S, Eisenlauer J. Einsatz des Strahlzonen-Schlaufenreaktors bei stofftransportlimitierten, mehrphasigen chemischen Reaktionen. CHEM-ING-TECH 2010. [DOI: 10.1002/cite.200900164] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
46
|
Cramer U, Henkel M, Käsbach C, Neumann S, Reitz T. Sind neue Versorgungsformen wie Selektivverträge, MVZ, §116 b SGB V, Integrierte Versorgung Bedrohung oder Chance für die Radiologie? ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252409] [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]
|
47
|
Klesing J, Chernousova S, Kovtun A, Neumann S, Ruiz L, Gonzalez-Calbet JM, Vallet-Regi M, Heumann R, Epple M. An injectable paste of calcium phosphate nanorods, functionalized with nucleic acids, for cell transfection and gene silencing. ACTA ACUST UNITED AC 2010. [DOI: 10.1039/c0jm01130d] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
48
|
Epple M, Ganesan K, Heumann R, Klesing J, Kovtun A, Neumann S, Sokolova V. Application of calcium phosphatenanoparticles in biomedicine. ACTA ACUST UNITED AC 2010. [DOI: 10.1039/b910885h] [Citation(s) in RCA: 263] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
49
|
Neumann S, Schmidt W, Niendorf M, Schmitz K. Verifizierung eines sonographischen Meßverfahrens zur Bewertung des Schrauben-Knochen-Verbundes anhand mechanischer Parameter. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1998.43.s1.264] [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: 11/15/2022]
|
50
|
Schön J, Neumann S, Wildt DE, Pukazhenthi BS, Jewgenow K. Localization of Oestrogen Receptors in the Epididymis During Sexual Maturation of the Domestic Cat. Reprod Domest Anim 2009; 44 Suppl 2:294-301. [DOI: 10.1111/j.1439-0531.2009.01391.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|