1
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Ebert T, Hamuda N, City-Elifaz E, Kobo O, Roguin A. Trends in CV mortality among patients with known mental and behavioral disorders in the US between 1999 and 2020. Front Psychiatry 2023; 14:1255323. [PMID: 38025453 PMCID: PMC10646424 DOI: 10.3389/fpsyt.2023.1255323] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Patients with mental disorders are at increased risk of cardiovascular events. We aimed to assess the cardiovascular mortality trends over the last two decades among patients with mental and behavioral co-morbidities in the US. Methods We performed a retrospective, observational study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death dataset. We determined national trends in age-standardized mortality rates attributed to cardiovascular diseases in patients with and without mental and behavioral disorders, from 1999 to 2020, stratified by mental and behavioral disorders subtype [ICD10 codes F], age, gender, race, and place of residence. Results Among more than 18.7 million cardiovascular deaths in the United States (US), 13.5% [2.53 million] were patients with a concomitant mental and behavioral disorder. During the study period, among patients with mental and behavioral disorders, the age-adjusted mortality rate increased by 113.9% Vs a 44.8% decline in patients with no mental disorder (both p<0.05). In patients with mental and behavioral disorders, the age-adjusted mortality rate increased more significantly among patients whose mental and behavioral disorder was secondary to substance abuse (+532.6%, p<0.05) than among those with organic mental disorders, such as dementia or delirium (+6.2%, P- nonsignificant). Male patients (+163.6%) and residents of more rural areas (+128-162%) experienced a more prominent increase in age-adjusted cardiovascular mortality. Discussion While there was an overall reduction in cardiovascular mortality in the US in the past two decades, we demonstrated an overall increase in cardiovascular mortality among patients with mental disorders.
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Affiliation(s)
- Tanya Ebert
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
- Department of Psychiatry, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nashed Hamuda
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Efrat City-Elifaz
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
- Department of Psychiatry, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ofer Kobo
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ariel Roguin
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
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2
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Ebert T, Goldschmid N, Sabo E, City-Elifaz E. Effects of COVID-19 Lockdowns on the Development of Educational, Social and Emotional Gaps among Children: A Retrospective Chart Review. Isr Med Assoc J 2022; 25:791-796. [PMID: 36573771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND School closures due to the coronavirus disease 2019 (COVID-19) outbreak affected students physically, socially, and psychologically with an increase in the number of children and adolescent presenting with anxiety, depression, and drug abuse. OBJECTIVES To examine the impact of COVID-19 and lockdown on the mental health of minors during the pandemic period and to characterize the type and number of referrals to a regional psychiatric outpatient clinic. METHODS This study included 380 children evaluated in an outpatient child psychiatric clinic. They were divided into two groups: before the lockdowns (BLD) (n=248), from January 2019 to February 2020, and during the lockdowns (LD) (n=132), from March 2020 to April 2021. RESULTS When comparing the LD to BLD, there was increase in suicide attempts (9.8% vs. 2.8%) and in the use of psychotherapy (81% vs. 56%). There was a decrease in the diagnoses of behavior disorders (29.5% vs. 44.8%) and ADHD (29.5% vs. 50%); as well as a decrease in stimulant usage (22.7% vs. 38%). There was a statistically non-significant increase in the number of children with depression, anxiety, and drug-use disorder. CONCLUSIONS Many children developed educational, social, emotional, and behavioral gaps during LD, and they lost skills to deal with everyday problems due to social isolation. It is important to follow the long-term impact of the lockdowns and social isolation.
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Affiliation(s)
- Tanya Ebert
- Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel, Department of Children and Adolescent Psychiatry, Hillel Yaffe Medical Center, Hadera, Israel
| | - Nimrod Goldschmid
- Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel, Medical Center Management and Patient Safety Unit
| | - Edmond Sabo
- Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel, Department of Pathology, Carmel Medical Center, Haifa, Israel
| | - Efrat City-Elifaz
- Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel, Department of Children and Adolescent Psychiatry, Hillel Yaffe Medical Center, Hadera, Israel
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3
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Filipova V, Stuerzebecher PE, Kralisch S, Schubert MR, Hoffmann A, Oliveira F, Sheikh B, Blueher M, Kogel A, Scholz M, Miehle K, Ebert T, Laufs U, Toenjes A, Boeckel JN. Leptin mediates protective effects on the vasculature. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3057] [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: 11/12/2022] Open
Abstract
Abstract
Introduction and purpose
Lipodystrophy (LD) syndromes are characterized by the loss of adipose tissue resulting in metabolic complications and accelerated atherosclerosis. The systemic concentration of the adipokine leptin is reduced in LD as a result of adipose tissue deficiency. A therapeutical option to treat LD is the substitution of leptin, which improves metabolic complications and reduces mortality. However, the vascular effects of leptin remain largely unknown.
Here we analyze the direct effects of leptin on the vascular system and the development of atherosclerosis.
Methods and results
Treatment of human endothelial cells (ECs) with leptin reduced endothelial inflammation and the process of endothelial-to-mesenchymal transition (EndMT) (CNN1, −41.4%, p<0.05, n=4). In addition, leptin administration prevented the EndMT-induced increase of endothelial permeability. The protective effect of leptin on EndMT was confirmed in vivo in a combined lipodystrophic and atherosclerosis-prone mouse model (LDLR−/−; aP2-nSrebp1c). Treatment of the mice with leptin (3.0 mg/kg body weight daily for 8 weeks) decreased EndMT. Leptin showed no effect on plaques size but reduced the protrusion of plaques in atherosclerotic areas of the aortic roots (−31%, p<0.05, n=4–6).
Cytokine screening revealed an increase of the growth differentiation factor 15 (GDF15) in serum of LD patients (+26.2%, p<0.05, n=53–58) and in ECs after EndMT (+138%, p<0.05, n=6743–10920). This increase was reversed using leptin treatment in ECs undergoing EndMT, in the LD mice model, and in LD patients after 4 weeks of leptin administration. Indeed, treatment of endothelial cells with GDF15 induced EndMT (CNN1, +7.7-fold-control, p<0.05, n=3), and impaired EC barrier function. Neutralizing antibodies targeting GDF15 inhibited EndMT-mediated expression of mesenchymal genes (CNN1, −54%, p<0.05, n=4). The treatment of ECs with serum from LD patients induced EndMT and the increase of mesenchymal marker expression was inhibited with additional administration with neutralizing antibodies targeting GDF15 (CNN1, −28%, p<0.05, n=3).
Conclusion
Our findings indicate that EndMT is part of the cardiovascular disease progression in lipodystrophy syndromes. Leptin treatment has direct protective vascular effects by preventing inflammation, EndMT, and maintaining endothelial integrity.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)
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Affiliation(s)
- V Filipova
- University Hospital Leipzig , Leipzig , Germany
| | | | - S Kralisch
- University of Leipzig Medical Center , Leipzig , Germany
| | | | - A Hoffmann
- University Hospital Wuerzburg , Wuerzburg , Germany
| | - F Oliveira
- University of Leipzig and University Hospital Leipzig, Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum Munich , Leipzig , Germany
| | - B Sheikh
- University of Leipzig and University Hospital Leipzig, Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum Munich , Leipzig , Germany
| | - M Blueher
- University of Leipzig Medical Center , Leipzig , Germany
| | - A Kogel
- University Hospital Leipzig , Leipzig , Germany
| | - M Scholz
- University of Leipzig , Leipzig , Germany
| | - K Miehle
- University of Leipzig Medical Center , Leipzig , Germany
| | - T Ebert
- University of Leipzig Medical Center , Leipzig , Germany
| | - U Laufs
- University Hospital Leipzig , Leipzig , Germany
| | - A Toenjes
- University of Leipzig Medical Center , Leipzig , Germany
| | - J N Boeckel
- University Hospital Leipzig , Leipzig , Germany
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4
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Sander S, Ebert T, Hartnagel D, Hesse M, Pan X, Schaumann G, Šmíd M, Falk K, Roth M. Microstructured layered targets for improved laser-induced x-ray backlighters. Phys Rev E 2021; 104:065207. [PMID: 35030937 DOI: 10.1103/physreve.104.065207] [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: 03/01/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
We present the usage of two-layer targets with laser-illuminated front-side microstructures for x-ray backlighter applications. The targets consisted of a silicon front layer and copper back side layer. The structured layer was irradiated by the 500-fs PHELIX laser with an intensity above 10^{20}Wcm^{-2}. The total emission and one-dimensional extent of the copper Kα x-ray emission as well as a wide spectral range between 7.9 and 9.0 keV were recorded with an array of crystal spectrometers. The measurements show that the front-side modifications of the silicon in the form of conical microstructures maintain the same peak brightness of the Kα emission as flat copper foils while suppressing the thermal emission background significantly. The observed Kα source sizes can be influenced by tilting the conical microstructures with respect to the laser axis. Overall, the recorded copper Kα photon yields were in the range of 10^{11}sr^{-1}, demonstrating the suitability of these targets for probing applications without subjecting the probed material to additional heating from thermal line emission.
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Affiliation(s)
- S Sander
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - T Ebert
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Hartnagel
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M Hesse
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - X Pan
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
| | - G Schaumann
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M Šmíd
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
| | - K Falk
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
- Institute of Physics of the ASCR, 182 21 Prague, Czech Republic
| | - M Roth
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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5
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Zimmer M, Scheuren S, Ebert T, Schaumann G, Schmitz B, Hornung J, Bagnoud V, Rödel C, Roth M. Analysis of laser-proton acceleration experiments for development of empirical scaling laws. Phys Rev E 2021; 104:045210. [PMID: 34781535 DOI: 10.1103/physreve.104.045210] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Numerous experiments on laser-driven proton acceleration in the MeV range have been performed with a large variety of laser parameters since its discovery around the year 2000. Both experiments and simulations have revealed that protons are accelerated up to a maximum cut-off energy during this process. Several attempts have been made to find a universal model for laser proton acceleration in the target normal sheath acceleration regime. While these models can qualitatively explain most experimental findings, they can hardly be used as predictive models, for example, for the energy cut-off of accelerated protons, as many of the underlying parameters are often unknown. Here we analyze experiments on laser proton acceleration in which scans of laser and target parameters were performed. We derive empirical scaling laws from these parameter scans and combine them in a scaling law for the proton energy cut-off that incorporates the laser pulse energy, the laser pulse duration, the focal spot radius, and the target thickness. Using these scaling laws, we give examples for predicting the proton energy cut-off and conversion efficiency for state-of-the-art laser systems.
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Affiliation(s)
- M Zimmer
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - S Scheuren
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - T Ebert
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - G Schaumann
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - B Schmitz
- Institute for Accelerator Science and Electromagnetic Fields, Technical University of Darmstadt, Schlossgartenstr. 8, 64289 Darmstadt, Germany
| | - J Hornung
- GSI Helmholtz Centre for Heavy Ion Research, Planckstr. 1, 64291 Darmstadt, Germany
- Friedrich-Schiller-Universität Jena, Fürstengraben 1, 07743 Jena, Germany
- Helmholtz-Institut Jena, Fröbelstieg 3, 07743 Jena, Germany
| | - V Bagnoud
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
- GSI Helmholtz Centre for Heavy Ion Research, Planckstr. 1, 64291 Darmstadt, Germany
| | - C Rödel
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Roth
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
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6
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Ebert T, Qureshi AR, Lamina C, Fotheringham J, Froissart M, Eckardt KU, Wheeler DC, Floege J, Kronenberg F, Stenvinkel P. Time-dependent lipid profile inversely associates with mortality in hemodialysis patients - independent of inflammation/malnutrition. J Intern Med 2021; 290:910-921. [PMID: 33998741 DOI: 10.1111/joim.13291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/22/2020] [Revised: 02/02/2021] [Accepted: 02/18/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with end-stage kidney disease have an extremely high cardiovascular mortality rate, but there is a paradoxical relationship between lipid profile and survival in haemodialysis patients. To investigate whether inflammation/malnutrition confounds the associations between lipids and mortality, we studied a full lipid profile comprising of five clinically well-established lipid parameters and its associations with mortality in a large, multinational European cohort with a median follow-up >3 years. METHODS The association between quartiles of total, high-density lipoprotein (HDL), non-HDL, low-density lipoprotein (LDL) cholesterol, as well as triglyceride, levels and the end-points of all-cause, cardiovascular and non-cardiovascular mortality was assessed in a cohort of 5,382 incident, adult haemodialysis patients from >250 Fresenius Medical Care dialysis centres out of 14 participating countries using baseline and time-dependent Cox models. Analyses were fully adjusted and stratified for inflammation/malnutrition status and other patient-level variables. RESULTS Time-dependent quartiles of total, HDL, non-HDL and LDL cholesterol were inversely associated with the hazard for all-cause, cardiovascular and non-cardiovascular mortality. Compared with the lowest quartile of the respective lipid parameter, hazard ratios of other quartiles were <0.86. Similar, albeit weaker, associations were found with baseline lipid profile and mortality. Neither time-dependent nor baseline associations between lipid profile and mortality were affected by inflammation/malnutrition, statin use or geography. CONCLUSIONS Baseline and time-dependent lipid profile are inversely associated with mortality in a large, multicentre cohort of incident haemodialysis patients. Inflammation/malnutrition is not a confounder nor effect modificator of the associations between lipid profile and mortality in European haemodialysis patients.
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Affiliation(s)
- T Ebert
- From the, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A R Qureshi
- From the, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - C Lamina
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Fotheringham
- Sheffield Kidney Institute, Northern General Hospital, Sheffield, UK.,School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M Froissart
- Centre de Recherche Clinique (CRC), Lausanne University Hospital, Lausanne, Switzerland
| | - K-U Eckardt
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - D C Wheeler
- Department of Renal Medicine, University College London, London, UK
| | - J Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany
| | - F Kronenberg
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - P Stenvinkel
- From the, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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7
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Hesse M, Ebert T, Zimmer M, Scheuren S, Schaumann G, Roth M. Spatially resolved online particle detector using scintillators for laser-driven particle sources. Rev Sci Instrum 2021; 92:093302. [PMID: 34598491 DOI: 10.1063/5.0052507] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Laser-based particle accelerators have been an active field of research for over two decades moving from laser systems capable of one shot every hour to systems able to deliver repetition rates in the Hz regime. Based on the advancements in laser technology, the corresponding detection methods need to develop from single to multiple use with high readout speed. Here, we present an online compact tracker of particles using scintillators with nine resolvable energy levels and a spatial resolution of 3.6 × 3.6 mm2 over the whole active area. This paper describes the design and construction of the detector, which is based on pixellated scintillators embedded inside an absorber matrix. The scintillator pixels are fiberoptically coupled to a camera system for online readout and analysis. Calibration with a radioactive source and first experimental data measuring laser accelerated ions at the PHELIX laser at GSI, Darmstadt, Germany, are presented and discussed.
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Affiliation(s)
- M Hesse
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - T Ebert
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Zimmer
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - S Scheuren
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - G Schaumann
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Roth
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
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8
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Herden J, Ebert T, Schlager D, Pretzer J, Zumbé J, Sommerfeld HJ, Schafhauser W, Kriegmair M, Garcia Schürmann M, Distler F, Baur H, Oberpenning F, Reimann M, Schmidt S, Laabs S, Planz B, Gronau E, Platz G, Göll A, Buse S, Jones J, Haupt G, Waldner M, Heidenreich A, Khaljani E, Rübben H, Schultze-Seemann W, Weib P. [Treatment mapping of lower urinary tract symptoms due to benign prostatic hyperplasia-an analysis of the Governing Body of German Prostate Centers]. Urologe A 2020; 59:1082-1091. [PMID: 32274545 DOI: 10.1007/s00120-020-01192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Due to the high incidence and demographic development, there is an urgent need for healthcare research data on lower urinary tract symptoms due to benign prostatic hyperplasia (LTUS/BPH). Since 2005 the Governing Body of German Prostate Centers (DVPZ) has been collecting data from 22 prostate centers in order to determine the quality and type of cross-sectoral care in particular for LUTS/BPH patients. OBJECTIVES Presentation of the DVPZ database in general, as well as an investigation of treatment patterns for medical and instrumental therapies. MATERIALS AND METHODS The analysis is based on UroCloud data sets from 30 November 2017. In the UroCloud data on diagnostics, therapy and course of disease are recorded in a web-based manner. RESULTS A total of 29,555 therapies were documented for 18,299 patients (1.6/patient), divided into 48.5% instrumental, 29.2% medical treatment, and 18.0% "wait and see" (in 4.3% no assignment was possible). Patients treated with an instrumental therapy were oldest (median: 72 years, interquartile range: 66-77), had the largest prostate volumes (50 ml, 35-75 ml), and were mostly bothered by symptoms (International Prostate Symptom Score = 19/4). The majority of patients under medical treatment received alphablockers (56%); phytotherapeutics were used least frequently (3%). Instrumental therapies are dominated by transurethral resection (TUR) of the prostate (60.0%), open prostatectomy (9.4%) and laser therapy (5.0%), with laser therapy having the shortest hospital stay (5 days) and the lowest transfusion and re-intervention rates (1.0% and 4.6%, respectively). CONCLUSIONS The DVPZ certificate covers the complete spectrum of cross-sectoral care for LUTS/BPH patients and documents the use of the various therapies as well as their application and effectiveness in the daily routine setting.
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Affiliation(s)
- J Herden
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland. .,Prostatazentrum Köln, Campus Universitätsklinikum, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - T Ebert
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland.,Prostatazentrum Metropolregion Nürnberg, Nürnberg, Deutschland
| | - D Schlager
- Prostatazentrum Freiburg, Freiburg, Deutschland
| | - J Pretzer
- Berliner Prostatazentrum, Berlin, Deutschland
| | - J Zumbé
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland.,Prostatazentrum Leverkusen, Leverkusen, Deutschland
| | | | - W Schafhauser
- Prostatazentrum Hochfranken-Fichtelgebirge, Marktredwitz, Deutschland
| | - M Kriegmair
- Prostatazentrum Urologie Centrum München, Planegg, Deutschland
| | | | - F Distler
- Prostatazentrum Nürnberg-Mittelfranken, Nürnberg, Deutschland
| | - H Baur
- Prostatazentrum Nymphenburg, München, Deutschland
| | | | - M Reimann
- Prostatazentrum Moers, Moers, Deutschland
| | - S Schmidt
- Prostatazentrum Rhein-Ruhr, Oberhausen, Deutschland
| | - S Laabs
- Prostatazentrum Elbe-Weser, Stade, Deutschland
| | - B Planz
- Prostatazentrum Emscher-Lippe, Gladbeck, Deutschland
| | - E Gronau
- Prostatazentrum Münsterland, Münster, Deutschland
| | - G Platz
- Prostatazentrum Mainspitze, Rüsselsheim, Deutschland
| | - A Göll
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland.,Prostatazentrum Alfred Krupp Krankenhaus, Essen, Deutschland
| | - S Buse
- Prostatazentrum Alfred Krupp Krankenhaus, Essen, Deutschland
| | - J Jones
- Prostatazentrum Hochtaunus, Bad Homburg, Deutschland
| | - G Haupt
- Prostatazentrum Speyer, Speyer, Deutschland
| | - M Waldner
- Prostatazentrum Köln, Campus Hohenlind, Köln, Deutschland
| | - A Heidenreich
- Prostatazentrum Köln, Campus Universitätsklinikum, Kerpener Str. 62, 50937, Köln, Deutschland
| | - E Khaljani
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland
| | - H Rübben
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland
| | - W Schultze-Seemann
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland.,Prostatazentrum Freiburg, Freiburg, Deutschland
| | - P Weib
- Dachverband der Prostatazentren Deutschlands e. V., Berlin, Deutschland.,Kompetenznetz Prostata Siegen, Siegen, Deutschland
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9
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Tönjes A, Kralisch S, Hoffmann A, Schleinitz D, Kratzsch J, Blüher M, Stumvoll M, Kovacs P, Fasshauer M, Ebert T. Circulating Pro-Neurotensin in gestational diabetes mellitus. Nutr Metab Cardiovasc Dis 2019; 29:23-29. [PMID: 30527352 DOI: 10.1016/j.numecd.2018.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Pro-Neurotensin (NT), a stable surrogate parameter of NT, has recently been introduced as a peptide predicting the development of obesity, diabetes mellitus, cardiovascular diseases, and cardiovascular mortality. However, regulation of Pro-NT in gestational diabetes mellitus (GDM) remains uninvestigated. METHODS AND RESULTS Pro-NT was quantified in 74 women with GDM, 74 healthy, gestational age-matched, pregnant controls, as well as in a second cohort comprising of 74 healthy, non-pregnant control women, using a chemiluminometric sandwich immunoassay. Pro-NT was correlated to measures of obesity, hypertension, glucose and lipid metabolism, renal function, and inflammation. Mean ± standard deviation of circulating Pro-NT levels were not significantly different in women with GDM (100.2 ± 75.7 pmol/l) as compared to healthy, pregnant controls (103.2 ± 37.4 pmol/l) and healthy, non-pregnant female controls (105.9 ± 38.9 pmol/l) (p = 0.661). Homeostasis model assessment of insulin resistance (HOMA-IR) and creatinine positively correlated with serum Pro-NT in multivariate regression analysis. In contrast, free fatty acids (FFA) were inversely correlated with circulating Pro-NT. Results sustained adjustment for pregnancy status. CONCLUSIONS Circulating Pro-NT is not independently associated with GDM, but is with HOMA-IR, creatinine, and FFA even after adjustment for pregnancy status.
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Affiliation(s)
- A Tönjes
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - S Kralisch
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - A Hoffmann
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - D Schleinitz
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - J Kratzsch
- University of Leipzig, Institute of Laboratory Medicine, 04103, Leipzig, Germany
| | - M Blüher
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - M Stumvoll
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - P Kovacs
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - M Fasshauer
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany; Justus-Liebig-University, Institute of Nutritional Science, 35390, Giessen, Germany
| | - T Ebert
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany.
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Kralisch S, Hoffmann A, Klöting N, Bachmann A, Kratzsch J, Blüher M, Zhang MZ, Harris R, Stumvoll M, Fasshauer M, Ebert T. The novel adipokine/hepatokine fetuin B in severe human and murine diabetic kidney disease. Diabetes & Metabolism 2017; 43:465-468. [DOI: 10.1016/j.diabet.2017.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/04/2017] [Accepted: 01/08/2017] [Indexed: 12/27/2022]
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Kralisch S, Hoffmann A, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M, Ebert T. The brown-fat-secreted adipokine neuregulin 4 is decreased in gestational diabetes mellitus. Diabetes Metab 2017; 44:150-154. [PMID: 28709749 DOI: 10.1016/j.diabet.2017.06.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 01/20/2023]
Abstract
AIMS Neuregulin 4 has recently been recognized as a novel adipokine secreted by brown adipose tissue (BAT), with beneficial effects on murine insulin resistance and hepatic steatosis. Yet, thus far, neither regulation of neuregulin 4 in gestational diabetes mellitus (GDM) nor its longitudinal changes in the peripartum period have been elucidated. METHODS Circulating neuregulin 4 levels were measured by ELISA in 74 women with GDM and 74 healthy, gestational-age-matched controls. Also, neuregulin 4 was quantified during pregnancy and compared with postpartum levels in a follow-up study of 25 women with previous GDM and 25 healthy control women. RESULTS Women with GDM had lower median serum levels of the novel BAT-secreted adipokine neuregulin 4 (3.0μg/L) compared with healthy (non-GDM) pregnant controls (3.5μg/L; P=0.020), and the area under the glucose curve (AUCGlucose) was an independent and negative predictor of circulating neuregulin 4 (P=0.033). Also, median postpartum serum concentrations of neuregulin 4 (3.2μg/L) were not significantly different from prepartum levels (2.8μg/L; P=0.328). In addition, neuregulin 4 was positively and independently associated with irisin (P=0.009), but not other BAT-secreted adipokines. CONCLUSION/INTERPRETATION Women with GDM have significantly lower circulating neuregulin 4 levels compared with healthy pregnant controls, and the AUCGlucose is negatively and independently associated with neuregulin 4 during pregnancy. Neuregulin 4 is positively correlated with irisin during pregnancy, as well as in a longitudinal fashion. Future studies are now needed to better elucidate the precise pathomechanisms of the regulation of BAT-secreted adipokines during pregnancy.
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Affiliation(s)
- S Kralisch
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany
| | - A Hoffmann
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - J Kratzsch
- Institute of Laboratory Medicine, University of Leipzig, 04103 Leipzig, Germany
| | - M Blüher
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - M Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany
| | - M Fasshauer
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany
| | - T Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB Adiposity Diseases, 04103 Leipzig, Germany.
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Ebert T, Platz M, Kralisch S, Lossner U, Jessnitzer B, Richter J, Blüher M, Stumvoll M, Fasshauer M. Serum Levels of Copeptin are Decreased in Gestational Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2016; 124:257-60. [DOI: 10.1055/s-0035-1565172] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 10/22/2022]
Affiliation(s)
- T. Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M. Platz
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - S. Kralisch
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - U. Lossner
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - B. Jessnitzer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - J. Richter
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M. Blüher
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M. Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M. Fasshauer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
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Ebert T, Wollbrink A, Seifert A, John R, Spange S. Multiple polymerization – formation of hybrid materials consisting of two or more polymers from one monomer. Polym Chem 2016. [DOI: 10.1039/c6py01619g] [Citation(s) in RCA: 5] [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: 01/12/2023]
Abstract
The synthesis of hybrid materials consisting of three different components from only one monomer is reported for the first time.
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Affiliation(s)
- T. Ebert
- Polymer Chemistry
- Technische Universität Chemnitz
- 09107 Chemnitz
- Germany
| | - A. Wollbrink
- Institute of Physical Chemistry and Electrochemistry
- Leibniz University Hannover
- D-30167 Hannover
- Germany
| | - A. Seifert
- Polymer Chemistry
- Technische Universität Chemnitz
- 09107 Chemnitz
- Germany
| | - R. John
- Polymer Chemistry
- Technische Universität Chemnitz
- 09107 Chemnitz
- Germany
| | - S. Spange
- Polymer Chemistry
- Technische Universität Chemnitz
- 09107 Chemnitz
- Germany
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Ben-David H, Hornung V, Ebert T, Livneh A, Ben-Zvi I. Toll like receptor 2 is overexpressed in FMF patients during attacks and inhibited by colchicine treatment. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599924 DOI: 10.1186/1546-0096-13-s1-p74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ebert T, Zolotov Y, Eliav S, Ginzburg O, Shapira I, Magnezi R. Assessment of Israeli Physicians' Knowledge, Experience and Attitudes towards Medical Cannabis: A Pilot Study. Isr Med Assoc J 2015; 17:437-441. [PMID: 26357721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Cannabis has been used throughout history for different purposes but was outlawed in the United States in 1937; many countries followed suit. Although recently reintroduced as a medical treatment in several countries, the use of cannabis in Israel is permitted for some medical purposes but is still controversial, eliciting heated public and professional debate. The few published studies on physicians' attitudes to medical cannabis found them to be generally unsupportive. OBJECTIVES To examine, for the first time, the experience, knowledge and attitudes of Israeli physicians towards medical cannabis (MC). METHODS A 32 item questionnaire reflected physicians' demographics, knowledge of and experience with MC and their attitudes to this treatment. RESULTS Seventy-two physicians participated in this study. Physicians generally agreed that MC treatment could be helpful for chronic and for terminally ill patients (n = 61, 79.2%). Oncologists and pain specialists did not agree unanimously that MC can undermine mental health, whereas other physicians did (P < 0.001, df = 4). Physicians who recommended MC in the past (once or more) agreed, more than physicians who did not, with the statement "MC treatment in Israel is accessible to patients who need it" (P < 0.05, df = 2). CONCLUSIONS In contrast to other studies we found partial acceptance of MC as a therapeutic agent. Further in-depth studies are needed to address regulatory and educational needs.
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Lammerding-Koeppel M, Ebert T, Goerlitz A, Karsten G, Nounla C, Schmidt S, Stosch C, Dieter P. German MedicalTeachingNetwork (MDN) implementing national standards for teacher training. Med Teach 2015; 38:378-84. [PMID: 26052882 DOI: 10.3109/0142159x.2015.1047752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND An increasing demand for proof of professionalism in higher education strives for quality assurance (QA) and improvement in medical education. A wide range of teacher trainings is available to medical staff in Germany. Cross-institutional approval of individual certificates is usually a difficult and time consuming task for institutions. In case of non-acceptance it may hinder medical teachers in their professional mobility. AIM The faculties of medicine aimed to develop a comprehensive national framework, to promote standards for formal faculty development programmes across institutions and to foster professionalization of medical teaching. METHODS AND RESULTS Addressing the above challenges in a joint approach, the faculties set up the national MedicalTeacherNetwork (MDN). Great importance is attributed to work out nationally concerted standards for faculty development and an agreed-upon quality control process across Germany. Medical teachers benefit from these advantages due to portability of faculty development credentials from one faculty of medicine to another within the MDN system. CONCLUSION The report outlines the process of setting up the MDN and the national faculty development programme in Germany. Success factors, strengths and limitations are discussed from an institutional, individual and general perspective. Faculties engaged in similar developments might be encouraged to transfer the MDN concept to their countries.
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Affiliation(s)
| | - T Ebert
- b Goethe University Frankfurt/Main , Germany
| | - A Goerlitz
- c Institut fuer Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universitaet Muenchen , Germany
| | | | - C Nounla
- e Technische Universitaet Braunschweig , Germany
| | - S Schmidt
- f Charité - University Medicine Berlin , Germany
| | - C Stosch
- g University of Cologne , Germany
| | - P Dieter
- h German Association of Medical Faculties , Germany
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Kralisch S, Ebert T, Wurst U, Hoffmann A, Lössner U, Kratzsch J, Blüher M, Stumvoll M, Tönjes A, Fasshauer M. Circulating betatrophin is increased in type 2 and gestational diabetes mellitus. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549800] [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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Ebert T, Schechtman M, Midbari Y, Weizman A, Shinitzky M, Spivak B. Effect of Clozapine and Other Antipsychotics on the Level of Platelet-Associated Autoantibodies in Children with Schizophrenia: A Longitudinal Follow-Up Study. Neuropsychobiology 2015; 71:120-124. [PMID: 25871884 DOI: 10.1159/000370077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/11/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have demonstrated significantly higher blood titers of platelet-associated autoantibodies (PAA) in adult schizophrenia patients compared to normal healthy subjects. In addition, young adult schizophrenia patients at their early stages of the disorder displayed higher PAA titers than older patients with longer duration of the disorder. AIM To assess longitudinally the blood titers of PAA in inpatients with childhood-onset schizophrenia at admission, after short- and long-term follow-up, and the correlation of these titers with the response to clozapine and other antipsychotic treatments. METHODS Thirty children, age range of 6-12 (mean ± SD: 9.6 ± 1.5 years), with DSM-IV TR schizophrenia in active psychotic state were assessed 3 times: at baseline, after short-term (8-17 weeks; n = 26) and after long-term follow-up (33-170 weeks; n = 19). The blood titers of PAA were analyzed using ELISA and expressed by a linear optical density (OD) scale. A test recording >1.4 OD units was predefined as the positive cutoff value. RESULTS On long-term follow-up, 9 out of the 17 children who were PAA-positive at baseline became PAA-negative: 7 already after 2 months of clozapine treatment and 2 following 3 years of risperidone treatment. Eight children remained PAA-positive during the entire study period. There was no significant correlation between the clinical improvement (as assessed by change in the Positive and Negative Syndrome Scale score) and the alteration in PAA levels (n = 19, r = -0.4, p = 0.088). CONCLUSIONS High rates of positive PAA in COS patients may indicate an active autoimmune process in early-onset schizophrenia. It is concluded that PAA may serve as a biomarker for the diagnosis of COS, but does not predict the response to treatment. A transition to a PAA-negative status does not indicate an improvement in psychosis. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Tanya Ebert
- Beer Yaakov - Ness-Ziona Mental Health Center, Ness Ziona, Israel
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Ebert T, Kralisch S, Hoffmann A, Bachmann A, Lössner U, Kratzsch J, Blüher M, Stumvoll M, Tönjes A, Fasshauer M. Circulating angiopoietin-like protein 8 is independently associated with fasting plasma glucose and type 2 diabetes mellitus. J Clin Endocrinol Metab 2014; 99:E2510-7. [PMID: 25325797 DOI: 10.1210/jc.2013-4349] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [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: 11/19/2022]
Abstract
OBJECTIVE Angiopoietin-like protein 8 (Angptl8) has recently been introduced as a novel adipokine/hepatokine that promotes pancreatic β-cell proliferation and improves glucose tolerance in mouse models of insulin resistance. However, regulation of Angptl8 in human type 2 diabetes mellitus (T2DM) and renal dysfunction has not been determined. RESEARCH DESIGN AND METHODS Serum Angptl8 levels were quantified by ELISA in 62 patients with T2DM as compared with 58 nondiabetic subjects in vivo. Within both groups, about half of the patients were on chronic hemodialysis or had an estimated glomerular filtration rate above 50 mL/min/1.73 m(2). Furthermore, we investigated the effect of insulin and differentiation on Angptl8 mRNA expression in 3T3-L1 adipocytes in vitro. RESULTS Median [interquartile range] serum Angptl8 levels were higher in patients with T2DM (1.19 [0.37] μg/L) as compared with nondiabetic subjects (1.03 [0.47] μg/L) (P = .005). Furthermore, the adipokine/hepatokine was significantly higher in women (1.21 [0.47] μg/L) as compared with men (1.05 [0.44] μg/L]) (P = .013). In multivariate analysis, fasting glucose and T2DM but not renal function remained independent and positive predictors of circulating Angptl8 even after adjustment for markers of obesity, lipid status, and inflammation (P < .05). Furthermore, Angptl8 mRNA expression was induced by insulin and during adipogenesis in 3T3-L1 adipocytes in vitro. CONCLUSIONS Circulating Angptl8 is positively and independently associated with T2DM and fasting glucose in vivo. Furthermore, Angptl8 mRNA expression is induced by insulin and during adipogenesis in 3T3-L1 adipocytes in vitro.
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Affiliation(s)
- T Ebert
- Department of Endocrinology and Nephrology (T.E., S.K., A.H., A.B., U.L., M.B., M.S., A.T., M.F.) and Institute of Laboratory Medicine (J.K.), University of Leipzig, and Integrated Research and Treatment Center Adiposity Diseases (T.E., S.K., U.L., A.T., M.F.), Leipzig University Medical Center, 04103 Leipzig, Germany
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Ebert T, Schechtman M, Ram A, Kosov I, Weizman A, Shinitzky M, Spivak B. High circulatory titer of platelet-associated autoantibodies in childhood onset schizophrenia and its diagnostic implications. Neuropsychobiology 2014; 68:124-7. [PMID: 23881299 DOI: 10.1159/000353267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/27/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND It has been suggested that the etiology of schizophrenia, in a distinct group of patients, originates from an autoimmune reaction against platelets. Previous studies have demonstrated significantly higher blood titers of platelet-associated autoantibodies (PAA) in adult schizophrenia patients as compared to normal healthy subjects. In addition, young adult schizophrenia patients at their early stages of the disorder displayed higher PAA titers than older patients with longer duration of the disorder. AIM To assess the blood titers of PAA in children with schizophrenia as compared to matched control subjects without psychotic disorders, as a possible diagnostic parameter. METHODS Twenty-nine children with DSM-IV schizophrenia in the active psychotic state, with an age range of 6-12 years (mean ± SD: 9.6 ± 1.5 years), with average Positive and Negative Syndrome Scale scores of 108 ± 19.2, were assessed. The control group consisted of 25 children with DSM-IV conduct disorder in a similar age range of 5-12 years (mean ± SD: 9.5 ± 1.6 years). The blood titers of PAA were evaluated using an optimized ELISA test, expressed by a linear optical density (OD) scale. The blood samples of all participants were tested anonymously and were scored under a code number. A test recording above 1.4 OD units was predefined as positive. RESULTS The titers of PAA of children with schizophrenia (1.9 ± 0.5 OD units, range: 0.7-2.44 units) were significantly (p < 0.00001) higher than those of the control group (1.0 ± 0.4 OD units, range: 0.45-2.28 units). In 83% of the children with schizophrenia (24 out of the 29 patients) a positive test, i.e. OD >1.4, was detected. In contrast, in the control group, only 12% (3 of the 25 subjects) displayed a positive test, p < 0.00001. CONCLUSIONS High titers of PAA in children with schizophrenia as compared with nonpsychotic controls may indicate an active autoimmune process in the early onset of schizophrenia. The PAA level may therefore provide a supportive diagnostic biomarker for childhood schizophrenia.
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Affiliation(s)
- Tanya Ebert
- Beer Yaakov - Ness-Ziona Mental Health Center, Beer Yaakov, Israel
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Schaarschmidt W, Richter J, Kley K, Kralisch S, Jank A, Ebert T, Lössner U, Jessnitzer B, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M, Stepan H. Serum levels of growth arrest specific protein 6 are increased in preeclampsia. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388029] [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] Open
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22
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Ebert T, Hopf LM, Wurst U, Bachmann A, Kralisch S, Lössner U, Platz M, Kratzsch J, Stolzenburg JU, Dietel A, Grisk O, Beige J, Anders M, Bast I, Klöting N, Blüher M, Stumvoll M, Fasshauer M. Circulating adipocyte fatty acid binding protein is increased in chronic and acute renal dysfunction. Nutr Metab Cardiovasc Dis 2014; 24:1027-1034. [PMID: 24813306 DOI: 10.1016/j.numecd.2014.03.006] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 03/14/2014] [Accepted: 03/17/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS The adipokine adipocyte fatty acid binding protein (AFABP) is positively associated with the development of the metabolic syndrome, diabetes mellitus, and cardiovascular disease. We hypothesized that AFABP also increases with deteriorating renal function. METHODS AND RESULTS Serum AFABP levels were quantified by enzyme linked immunosorbent assay in 532 patients with chronic kidney disease (CKD) covering the whole spectrum of estimated glomerular filtration rate (eGFR) categories from G1 to G5 (study population 1). Furthermore, AFABP was measured in 32 patients before and within 30 h after elective unilateral nephrectomy, a model of acute kidney dysfunction (AKD) (study population 2). Moreover, circulating AFABP was investigated in rats undergoing bilateral nephrectomy (BNE) as compared to sham-operated animals. Median serum AFABP levels adjusted for age, gender, and body mass index significantly increased with increasing eGFR category (G1: 22.0 μg/l; G2: 34.6 μg/l; G3: 56.7 μg/l; G4: 95.2 μg/l; and G5: 173.9 μg/l). Furthermore, renal dysfunction remained positively associated with AFABP in multivariate analysis in this cohort. In patients undergoing unilateral nephrectomy, AFABP increased significantly after surgery (42.1 μg/l) as compared to pre-surgical values (29.3 μg/l). Furthermore, relative changes of post-to-pre-surgical AFABP levels were independently associated with relative changes of post-to-pre-surgical creatinine concentrations. After BNE in rats, AFABP increased significantly as compared to sham-operated animals. CONCLUSIONS We show that AFABP is significantly elevated in CKD and AKD patients. Furthermore, measures of renal function are associated with circulating AFABP. Moreover, animal experiments indicate that AFABP levels strongly depend on renal function.
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Affiliation(s)
- T Ebert
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany.
| | - L M Hopf
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - U Wurst
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - A Bachmann
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - S Kralisch
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - U Lössner
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - M Platz
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - J Kratzsch
- University of Leipzig, Institute of Laboratory Medicine, 04103 Leipzig, Germany
| | - J U Stolzenburg
- University of Leipzig, Department of Urology, 04103 Leipzig, Germany
| | - A Dietel
- University of Leipzig, Department of Urology, 04103 Leipzig, Germany
| | - O Grisk
- University of Greifswald, Department of Physiology, 17495 Greifswald, Karlsburg, Germany
| | - J Beige
- Hospital St. Georg, Division of Nephrology and KfH Renal Unit, 04129 Leipzig, Germany
| | - M Anders
- Outpatient Nephrology Care Unit, 04107 and 04178 Leipzig, Germany
| | - I Bast
- Outpatient Nephrology Care Unit, 04107 and 04178 Leipzig, Germany
| | - N Klöting
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
| | - M Blüher
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - M Stumvoll
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany
| | - M Fasshauer
- University of Leipzig, Department of Endocrinology and Nephrology, 04103 Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
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Ebert T, Kralisch S, Loessner U, Jessnitzer B, Stumvoll M, Fasshauer M, Tönjes A. Relationship between serum levels of angiopoietin-related growth factor and metabolic risk factors. Horm Metab Res 2014; 46:685-90. [PMID: 25011017 DOI: 10.1055/s-0034-1382078] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 10/25/2022]
Abstract
Angiopoietin-related growth factor (AGF, also known as angiopoietin-like protein 6) has been introduced as a novel hepatocyte-derived factor, which antagonizes obesity and insulin resistance in mice. However, human studies show conflicting results and are limited to a small cohort of patients. In the current study, we therefore sought to investigate AGF serum levels in a large metabolically well-characterized cohort. AGF serum concentrations were determined by commercial enzyme-linked immunosorbent assay in 697 patients of a cohort from Eastern Germany (Sorbs). Correlations of AGF serum levels with clinical and biochemical measures of glucose and lipid metabolism, as well as markers of renal function, were investigated. In nondiabetic subjects (n=627), AGF was positively correlated with markers of insulin resistance and negatively correlated with high-density lipoprotein cholesterol in univariate analyses (p<0.05). After adjustment for age, gender, and body mass index, none of these factors remained independently associated with AGF, neither in nondiabetic subjects nor in patients with type 2 diabetes mellitus (T2DM) (n=70). However, we confirmed existing data of significantly higher AGF concentrations in patients with T2DM as compared to controls in this large cohort. Circulating AGF is elevated in subjects with T2DM and related to the type of antidiabetic treatment, but is not independently associated with anthropometric parameters, indices of insulin sensitivity and secretion, or a number of other adipokines.
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Affiliation(s)
- T Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - S Kralisch
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - U Loessner
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - B Jessnitzer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Fasshauer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - A Tönjes
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
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Hoffmann A, Kralisch S, Duhring S, Ebert T, Jeromin F, Kloting N, Bluher M, Burckhardt R, Fasshauer M. Effects of leptin on macrophages in vivo. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Ebert T, Hindricks J, Kralisch S, Lossner U, Jessnitzer B, Richter J, Blüher M, Stumvoll M, Fasshauer M. Serum levels of fractalkine are associated with markers of insulin resistance in gestational diabetes. Diabet Med 2014; 31:1014-7. [PMID: 24673545 DOI: 10.1111/dme.12451] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 10/31/2013] [Revised: 12/22/2013] [Accepted: 03/20/2014] [Indexed: 12/13/2022]
Abstract
AIMS Fractalkine has recently been introduced as an adipokine that improves glucose tolerance. Regulation of fractalkine in gestational diabetes, as well as its association with markers of obesity, glucose and lipid metabolism, inflammation and renal function, has not been elucidated. METHODS Circulating fractalkine was quantified by enzyme-linked immunosorbent assay in 74 women with gestational diabetes and 74 healthy, pregnant control subjects matched for age, BMI, and gestational age. RESULTS Median (interquartile range) levels of fractalkine were not significantly different between the two groups [gestational diabetes: 2.24 (2.16) μg/l; control: 2.45 (1.38) μg/l] (P = 0.461). In multivariate linear regression analysis, fractalkine remained independently associated with homeostasis model assessment of insulin resistance (β = -0.253, P = 0.002) and the proinflammatory adipokine progranulin (β = 0.218, P = 0.007). CONCLUSIONS Circulating fractalkine is not different between women with gestational diabetes and control subjects, but the adipokine is independently associated with markers of insulin resistance and proinflammatory progranulin in pregnancy.
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Affiliation(s)
- T Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany; IFB AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
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26
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Hoffmann A, Kralisch S, Dühring S, Ebert T, Jeromin F, Klöting N, Blüher M, Burkhard R, Fasshauer M. Effects of leptin on macrophages in vivo. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374951] [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: 10/25/2022]
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27
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Ebert T, Hopf LM, Wurst U, Bachmann A, Lößner U, Kratzsch J, Stolzenburg JU, Dietel A, Beige J, Anders M, Bast I, Blüher M, Stumvoll M, Fasshauer M, Kralisch S. Serum levels of the adipokine adipocyte fatty acid binding protein are increased in chronic and acute renal dysfunction. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375032] [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: 10/25/2022]
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28
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Stepan H, Wurst U, Ebert T, Kralisch S, Jank A, Drewlo S, Schrey S, Lössner U, Platz M, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M. The adipokine preadipocyte factor-1 is downregulated in preeclampsia and expressed in placenta. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374860] [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: 10/25/2022]
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29
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Ebert T, Midbari Y, Shmilovitz R, Kosov I, Kotler M, Weizman A, Ram A. Metabolic effects of antipsychotics in prepubertal children: a retrospective chart review. J Child Adolesc Psychopharmacol 2014; 24:218-22. [PMID: 24816004 DOI: 10.1089/cap.2013.0116] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Antipsychotics, especially atypical ones, are in common use in children and adolescents with psychotic or affective spectrum disorders, as well as in various other psychopathologies. The adverse effects of atypical antipsychotics in children and adolescents are similar to those seen in adults, and include weight gain, elevated blood glucose levels, and hyperlipidemia. In this retrospective chart review, we compared these adverse events in children who were treated with typical, atypical, or no antipsychotic treatment. METHODS The medical charts of 72 children, 65 boys and 7 girls, were reviewed. All children were 6-13 years old (mean age 9.5±1.7 years). In total, 48 children received antipsychotic treatment, and 24 children were in the control group. Data were extracted from the medical charts, including weight, height, body mass index (BMI), blood pressure, aspartate transaminase (AST), alanine transaminase (ALT), triglycerides, total cholesterol, and glucose blood levels. We examined the values in the beginning of the antipsychotic treatment and at release from the hospital in the study group, and at admission and in the end of the drug-free period or at release from the hospital (a duration of at least 4 weeks) in the control group. RESULTS The average weight gain was 3.9±3.8 kg in the atypical antipsychotic treatment (AAT) group, 1.1±4.4 kg in the typical antipsychotic treatment (TAT) group, and 0.23±2.9 kg in the control group. The average increase in BMI was 15.1±22.0 percentiles in the AAT group, 6.4±14.2 percentiles in the TAT group, and 1.6±12.5 percentiles in the control group. No statistically significant difference was found in the increase in height percentile. There were no significant differences in the rates of elevated values of serum triglycerides, cholesterol, AST, ALT, or fasting blood glucose. CONCLUSIONS We found a significant increase in both absolute weight gain and BMI percentile following atypical antipsychotic treatment. In contrast, typical antipsychotic treatment did not affect weight gain significantly, and the same was true for the control group. In addition, the rates of elevated values of biochemical parameters (AST, ALT, total cholesterol, triglycerides, and fasting blood glucose levels) were very low at the beginning of the study, and were not significantly altered by the various treatments.
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Affiliation(s)
- Tanya Ebert
- 1 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
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Platz MR, Ebert T, Kralisch S, Wurst U, Lossner U, Jessnitzer B, Blüher M, Stumvoll M, Fasshauer M. Relationship between serum levels of sclerostin and metabolic risk factors in patients with gestational diabetes mellitus. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Saisky Y, Hasid S, Ebert T, Kosov I. [Issues in psychiatric evaluation of children and adolescents with visual impairment]. Harefuah 2014; 153:109-125. [PMID: 24716430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.
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Ebert T, Roth I, Richter J, Tönjes A, Kralisch S, Lossner U, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M. Different associations of adipokines in lean and healthy adults. Horm Metab Res 2014; 46:41-7. [PMID: 24043573 DOI: 10.1055/s-0033-1353198] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 10/26/2022]
Abstract
Regulation of adipokines in lean adults without metabolic disease and without eating disorders has not been comprehensively elucidated. We hypothesized that some of the established associations of these adipocyte-secreted proteins with anthropometric and biochemical measures of glucose homeostasis, lipid metabolism, renal function, as well as inflammation, differ in healthy and low weight adults as compared to overweight/obese patients. Eighty-one subjects with a body mass-index below 22.0 kg/m2 and without malnutrition or eating disorders, as well as fifty overweight/obese patients, were recruited for the study. Serum concentrations of seven adipokines (adiponectin, leptin, adipocyte fatty acid-binding protein [AFABP], chemerin, fibroblast growth factor [FGF]-21, resistin, retinol-binding protein [RBP]-4) were measured by enzyme-linked immunosorbent assays. Lean probands had significantly higher levels of adiponectin and resistin, as well as lower levels of leptin, AFABP, and RBP-4, as compared to overweight/obese subjects. Serum concentrations of adiponectin, leptin, AFABP, chemerin, and resistin were significantly higher in lean women as compared to men (p<0.05). In lean subjects, fasting insulin independently predicted leptin and resistin concentrations. Furthermore, C-reactive protein was independently associated with circulating AFABP and chemerin. Moreover, lean body mass was an independent predictor of leptin, fat mass predicted AFABP levels, whereas RBP-4 was independently correlated to age and triglycerides. In addition, high density lipoprotein cholesterol predicted AFABP. Our results support the notion that several of these adipokines are regulated in a different manner in lean adults as compared to overweight/obese subjects and patients with eating disorders.
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Affiliation(s)
- T Ebert
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - I Roth
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - J Richter
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - A Tönjes
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - S Kralisch
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - U Lossner
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - J Kratzsch
- Institute of Laboratory Medicine, University of Leipzig, Leipzig, Germany
| | - M Blüher
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Fasshauer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
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Kralisch S, Ebert T, Lossner U, Jessnitzer B, Stumvoll M, Fasshauer M. Adipocyte fatty acid-binding protein is released from adipocytes by a non-conventional mechanism. Int J Obes (Lond) 2013; 38:1251-4. [PMID: 24445660 DOI: 10.1038/ijo.2013.232] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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] [Received: 08/01/2013] [Revised: 11/18/2013] [Accepted: 12/08/2013] [Indexed: 01/22/2023]
Abstract
Adipocyte fatty acid-binding protein (AFABP) is an adipokine, which induces insulin resistance. However, AFABP does not possess any secretion-directed signals and the mechanisms for AFABP release have not been thoroughly assessed so far. In the current study, mechanisms for AFABP secretion were elucidated in 3T3-L1 adipocytes in vitro in the presence or absence of hormonal stimulation, calcium ionophore and secretion inhibitors by cell fractionation experiments, immunoblotting and ELISAs. We demonstrate that AFABP secretion is upregulated during adipocyte differentiation. AFABP secretion is not influenced by treatment with protein secretion inhibitors that block vesicular traffic at the endoplasmic reticulum and the Golgi apparatus. AFABP is secreted partially by adipocyte-derived microvesicles (ADMs), an established mechanism for unconventional secretion from adipocytes. Both total and ADM-secreted AFABP are downregulated by insulin and upregulated by the calcium ionophore ionomycin. Furthermore, murine RAW 264.7 macrophages secrete AFABP and AFABP release from these cells is upregulated by lipopolysaccharide treatment. Taken together, these results suggest that AFABP is actively released by unconventional mechanisms and by ADMs from 3T3-L1 adipocytes. Furthermore, AFABP secretion from fat cells is regulated by insulin and intracellular calcium.
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Affiliation(s)
- S Kralisch
- 1] Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany [2] IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - T Ebert
- 1] Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany [2] IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - U Lossner
- 1] Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany [2] IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - B Jessnitzer
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Stumvoll
- Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
| | - M Fasshauer
- 1] Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany [2] IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
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Schaarschmidt W, Richter J, Kley K, Kralisch S, Jank A, Ebert T, Lössner U, Jessnitzer B, Kratzsch J, Blüher M, Stumvoll M, Fasshauer M, Stepan H. Serum levels of growth arrest specific protein 6 are increased in preeclampsia. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361248] [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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Midbari Y, Ebert T, Kosov I, Kotler M, Weizman A, Ram A. Hematological and cardiometabolic safety of clozapine in the treatment of very early onset schizophrenia: a retrospective chart review. J Child Adolesc Psychopharmacol 2013; 23:516-21. [PMID: 24111981 DOI: 10.1089/cap.2013.0050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE There are very few studies in the literature regarding clozapine use in children <13 years of age. In this retrospective chart review, we compared the safety of clozapine--as determined by hematological and cardiometabolic changes - to that of non-clozapine antipsychotics used in the treatment of childhood-onset schizophrenia (COS). METHODS The clozapine treatment group (CTG) consisted of 17 COS patients (mean age 10.4 ± 2 years) who were hospitalized in a psychiatric ward between the years 2005 and 2012. The control group consisted of 19 COS patients (mean age 10.1 ± 1.4 years) who were hospitalized in the same ward during the same time period, and were treated with non-clozapine antipsychotics. A retrospective chart review was conducted. Hematological (white blood cells, absolute neutrophil count [ANC], red blood cells, platelets), metabolic (aspartate transaminase, alanine transaminase, triglycerides, total cholesterol, bilirubin) and cardiac (heart rate) values were extracted from the medical charts. RESULTS The average follow-up periods for the CTG and the control group were 332.9 ± 200.5 days and 291.7 ± 157 days, respectively. In the CTG, moderate neutropenia (ANC<1500/mm(3)) and mild neutropenia (1500/mm(3)<ANC<2000/mm(3)) were observed in two children (12%) and one child (6%), respectively. The neutropenia was transient in all cases. Treatment with clozapine was permanently discontinued only in one child (6%). There were no cases of agranulocytosis or severe infection in the CTG. In the control group, two children (11%) showed hematological abnormalities. Hyperlipidemia was observed in one child (6%) in the CTG at release from the hospital. Significantly more children (47%) in the CTG had tachycardia (heart rate>100 beats per minute) at release from the hospital, compared with only one child (5%) in the control group (p=0.006). CONCLUSIONS It appears that clozapine use in very early onset schizophrenia is safe. Although hematological adverse effects did occur in our study, the rates were not much higher than those seen in the control group. We found that the hematological abnormalities in the CTG were mostly transient, and that treatment with clozapine can be safely continued or renewed.
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Affiliation(s)
- Yael Midbari
- 1 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
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Schrey S, Stepan H, Richter J, Hopf LM, Kralisch S, Jank A, Ebert T, Blüher M, Stumvoll M, Fasshauer M. Serum levels of adipokine fibroblast growth factor-21 are increased in preeclampsia. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347716] [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] Open
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Schaarschmidt W, Richter J, Kley K, Kralisch S, Jank A, Ebert T, Lössner U, Jessnitzer B, Kratzsch J, Blüher M, Michael S, Fasshauer M, Stepan H. Serum levels of growth arrest specific protein 6 are increased in preeclampsia. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347730] [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] Open
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38
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Richter J, Hindricks J, Hopf LM, Kley K, Kralisch S, Ebert T, Lößner U, Blüher M, Stumvoll M, Fasshauer M. Serum levels of the adipokine fibroblast growth factor-21 are increased in preeclampsia. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341704] [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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Ebert T, Hindricks J, Kralisch S, Lössner U, Jessnitzer B, Hopf L, Blüher M, Stumvoll M, Fasshauer M. Serum levels of the myokine irisin are predicted by markers of insulin resistance during pregnancy and after delivery. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341742] [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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Richter J, Ebert T, Kralisch S, Lößner U, Jeßnitzer B, Blüher M, Stumvoll M, Fasshauer M. Copeptin serum levels are decreased in gestational diabetes mellitus. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314602] [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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41
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Ebert T, Kralisch S, Lößner U, Jeßnitzer B, Stumvoll M, Fasshauer M, Tönjes A. Angiopoietin-related growth factor in the self-contained population of Sorbs. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314522] [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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42
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Selig L, Ebert T, Reiche M, Kley K, Lößner U, Kratzsch J, Blüher M, Stumvoll M, Bödeker H, Mössner J, Fasshauer M. Serum levels of the adipokine adipocyte fatty acid binding protein are decreased in chronic pancreatitis. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277546] [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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Schmitz-Dräger B, Tirsar LA, Schmitz-Dräger C, Dörsam J, Ebert T, Bismarck E. Rolle der Immunzytologie in der Abklärung von Patienten mit schmerzloser Makrohämaturie. Urologe A 2010; 49:741-6. [DOI: 10.1007/s00120-010-2248-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schmitz-Dräger BJ, Tirsar LA, Schmitz-Dräger C, Beiche B, Bismarck E, Ebert T. [Analyses of the role of immunocytology in the differential diagnosis of patients with asymptomatic microhematuria]. Urologe A 2009; 47:190-4. [PMID: 18064433 DOI: 10.1007/s00120-007-1598-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
INTRODUCTION Discriminating between malignant and nonmalignant conditions remains a challenge in the evaluation of patients with asymptomatic microhematuria. In this prospective study the role of immunocytology in the assessment microhematuria was studied. MATERIAL AND METHODS uCyt is a commercially available immunocytological assay based on microscopical detection of tumor-associated antigens in urothelial cells by immunofluorescence. Between September 2000 and December 2006, 222 consecutive patients with newly diagnosed painless microhematuria without prior transitional cell carcinoma were included. All urine samples were examined cytologically and immunocytologically. A total of 211 samples (95%) were assessable. RESULTS Clinical examination by physical examination, cystoscopy, laboratory tests, and imaging yielded bladder cancer in ten cases (4%). Further diagnoses were BPH (27%), cystitis (including IC) (12%), urolithiasis (9%), urethral or ureteral strictures (6%), papilloma (2%), and"further conditions" (16%). In 52 patients (23%) reasons for hematuria were not identified. Immunocytology was positive in 8 of 10 bladder tumors (80%) and negative in 178 patients with non-tumor-related hematuria (89%). CONCLUSIONS The high sensitivity and good specificity of immunocytology is comparable with that reported in the literature despite a very low disease prevalence in this population. If assessment of these patients would have only been based on immunocytology, 180 costly and invasive diagnostic procedures would have been saved, with only 29 individuals (14%) undergoing these examinations unnecessarily. The authors conclude that these findings justify further investigation of this issue.
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Ebert T, Stein S, Stepan H, Kratzsch J, Verlohren M, Verlohren HJ, Drynda K, Lössner U, Blüher M, Stumvoll M, Fasshauer M. Serum FGF21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Reisenbüchler C, Ebert T, Schrey S, Fasshauer M, Stepan H. Signifikant erhöhte „angiopoietin related growth factor“-Konzentrationen bei Präeklampsie. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1216307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reisenbüchler C, Ebert T, Schrey S, Fasshauer M, Stepan H. RBP4-Serumkonzentrationen bei Präeklampsie. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1216306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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48
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Schmitz-Dräger B, Rohde D, Peschkes C, Ebert T, Ackermann R. Monoklonale Antikörper gegen Harnblasenkarzinome-ein Beitrag zur Verbesserung der Diagnostik? Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1061365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schmitz-Dräger B, Strich W, Gerke R, Decken K, Ebert T. Filterimmunzytologie (FLIC) - Klinische Ergebnisse und Entwicklung einer neuartigen FLIC-Technik. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1057871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Schmitz-Dräger BJ, Tirsar LA, Schmitz-Dräger C, Dörsam J, Mellan Z, Bismarck E, Ebert T. Immunocytology in the assessment of patients with asymptomatic hematuria. World J Urol 2007; 26:31-7. [PMID: 18075743 DOI: 10.1007/s00345-007-0228-x] [Citation(s) in RCA: 19] [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: 10/09/2007] [Accepted: 11/11/2007] [Indexed: 10/22/2022] Open
Abstract
Painless hematuria has remained a diagnostic challenge in daily urological practice. Key problem in the assessment of these patients is the discrimination between malignant and non-malignant conditions. In this prospective study the role of immunocytology in the evaluation of patients with hematuria was investigated. Ucyt is a commercially available immunocytological assay based upon microscopical detection of tumor-associated antigens on the membrane of urothelial cells by immunofluorescence. Between October 2000 and July 2007, 301 consecutive patients with a first episode of painless hematuria without prior transitional cell carcinoma were included. Urine samples were obtained from all patients and examined cytologically and immunocytologically. Clinical assessment by physical examination, laboratory tests, endoscopy and imaging in 228 cases with microhematuria and 66 cases with gross hematuria yielded bladder cancer in 10 (4.6%) and 17 (27%) patients, respectively. Clinical workup demonstrated that composition of both groups was entirely different. Sensitivity of cystoscopy and immunocytology was similar in both groups. Furthermore, a negative finding in cystoscopy and immunocytology virtually excluded the presence of urothelial cancer. However, while predictive values of immunocytology were clearly superior to cytology in gross hematuria, cytology performed better in the microhematuria cohort. Combination of cystoscopy and immunocytology yield 100% sensitivity in the assessment of patients with painless hematuria. Based upon performance characteristics the authors recommend to replace urine cytology by a more sensitive marker like immunocytology in gross hematuria. In patients with microhematuria immunocytology could be used to select for patients at risk for urothelial cancer and thus spare negative patients from further examinations.
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