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Rühling S, Dittmann J, Müller T, Husseini ME, Bodden J, Hernandez Petzsche MR, Löffler MT, Sollmann N, Baum T, Seifert-Klauss V, Wostrack M, Zimmer C, Kirschke JS. Sex differences and age-related changes in vertebral body volume and volumetric bone mineral density at the thoracolumbar spine using opportunistic QCT. Front Endocrinol (Lausanne) 2024; 15:1352048. [PMID: 38440788 PMCID: PMC10911120 DOI: 10.3389/fendo.2024.1352048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/22/2024] [Indexed: 03/06/2024] Open
Abstract
Objectives To quantitatively investigate the age- and sex-related longitudinal changes in trabecular volumetric bone mineral density (vBMD) and vertebral body volume at the thoracolumbar spine in adults. Methods We retrospectively included 168 adults (mean age 58.7 ± 9.8 years, 51 women) who received ≥7 MDCT scans over a period of ≥6.5 years (mean follow-up 9.0 ± 2.1 years) for clinical reasons. Level-wise vBMD and vertebral body volume were extracted from 22720 thoracolumbar vertebrae using a convolutional neural network (CNN)-based framework with asynchronous calibration and correction of the contrast media phase. Human readers conducted semiquantitative assessment of fracture status and bony degenerations. Results In the 40-60 years age group, women had a significantly higher trabecular vBMD than men at all thoracolumbar levels (p<0.05 to p<0.001). Conversely, men, on average, had larger vertebrae with lower vBMD. This sex difference in vBMD did not persist in the 60-80 years age group. While the lumbar (T12-L5) vBMD slopes in women only showed a non-significant trend of accelerated decline with age, vertebrae T1-11 displayed a distinct pattern, with women demonstrating a significantly accelerated decline compared to men (p<0.01 to p<0.0001). Between baseline and last follow-up examinations, the vertebral body volume slightly increased in women (T1-12: 1.1 ± 1.0 cm3; L1-5: 1.0 ± 1.4 cm3) and men (T1-12: 1.2 ± 1.3 cm3; L1-5: 1.5 ± 1.6 cm3). After excluding vertebrae with bony degenerations, the residual increase was only small in women (T1-12: 0.6 ± 0.6 cm3; L1-5: 0.7 ± 0.7 cm3) and men (T1-12: 0.7 ± 0.6 cm3; L1-5: 1.2 ± 0.8 cm3). In non-degenerated vertebrae, the mean change in volume was <5% of the respective vertebral body volumes. Conclusion Sex differences in thoracolumbar vBMD were apparent before menopause, and disappeared after menopause, likely attributable to an accelerated and more profound vBMD decline in women at the thoracic spine. In patients without advanced spine degeneration, the overall volumetric changes in the vertebral body appeared subtle.
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Affiliation(s)
- Sebastian Rühling
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jonas Dittmann
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Tobias Müller
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Malek El Husseini
- Department of Informatics, TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Moritz R Hernandez Petzsche
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian T Löffler
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Vanadin Seifert-Klauss
- Department of Gynaecology, Interdisciplinary Osteoporosis Center, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Maria Wostrack
- Department of Neurosurgery, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Gompel A, Seifert-Klauss V, Simon JA, Prior JC. Lack of evidence that progesterone in ovulatory cycles causes breast cancer. Climacteric 2023; 26:634-637. [PMID: 37671636 DOI: 10.1080/13697137.2023.2249813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/12/2023] [Indexed: 09/07/2023]
Abstract
A recent Perspective article asserted that progesterone secretion during ovulatory cycles is the cause of breast cancer. However, we challenge most of the evidence developed in this publication. First, there is a lack of evidence that progesterone is mutagenic for breast cells. Cause of a cancer should mean initiation by mutation, as opposed to promotion. Second, subclinical ovulatory disturbances occur rather frequently in normal-length menstrual cycles. Third, the authors attribute a potential carcinogenic effect to progesterone secreted during menstrual cycles but not to progesterone during pregnancy. They did not discuss breast cancer evidence from progesterone/progestin therapeutics. They argue that in genetic primary amenorrhea, a hypothetic lower risk of breast cancer could be due to the lack of progesterone, despite the progesterone/progestin in hormone replacements these women receive. Fourth, they advocate a regulatory effect of progesterone on several genes potentially involved in cancer genesis. In particular, they attribute a lower risk of breast cancer in women with Mayer-Rokitansky-Küster-Hauser syndrome to a defect in the progesterone-stimulated Wnt4 gene. However, this defect is only present in a small subset. Thus, the postulated progesterone breast cancer risk is unconvincing, which we discuss point by point in this commentary.
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Affiliation(s)
- A Gompel
- Gynecology-Endocrinology, Paris-Cité University, Paris, France
| | | | - J A Simon
- IntimMedicine Specialists, George Washington University, Washington, DC, USA
| | - J C Prior
- Endocrinology & Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, BC, Canada
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Xanthopoulos A, Samt AK, Guder C, Taylor N, Roberts E, Herf H, Messner V, Trill A, Holzmann KLK, Kiechle M, Seifert-Klauss V, Zschaeck S, Schatka I, Tauber R, Schmidt R, Enste K, Pockley AG, Lobinger D, Multhoff G. Hsp70-A Universal Biomarker for Predicting Therapeutic Failure in Human Female Cancers and a Target for CTC Isolation in Advanced Cancers. Biomedicines 2023; 11:2276. [PMID: 37626772 PMCID: PMC10452093 DOI: 10.3390/biomedicines11082276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Heat shock protein 70 (Hsp70) is frequently overexpressed in many different tumor types. However, Hsp70 has also been shown to be selectively presented on the plasma membrane of tumor cells, but not normal cells, and this membrane form of Hsp70 (mHsp70) could be considered a universal tumor biomarker. Since viable, mHsp70-positive tumor cells actively release Hsp70 in lipid micro-vesicles, we investigated the utility of Hsp70 in circulation as a universal tumor biomarker and its potential as an early predictive marker of therapeutic failure. We have also evaluated mHsp70 as a target for the isolation and enumeration of circulating tumor cells (CTCs) in patients with different tumor entities. Circulating vesicular Hsp70 levels were measured in the peripheral blood of tumor patients with the compHsp70 ELISA. CTCs were isolated using cmHsp70.1 and EpCAM monoclonal antibody (mAb)-based bead approaches and characterized by immunohistochemistry using cytokeratin and CD45-specific antibodies. In two out of 35 patients exhibiting therapeutic failure two years after initial diagnosis of non-metastatic breast cancer, progressively increasing levels of circulating Hsp70 had already been observed during therapy, whereas levels in patients without subsequent recurrence remained unaltered. With regards to CTC isolation from patients with different tumors, an Hsp70 mAb-based selection system appears superior to an EpCAM mAb-based approach. Extracellular and mHsp70 can therefore serve as a predictive biomarker for therapeutic failure in early-stage tumors and as a target for the isolation of CTCs in various tumor diseases.
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Affiliation(s)
- Alexia Xanthopoulos
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Ann-Kathrin Samt
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Christiane Guder
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Nicholas Taylor
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Erika Roberts
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Hannah Herf
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Verena Messner
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Anskar Trill
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Katharina Larissa Kreszentia Holzmann
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
| | - Marion Kiechle
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.K.); (V.S.-K.)
| | - Vanadin Seifert-Klauss
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.K.); (V.S.-K.)
| | - Sebastian Zschaeck
- Department of Radiation Oncology and Radiotherapy, Charité Berlin, 10117 Berlin, Germany;
| | - Imke Schatka
- Department of Nuclear Medicine, Charité Berlin, 10117 Berlin, Germany;
| | - Robert Tauber
- Department of Urology, Klinkum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany;
| | - Robert Schmidt
- Krankenhaus für Naturheilweisen, 81545 Munich, Germany; (R.S.); (K.E.)
| | - Katrin Enste
- Krankenhaus für Naturheilweisen, 81545 Munich, Germany; (R.S.); (K.E.)
| | - Alan Graham Pockley
- John van Geest Cancer Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK;
| | - Dominik Lobinger
- Department of Thoracic Surgery, München Klinik Bogenhausen, Lehrkrankenhaus der TU München, 81925 Munich, Germany;
| | - Gabriele Multhoff
- Center for Translational Cancer Research TU München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (A.X.); (A.-K.S.); (C.G.); (N.T.); (E.R.); (H.H.); (V.M.); (A.T.)
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany
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Berger R, Abele H, Bahlmann F, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Hayward A, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Kunze M, Kuon RJ, Kyvernitakis I, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nothacker M, Olbertz D, Ramsell A, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Stubert J, Surbek D. Correction: Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, September 2022) - Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and on the Management of Preterm Premature Rupture of Membranes. Geburtshilfe Frauenheilkd 2023; 83:1043. [PMID: 37588258 PMCID: PMC10427200 DOI: 10.1055/a-2114-0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
[This corrects the article DOI: 10.1055/a-2044-0345.].
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Graz, Graz, Austria
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | - Susanne Grylka-Baeschlin
- Zürcher Hochschule für angewandte Wissenschaften, Institut für Hebammenwissenschaft und reproduktive Gesundheit, Zürich, Switzerland
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Ruben-J. Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, München, Germany
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin
| | - Dirk Olbertz
- Klinik für Neonatologie, Klinikum Südstadt Rostock, Rostock, Germany
| | | | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
| | | | | | - Daniel Surbek
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Universität Bern, Bern, Switzerland
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Berger R, Abele H, Bahlmann F, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Hayward A, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Kunze M, Kuon RJ, Kyvernitakis I, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nothacker M, Olbertz D, Ramsell A, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Stubert J, Surbek D. Correction: Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/025, September 2022) - Part 1 with Recommendations on the Epidemiology, Etiology, Prediction, Primary and Secondary Prevention of Preterm Birth. Geburtshilfe Frauenheilkd 2023; 83:1043. [PMID: 37588254 PMCID: PMC10427203 DOI: 10.1055/a-2114-0548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
[This corrects the article DOI: 10.1055/a-2044-0203.].
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Graz, Graz, Austria
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | - Susanne Grylka-Baeschlin
- Zürcher Hochschule für angewandte Wissenschaften, Institut für Hebammenwissenschaft und reproduktive Gesundheit, Zürich, Switzerland
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Ruben-J. Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, München, Germany
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin, Germany
| | - Dirk Olbertz
- Klinik für Neonatologie, Klinikum Südstadt Rostock, Rostock, Germany
| | | | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
| | | | | | - Daniel Surbek
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Universität Bern, Bern, Switzerland
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Rühling S, Schwarting J, Froelich MF, Löffler MT, Bodden J, Hernandez Petzsche MR, Baum T, Wostrack M, Aftahy AK, Seifert-Klauss V, Sollmann N, Zimmer C, Kirschke JS, Tollens F. Cost-effectiveness of opportunistic QCT-based osteoporosis screening for the prediction of incident vertebral fractures. Front Endocrinol (Lausanne) 2023; 14:1222041. [PMID: 37576975 PMCID: PMC10422975 DOI: 10.3389/fendo.2023.1222041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Objectives Opportunistic quantitative computed tomography (oQCT) derived from non-dedicated routine CT has demonstrated high accuracy in diagnosing osteoporosis and predicting incident vertebral fractures (VFs). We aimed to investigate the cost-effectiveness of oQCT screening compared to dual-energy X-ray absorptiometry (DXA) as the standard of care for osteoporosis screening. Methods Three screening strategies ("no osteoporosis screening", "oQCT screening", and "DXA screening") after routine CT were simulated in a state-transition model for hypothetical cohorts of 1,000 patients (women and men aged 65 years) over a follow-up period of 5 years (base case). The primary outcomes were the cumulative costs and the quality-adjusted life years (QALYs) estimated from a U.S. health care perspective for the year 2022. Cost-effectiveness was assessed based on a willingness-to-pay (WTP) threshold of $70,249 per QALY. The secondary outcome was the number of prevented VFs. Deterministic and probabilistic sensitivity analyses were conducted to test the models' robustness. Results Compared to DXA screening, oQCT screening increased QALYs in both sexes (additional 2.40 per 1,000 women and 1.44 per 1,000 men) and resulted in total costs of $3,199,016 and $950,359 vs. $3,262,934 and $933,077 for women and men, respectively. As a secondary outcome, oQCT screening prevented 2.6 and 2.0 additional VFs per 1,000 women and men, respectively. In the probabilistic sensitivity analysis, oQCT screening remained cost-effective in 88.3% (women) and 90.0% (men) of iterations. Conclusion oQCT screening is a cost-effective ancillary approach for osteoporosis screening and has the potential to prevent a substantial number of VFs if considered in daily clinical practice.
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Affiliation(s)
- Sebastian Rühling
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Mannheim, Germany
| | - Maximilian T. Löffler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Moritz R. Hernandez Petzsche
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maria Wostrack
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - A. Kaywan Aftahy
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Vanadin Seifert-Klauss
- Department of Gynecology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Fabian Tollens
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Mannheim, Germany
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Berger R, Abele H, Bahlmann F, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Hayward A, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Kunze M, Kuon RH, Kyvernitakis I, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nothacker M, Olbertz D, Ramsell A, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Stubert J, Surbek D. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, September 2022) - Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and on the Management of Preterm Premature Rupture of Membranes. Geburtshilfe Frauenheilkd 2023; 83:569-601. [PMID: 37169014 PMCID: PMC10166648 DOI: 10.1055/a-2044-0345] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/22/2023] [Indexed: 05/13/2023] Open
Abstract
Aim The revision of this guideline was coordinated by the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (OEGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of the guideline is to improve the prediction, prevention and management of preterm birth based on evidence from the current literature, the experience of members of the guidelines commission, and the viewpoint of self-help organizations. Methods The members of the contributing professional societies and organizations developed recommendations and statements based on international literature. The recommendations and statements were presented and adopted using a formal process (structured consensus conferences with neutral moderation, written Delphi vote). Recommendations Part 2 of this short version of the guideline presents statements and recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Graz, Graz, Austria
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | - Susanne Grylka-Baeschlin
- Zürcher Hochschule für angewandte Wissenschaften, Institut für Hebammenwissenschaft und reproduktive Gesundheit, Zürich, Switzerland
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Ruben-H. Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, München, Germany
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin
| | - Dirk Olbertz
- Klinik für Neonatologie, Klinikum Südstadt Rostock, Rostock, Germany
| | | | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
| | | | | | - Daniel Surbek
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Universität Bern, Bern, Switzerland
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Berger R, Abele H, Bahlmann F, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Hayward A, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Kunze M, Kuon RJ, Kyvernitakis I, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nothacker M, Olbertz D, Ramsell A, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Stubert J, Surbek D. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/025, September 2022) - Part 1 with Recommendations on the Epidemiology, Etiology, Prediction, Primary and Secondary Prevention of Preterm Birth. Geburtshilfe Frauenheilkd 2023; 83:547-568. [PMID: 37152544 PMCID: PMC10159718 DOI: 10.1055/a-2044-0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/22/2023] [Indexed: 05/09/2023] Open
Abstract
Aim This revised guideline was coordinated by the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (OEGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). It aims to improve the prediction, prevention, and management of preterm birth, based on evidence from the current literature, the experience of members of the guidelines commission, and the viewpoint of self-help organizations. Methods The members of the contributing professional societies and organizations developed recommendations and statements based on international literature. The recommendations and statements were presented and adopted using a formal process (structured consensus conferences with neutral moderation, written Delphi vote). Recommendations Part 1 of this short version of the guideline presents statements and recommendations on the epidemiology, etiology, prediction, and primary and secondary prevention of preterm birth.
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Graz, Graz, Austria
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | - Susanne Grylka-Baeschlin
- Zürcher Hochschule für angewandte Wissenschaften, Institut für Hebammenwissenschaft und reproduktive Gesundheit, Zürich, Switzerland
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | - Mirjam Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Ruben-J. Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, München, Germany
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin, Germany
| | - Dirk Olbertz
- Klinik für Neonatologie, Klinikum Südstadt Rostock, Rostock, Germany
| | | | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
| | | | | | - Daniel Surbek
- Universitätsklinik für Frauenheilkunde, Inselspital Bern, Universität Bern, Bern, Switzerland
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Seifert-Klauss V. Phytotherapie bei klimakterischen Beschwerden. Gynäkologische Endokrinologie 2022. [DOI: 10.1007/s10304-022-00468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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10
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Barbi L, Martinez-Hurtado J, Schmidmayr M, Seifert-Klauss V. P-637 Evaluation of a digitally integrated ovulation prediction kit with proof of ovulation – a pilot study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is a digital ovulation prediction kit (OPK) with integrated progesterone measurements a useful tool in predicting and proving ovulation?
Summary answer
The digitally integrated OPK with progesterone integration may be a helpful tool for couples to identify the woman’s fertile window and detect anovulation.
What is known already
Apart from detecting the coming fertile window (i.e. the period of the highest probability of conception during the menstrual cycle, including the 5 days previous to and the day of ovulation itself), knowledge whether the likely ovulation indeed occurs, is crucial for achieving pregnancy. As women’s hormone profiles show intra- and interindividual variations, an individual prediction of the fertile window is a promising approach for couples, particularly in early premature ovarian insufficiency and perimenopause. Information whether the presumed ovulation has actually happened is not provided by most cycle apps.
Study design, size, duration
Healthy women, aged 21 to 44 years, who had not been taking hormonal contraceptives for at least three months were recruited via social media, paper postings and hand-outs. Women with infertility for more than 24 months were excluded. Up to three cycles were measured in every woman in case of a lacking pregnancy.
Participants/materials, setting, methods
Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) in first morning urine were gaged via lateral flow immunoassay test strips (LFIA) (RunBio Biotechnology Ltd.). Three algorithms of the smartphone application Pearl Fertility (iOS 1.0.3-1.0.5, Colorimetrix GmbH) were applied to predict the day of ovulation. Photographic visual control of the LH test strips, vaginal ultrasound close to the predicted ovulation and progesterone (PdG LFIA) were used to confirm ovulation, human chorionic gonadotropin (HCG LIFA) to confirm pregnancy.
Main results and the role of chance
36 cycles of 19 women recruited for this pilot study were started. 6 participants dropped out or were excluded, leaving 25 evaluable cycles in 13 healthy women, average age 37 years (range 30 to 44), who had not been taking hormonal contraceptives for at least three months. 76 % of the analysable cycles had corresponding prediction of ovulation by algorithm and by visual control of the measured maximum value of LH (OVV). OVV corresponded with the day of ovulation determined retrospectively by length of luteal phase in 75 % (Bland-Altman plot (acceptable deviation Δ≤|2| days)). Prediction of ovulation differed by 2.12±3.13 days (mean±SD) between OVV and prospective cycle-length-based data (Wilcoxon signed-rank test (p < 0,05)). The PdG LIFA suggested ovulation in 84 % of the cycles with presumed ovulation by postovulatory PdG measurement. 6 of the participating women got pregnant during the study. Analysis of cumulative rate of pregnancy with 95 % confidence interval resulted in 25±21 %, 40±19 % and 40±17 % within the first, second and third cycle.
Limitations, reasons for caution
In order to make valid statements about the benefit of digitally integrated OPKs, further research with a larger population is needed. Perimenopausal women and patients with irregular cycles may specifically benefit from individual self-monitoring.
Wider implications of the findings
The knowledge of the fertile window is expected to help fertile couples to achieve pregnancy and proof of ovulation or anovulation may detect infertility due to anovulation sooner, thereby reducing the interval until diagnosis and treatment.
Trial registration number
'not applicable'
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Affiliation(s)
- L Barbi
- Technical University Munich, Klinik und Poliklinik für Frauenheilkunde , Munich, Germany
| | | | - M Schmidmayr
- Technical University Munich, Klinik und Poliklinik für Frauenheilkunde , Munich, Germany
| | - V Seifert-Klauss
- Technical University Munich, Klinik und Poliklinik für Frauenheilkunde , Munich, Germany
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11
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Schäfer-Graf U, Seifert-Klauss V. Typ-1-Diabetes – besondere Herausforderungen für Frauen. Diabetologe 2022. [DOI: 10.1007/s11428-022-00857-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Wallwiener LM, Kapfer B, Seifert-Klauss V. Knochengesundheit und Hochleistungssport. Gynäkologische Endokrinologie 2021. [DOI: 10.1007/s10304-021-00400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ZusammenfassungRegelmäßige körperliche Betätigung trägt zu einer gesunden Knochendichte bei, Leistungssportlerinnen in einigen Sportarten weisen jedoch eine erhöhte Prävalenz erniedrigter Knochendichte sowie vermehrt Stressfrakturen auf. Häufig liegt dem ein relatives Energiedefizit (RED), verbunden mit hoher mechanischer Belastung und intensivem Trainingsalltag, zugrunde. Das Vorliegen eines RED im Sport ist oft unterdiagnostiziert, daher hat sich eine systematische multidisziplinäre Zusammenarbeit unter Zuhilfenahme standardisierter Tests, z. B. des RED‑S CAT (Relative Energy Deficiency in Sport Clinical Assessment Tool) als hilfreich erwiesen. Therapieansätze zielen primär auf eine Behebung der negativen Energiebilanz der Patientin als auch auf psychotherapeutische Interventionen ab. Darüber hinaus kann in schweren Fällen eine medikamentöse Therapie zur Unterstützung sowohl einer ausgeglichenen hormonellen Situation als auch des Knochenstoffwechsels notwendig sein.
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13
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Tropschuh K, Dinkel A, Seifert-Klauss V, Schmidmayr M. Chronischer Unterbauchschmerz, Stimmung und Prostaglandin-E2-Level in der Douglas-Flüssigkeit bei Patientinnen mit und ohne Endometriose. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Tropschuh
- Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Frauenheilkunde
| | - A Dinkel
- Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Psychosomatik und Psychotherapie
| | - V Seifert-Klauss
- Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Frauenheilkunde
| | - M Schmidmayr
- Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Frauenheilkunde
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14
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Tropschuh K, Dinkel A, Seifert-Klauss V, Schmidmayr M. Chronischer Unterbauchschmerz, Stimmung und Prostaglandin-E2-Level in der Douglas-Flüssigkeit bei Patientinnen mit und ohne Endometriose. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Tropschuh
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München
| | - A Dinkel
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München
| | - V Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München
| | - M Schmidmayr
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München
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15
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Leonhardt Y, May P, Gordijenko O, Koeppen-Ursic VA, Brandhorst H, Zimmer C, Makowski MR, Baum T, Kirschke JS, Gersing AS, Seifert-Klauss V, Schwaiger BJ. Opportunistic QCT Bone Mineral Density Measurements Predicting Osteoporotic Fractures: A Use Case in a Prospective Clinical Cohort. Front Endocrinol (Lausanne) 2020; 11:586352. [PMID: 33240220 PMCID: PMC7680958 DOI: 10.3389/fendo.2020.586352] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/14/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To assess whether volumetric vertebral bone mineral density (BMD) measured with opportunistic quantitative computed tomography (QCT) (i.e., CT acquired for other reasons) can predict osteoporotic fracture occurrence in a prospective clinical cohort and how this performs in comparison to dual-energy X-ray absorptiometry (DXA) measurements. METHODS In the database of our fracture liaison service, 58 patients (73 ± 11 years, 72% women) were identified that had at least one prevalent low-energy fracture and had undergone CT of the spine. BMD was determined by converting HU using scanner-specific conversion equations. Baseline DXA was available for 31 patients. During a 3-year follow-up, new fractures were diagnosed either by (i) recent in-house imaging or (ii) clinical follow-up with validated external reports. Associations were assessed using logistic regression models, and cut-off values were determined with ROC/Youden analyses. RESULTS Within 3 years, 20 of 58 patients presented new low-energy fractures (34%). Mean QCT BMD of patients with fractures was significantly lower (56 ± 20 vs. 91 ± 38 mg/cm3; p = 0.003) and age was higher (77 ± 10 vs. 71 ± 11 years; p = 0.037). QCT BMD was significantly associated with the occurrence of new fractures, and the OR for developing a new fracture during follow-up was 1.034 (95% CI, 1.010-1.058, p = 0.005), suggesting 3% higher odds for every unit of BMD decrease (1 mg/cm3). Age and sex showed no association. For the differentiation between patients with and without new fractures, ROC showed an AUC of 0.76 and a Youden's Index of J = 0.48, suggesting an optimal cut-off value of 82 mg/cm3. DXA T-scores showed no significant association with fracture occurrence in analogous regression models. CONCLUSION In this use case, opportunistic BMD measurements attained through QCT predicted fractures during a 3-year follow-up. This suggests that opportunistic measurements are useful to reduce the diagnostic gap and evaluate the fracture risk in osteoporotic patients.
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Affiliation(s)
- Yannik Leonhardt
- Department of Radiology, School of Medicine, Technical University of Munich, Munich, Germany
- *Correspondence: Yannik Leonhardt,
| | - Pauline May
- Interdisciplinary Osteoporosis Center, Department of Gynaecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Olga Gordijenko
- Department of Trauma Surgery, School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika A. Koeppen-Ursic
- Department of Orthopedics and Trauma Surgery, Klinikum Freising, Technical University of Munich, Freising, Germany
| | - Henrike Brandhorst
- Interdisciplinary Osteoporosis Center, Department of Gynaecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R. Makowski
- Department of Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S. Gersing
- Department of Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Vanadin Seifert-Klauss
- Interdisciplinary Osteoporosis Center, Department of Gynaecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Benedikt J. Schwaiger
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
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16
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Toth B, Baston-Büst DM, Behre HM, Bielfeld A, Bohlmann M, Bühling K, Dittrich R, Goeckenjan M, Hancke K, Kliesch S, Köhn FM, Krüssel J, Kuon R, Liebenthron J, Nawroth F, Nordhoff V, Pinggera GM, Rogenhofer N, Rudnik-Schöneborn S, Schuppe HC, Schüring A, Seifert-Klauss V, Strowitzki T, Tüttelmann F, Vomstein K, Wildt L, Wischmann T, Wunder D, Zschocke J. Diagnosis and Therapy Before Assisted Reproductive Treatments. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Register Number 015-085, February 2019) - Part 1, Basic Assessment of the Woman. Geburtshilfe Frauenheilkd 2019; 79:1278-1292. [PMID: 31875858 DOI: 10.1055/a-1017-3389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German/Austrian/Swiss interdisciplinary S2k guideline on "Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)" was published in February 2019. This guideline was developed in the context of the guidelines program of the German Society of Gynecology and Obstetrics (DGGG) in cooperation with the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). Aims One third of the causes of involuntary childlessness are still unclear, even if the woman or man have numerous possible risk factors. Because the topic is still very much taboo, couples may be socially isolated and often only present quite late to a fertility center. At present, there is no standard treatment concept, as currently no standard multidisciplinary procedures exist for the diagnostic workup and treatment of infertility. The aim of this guideline is to provide physicians with evidence-based recommendations for counselling, diagnostic workup and treatment. Methods This S2k guideline was developed on behalf of the Guidelines Commission of the DGGG by representative members from different professional medical organizations and societies using a structured consensus process. Recommendations The first part of this guideline focuses on the basic assessment of affected women, including standard anatomical and endocrinological diagnostic procedures and examinations into any potential infections. Other areas addressed in this guideline are the immunological workup with an evaluation of the patient's vaccination status, an evaluation of psychological factors, and the collection of data relating to other relevant factors affecting infertility. The second part will focus on explanations of diagnostic procedures compiled in collaboration with specialists from other medical specialties such as andrologists, human geneticists and oncologists.
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Affiliation(s)
- Bettina Toth
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | | | - Hermann M Behre
- Zentrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Halle (Saale), Halle (Saale), Germany
| | | | - Michael Bohlmann
- Zentrum für Gynäkologie und Geburtshilfe, St. Elisabethen-Krankenhaus Lörrach, Lörrach, Germany
| | - Kai Bühling
- Abteilung für gynäkologische Endokrinologie, Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Dittrich
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Katharina Hancke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm, Ulm, Germany
| | - Sabine Kliesch
- Centrum für Reproduktionsmedizin und Andrologie, Abteilung für Klinische und Operative Andrologie, Universitätsklinik Münster, Münster, Germany
| | | | - Jan Krüssel
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ruben Kuon
- Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jana Liebenthron
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Verena Nordhoff
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinik Münster, Münster, Germany
| | | | - Nina Rogenhofer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Ludwig-Maximilians-Universität München, München, Germany
| | | | - Hans-Christian Schuppe
- Klinik und Poliklinik für Urologie, pädiatrische Urologie und Andrologie, Universitätsklinikum Gießen und Marburg GmbH - Standort Gießen, Gießen, Germany
| | - Andreas Schüring
- UKM Kinderwunschzentrum, Universitätsklinikum Münster, Münster, Germany
| | - Vanadin Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München, München, Germany
| | - Thomas Strowitzki
- Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Frank Tüttelmann
- Institut für Humangenetik, Universitätsklinikum Münster, Münster, Germany
| | - Kilian Vomstein
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | - Ludwig Wildt
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | - Tewes Wischmann
- Institut für medizinische Psychologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Dorothea Wunder
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinik Lausanne, Lausanne, Switzerland
| | - Johannes Zschocke
- Sektion für Humangenetik, Medizinische Universität Innsbruck, Innsbruck, Austria
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Toth B, Baston-Büst DM, Behre HM, Bielfeld A, Bohlmann M, Bühling K, Dittrich R, Goeckenjan M, Hancke K, Kliesch S, Köhn FM, Krüssel J, Kuon R, Liebenthron J, Nawroth F, Nordhoff V, Pinggera GM, Rogenhofer N, Rudnik-Schöneborn S, Schuppe HC, Schüring A, Seifert-Klauss V, Strowitzki T, Tüttelmann F, Vomstein K, Wildt L, Wischmann T, Wunder D, Zschocke J. Diagnosis and Treatment Before Assisted Reproductive Treatments. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Register Number 015-085, February 2019) - Part 2, Hemostaseology, Andrology, Genetics and History of Malignant Disease. Geburtshilfe Frauenheilkd 2019; 79:1293-1308. [PMID: 31875859 DOI: 10.1055/a-1017-3478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German-language interdisciplinary S2k guideline on "Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)" was published in February 2019. The guideline was developed in the context of the guidelines program of the German Society of Gynecology and Obstetrics (DGGG) in cooperation with the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). Aim In one third of cases, the cause of involuntary childlessness remains unclear, even if the woman or man have numerous possible risk factors. Because the topic is still very much taboo, couples may be socially isolated and often only present quite late to a fertility center. There is no standard treatment concept for these patients at present, as there are currently no standard multidisciplinary procedures for the diagnostic workup and treatment of infertility. The aim of this guideline is to provide physicians with evidence-based recommendations for counselling, diagnosis and treatment. Methods This S2k guideline was developed on behalf of the Guidelines Commission of the DGGG by representative members from different professional medical organizations and societies using a structured consensus process. Recommendations This second part of the guideline describes the hematological workup for women as well as additional diagnostic procedures which can be used to investigate couples and which are carried out in cooperation with physicians working in other medical fields such as andrologists, geneticists and oncologists.
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Affiliation(s)
- Bettina Toth
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | | | - Hermann M Behre
- Zentrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Halle (Saale), Halle (Saale), Germany
| | | | - Michael Bohlmann
- Zentrum für Gynäkologie und Geburtshilfe, St. Elisabethen-Krankenhaus Lörrach, Lörrach, Germany
| | - Kai Bühling
- Abteilung für gynäkologische Endokrinologie, Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Dittrich
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Katharina Hancke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm, Ulm, Germany
| | - Sabine Kliesch
- Centrum für Reproduktionsmedizin und Andrologie, Abteilung für Klinische und Operative Andrologie, Universitätsklinik Münster, Münster, Germany
| | | | - Jan Krüssel
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ruben Kuon
- Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jana Liebenthron
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Verena Nordhoff
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinik Münster, Münster, Germany
| | | | - Nina Rogenhofer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Ludwig-Maximilians-Universität München, München, Germany
| | | | - Hans-Christian Schuppe
- Klinik und Poliklinik für Urologie, pädiatrische Urologie und Andrologie, Universitätsklinikum Gießen und Marburg GmbH - Standort Gießen, Gießen, Germany
| | - Andreas Schüring
- UKM Kinderwunschzentrum, Universitätsklinikum Münster, Münster, Germany
| | - Vanadin Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München, München, Germany
| | - Thomas Strowitzki
- Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Frank Tüttelmann
- Institut für Humangenetik, Universitätsklinikum Münster, Münster, Germany
| | - Kilian Vomstein
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | - Ludwig Wildt
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | - Tewes Wischmann
- Institut für medizinische Psychologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Dorothea Wunder
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinik Lausanne, Lausanne, Switzerland
| | - Johannes Zschocke
- Sektion für Humangenetik, Medizinische Universität Innsbruck, Innsbruck, Austria
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18
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Berger R, Abele H, Bahlmann F, Bedei I, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Jendreizeck A, Krentel H, Kuon R, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nicin T, Nothacker M, Olbertz D, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Steppat S, Surbek D. [Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) - Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes]. Z Geburtshilfe Neonatol 2019; 223:373-394. [PMID: 31801169 DOI: 10.1055/a-1008-8730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. METHODS The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). RECOMMENDATIONS Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.
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Affiliation(s)
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main
| | - Ivonne Bedei
- Frauenklinik, Klinikum Frankfurt Höchst, Frankfurt am Main
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | | | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | | | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt
| | | | - Harald Krentel
- Frauenklinik, Annahospital Herne, Elisabethgruppe Katholische Kliniken Rhein Ruhr, Herne
| | - Ruben Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg
| | - Silke Mader
- European Foundation for the Care of the Newborn Infants
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg
| | - Werner Mendling
- Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe an der Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal
| | | | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin
| | - Dirk Olbertz
- Abteilung Neonatologie und neonatologische Intensivmedizin, Klinikum Südstadt Rostock, Rostock
| | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin
| | | | - Florian Schütz
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | | | | | - Daniel Surbek
- Universitäts-Frauenklinik, Inselspital, Universität Bern, Bern, Schweiz
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19
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Dieckmeyer M, Ruschke S, Rohrmeier A, Syväri J, Einspieler I, Seifert-Klauss V, Schmidmayr M, Metz S, Kirschke JS, Rummeny EJ, Zimmer C, Karampinos DC, Baum T. Vertebral bone marrow fat fraction changes in postmenopausal women with breast cancer receiving combined aromatase inhibitor and bisphosphonate therapy. BMC Musculoskelet Disord 2019; 20:515. [PMID: 31694630 PMCID: PMC6836649 DOI: 10.1186/s12891-019-2916-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/25/2019] [Indexed: 01/02/2023] Open
Abstract
Background Quantification of vertebral bone marrow (VBM) water–fat composition has been proposed as advanced imaging biomarker for osteoporosis. Estrogen deficiency is the primary reason for trabecular bone loss in postmenopausal women. By reducing estrogen levels aromatase inhibitors (AI) as part of breast cancer therapy promote bone loss. Bisphosphonates (BP) are recommended to counteract this adverse drug effect. The purpose of our study was to quantify VBM proton density fat fraction (PDFF) changes at the lumbar spine using chemical shift encoding-based water-fat MRI (CSE-MRI) and bone mineral density (BMD) changes using dual energy X-ray absorptiometry (DXA) related to AI and BP treatment over a 12-month period. Methods Twenty seven postmenopausal breast cancer patients receiving AI therapy were recruited for this study. 22 subjects completed the 12-month study. 14 subjects received AI and BP (AI+BP), 8 subjects received AI without BP (AI-BP). All subjects underwent 3 T MRI. An eight-echo 3D spoiled gradient-echo sequence was used for CSE-based water-fat separation at the lumbar spine to generate PDFF maps. After manual segmentation of the vertebral bodies L1-L5 PDFF values were extracted for each vertebra and averaged for each subject. All subjects underwent DXA of the lumbar spine measuring the average BMD of L1-L4. Results Baseline age, PDFF and BMD showed no significant difference between the two groups (p > 0.05). There was a relative longitudinal increase in mean PDFF (∆relPDFF) in both groups (AI+BP: 5.93%; AI-BP: 3.11%) which was only significant (p = 0.006) in the AI+BP group. ∆relPDFF showed no significant difference between the two groups (p > 0.05). There was no significant longitudinal change in BMD (p > 0.05). Conclusions Over a 12-month period, VBM PDFF assessed with CSE-MRI significantly increased in subjects receiving AI and BP. The present results contradict previous results regarding the effect of only BP therapy on bone marrow fat content quantified by magnetic resonance spectroscopy and bone biopsies. Future longer-term follow-up studies are needed to further characterize the effects of combined AI and BP therapy.
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Affiliation(s)
- Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroadiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Stefan Ruschke
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Alexander Rohrmeier
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan Syväri
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Ingo Einspieler
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Vanadin Seifert-Klauss
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Monika Schmidmayr
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stephan Metz
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroadiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Ernst J Rummeny
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroadiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroadiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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20
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Berger R, Abele H, Bahlmann F, Bedei I, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Jendreizeck A, Krentel H, Kuon R, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nicin T, Nothacker M, Olbertz D, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Steppat S, Surbek D. Prävention und Therapie der Frühgeburt. Leitlinie der DGGG, OEGGG und SGGG (S2k-Niveau, AWMF-Registernummer 015/025, Februar 2019) – Teil 1 mit Empfehlungen zur Epidemiologie, Ätiologie, Prädiktion, primären und sekundären Prävention der Frühgeburt. Z Geburtshilfe Neonatol 2019; 223:304-316. [DOI: 10.1055/a-0979-1028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Zusammenfassung
Ziel Offizielle Leitlinie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (ÖGGG) und der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Ziel der Leitlinie ist es, die Prädiktion, die Prävention und das Management der Frühgeburt anhand der aktuellen Literatur, der Erfahrung der Mitglieder der Leitlinienkommission einschließlich der Sicht der Selbsthilfe evidenzbasiert zu verbessern.
Methoden Anhand der internationalen Literatur entwickelten die Mitglieder der beteiligten Fachgesellschaften und Organisationen Empfehlungen und Statements. Diese wurden in einem formalen Prozess (strukturierte Konsensuskonferenzen mit neutraler Moderation, schriftliche Delphi-Abstimmung) verabschiedet.
Empfehlungen Der Teil I dieser Kurzversion der Leitlinie zeigt Statements und Empfehlungen zur Epidemiologie, Ätiologie, der Prädiktion sowie der primären und sekundären Prävention der Frühgeburt.
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Affiliation(s)
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main
| | - Ivonne Bedei
- Frauenklinik, Klinikum Frankfurt Höchst, Frankfurt am Main
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | | | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck
| | | | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Schweiz
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt
| | | | - Harald Krentel
- Frauenklinik, Annahospital Herne, Elisabethgruppe Katholische Kliniken Rhein Ruhr, Herne
| | - Ruben Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg
| | - Silke Mader
- European Foundation for the Care of the Newborn Infants
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg
| | - Werner Mendling
- Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe an der Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal
| | | | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin
| | - Dirk Olbertz
- Abteilung Neonatologie und neonatologische Intensivmedizin, Klinikum Südstadt Rostock, Rostock
| | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin
| | | | - Florian Schütz
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | | | | | - Daniel Surbek
- Universitäts-Frauenklinik, Inselspital, Universität Bern, Bern, Schweiz
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21
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Berger R, Abele H, Bahlmann F, Bedei I, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Jendreizeck A, Krentel H, Kuon R, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nicin T, Nothacker M, Olbertz D, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Steppat S, Surbek D. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) - Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes. Geburtshilfe Frauenheilkd 2019; 79:813-833. [PMID: 31423017 DOI: 10.1055/a-0903-2735] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 01/25/2023] Open
Abstract
Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | - Ivonne Bedei
- Frauenklinik, Klinikum Frankfurt Höchst, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | | | - Harald Krentel
- Frauenklinik, Annahospital Herne, Elisabethgruppe Katholische Kliniken Rhein Ruhr, Herne, Germany
| | - Ruben Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of the Newborn Infants
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe an der Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin, Germany
| | - Dirk Olbertz
- Abteilung Neonatologie und neonatologische Intensivmedizin, Klinikum Südstadt Rostock, Rostock, Germany
| | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | | | - Daniel Surbek
- Universitäts-Frauenklinik, Inselspital, Universität Bern, Bern, Switzerland
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Berger R, Abele H, Bahlmann F, Bedei I, Doubek K, Felderhoff-Müser U, Fluhr H, Garnier Y, Grylka-Baeschlin S, Helmer H, Herting E, Hoopmann M, Hösli I, Hoyme U, Jendreizeck A, Krentel H, Kuon R, Lütje W, Mader S, Maul H, Mendling W, Mitschdörfer B, Nicin T, Nothacker M, Olbertz D, Rath W, Roll C, Schlembach D, Schleußner E, Schütz F, Seifert-Klauss V, Steppat S, Surbek D. Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) - Part 1 with Recommendations on the Epidemiology, Etiology, Prediction, Primary and Secondary Prevention of Preterm Birth. Geburtshilfe Frauenheilkd 2019; 79:800-812. [PMID: 31423016 DOI: 10.1055/a-0903-2671] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 12/13/2022] Open
Abstract
Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recent scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods Based on the international literature, the members of the participating medical societies and organizations developed Recommendations and Statements. These were adopted following a formal process (structured consensus conference with neutral moderation, voting was done in writing using the Delphi method to achieve consensus). Recommendations Part I of this short version of the guideline lists Statements and Recommendations on the epidemiology, etiology, prediction and primary and secondary prevention of preterm birth.
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Affiliation(s)
- Richard Berger
- Frauenklinik, Marienhaus Klinikum Neuwied, Neuwied, Germany
| | - Harald Abele
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Franz Bahlmann
- Frauenklinik, Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | - Ivonne Bedei
- Frauenklinik, Klinikum Frankfurt Höchst, Frankfurt am Main, Germany
| | | | - Ursula Felderhoff-Müser
- Klinik für Kinderheilkunde I/Perinatalzentrum, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Herbert Fluhr
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Yves Garnier
- Frauenklinik, Klinikum Osnabrück, Osnabrück, Germany
| | | | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Markus Hoopmann
- Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Irene Hösli
- Frauenklinik, Universitätsspital Basel, Basel, Switzerland
| | - Udo Hoyme
- Frauenklinik, Ilm-Kreis-Kliniken, Arnstadt, Germany
| | | | - Harald Krentel
- Frauenklinik, Annahospital Herne, Elisabethgruppe Katholische Kliniken Rhein Ruhr, Herne, Germany
| | - Ruben Kuon
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Wolf Lütje
- Frauenklinik, Evangelisches Amalie Sieveking-Krankenhaus Hamburg, Hamburg, Germany
| | - Silke Mader
- European Foundation for the Care of the Newborn Infant
| | - Holger Maul
- Frauenklinik, Asklepios Kliniken Hamburg, Hamburg, Germany
| | - Werner Mendling
- Deutsches Zentrum für Infektionen in Gynäkologie und Geburtshilfe an der Frauenklinik, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
| | | | | | - Monika Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Berlin, Germany
| | - Dirk Olbertz
- Abteilung Neonatologie und neonatologische Intensivmedizin, Klinikum Südstadt Rostock, Rostock, Germany
| | - Werner Rath
- Emeritus, Universitätsklinikum Aachen, Aachen, Germany
| | - Claudia Roll
- Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Datteln, Germany
| | - Dietmar Schlembach
- Klinik für Geburtsmedizin, Klinikum Neukölln/Berlin Vivantes Netzwerk für Gesundheit, Berlin, Germany
| | | | - Florian Schütz
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | | | - Daniel Surbek
- Universitäts-Frauenklinik, Inselspital, Universität Bern, Bern, Switzerland
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Meyer S, Seifert-Klauss V. Hormontherapie in der Peri- und Postmenopause. Dtsch Med Wochenschr 2018; 143:1636-1647. [DOI: 10.1055/a-0441-4540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AbstractThe recently published 18-year-follow-up of the WHI-study might resolve the long-standing dispute about hormone therapy, possibly reconciling the opposing parties attributing life-threatening risks to either the administration or the withholding of hormone therapy. 16 608 women without hysterectomy had taken either combined hormone therapy with estrogen and progestin or placebo for an average of 5.2 years, while 10 739 women after hysterectomy (and bilateral ovarectomy in 40 %) had taken either estrogen therapy alone or placebo for an average of 7 years. 7489 deaths were recorded until 2014. Over both studies, mortality was 27.1 % after hormone therapy and 27.6 % after placebo. New findings on perimenopause can help towards phase-adapted and complaint-targeted hormone therapy in the future.
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Oyan A, Schmidmayr M, Stassek J, Sperl L, Hanusch Y, Seifert-Klauss V. NLR und PLR – mögliche Prognose-Marker chronischer Entzündung im Kontext des PCO-Syndroms? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Oyan
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
| | - M Schmidmayr
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
| | - J Stassek
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
| | - L Sperl
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
| | - Y Hanusch
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
| | - V Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde der TU München, Klinikum rechts der Isar, München, Deutschland
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25
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Kotzur F, Berger H, Schmidmayr M, Kleinsorge F, Seifert-Klauss V. Therapie-refraktäre anämisierende Vaginalblutungen bei arterieller Gefäßmalformation im uterinen und ovariellen Versorgungsgebiet – ein Fallbericht. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Kotzur
- Klinikum der Technischen Universität München, Frauenklinik, München, Deutschland
| | - H Berger
- Klinikum der Technischen Universität München, Interventionelle Radiologie, München, Deutschland
| | - M Schmidmayr
- Klinikum der Technischen Universität München, Frauenklinik, München, Deutschland
| | - F Kleinsorge
- Klinikum der Technischen Universität München, Frauenklinik, München, Deutschland
| | - V Seifert-Klauss
- Klinikum der Technischen Universität München, Frauenklinik, München, Deutschland
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26
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Kotzur F, Schmidmayr M, Kleinsorge F, Seifert-Klauss V. Falsch-hohe Sexualhormonmessung in der Postmenopause – ein Fallbericht. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1655521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Kotzur
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - M Schmidmayr
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - F Kleinsorge
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - V Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
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27
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Kleinsorge F, Schmidmayr M, Kotzur F, Seifert-Klauss V. PROGEST – eine Doppelblindstudie zur Untersuchung der Wirksamkeit unterschiedlicher Dosierungen von Progesteron im Vergleich zu Placebo zur Behandlung von vasomotorischen Symptomen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1655522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Kleinsorge
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - M Schmidmayr
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - F Kotzur
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
| | - V Seifert-Klauss
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München
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28
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Nikas I, Hapfelmeier A, Mollenhauer M, Angermeier D, Bettstetter M, Götz R, Schmidmayr M, Seifert-Klauss V, Muckenhuber A, Schenck U, Weirich G. Integrated morphologic and molecular analysis of Trichomonas vaginalis, Mycoplasma hominis, and human papillomavirus using cytologic smear preparations. Parasitol Res 2018; 117:1443-1451. [PMID: 29549429 DOI: 10.1007/s00436-018-5829-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/06/2018] [Indexed: 01/03/2023]
Abstract
Pathogenic microbes may colonize the female genital tract via sexual transmission and cause health issues like inflammation or malignancy, summarized as sexually transmitted disease (STD). A major representative of such pathogens is Trichomonas vaginalis (T.v.), whose role in the etiology of cervical cancer remains elusive. Traditional morphologic screening of cervical smears is able to detect T.v., although its identification may be complicated by look-alikes such as degenerated granulocytes and basal cells. In addition, the parasite's endosymbiont Mycoplasma hominis (M.h.) cannot be detected in the Pap test. This investigation was aimed at designing a PCR-based method to detect specific pathogenic germs by using cervical cytology slides to overcome morphologic uncertainty and increase diagnostic accuracy. To test our molecular screening method on T.v., M.h., and HPV in archival smears, we elaborated a multiplex PCR approach based on microdissection. This assay was applied to a minute quantity of starting material which harbored or was suspected to harbor T.v.; the resulting isolated DNA was used for subsequent molecular analyses of T.v., M.h., and HPV. We clarified the diagnosis of genital T.v. infection in 88 and 1.8% of morphologically suspicious and T.v.-negative cases, respectively. We also revealed a tendency of M.h. co-infection in high-risk HPV cases. In conclusion, a microdissection-based approach to detect pathogenic microbes such as T.v., HPV, and M.h. is a molecular tool easy to implement and may help to better understand the interactivity of these germs with respect to pathogenesis.
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Affiliation(s)
- I Nikas
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.,School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - A Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, Technische Universität München, Munich, Germany
| | - M Mollenhauer
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - D Angermeier
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | | | - R Götz
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - M Schmidmayr
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - A Muckenhuber
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - U Schenck
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.,MVZ Gynäkologie & Pathologie, Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.
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29
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Cheney CP, Thorand B, Huth C, Berger K, Peters A, Seifert-Klauss V, Kiechle M, Strauch K, Quante AS. The Association between Serum 25-Hydroxyvitamin D and Cancer Risk: Results from the Prospective KORA F4 Study. Oncol Res Treat 2018; 41:117-121. [PMID: 29485414 DOI: 10.1159/000485512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 11/21/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many studies have examined the relationship between vitamin D and specific types of cancer with inconsistent results. Furthermore, to date, no observational studies have demonstrated a clear relationship between vitamin D and total cancer risk. METHODS We analyzed data from a population-based prospective cohort study including 2,003 initially cancer-free participants from the KORA F4 study with baseline serum 25-hydroxyvitamin D (25(OH)D) measurements (surveyed between 2006 and 2008). We used Cox proportional hazard models to assess the association between 25(OH)D levels and incident cancer risk. RESULTS Within a follow-up period of 7 years, 69 of the participants developed cancer. Overall, we observed no significant relationship between serum 25(OH)D levels and cancer risk. The hazard ratio (HR) per 1 ng/ml increase in 25 (OH)D for this relationship was 1.00 (95% confidence interval (CI) 0.97-1.04) adjusting for age, sex, body mass index, and season of blood draw. This was also true in subgroup analysis for prostate cancer (HR 0.95, 95% CI 0.88-1.03), breast cancer (HR 1.03, 95% CI 0.97-1.09), and colorectal cancer (HR 0.97, 95% CI 0.88-1.07). CONCLUSION Our study found no protective effect of 25(OH)D against developing cancer. However, studies with more participants and additional measurements of 25(OH)D are still needed to accurately clarify the relationship between 25(OH)D and total cancer risk.
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Abstract
Mobile point-of-care diagnostics are paramount for the provision of healthcare. Hormonal diagnostics are powerful tools to monitor timely changes in human physiology. Hormone concentrations in serum directly correlate with urine excretions with minor time delays. Therefore, rapid tests for hormones in urine have been widely used for decades as means of early diagnostics, particularly in lateral flow immunoassay formats. However, the challenge of reading and interpreting these binary tests remains. Here we present a method for utilizing mobile technologies to quantitatively read and interpret hormonal test strips. The method demonstrates the detection of a urinary by-product of progesterone, pregnanediol glucuronide (PdG), and its relation to ovulation and the fertility cycle.
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Affiliation(s)
- P R Matías-García
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - A Beckley
- MFB Fertility Inc., Boulder, CO, USA
| | - M Schmidmayr
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
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Schlammerl K, Seifert-Klauss V. Shared decision-making (SDM) in der Osteoporosetherapie: Profitieren Patienten mit Depression besonders? Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- K Schlammerl
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
| | - V Seifert-Klauss
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
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Senger A, Sperl L, Stassek J, Seifert-Klauss V. Auswirkung verschiedener Definitionen des Polyzystischen Ovar-Syndroms (PCOS) auf Häufigkeit und Symptomausprägung. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- A Senger
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
| | - L Sperl
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
| | - J Stassek
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
| | - V Seifert-Klauss
- Interdisziplinäres Osteoporosezentrum, Frauenklinik und Poliklinik der Technischen Universität München
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Brandhorst H, Koeppen V, Gordijenko O, Seifert-Klauss V. Entlass-Management verbessern und Sektorengrenzen überwinden: warum ein ‚Fraktur-Liaison-Service (FLS)‘ sinnvoll ist. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- H Brandhorst
- Interdisziplinäres Osteoporosezentrum, Klinik und Poliklinik für Frauenheilkunde der Technischen Universität München
| | - V Koeppen
- Interdisziplinäres Osteoporosezentrum, Klinik und Poliklinik für Frauenheilkunde der Technischen Universität München
| | - O Gordijenko
- Interdisziplinäres Osteoporosezentrum, Klinik und Poliklinik für Frauenheilkunde der Technischen Universität München
| | - V Seifert-Klauss
- Interdisziplinäres Osteoporosezentrum, Klinik und Poliklinik für Frauenheilkunde der Technischen Universität München
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Stassek J, Erdmann J, Ohnolz F, Berg FD, Kiechle M, Seifert-Klauss V. C-Peptide, Baseline and Postprandial Insulin Resistance after a Carbohydrate-Rich Test Meal - Evidence for an Increased Insulin Clearance in PCOS Patients? Geburtshilfe Frauenheilkd 2017; 77:59-65. [PMID: 28190890 DOI: 10.1055/s-0042-119199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction Known characteristics of patients with PCOS include infertility, menstrual disorders, hirsutism and also often insulin resistance. These symptoms increase with increasing body weight. In the LIPCOS study (Lifestyle Intervention for Patients with Polycystic Ovary Syndrome [PCOS]) long-term changes of the PCOS in dependence on pregnancy and parenthood were systematically assessed. In the framework of the LIPCOS study, PCOS patients were given a standardised carbohydrate-rich test meal in order to examine glucose homeostasis and insulin secretion. The results were compared with those of a eumenorrhoeic control group who all had corresponding BMI values and corresponding ages. Methods and Patients 41 PCOS patients (without diabetes) and 68 controls received a standardised carbohydrate-rich test meal (260 kcal, 62 % carbohydrates, 32 % fat, 6 % proteins) in order to generate a submaximal insulin and glucose stimulation. The values were determined at baseline and postprandial after 60, 120 and 180 minutes. In addition, the corresponding C-peptide levels were recorded. Results In the PCOS patients (n = 41), the insulin secretion test after a standardised test meal showed almost identical baseline and postprandial insulin levels when compared with those of the age- and BMI-matched eumenorrhoeic controls (n = 68). In the PCOS patients, the baseline and postprandial glucose levels were significantly elevated (92.88 ± 10.28 [PCOS] vs. 85.07 ± 9.42 mg/dL [controls]; p < 0.001) so was C-peptide (p < 0.025). Conclusions In the present study we have shown for the first time that, after consumption of a standardised test meal, PCOS patients formally exhibit a higher fasting insulin resistance than controls. In spite of the higher stimulated C-peptide levels, the insulin levels did not increase more strongly with increasing glucose levels than in controls which may be indicative of a higher insulin clearance in PCOS patients.
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Affiliation(s)
- J Stassek
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - J Erdmann
- Hochschule Weihenstephan-Triesdorf, Weidenbach, Germany
| | - F Ohnolz
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - F D Berg
- Gemeinschaftspraxis Prof. Berg und Dr. Lesoine, München, Germany
| | - M Kiechle
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany
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35
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Kleinsorge F, Schmidmayr M, Niepoth K, Seifert-Klauss V. Adenomyosis uteri – sonographische Zeichen und klinische Symptomatik. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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36
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Prior JC, Hitchcock CL, Vigna YM, Seifert-Klauss V. Premenopausal Trabecular Bone Loss is Associated with a Family History of Fragility Fracture. Geburtshilfe Frauenheilkd 2016; 76:895-901. [PMID: 27582584 DOI: 10.1055/s-0042-103751] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Although a fragility fracture family history (FFFH+) has repeatedly been shown to be associated with lower bone mineral density (BMD), its relationship to human BMD change is unclear. Animal research, however, documented that different purebred strains within rodent species have wide ranges in rates of bone acquisition during growth as well as in change post-ovariectomy. Our objective was to compare the rate of premenopausal spinal trabecular BMD change between women with and without a general family history of fragility fracture. PARTICIPANTS AND METHODS Healthy premenopausal community women participated in prospective observational studies at two academic medical research centres: Vancouver, Canada (n = 66) and Munich, Germany (n = 20). The primary outcome was annual spinal BMD change, measured by quantitative computed tomography (QCT). The two studies employed similar methodologies for assessing QCT and FFFH. RESULTS Volunteer community participants had a mean age of 36.0 (SD, 6.9) years, body mass index 22.5 (2.4) and baseline QCT of 150.2 (22.5) mg/cm3 trabecular bone. The rates of BMD change were similar in both cities: - 3.5 (5.1)/year Vancouver, - 2.0 (3.4)/year Munich (95 % CI of difference: - 3.9, 0.9). Over a third of the women (31 of the 86, 36 %) reported FFFH+. Those with and without a FFFH were similar in demographics, nutrition, exercise, menstrual cycle and luteal phase lengths and physiological measures (serum calcium, osteocalcin and estradiol). However, women with FFFH+ lost trabecular BMD more rapidly: FFFH+, - 4.9 (5.0), FFFH-, - 2.2 (4.4) mg/cm3/year (95 % CI diff - 0.7 to - 4.8, F1.83 = 7.88, p = 0.006). FFFH+ explained 7.7 % of the variance in QCT volumetric trabecular spinal bone change/year in these healthy premenopausal women. CONCLUSION This study shows for the first time that having a history of a fragility fracture in a family member is associated with a greater rate of premenopausal spinal trabecular bone loss.
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Affiliation(s)
- J C Prior
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada; Dept. of Medicine, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - C L Hitchcock
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Y M Vigna
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Gynecologic Endocrinology and Interdisciplinary Osteoporosis Center (IOZ), Klinikum rechts der Isar, TUM Munich, Germany
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Baum T, Karampinos DC, Seifert-Klauss V, Pencheva TD, Jungmann PM, Rummeny EJ, Müller D, Bauer JS. Use of MR-based trabecular bone microstructure analysis at the distal radius for osteoporosis diagnostics: a study in post-menopausal women with breast cancer and treated with aromatase inhibitor. ACTA ACUST UNITED AC 2016; 13:29-32. [PMID: 27252740 DOI: 10.11138/ccmbm/2016.13.1.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Treatment with aromatase inhibitor (AI) is recommended for post-menopausal women with hormone-receptor positive breast cancer. However, AI therapy is known to induce bone loss leading to osteoporosis with an increased risk for fragility fractures. The purpose of this study was to investigate whether changes of magnetic resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarker can already be detected in subjects with AI intake but still without evidence for osteoporosis according to dual energy X-ray absorptiometry (DXA)-based bone mineral density (BMD) measurements as current clinical gold standard. METHODS Twenty-one postmenopausal women (62±6 years of age) with hormone-receptor positive breast cancer, ongoing treatment with aromatase inhibitor for 23±15 months, and no evidence for osteoporosis (current DXA T-score greater than -2.5) were recruited for this study. Eight young, healthy women (24±2 years of age) were included as controls. All subjects underwent 3 Tesla magnetic resonance imaging (MRI) of the distal radius to assess the trabecular bone microstructure. RESULTS Trabecular bone microstructure parameters were not significantly (p>0.05) different between subjects with AI intake and controls, including apparent bone fraction (0.42±0.03 vs. 0.42±0.05), trabecular number (1.95±0.10 mm(-1) vs 1.89±0.15 mm(-1)), trabecular separation (0.30±0.03 mm vs 0.31±0.06 mm), trabecular thickness (0.21±0.01 mm vs 0.22±0.02 mm), and fractal dimension (1.70±0.02 vs. 1.70±0.03). CONCLUSION These findings suggest that the initial deterioration of trabecular bone microstructure as measured by MRI and BMD loss as measured by DXA occur not sequentially but rather simultaneously. Thus, the use of MR-based trabecular bone microstructure assessment is limited as early diagnostic biomarker in this clinical setting.
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Affiliation(s)
- Thomas Baum
- Klinikum rechts der Isar, Technische Universität München, München, Germany
| | | | | | | | - Pia M Jungmann
- Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Ernst J Rummeny
- Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Dirk Müller
- Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Jan S Bauer
- Klinikum rechts der Isar, Technische Universität München, München, Germany
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Thaler MA, Seifert-Klauss V, Luppa PB. The biomarker sex hormone-binding globulin - from established applications to emerging trends in clinical medicine. Best Pract Res Clin Endocrinol Metab 2015; 29:749-60. [PMID: 26522459 DOI: 10.1016/j.beem.2015.06.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Sex hormone-binding globulin (SHBG) is a serum glycoprotein exhibiting the unique feature of binding sex steroids with high affinity and specificity. Its serum levels are regulated not only by androgens and estrogens but also by thyroid hormones and other metabolic factors. Several disease conditions are accompanied by altered SHBG levels such as hyper- and hypoandrogenism, thyroid disorders, pituitary diseases, liver disorders, and breast as well as prostate cancer. Additionally, several drugs and alcohol consumption influence serum concentrations of SHBG. In some cases, altered SHBG levels are a specific result of the underlying pathology. In others, they merely constitute an epiphenomenon, which still might offer the possibility of using serum measurements of SHBG as surrogate marker. This review article portrays the different disorders associated with altered SHBG levels and discusses the usefulness of SHBG as disease biomarker from a clinicians as well as from an endocrinological researchers point of view.
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Affiliation(s)
- Markus A Thaler
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675 München, Germany.
| | - Vanadin Seifert-Klauss
- Frauenklinik und Poliklinik, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675 München, Germany.
| | - Peter B Luppa
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675 München, Germany.
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Kleinsorge F, Schmidmayr M, Seifert-Klauss V. Important aspects in diagnosing adenomyosis. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1558387] [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] Open
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Schmidmayr M, Niepoth K, Seifert-Klauss V. Case Report: Endometriose des Mons pubis und tief infiltrierende Douglas-Endometriose bei 27-jähriger Patientin ohne Vor-Operation und Endometriose des Mons pubis bei 30-jähriger Patientin nach 2x Sectio. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1558377] [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] Open
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Schlammerl K, Seifert-Klauss V. Shared-decision-making: The impact of decisions on persistence in osteoporosis therapy. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547683] [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: 10/23/2022]
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Baum T, Karampinos DC, Brockow K, Seifert-Klauss V, Jungmann PM, Biedermann T, Rummeny EJ, Bauer JS, Müller D. MR-based trabecular bone microstructure is not altered in subjects with indolent systemic mastocytosis. Clin Imaging 2014; 39:886-9. [PMID: 25542754 DOI: 10.1016/j.clinimag.2014.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 11/30/2014] [Accepted: 12/08/2014] [Indexed: 11/18/2022]
Abstract
Subjects with indolent systemic mastocytosis (ISM) have an increased risk for osteoporosis. It has been demonstrated that trabecular bone microstructure analysis improves the prediction of bone strength beyond dual-energy X-ray absorptiometry-based bone mineral density. The purpose of this study was to obtain Magnetic Resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarkers in subjects with ISM (n=18) and compare them with those of normal controls (n=18). Trabecular bone microstructure parameters were not significantly (P>.05) different between subjects with ISM and controls. These findings revealed important pathophysiological information about ISM-associated osteoporosis and may limit the use of trabecular bone microstructure analysis in this clinical setting.
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Affiliation(s)
- Thomas Baum
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany.
| | - Dimitrios C Karampinos
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - Knut Brockow
- Klinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Biedersteiner Str. 29, 80802 München, Germany
| | - Vanadin Seifert-Klauss
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - Pia M Jungmann
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - Tilo Biedermann
- Klinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Biedersteiner Str. 29, 80802 München, Germany
| | - Ernst J Rummeny
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - Jan S Bauer
- Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - Dirk Müller
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany; Institut und Poliklinik für Diagnostische Radiologie, Universitätsklinikum Köln, Kerpener Str. 62, 50937 Köln, Germany
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Sperl L, Stassek J, Ohnolz F, Kiechle M, Seifert-Klauss V. LIPCOS (Lebensstil-Intervention bei PCOS) – eine prospektive Beobachtungsstudie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387963] [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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Schlammerl K, Seifert-Klauss V. Partizipative Entscheidungsfindung in der Osteoporosetherapie: Hat die getroffene Entscheidung Einfluss auf die Persistenz? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1387994] [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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Schmidmayr M, Seifert-Klauss V, Kiechle M. Pille und Krebsrisiko. Gynäkologische Endokrinologie 2014. [DOI: 10.1007/s10304-013-0623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schlammerl K, Seifert-Klauss V. The impact of shared-decision-making on persistence in Osteoporosis-Therapy. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372062] [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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Seifert-Klauss V, Ritzinger AC, Lesoine B, Kiechle M, Schmidmayr M, Berg D. Ovulation influences bone metabolism in women undergoing controlled ovarian stimulation. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372059] [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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Stassek J, Ohnolz F, Erdmann J, Berg D, Kiechle M, Seifert-Klauss V. Long-term follow-up of PCOS-patients – the LIPCOS Trial. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372094] [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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Seifert-Klauss V. Endokrinologie. Klimawandel - Wenn Frauen in die Wechseljahre kommen. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0032-1328628] [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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Lohmaier J, Straub L, Artmann A, Luppa P, Kiechle M, Seifert-Klauss V. 25-Hydroxyvitamin D im Serum und Biopsie-Ergebnisse bei Frauen mit auffälliger Mammografie. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347849] [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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