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Kohlmeier L, von der Born J, Lehmann E, Fröde K, Grabitz C, Greiner AS, Albrecht AA, Memaran N, Sugianto RI, Tegtbur U, Schmidt BMW, Kanzelmeyer N, Melk A. Physical activity and its impact on cardiovascular health in pediatric kidney transplant recipients. Pediatr Nephrol 2024; 39:1587-1598. [PMID: 38103064 PMCID: PMC10943152 DOI: 10.1007/s00467-023-06248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Cardiovascular (CV) morbidity after kidney transplantation (KTx) in childhood is of increasing importance. In light of a high prevalence of CV risk factors, protective measures such as physical activity (PA) come into focus. Our aim was to comprehensively assess PA in pediatric KTx recipients and evaluate its impact on CV health. METHODS Forty-eight patients were assessed for frequency, duration, intensity, and setting of PA using the "Motorik-Modul" PA questionnaire. Walking-based activity was measured by accelerometer in a subgroup (n = 23). CV risk factors and subclinical CV organ damage were determined. The impact of PA on CV parameters was analyzed using linear regression models. RESULTS Fifty-two percent of pediatric KTx recipients did not reach WHO recommended PA level; 54% did not engage in PA with vigorous intensity (VPA). Twenty-nine percent indicated an extremely inactive lifestyle (< 120 min/week of moderate to vigorous intensity PA, MVPA). Compared to the healthy German KiGGS cohort, KTx recipients specifically lacked engagement in sport activities (KTx: 129 min/week; 95%CI, 97-162 vs. KiGGS, 242 min/week; 95%CI, 230-253). VPA was associated with lower systolic blood pressure (p = 0.024) and resting heart rate (p = 0.005), MVPA with fewer components of the post-transplant metabolic syndrome (p = 0.037), and better left ventricular diastolic function (p = 0.006). CONCLUSIONS A considerable lack of PA, especially VPA, exists in young KTx recipients. PA was positively associated with important parameters of CV health. While long-term CV protection through PA seems promising in pediatric KTx recipients, specific educational approaches are most likely needed to increase patients' engagement in sport activities.
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Affiliation(s)
- Lena Kohlmeier
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jeannine von der Born
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Elena Lehmann
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kerstin Fröde
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Carl Grabitz
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anne-Sophie Greiner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Nima Memaran
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Rizky I Sugianto
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Bernhard M W Schmidt
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Nele Kanzelmeyer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Qu D, Schürmann P, Rothämel T, Fleßner J, Rehberg D, Dörk T, Klintschar M. Revisiting the association of sudden infant death syndrome (SIDS) with polymorphisms of NHE3 and IL13. Int J Legal Med 2024; 138:743-749. [PMID: 38091065 PMCID: PMC11003888 DOI: 10.1007/s00414-023-03139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/20/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Disturbances of the central nervous system and immune system are thought to play a role in sudden infant death syndrome (SIDS). Dysregulated expression of sodium (Na+)/hydrogen (H+) exchanger 3 (NHE3) in the brainstem and of interleukin 13 (IL13) in the lungs has been observed in SIDS. An association of single-nucleotide polymorphisms (SNPs) in NHE3 and IL13 with SIDS has been proposed, but controversial results were reported. Therefore, there is a need to revisit the association of SNPs in NHE3 and IL13 with SIDS. METHODS Genotyping of rs71597645 (G1131A) and rs2247114 (C2405T) in NHE3 and rs20541 (+ 4464A/G) in IL13 was performed in 201 SIDS cases and 338 controls. A meta-analysis was performed after merging our data with previously published data (all from European populations). RESULTS Polymorphisms rs2247114 (NHE3) and rs20541 (IL13) were significantly associated with SIDS overall and in multiple subgroups, but no association was found for rs71597645 (NHE3). After combining our data with previously published data, a fixed-effect meta-analysis showed that rs2247114 in NHE3 retained a significant association with SIDS under a recessive model (OR 2.78, 95%CI 1.53 to 5.06; p = 0.0008). CONCLUSION Our findings suggest an association of NHE3 variant rs2247114 (C2405T), though not rs71597645 (NHE3), with SIDS. A potential role of rs20541 (IL13) still has to be elucidated. Especially NHE3 seems to be an interesting topic for future SIDS research.
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Affiliation(s)
- Dong Qu
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Peter Schürmann
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thomas Rothämel
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jessica Fleßner
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Daniela Rehberg
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Offergeld C, Kuhn S, Kromeier J, Heermann S, Widder A, Flayyih O, Everad F, Knopf A, Albrecht T, Burkhardt V, Hildenbrand T, Ramackers W. [Is the use of virtual reality in otorhinolaryngology teaching automatically positively rated by students? : A questionnaire-based evaluation among students]. HNO 2024; 72:367-374. [PMID: 38578464 PMCID: PMC11045625 DOI: 10.1007/s00106-024-01453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Analogous to the situation in other disciplines, digital ENT teaching made significant progress during the pandemic. Most ENT clinics nationwide were able to offer a complete virtual teaching program in time. Innovative teaching methods were also used early on. This was recognized in student teaching evaluations. Due to the expansion of virtual reality (VR) in medical teaching, even greater satisfaction should be expected through improved teaching quality. MATERIALS AND METHODS Surveys were performed with students (n = 180) of the ENT block internship in the summer semester of 2023. The aim of the evaluation was to determine the students' satisfaction with and subjective effectiveness of the newly implemented VR digital teaching method for teaching ear anatomy and coniotomy. A survey was also carried out among resident physicians. RESULTS The ENT teaching was perceived favorably by the students, with an average rating of 11.7 out of 15. The learning effectiveness and the value of VR in the ENT learning portfolio was evaluated varyingly by the students. The physicians' assessment was different, with a more positive perception. CONCLUSION Virtual reality represents an innovative component in the teaching portfolio of otolaryngology. This new teaching method is viewed and accepted as a future-oriented tool. Remarkably, the physicians involved voted consistently positively, while the students gave more critical assessments and pointed out limitations in the individual and subjective areas. These findings are in contrast to the further development of innovative teaching methods demanded by student interest groups.
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Affiliation(s)
- C Offergeld
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - S Kuhn
- Institut für Digitalisierung in der Medizin, Universitätsklinikum Gießen-Marburg, Marburg, Deutschland
| | - J Kromeier
- Klinik für Radiologie, St. Josef-Krankenhaus Freiburg, Freiburg, Deutschland
| | - S Heermann
- Institut für Anatomie und Zellbiologie, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - A Widder
- Studiendekanat der Med. Fak., Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - O Flayyih
- Studiendekanat der Med. Fak., Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - F Everad
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - A Knopf
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - T Albrecht
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - V Burkhardt
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - T Hildenbrand
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - W Ramackers
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
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Leenaars CHC, Stafleu FR, Häger C, Nieraad H, Bleich A. A systematic review of animal and human data comparing the nasal potential difference test between cystic fibrosis and control. Sci Rep 2024; 14:9664. [PMID: 38671057 PMCID: PMC11053161 DOI: 10.1038/s41598-024-60389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
The nasal potential difference test (nPD) is an electrophysiological measurement which is altered in patients and animal models with cystic fibrosis (CF). Because protocols and outcomes vary substantially between laboratories, there are concerns over its validity and precision. We performed a systematic literature review (SR) of the nPD to answer the following review questions: A. Is the nasal potential difference similarly affected in CF patients and animal models?", and B. "Is the nPD in human patients and animal models of CF similarly affected by various changes in the experimental set-up?". The review protocol was preregistered on PROSPERO (CRD42021236047). We searched PubMed and Embase with comprehensive search strings. Two independent reviewers screened all references for inclusion and extracted all data. Included were studies about CF which described in vivo nPD measurements in separate CF and control groups. Risk of bias was assessed, and three meta-analyses were performed. We included 130 references describing nPD values for CF and control subjects, which confirmed substantial variation in the experimental design and nPD outcome between groups. The meta-analyses showed a clear difference in baseline nPD values between CF and control subjects, both in animals and in humans. However, baseline nPD values were, on average, lower in animal than in human studies. Reporting of experimental details was poor for both animal and human studies, and urgently needs to improve to ensure reproducibility of experiments within and between species.
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Affiliation(s)
| | - Frans R Stafleu
- Department of Animals in Science and Society-Human-Animal Relationship, Utrecht University, Utrecht, The Netherlands
| | - Christine Häger
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Hendrik Nieraad
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - André Bleich
- Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
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Chatterjee S, Leach-Mehrwald M, Huang CK, Xiao K, Fuchs M, Otto M, Lu D, Dang V, Winkler T, Dunbar CE, Thum T, Bär C. Telomerase is essential for cardiac differentiation and sustained metabolism of human cardiomyocytes. Cell Mol Life Sci 2024; 81:196. [PMID: 38658440 PMCID: PMC11043037 DOI: 10.1007/s00018-024-05239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
Telomeres as the protective ends of linear chromosomes, are synthesized by the enzyme telomerase (TERT). Critically short telomeres essentially contribute to aging-related diseases and are associated with a broad spectrum of disorders known as telomeropathies. In cardiomyocytes, telomere length is strongly correlated with cardiomyopathies but it remains ambiguous whether short telomeres are the cause or the result of the disease. In this study, we employed an inducible CRISPRi human induced pluripotent stem cell (hiPSC) line to silence TERT expression enabling the generation of hiPSCs and hiPSC-derived cardiomyocytes with long and short telomeres. Reduced telomerase activity and shorter telomere lengths of hiPSCs induced global transcriptomic changes associated with cardiac developmental pathways. Consequently, the differentiation potential towards cardiomyocytes was strongly impaired and single cell RNA sequencing revealed a shift towards a more smooth muscle cell like identity in the cells with the shortest telomeres. Poor cardiomyocyte function and increased sensitivity to stress directly correlated with the extent of telomere shortening. Collectively our data demonstrates a TERT dependent cardiomyogenic differentiation defect, highlighting the CRISPRi TERT hiPSCs model as a powerful platform to study the mechanisms and consequences of short telomeres in the heart and also in the context of telomeropathies.
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Affiliation(s)
- Shambhabi Chatterjee
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
- Center of Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Megan Leach-Mehrwald
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Cheng-Kai Huang
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Ke Xiao
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Maximilian Fuchs
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Mandy Otto
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Dongchao Lu
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
- Center of Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Vinh Dang
- Translational Stem Cell Biology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas Winkler
- Translational Stem Cell Biology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cynthia E Dunbar
- Translational Stem Cell Biology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
- Center of Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.
- Center of Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany.
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany.
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van Baal K, Hemmerling M, Stahmeyer JT, Stiel S, Afshar K. End-of-life care in Germany between 2016 and 2020 - A repeated cross-sectional analysis of statutory health insurance data. BMC Palliat Care 2024; 23:105. [PMID: 38643167 PMCID: PMC11031961 DOI: 10.1186/s12904-024-01387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 02/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND The Hospice and Palliative Care Act of 2015 aimed at developing and regulating the provision of palliative care (PC) services in Germany. As a result of the legal changes, people with incurable diseases should be enabled to experience their final stage of life including death according to their own wishes. However, it remains unknown whether the act has impacted end-of-life care (EoLC) in Germany. OBJECTIVE The present study examined trends in EoLC indicators for patients who died between 2016 and 2020, in the context of Lower Saxony, Germany. METHODS Repeated cross-sectional analysis was conducted on data from the statutory health insurance fund AOK Lower Saxony (AOK-LS), referring to the years 2016-2020. EoLC indicators were: (1) the number of patients receiving any form of outpatient PC, (2) the number of patients receiving generalist outpatient PC and (3) specialist outpatient PC in the last year of life, (4) the onset of generalist outpatient PC and (5) the onset of specialist outpatient PC before death, (6) the number of hospitalisations in the 6 months prior to death and (7) the number of days spent in hospital in the 6 months prior to death. Data for each year were analysed descriptively and a comparison between 2016 and 2020 was carried out using t-tests and chi-square tests. RESULTS Data from 160,927 deceased AOK-LS members were analysed. The number of patients receiving outpatient PC remained almost consistent over time (2016 vs. 2020 p = .077). The number of patients receiving generalist outpatient PC decreased from 28.4% (2016) to 24.5% (2020; p < .001), whereas the number of patients receiving specialist outpatient PC increased from 8.5% (2016) to 11.2% (2020; p < .001). The onset of generalist outpatient PC moved from 106 (2016) to 93 days (2020; p < .001) before death, on average. The onset of specialist outpatient PC showed the reverse pattern (2016: 55 days before death; 2020: 59 days before death; p = .041). CONCLUSION Despite growing needs for PC at the end of life, the number of patients receiving outpatient PC did not increase between 2016 and 2020. Furthermore, specialist outpatient PC is being increasingly prescribed over generalist outpatient PC. Although the early initiation of outpatient PC has been proven valuable for the majority of people at the end of life, generalist outpatient PC was not initiated earlier in the disease trajectory over the study period, as was found to be true for specialist outpatient PC. Future studies should seek to determine how existing PC needs can be optimally met within the outpatient sector and identify factors that can support the earlier initiation of especially generalist outpatient PC. TRIAL REGISTRATION The study "Optimal Care at the End of Life" was registered in the German Clinical Trials Register (DRKS00015108; 22 January 2019).
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Affiliation(s)
- Katharina van Baal
- Institute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Melissa Hemmerling
- AOK Lower Saxony, Department for Health Services Research, Hildesheimer Str. 273, 30519, Hannover, Germany
| | - Jona Theodor Stahmeyer
- AOK Lower Saxony, Department for Health Services Research, Hildesheimer Str. 273, 30519, Hannover, Germany
| | - Stephanie Stiel
- Institute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Kambiz Afshar
- Institute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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Ackmann J, Brüge A, Gotina L, Lim S, Jahreis K, Vollbrecht AL, Kim YK, Pae AN, Labus J, Ponimaskin E. Structural determinants for activation of the Tau kinase CDK5 by the serotonin receptor 5-HT7R. Cell Commun Signal 2024; 22:233. [PMID: 38641599 PMCID: PMC11031989 DOI: 10.1186/s12964-024-01612-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/11/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Multiple neurodegenerative diseases are induced by the formation and deposition of protein aggregates. In particular, the microtubule-associated protein Tau leads to the development of so-called tauopathies characterized by the aggregation of hyperphosphorylated Tau within neurons. We recently showed that the constitutive activity of the serotonin receptor 7 (5-HT7R) is required for Tau hyperphosphorylation and aggregation through activation of the cyclin-dependent kinase 5 (CDK5). We also demonstrated physical interaction between 5-HT7R and CDK5 at the plasma membrane suggesting that the 5-HT7R/CDK5 complex is an integral part of the signaling network involved in Tau-mediated pathology. METHODS Using biochemical, microscopic, molecular biological, computational and AI-based approaches, we investigated structural requirements for the formation of 5-HT7R/CDK5 complex. RESULTS We demonstrated that 5-HT7R domains responsible for coupling to Gs proteins are not involved in receptor interaction with CDK5. We also created a structural model of the 5-HT7R/CDK5 complex and refined the interaction interface. The model predicted two conserved phenylalanine residues, F278 and F281, within the third intracellular loop of 5-HT7R to be potentially important for complex formation. While site-directed mutagenesis of these residues did not influence Gs protein-mediated receptor signaling, replacement of both phenylalanines by alanine residues significantly reduced 5-HT7R/CDK5 interaction and receptor-mediated CDK5 activation, leading to reduced Tau hyperphosphorylation and aggregation. Molecular dynamics simulations of 5-HT7R/CDK5 complex for wild-type and receptor mutants confirmed binding interface stability of the initial model. CONCLUSIONS Our results provide a structural basis for the development of novel drugs targeting the 5-HT7R/CDK5 interaction interface for the selective treatment of Tau-related disorders, including frontotemporal dementia and Alzheimer's disease.
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Affiliation(s)
- Jana Ackmann
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Alina Brüge
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Lizaveta Gotina
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
- Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Daejeon, Republic of Korea
| | - Sungsu Lim
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
| | - Kathrin Jahreis
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anna-Lena Vollbrecht
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Yun Kyung Kim
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
- Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Daejeon, Republic of Korea
| | - Ae Nim Pae
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
- Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Daejeon, Republic of Korea
| | - Josephine Labus
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Evgeni Ponimaskin
- Department of Cellular Neurophysiology, Institute for Neurophysiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Maier HB, Neyazi A, Bundies GL, Meyer-Bockenkamp F, Bleich S, Pathak H, Ziert Y, Neuhaus B, Müller FJ, Pollmann I, Illig T, Mücke S, Müller M, Möller BK, Oeltze-Jafra S, Kacprowski T, Voges J, Müntefering F, Scheiber J, Reif A, Aichholzer M, Reif-Leonhard C, Schmidt-Kassow M, Hegerl U, Reich H, Unterecker S, Weber H, Deckert J, Bössel-Debbert N, Grabe HJ, Lucht M, Frieling H. Validation of the predictive value of BDNF -87 methylation for antidepressant treatment success in severely depressed patients-a randomized rater-blinded trial. Trials 2024; 25:247. [PMID: 38594753 PMCID: PMC11005235 DOI: 10.1186/s13063-024-08061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is essential for antidepressant treatment of major depressive disorder (MDD). Our repeated studies suggest that DNA methylation of a specific CpG site in the promoter region of exon IV of the BDNF gene (CpG -87) might be predictive of the efficacy of monoaminergic antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and others. This trial aims to evaluate whether knowing the biomarker is non-inferior to treatment-as-usual (TAU) regarding remission rates while exhibiting significantly fewer adverse events (AE). METHODS The BDNF trial is a prospective, randomized, rater-blinded diagnostic study conducted at five university hospitals in Germany. The study's main hypothesis is that {1} knowing the methylation status of CpG -87 is non-inferior to not knowing it with respect to the remission rate while it significantly reduces the AE rate in patients experiencing at least one AE. The baseline assessment will occur upon hospitalization and a follow-up assessment on day 49 (± 3). A telephone follow-up will be conducted on day 70 (± 3). A total of 256 patients will be recruited, and methylation will be evaluated in all participants. They will be randomly assigned to either the marker or the TAU group. In the marker group, the methylation results will be shared with both the patient and their treating physician. In the TAU group, neither the patients nor their treating physicians will receive the marker status. The primary endpoints include the rate of patients achieving remission on day 49 (± 3), defined as a score of ≤ 10 on the Hamilton Depression Rating Scale (HDRS-24), and the occurrence of AE. ETHICS AND DISSEMINATION The trial protocol has received approval from the Institutional Review Boards at the five participating universities. This trial holds significance in generating valuable data on a predictive biomarker for antidepressant treatment in patients with MDD. The findings will be shared with study participants, disseminated through professional society meetings, and published in peer-reviewed journals. TRIAL REGISTRATION German Clinical Trial Register DRKS00032503. Registered on 17 August 2023.
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Affiliation(s)
- Hannah Benedictine Maier
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
| | - Alexandra Neyazi
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg (OVGU), Magdeburg, Germany
| | - Gabriel L Bundies
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Fiona Meyer-Bockenkamp
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Hansi Pathak
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Yvonne Ziert
- Institute of Biostatistics, Hannover Medical School, Hannover, Germany
| | - Barbara Neuhaus
- Center for Clinial Trials (ZKS), Hannover Medical School, Hannover, Germany
| | - Franz-Josef Müller
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig Holstein, Kiel, Germany
- Department of Genome Regulation, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Iris Pollmann
- Department of Psychiatry and Psychotherapy, University Hospital Schleswig Holstein, Kiel, Germany
| | - Thomas Illig
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Stefanie Mücke
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Meike Müller
- Department of Biomarker Analysis and Development, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover, Germany
| | - Brinja Kira Möller
- Department of Biomarker Analysis and Development, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover, Germany
| | - Steffen Oeltze-Jafra
- Peter L. Reichertz Institute for Medical Informatics, Hannover Medical School, Hannover, Germany
| | - Tim Kacprowski
- Division Data Science in Biomedicine, Peter L. Reichertz Institute of Technische Universität Braunschweig and Hannover Medical School, Braunschweig, Germany
- Braunschweig Integrated Centre for Systems Biology, Technische Universität Braunschweig, Braunschweig, Germany
| | - Jan Voges
- Institut Für Informationsverarbeitung, Leibniz University Hannover, Hannover, Germany
| | - Fabian Müntefering
- Institut Für Informationsverarbeitung, Leibniz University Hannover, Hannover, Germany
| | | | - Andreas Reif
- Department for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, Frankfurt Am Main, 60596, Germany
| | - Mareike Aichholzer
- Department for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
| | - Christine Reif-Leonhard
- Department for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
| | - Maren Schmidt-Kassow
- Department for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
| | - Ulrich Hegerl
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Senckenberg Distinguished Professorship, Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe Universität Frankfurt Am Main, Frankfurt, Germany
| | - Hanna Reich
- Department for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg (UKW), Würzburg, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg (UKW), Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg (UKW), Würzburg, Germany
| | - Nicole Bössel-Debbert
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Michael Lucht
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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9
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Lengert L, Tomanek M, Ghoncheh M, Lohmann H, Prenzler N, Kalies S, Johannsmeier S, Ripken T, Heisterkamp A, Maier H. Acoustic stimulation of the human round window by laser-induced nonlinear optoacoustics. Sci Rep 2024; 14:8214. [PMID: 38589426 PMCID: PMC11001906 DOI: 10.1038/s41598-024-58129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
The feasibility of low frequency pure tone generation in the inner ear by laser-induced nonlinear optoacoustic effect at the round window was demonstrated in three human cadaveric temporal bones (TB) using an integral pulse density modulation (IPDM). Nanosecond laser pulses with a wavelength in the near-infrared (NIR) region were delivered to the round window niche by an optical fiber with two spherical lenses glued to the end and a viscous gel at the site of the laser focus. Using IPDM, acoustic tones with frequencies between 20 Hz and 1 kHz were generated in the inner ear. The sound pressures in scala tympani and vestibuli were recorded and the intracochlear pressure difference (ICPD) was used to calculate the equivalent sound pressure level (eq. dB SPL) as an equivalent for perceived loudness. The results demonstrate that the optoacoustic effect produced sound pressure levels ranging from 140 eq. dB SPL at low frequencies ≤ 200 Hz to 90 eq. dB SPL at 1 kHz. Therefore, the produced sound pressure level is potentially sufficient for patients requiring acoustic low frequency stimulation. Hence, the presented method offers a potentially viable solution in the future to provide the acoustic stimulus component in combined electro-acoustic stimulation with a cochlear implant.
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Affiliation(s)
- Liza Lengert
- Laser Zentrum Hannover E.V., Hollerithallee 8, 30419, Hannover, Germany
- NIFE, Lower Saxony Center for Biomedical Engineering, Implant Research and Development, Hannover, Germany
| | - Michael Tomanek
- Department of Otorhinolaryngology and Cluster of Excellence "Hearing4all", Hannover Medical School, VIANNA/NIFE, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Mohammad Ghoncheh
- Department of Otorhinolaryngology and Cluster of Excellence "Hearing4all", Hannover Medical School, VIANNA/NIFE, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Hinnerk Lohmann
- Laser Zentrum Hannover E.V., Hollerithallee 8, 30419, Hannover, Germany
| | - Nils Prenzler
- Department of Otorhinolaryngology and Cluster of Excellence "Hearing4all", Hannover Medical School, VIANNA/NIFE, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Stefan Kalies
- Institute of Quantum Optics, Leibniz University Hannover, Hannover, Germany
| | - Sonja Johannsmeier
- Laser Zentrum Hannover E.V., Hollerithallee 8, 30419, Hannover, Germany
- NIFE, Lower Saxony Center for Biomedical Engineering, Implant Research and Development, Hannover, Germany
| | - Tammo Ripken
- Laser Zentrum Hannover E.V., Hollerithallee 8, 30419, Hannover, Germany
- NIFE, Lower Saxony Center for Biomedical Engineering, Implant Research and Development, Hannover, Germany
| | | | - Hannes Maier
- Department of Otorhinolaryngology and Cluster of Excellence "Hearing4all", Hannover Medical School, VIANNA/NIFE, Stadtfelddamm 34, 30625, Hannover, Germany.
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10
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Aldag N, Nogueira W. Psychoacoustic and electroencephalographic responses to changes in amplitude modulation depth and frequency in relation to speech recognition in cochlear implantees. Sci Rep 2024; 14:8181. [PMID: 38589483 PMCID: PMC11002021 DOI: 10.1038/s41598-024-58225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
Temporal envelope modulations (TEMs) are one of the most important features that cochlear implant (CI) users rely on to understand speech. Electroencephalographic assessment of TEM encoding could help clinicians to predict speech recognition more objectively, even in patients unable to provide active feedback. The acoustic change complex (ACC) and the auditory steady-state response (ASSR) evoked by low-frequency amplitude-modulated pulse trains can be used to assess TEM encoding with electrical stimulation of individual CI electrodes. In this study, we focused on amplitude modulation detection (AMD) and amplitude modulation frequency discrimination (AMFD) with stimulation of a basal versus an apical electrode. In twelve adult CI users, we (a) assessed behavioral AMFD thresholds and (b) recorded cortical auditory evoked potentials (CAEPs), AMD-ACC, AMFD-ACC, and ASSR in a combined 3-stimulus paradigm. We found that the electrophysiological responses were significantly higher for apical than for basal stimulation. Peak amplitudes of AMFD-ACC were small and (therefore) did not correlate with speech-in-noise recognition. We found significant correlations between speech-in-noise recognition and (a) behavioral AMFD thresholds and (b) AMD-ACC peak amplitudes. AMD and AMFD hold potential to develop a clinically applicable tool for assessing TEM encoding to predict speech recognition in CI users.
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Affiliation(s)
- Nina Aldag
- Department of Otolaryngology, Hannover Medical School and Cluster of Excellence 'Hearing4all', Hanover, Germany
| | - Waldo Nogueira
- Department of Otolaryngology, Hannover Medical School and Cluster of Excellence 'Hearing4all', Hanover, Germany.
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11
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Tetzlaff J, Epping J, Stahmeyer JT, Liebers F, Hegewald J, Sperlich S, Beller J, Tetzlaff F. The development of working life expectancy without musculoskeletal diseases against the backdrop of extended working lives. Sci Rep 2024; 14:7930. [PMID: 38575680 PMCID: PMC10994922 DOI: 10.1038/s41598-024-58650-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
Musculoskeletal diseases (MSDs) are a major predictor of early retirement. Against the backdrop of the extension of working life, we investigated time trends and educational inequalities in years spent in the labour market free of MSD. Based on German statutory health insurance data (N = 3,405,673), total life years free of MSD (Healthy Life Expectancy, HLE) and years spent in the labour force free of MSD (Healthy Working Life Expectancy, HWLE) were estimated for three periods (2006-2008, 2011-2013, 2016-2018) using multistate analyses. Educational inequalities (8 to 11 vs. 12 or more years of schooling) are reported for 2011-2013. HLE decreased slightly over time in all genders. HWLE in women increased, while it remained rather constant in men. Over time, the share of years in the labour force spent free of MSD declined continuously. People with lower education had lower HLE and HWLE than individuals with higher education. With respect to musculoskeletal diseases, the increase in disease-free working life years cannot keep pace with the extension of working life, resulting in an increasing proportion of years spent in impaired musculoskeletal health in the labour market. Effective prevention strategies are needed, focusing especially on individuals with lower educational attainment.
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Affiliation(s)
- Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany.
| | - Jelena Epping
- Medical Sociology Unit, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
| | | | - Falk Liebers
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Janice Hegewald
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Stefanie Sperlich
- Medical Sociology Unit, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
| | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
| | - Fabian Tetzlaff
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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12
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Pink I, Hennigs JK, Ruhl L, Sauer A, Boblitz L, Huwe M, Fuge J, Falk CS, Pietschmann T, de Zwaan M, Prasse A, Kluge S, Klose H, Hoeper MM, Welte T. Blood T cell phenotypes correlate with fatigue severity in post-acute sequelae of COVID-19. Infection 2024; 52:513-524. [PMID: 37924472 PMCID: PMC10954951 DOI: 10.1007/s15010-023-02114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/09/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE Post-acute sequelae of COVID-19 (PASC) affect approximately 10% of convalescent patients. The spectrum of symptoms is broad and heterogeneous with fatigue being the most often reported sequela. Easily accessible blood biomarkers to determine PASC severity are lacking. Thus, our study aimed to correlate immune phenotypes with PASC across the severity spectrum of COVID-19. METHODS A total of 176 originally immunonaïve, convalescent COVID-19 patients from a prospective cohort during the first pandemic phase were stratified by initial disease severity and underwent clinical, psychosocial, and immune phenotyping around 10 weeks after first COVID-19 symptoms. COVID-19-associated fatigue dynamics were assessed and related to clinical and immune phenotypes. RESULTS Fatigue and severe fatigue were commonly reported irrespective of initial COVID-19 severity or organ-specific PASC. A clinically relevant increase in fatigue severity after COVID-19 was detected in all groups. Neutralizing antibody titers were higher in patients with severe acute disease, but no association was found between antibody titers and PASC. While absolute peripheral blood immune cell counts in originally immunonaïve PASC patients did not differ from unexposed controls, peripheral CD3+CD4+ T cell counts were independently correlated with fatigue severity across all strata in multivariable analysis. CONCLUSIONS Patients were at similar risk of self-reported PASC irrespective of initial disease severity. The independent correlation between fatigue severity and blood T cell phenotypes indicates a possible role of CD4+ T cells in the pathogenesis of post-COVID-19 fatigue, which might serve as a blood biomarker.
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Affiliation(s)
- Isabell Pink
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.
| | - Jan K Hennigs
- Division of Respiratory Medicine, II. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Louisa Ruhl
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), TTU-IICH, Hannover, Germany
| | - Andrea Sauer
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Lennart Boblitz
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Marie Huwe
- Division of Respiratory Medicine, II. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Jan Fuge
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Christine S Falk
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Thomas Pietschmann
- Institute of Experimental Virology, Hannover Medical School, TWINCORE Research Center, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Antje Prasse
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Hans Klose
- Division of Respiratory Medicine, II. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Marius M Hoeper
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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13
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Sivaraman K, Liu B, Martinez-Delgado B, Held J, Büttner M, Illig T, Volland S, Gomez-Mariano G, Jedicke N, Yevsa T, Welte T, DeLuca DS, Wrenger S, Olejnicka B, Janciauskiene S. Human Bronchial Epithelial Cell Transcriptome Changes in Response to Serum from Patients with Different Status of Inflammation. Lung 2024; 202:157-170. [PMID: 38494528 PMCID: PMC11009779 DOI: 10.1007/s00408-024-00679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE To investigate the transcriptome of human bronchial epithelial cells (HBEC) in response to serum from patients with different degrees of inflammation. METHODS Serum from 19 COVID-19 patients obtained from the Hannover Unified Biobank was used. At the time of sampling, 5 patients had a WHO Clinical Progression Scale (WHO-CPS) score of 9 (severe illness). The remaining 14 patients had a WHO-CPS of below 9 (range 1-7), and lower illness. Multiplex immunoassay was used to assess serum inflammatory markers. The culture medium of HBEC was supplemented with 2% of the patient's serum, and the cells were cultured at 37 °C, 5% CO2 for 18 h. Subsequently, cellular RNA was used for RNA-Seq. RESULTS Patients with scores below 9 had significantly lower albumin and serum levels of E-selectin, IL-8, and MCP-1 than patients with scores of 9. Principal component analysis based on 500 "core genes" of RNA-seq segregated cells into two subsets: exposed to serum from 4 (I) and 15 (II) patients. Cells from a subset (I) treated with serum from 4 patients with a score of 9 showed 5566 differentially expressed genes of which 2793 were up- and 2773 downregulated in comparison with cells of subset II treated with serum from 14 patients with scores between 1 and 7 and one with score = 9. In subset I cells, a higher expression of TLR4 and CXCL8 but a lower CDH1, ACE2, and HMOX1, and greater effects on genes involved in metabolic regulation, cytoskeletal organization, and kinase activity pathways were observed. CONCLUSION This simple model could be useful to characterize patient serum and epithelial cell properties.
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Affiliation(s)
- Kokilavani Sivaraman
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Bin Liu
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Beatriz Martinez-Delgado
- Department of Molecular Genetics, Institute of Health Carlos III, Institute for Rare Diseases Research, CIBER of Rare Diseases (CIBERER), Majadahonda, 28220, Madrid, Spain
| | - Julia Held
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Manuela Büttner
- Hannover Medical School, Central Animal Facility, Hannover, Germany
| | - Thomas Illig
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Sonja Volland
- Hannover Medical School, Hannover Unified Biobank, Hannover, Germany
| | - Gema Gomez-Mariano
- Department of Molecular Genetics, Institute of Health Carlos III, Institute for Rare Diseases Research, CIBER of Rare Diseases (CIBERER), Majadahonda, 28220, Madrid, Spain
| | - Nils Jedicke
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Tetyana Yevsa
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Tobias Welte
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - David S DeLuca
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Sabine Wrenger
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Beata Olejnicka
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany
| | - Sabina Janciauskiene
- Department of Pulmonary and Infectious Diseases, Hannover Medical School, BREATH German Center for Lung Research (DZL), Feodor-Lynen-Str. 23, 30625, Hannover, Germany.
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14
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Fraccarollo D, Geffers R, Galuppo P, Bauersachs J. Mineralocorticoid receptor promotes cardiac macrophage inflammaging. Basic Res Cardiol 2024; 119:243-260. [PMID: 38329499 PMCID: PMC11008080 DOI: 10.1007/s00395-024-01032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
Inflammaging, a pro-inflammatory status that characterizes aging and primarily involving macrophages, is a master driver of age-related diseases. Mineralocorticoid receptor (MR) activation in macrophages critically regulates inflammatory and fibrotic processes. However, macrophage-specific mechanisms and the role of the macrophage MR for the regulation of inflammation and fibrotic remodeling in the aging heart have not yet been elucidated. Transcriptome profiling of cardiac macrophages from male/female young (4 months-old), middle (12 months-old) and old (18 and 24 months-old) mice revealed that myeloid cell-restricted MR deficiency prevents macrophage differentiation toward a pro-inflammatory phenotype. Pathway enrichment analysis showed that several biological processes related to inflammation and cell metabolism were modulated by the MR in aged macrophages. Further, transcriptome analysis of aged cardiac fibroblasts revealed that macrophage MR deficiency reduced the activation of pathways related to inflammation and upregulation of ZBTB16, a transcription factor involved in fibrosis. Phenotypic characterization of macrophages showed a progressive replacement of the TIMD4+MHC-IIneg/low macrophage population by TIMD4+MHC-IIint/high and TIMD4-MHC-IIint/high macrophages in the aging heart. By integrating cell sorting and transwell experiments with TIMD4+/TIMD4-macrophages and fibroblasts from old MRflox/MRLysMCre hearts, we showed that the inflammatory crosstalk between TIMD4- macrophages and fibroblasts may imply the macrophage MR and the release of mitochondrial superoxide anions. Macrophage MR deficiency reduced the expansion of the TIMD4- macrophage population and the emergence of fibrotic niches in the aging heart, thereby protecting against cardiac inflammation, fibrosis, and dysfunction. This study highlights the MR as an important mediator of cardiac macrophage inflammaging and age-related fibrotic remodeling.
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Affiliation(s)
- Daniela Fraccarollo
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str.1 30625, Hannover, Germany.
| | - Robert Geffers
- Research Group Genome Analytics, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Paolo Galuppo
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str.1 30625, Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str.1 30625, Hannover, Germany.
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15
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Stock C. pH-regulated single cell migration. Pflugers Arch 2024; 476:639-658. [PMID: 38214759 PMCID: PMC11006768 DOI: 10.1007/s00424-024-02907-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
Over the last two decades, extra- and intracellular pH have emerged as fundamental regulators of cell motility. Fundamental physiological and pathological processes relying on appropriate cell migration, such as embryonic development, wound healing, and a proper immune defense on the one hand, and autoimmune diseases, metastatic cancer, and the progression of certain parasitic diseases on the other, depend on surrounding pH. In addition, migrating single cells create their own localized pH nanodomains at their surface and in the cytosol. By this means, the migrating cells locally modulate their adhesion to, and the re-arrangement and digestion of, the extracellular matrix. At the same time, the cytosolic nanodomains tune cytoskeletal dynamics along the direction of movement resulting in concerted lamellipodia protrusion and rear end retraction. Extracellular pH gradients as found in wounds, inflamed tissues, or the periphery of tumors stimulate directed cell migration, and long-term exposure to acidic conditions can engender a more migratory and invasive phenotype persisting for hours up to several generations of cells after they have left the acidic milieu. In the present review, the different variants of pH-dependent single cell migration are described. The underlying pH-dependent molecular mechanisms such as conformational changes of adhesion molecules, matrix protease activity, actin (de-)polymerization, and signaling events are explained, and molecular pH sensors stimulated by H+ signaling are presented.
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Affiliation(s)
- Christian Stock
- Department of Gastroenterology, Hepatology, Infectiology & Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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16
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Becker HM, Seidler UE. Bicarbonate secretion and acid/base sensing by the intestine. Pflugers Arch 2024; 476:593-610. [PMID: 38374228 PMCID: PMC11006743 DOI: 10.1007/s00424-024-02914-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/21/2024]
Abstract
The transport of bicarbonate across the enterocyte cell membrane regulates the intracellular as well as the luminal pH and is an essential part of directional fluid movement in the gut. Since the first description of "active" transport of HCO3- ions against a concentration gradient in the 1970s, the fundamental role of HCO3- transport for multiple intestinal functions has been recognized. The ion transport proteins have been identified and molecularly characterized, and knockout mouse models have given insight into their individual role in a variety of functions. This review describes the progress made in the last decade regarding novel techniques and new findings in the molecular regulation of intestinal HCO3- transport in the different segments of the gut. We discuss human diseases with defects in intestinal HCO3- secretion and potential treatment strategies to increase luminal alkalinity. In the last part of the review, the cellular and organismal mechanisms for acid/base sensing in the intestinal tract are highlighted.
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Affiliation(s)
- Holger M Becker
- Department of Gastroenterology, Hannover Medical School, 30625, Hannover, Germany
| | - Ursula E Seidler
- Department of Gastroenterology, Hannover Medical School, 30625, Hannover, Germany.
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Keuper L, Seifert R. Drug advertising in the German free-of-charge health magazine Apotheken Umschau (Pharmacy review): a critical analysis. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:2145-2157. [PMID: 37792047 PMCID: PMC10933185 DOI: 10.1007/s00210-023-02744-7] [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] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023]
Abstract
In Germany, the Apotheken Umschau (Pharmacy review) is a very popular health magazine for lay people, which is available free of charge in pharmacies. In this study, drug advertising in the Apotheken Umschau was critically analyzed. To our knowledge, studies on drug advertisements in such magazines are scarce. For the analyses, a total of 123 different advertisements from all 48 issues of Apotheken Umschau in 2020 and 2021 were compared. Since 2021 is the first year that was completely characterized by the COVID-19 pandemic, it was thus also possible to work out pandemic effects. More preparations from the categories immune system, eyes and sleep were advertised in 2021. Accordingly, typical complaints home office workers were addressed. Advertisements provided only very modest scientific information, if at all. The Therapeutic Products Advertising Act (Medicines Advertising Law; Heilmittelwerbegesetz (HWG)) provides regulations regarding the handling of drug advertising. However, in various categories, we noted substantial deficiencies of the advertisements to comply to regulations, e.g. the disclosure of adverse effects and omission of the mandatory statement "For risks and adverse effects, read the package insert and ask your doctor or pharmacist (Für Risiken und Nebenwirkungen fragen Sie Ihren Arzt oder Apotheker oder lesen Sie die Packungsbeilage)". Fifty-one of the 123 advertisements featured females to appeal particularly to this target group. Furthermore, a homogeneous ethnic (Caucasian) picture and a traditional image of German society were presented although this clearly deviates from reality. In conclusion, this study provides insights into the yet poorly studied mechanisms of drug advertisement for lay people. Pharmacological evidence plays a much smaller role than psychology, marketing and traditional societal models. It appears that drug companies intentionally use the "grey area" of the Medicines Advertising Law to optimally promote their products and ignore mandatory statements. This practice must be stopped by stricter legal control to protect the consumer from misinformation. In this way, drug safety will be increased.
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Affiliation(s)
- Laura Keuper
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30655, Hannover, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30655, Hannover, Germany.
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18
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Wittau J, Celik S, Kacprowski T, Deserno TM, Seifert R. Fake paper identification in the pool of withdrawn and rejected manuscripts submitted to Naunyn-Schmiedeberg's Archives of Pharmacology. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:2171-2181. [PMID: 37796310 PMCID: PMC10933159 DOI: 10.1007/s00210-023-02741-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
Honesty of publications is fundamental in science. Unfortunately, science has an increasing fake paper problem with multiple cases having surfaced in recent years, even in renowned journals. There are companies, the so-called paper mills, which professionally fake research data and papers. However, there is no easy way to systematically identify these papers. Here, we show that scanning for exchanged authors in resubmissions is a simple approach to detect potential fake papers. We investigated 2056 withdrawn or rejected submissions to Naunyn-Schmiedeberg's Archives of Pharmacology (NSAP), 952 of which were subsequently published in other journals. In six cases, the stated authors of the final publications differed by more than two thirds from those named in the submission to NSAP. In four cases, they differed completely. Our results reveal that paper mills take advantage of the fact that journals are unaware of submissions to other journals. Consequently, papers can be submitted multiple times (even simultaneously), and authors can be replaced if they withdraw from their purchased authorship. We suggest that publishers collaborate with each other by sharing titles, authors, and abstracts of their submissions. Doing so would allow the detection of suspicious changes in the authorship of submitted and already published papers. Independently of such collaboration across publishers, every scientific journal can make an important contribution to the integrity of the scientific record by analyzing its own pool of withdrawn and rejected papers versus published papers according to the simple algorithm proposed in the present paper.
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Affiliation(s)
- Jonathan Wittau
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Serkan Celik
- Braunschweig Integrated Centre of Systems Biology, TU Braunschweig, Braunschweig, Germany
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106, Braunschweig, Germany
| | - Tim Kacprowski
- Braunschweig Integrated Centre of Systems Biology, TU Braunschweig, Braunschweig, Germany
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106, Braunschweig, Germany
| | - Thomas M Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106, Braunschweig, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
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19
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Niering M, Seifert J. The effects of visual skills training on cognitive and executive functions in stroke patients: a systematic review with meta-analysis. J Neuroeng Rehabil 2024; 21:41. [PMID: 38532485 PMCID: PMC10967170 DOI: 10.1186/s12984-024-01338-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
The visual system and associated skills are of particular importance in stroke rehabilitation. The process of neuroplasticity involved in restoring cognitive function during this period is mainly based on anatomical and physiological mechanisms. However, there is little evidence-based knowledge about the effects of visual skills training that could be used to improve therapeutic outcomes in cognitive rehabilitation. A computerized systematic literature search was conducted in the PubMed, Medline, and Web of Science databases from 1 January 1960 to 11 Febuary 2024. 1,787 articles were identified, of which 24 articles were used for the calculation of weighted standardized mean differences (SMD) after screening and eligibility verification. The findings revealed moderate effects for global cognitive function (SMD = 0.62) and activities of daily living (SMD = 0.55) as well as small effects for executive function (SMD = 0.20) - all in favor of the intervention group. The analyses indicate that the results may not be entirely robust, and should therefore be treated with caution when applied in practice. Visual skills training shows positive effects in improving cognitive and executive functions, especially in combination with high cognitive load and in an early phase of rehabilitation. An improvement in activities of daily living can also be observed with this type of intervention. The high heterogeneity of the studies and different treatment conditions require the identification of a relationship between certain visual skills and executive functions in future research.
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Affiliation(s)
- Marc Niering
- Institute of Biomechanics and Neurosciences, Nordic Science, Hannover, Germany
| | - Johanna Seifert
- Institute of Biomechanics and Neurosciences, Nordic Science, Hannover, Germany.
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
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20
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Atallah O, Alrefaie K, Al Krinawe Y. Crucial trials in neurosurgery: a must-know for every neurosurgeon. Neurosurg Rev 2024; 47:126. [PMID: 38512522 PMCID: PMC10957582 DOI: 10.1007/s10143-024-02358-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Oday Atallah
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg Street. Nr. 1, 30625, Hannover, Germany.
| | - Khadeja Alrefaie
- Faculty of Medicine, Royal College of Surgeons in Ireland, Busaiteen, Bahrain
| | - Yazeed Al Krinawe
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg Street. Nr. 1, 30625, Hannover, Germany
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21
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Kayser MZ, Suhling H, Fuge J, Hinze CA, Drick N, Kneidinger N, Behr J, Taube C, Welte T, Haasler I, Milger K. Long-term multicenter comparison shows equivalent efficacy of monoclonal antibodies in severe asthma therapy. BMC Pulm Med 2024; 24:149. [PMID: 38515071 PMCID: PMC10956233 DOI: 10.1186/s12890-024-02964-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Monoclonal antibodies (biologics) drastically changed severe asthma therapy. Mepolizumab (anti-interleukin (IL) 5), benralizumab (anti-IL5 receptor alpha), and dupilumab (anti-IL4/13) are the most used biologics in this context. While all biologics are efficient individually, the choice of biologic is complicated by insufficient data on their comparative long-term treatment efficacy. Here, we compare the real-life efficacy of these biologics in asthma therapy over 12 months. METHODS 280 severe asthma patients treated with mepolizumab (129/280, 46%), benralizumab (83/280, 30%) or dupilumab (68/280, 24%) for one year were analyzed retrospectively. Data were collected at baseline and after 6 and 12 months of therapy. Endpoints were changes pulmonary function (PF), exacerbation rate, oral corticosteroid (OCS) use and dose, asthma control test (ACT) score and fractional exhaled nitric oxide (FeNO) levels as well as responder status measured by the recently published "Biologic Asthma Response Score" (BARS). RESULTS All biologics led to significant improvements in PF, ACT and OCS dose. Only Mepolizumab and Benralizumab significantly decreased the exacerbation rate, while only Mepolizumab and Dupilumab significantly decreased FeNO. Responder rates measured by BARS were high across all groups: roughly half of all patients achieved full response and most of the remainder achieved at least partial responder status. Overall, outcomes were similar between groups after both 6 and 12 months. CONCLUSIONS All biologics showed great efficacy in individual parameters and high responder rates measured by BARS without a clinically relevant advantage for any antibody. Response was usually achieved after 6 months and retained at 12 months, emphasizing the utility of early response assessment.
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Affiliation(s)
- Moritz Z Kayser
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany.
| | - Hendrik Suhling
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany
| | - Jan Fuge
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Christopher A Hinze
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany
| | - Nora Drick
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany
| | - Nikolaus Kneidinger
- Department of Medicine V, University Hospital, LMU, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Jürgen Behr
- Department of Medicine V, University Hospital, LMU, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany
| | - Tobias Welte
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Lower Saxony, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Ina Haasler
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany
| | - Katrin Milger
- Department of Medicine V, University Hospital, LMU, Munich, Germany
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22
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Hardtke-Wolenski M, Landwehr-Kenzel S. Tipping the balance in autoimmunity: are regulatory t cells the cause, the cure, or both? Mol Cell Pediatr 2024; 11:3. [PMID: 38507159 PMCID: PMC10954601 DOI: 10.1186/s40348-024-00176-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
Regulatory T cells (Tregs) are a specialized subgroup of T-cell lymphocytes that is crucial for maintaining immune homeostasis and preventing excessive immune responses. Depending on their differentiation route, Tregs can be subdivided into thymically derived Tregs (tTregs) and peripherally induced Tregs (pTregs), which originate from conventional T cells after extrathymic differentiation at peripheral sites. Although the regulatory attributes of tTregs and pTregs partially overlap, their modes of action, protein expression profiles, and functional stability exhibit specific characteristics unique to each subset. Over the last few years, our knowledge of Treg differentiation, maturation, plasticity, and correlations between their phenotypes and functions has increased. Genetic and functional studies in patients with numeric and functional Treg deficiencies have contributed to our mechanistic understanding of immune dysregulation and autoimmune pathologies. This review provides an overview of our current knowledge of Treg biology, discusses monogenetic Treg pathologies and explores the role of Tregs in various other autoimmune disorders. Additionally, we discuss novel approaches that explore Tregs as targets or agents of innovative treatment options.
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Affiliation(s)
- Matthias Hardtke-Wolenski
- Hannover Medical School, Department of Gastroenterology Hepatology, Infectious Diseases and Endocrinology, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
- University Hospital Essen, Institute of Medical Microbiology, University Duisburg-Essen, Hufelandstraße 55, Essen, 45122, Germany
| | - Sybille Landwehr-Kenzel
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
- Hannover Medical School, Institute of Transfusion Medicine and Transplant Engineering, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
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23
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Baskal S, Posma RA, Bollenbach A, Dieperink W, Bakker SJL, Nijsten MW, Touw DJ, Tsikas D. GC-MS analysis of 4-hydroxyproline: elevated proline hydroxylation in metformin-associated lactic acidosis and metformin-treated Becker muscular dystrophy patients. Amino Acids 2024; 56:21. [PMID: 38461423 PMCID: PMC10925573 DOI: 10.1007/s00726-024-03383-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/31/2024] [Indexed: 03/12/2024]
Abstract
Metformin (N,N-dimethylbiguanide), an inhibitor of gluconeogenesis and insulin sensitizer, is widely used for the treatment of type 2 diabetes. In some patients with renal insufficiency, metformin can accumulate and cause lactic acidosis, known as metformin-associated lactic acidosis (MALA, defined as lactate ≥ 5 mM, pH < 7.35, and metformin concentration > 38.7 µM). Here, we report on the post-translational modification (PTM) of proline (Pro) to 4-hydroxyproline (OH-Pro) in metformin-associated lactic acidosis and in metformin-treated patients with Becker muscular dystrophy (BMD). Pro and OH-Pro were measured simultaneously by gas chromatography-mass spectrometry before, during, and after renal replacement therapy in a patient admitted to the intensive care unit (ICU) because of MALA. At admission to the ICU, plasma metformin concentration was 175 µM, with a corresponding lactate concentration of 20 mM and a blood pH of 7.1. Throughout ICU admission, the Pro concentration was lower compared to healthy controls. Renal excretion of OH-Pro was initially high and decreased over time. Moreover, during the first 12 h of ICU admission, OH-Pro seems to be renally secreted while thereafter, it was reabsorbed. Our results suggest that MALA is associated with hyper-hydroxyprolinuria due to elevated PTM of Pro to OH-Pro by prolyl-hydroxylase and/or inhibition of OH-Pro metabolism in the kidneys. In BMD patients, metformin, at the therapeutic dose of 3 × 500 mg per day for 6 weeks, increased the urinary excretion of OH-Pro suggesting elevation of Pro hydroxylation to OH-Pro. Our study suggests that metformin induces specifically the expression/activity of prolyl-hydroxylase in metformin intoxication and BMD.
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Affiliation(s)
- Svetlana Baskal
- Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Rene A Posma
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alexander Bollenbach
- Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Willem Dieperink
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten W Nijsten
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Daan J Touw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dimitrios Tsikas
- Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
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24
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Schlake K, Teller J, Hinken L, Laser H, Lichtinghagen R, Schäfer A, Fegbeutel C, Weissenborn K, Jung C, Worthmann H, Gabriel MM. Butyrylcholinesterase activity in patients with postoperative delirium after cardiothoracic surgery or percutaneous valve replacement- an observational interdisciplinary cohort study. BMC Neurol 2024; 24:80. [PMID: 38424490 PMCID: PMC10905803 DOI: 10.1186/s12883-024-03580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Postoperative delirium is a frequent and severe complication after cardiac surgery. Activity of butyrylcholinesterase (BChE) has been discussed controversially regarding a possible role in its development. This study aimed to investigate the relevance of BChE activity as a biomarker for postoperative delirium after cardiac surgery or percutaneous valve replacement. METHODS A total of 237 patients who received elective cardiothoracic surgery or percutaneous valve replacement at a tertiary care centre were admitted preoperatively. These patients were tested with the Montreal Cognitive Assessment investigating cognitive deficits, and assessed for postoperative delirium twice daily for three days via the 3D-CAM or the CAM-ICU, depending on their level of consciousness. BChE activity was measured at three defined time points before and after surgery. RESULTS Postoperative delirium occurred in 39.7% of patients (n = 94). Univariate analysis showed an association of pre- and postoperative BChE activity with its occurrence (p = 0.037, p = 0.001). There was no association of postoperative delirium and the decline in BChE activity (pre- to postoperative, p = 0.327). Multivariable analysis including either preoperative or postoperative BChE activity as well as age, MoCA, type 2 diabetes mellitus, coronary heart disease, type of surgery and intraoperative administration of red-cell concentrates was performed. Neither preoperative nor postoperative BChE activity was independently associated with the occurrence of postoperative delirium (p = 0.086, p = 0.484). Preoperative BChE activity was lower in older patients (B = -12.38 (95% CI: -21.94 to -2.83), p = 0.011), and in those with a history of stroke (B = -516.173 (95% CI: -893.927 to -138.420), p = 0.008) or alcohol abuse (B = -451.47 (95% CI: -868.38 to -34.55), p = 0.034). Lower postoperative BChE activity was independently associated with longer procedures (B = -461.90 (95% CI: -166.34 to -757.46), p = 0.002), use of cardiopulmonary bypass (B = -262.04 (95% CI: -485.68 to -38.39), p = 0.022), the number of administered red cell-concentrates (B = -40.99 (95% CI: -67.86 to -14.12), p = 0.003) and older age (B = -9.35 (95% CI: -16.04 to -2.66), p = 0.006). CONCLUSION BChE activity is not independently associated with the occurrence of postoperative delirium. Preoperative BChE values are related to patients' morbidity and vulnerability, while postoperative activities reflect the severity, length and complications of surgery.
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Affiliation(s)
- Konstantin Schlake
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Johannes Teller
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Lukas Hinken
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hans Laser
- Department for Educational and Scientific IT Systems, Hannover Medical School, MHH Information Technology, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ralf Lichtinghagen
- Institute of Clinical Chemistry, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andreas Schäfer
- Cardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christine Fegbeutel
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Karin Weissenborn
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Carolin Jung
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hans Worthmann
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maria Magdalena Gabriel
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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25
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Reiffen HP, Auf der Springe AE, Schiller B. [Anesthesia guidance with defective cuff]. Anaesthesiologie 2024; 73:165-167. [PMID: 38233564 PMCID: PMC10920478 DOI: 10.1007/s00101-024-01378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Hans-Peter Reiffen
- Klinik für Anästhesiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
| | - Anna Elisa Auf der Springe
- Klinik für Anästhesiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland
| | - Benjamin Schiller
- Klinik für Anästhesiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland
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26
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Rohrbeck A, Bruhn VA, Hussein N, Hagemann S, Just I. Clostridium botulinum C3bot mediated effects on cytokine-induced psoriasis-like phenotype in full-thickness skin model. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:1671-1686. [PMID: 37707681 PMCID: PMC10858834 DOI: 10.1007/s00210-023-02718-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
Clostridium botulinum C3 exoenzyme (C3bot) exclusively inhibits RhoA, B and C by ADP-ribosylation and is therefore used as a cell-permeable tool for investigating the cellular role of these Rho-GTPases. Rho-GTPases represent a molecular switch integrating different receptor signalling to downstream cascades including transcriptional cascades that regulate various cellular processes, such as regulation of actin cytoskeleton and cell proliferation. C3bot-induced inhibition of RhoA leads to reorganization of the actin cytoskeleton, morphological changes, and inhibition of cell proliferation as well as modulation of inflammatory response. In this study, we characterized the C3bot-mediated effects on a full-thickness skin model exhibiting a psoriasis-like phenotype through the addition of cytokines. Indeed, after the addition of cytokines, a decrease in epidermal thickness, parakeratosis, and induction of IL-6 was detected. In the next step, it was studied whether C3bot caused a reduction in the cytokine-induced psoriasis-like phenotypes. Basal addition of C3bot after cytokine induction of the full-thickness skin models caused less epidermal thinning and reduced IL-6 abundance. Simultaneous basal incubation with cytokines and C3bot, IL-6 abundance was inhibited, but epidermal thickness was only moderately affected. When C3bot was added apically to the skin model, IL-6 abundance was reduced, but no further effects on the psoriasis-like phenotype of the epidermis were observed. In summary, C3bot inhibits the cytokine-induced expression of IL-6 and thus may have an impact on the pro-inflammatory immune response in the psoriasis-like phenotype.
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Affiliation(s)
- Astrid Rohrbeck
- Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
| | - Vanessa Anna Bruhn
- Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Nali Hussein
- Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Sandra Hagemann
- Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Ingo Just
- Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
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27
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Bobylev D, Horke A, Avsar M, Cvitkovic T, Boethig D, Hazekamp M, Meyns B, Rega F, Dave H, Schmiady M, Ciubotaru A, Cheptanaru E, Vida V, Padalino M, Tsang V, Jashari R, Laufer G, Andreas M, Andreeva A, Tudorache I, Cebotari S, Haverich A, Sarikouch S. Matched comparison of decellularized homografts and bovine jugular vein conduits for pulmonary valve replacement in congenital heart disease. Cell Tissue Bank 2024; 25:55-66. [PMID: 36917328 PMCID: PMC10901942 DOI: 10.1007/s10561-023-10082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023]
Abstract
For decades, bovine jugular vein conduits (BJV) and classic cryopreserved homografts have been the two most widely used options for pulmonary valve replacement (PVR) in congenital heart disease. More recently, decellularized pulmonary homografts (DPH) have provided an alternative avenue for PVR. Matched comparison of patients who received DPH for PVR with patients who received bovine jugular vein conduits (BJV) considering patient age group, type of heart defect, and previous procedures. 319 DPH patients were matched to 319 BJV patients; the mean age of BJV patients was 15.3 (SD 9.5) years versus 19.1 (12.4) years in DPH patients (p = 0.001). The mean conduit diameter was 24.5 (3.5) mm for DPH and 20.3 (2.5) mm for BJV (p < 0.001). There was no difference in survival rates between the two groups after 10 years (97.0 vs. 98.1%, p = 0.45). The rate of freedom from endocarditis was significantly lower for BJV patients (87.1 vs. 96.5%, p = 0.006). Freedom from explantation was significantly lower for BJV at 10 years (81.7 vs. 95.5%, p = 0.001) as well as freedom from any significant degeneration at 10 years (39.6 vs. 65.4%, p < 0.001). 140 Patients, matched for age, heart defect type, prior procedures, and conduit sizes of 20-22 mm (± 2 mm), were compared separately; mean age BJV 8.7 (4.9) and DPH 9.5 (7.3) years (p = n.s.). DPH showed 20% higher freedom from explantation and degeneration in this subgroup (p = 0.232). Decellularized pulmonary homografts exhibit superior 10-year results to bovine jugular vein conduits in PVR.
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Affiliation(s)
- Dmitry Bobylev
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Alexander Horke
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Murat Avsar
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Tomislav Cvitkovic
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Dietmar Boethig
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Mark Hazekamp
- Department of Congenital Cardiac Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Bart Meyns
- Department of Cardiac Surgery, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Filip Rega
- Department of Cardiac Surgery, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hitendu Dave
- Division of Congenital Cardiovascular Surgery, University Children's Hospital, Zurich, Switzerland
| | - Martin Schmiady
- Division of Congenital Cardiovascular Surgery, University Children's Hospital, Zurich, Switzerland
- Cardiac Surgery Center, State Medical and Pharmaceutical University, Chisinau, Moldova
| | - Anatol Ciubotaru
- Cardiac Surgery Center, State Medical and Pharmaceutical University, Chisinau, Moldova
| | - Eduard Cheptanaru
- Cardiac Surgery Center, State Medical and Pharmaceutical University, Chisinau, Moldova
| | - Vladimiro Vida
- Pediatric and Congenital Cardiac Surgery Unit, Azienda Ospedaliera di Padova, University of Padua Medical School, Padua, Italy
| | - Massimo Padalino
- Pediatric and Congenital Cardiac Surgery Unit, Azienda Ospedaliera di Padova, University of Padua Medical School, Padua, Italy
| | - Victor Tsang
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Ramadan Jashari
- European Homograft Bank, Clinique Saint-Jean, Brussels, Belgium
| | - Günther Laufer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Martin Andreas
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Alexandra Andreeva
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Igor Tudorache
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Serghei Cebotari
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Samir Sarikouch
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany.
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Dressler D, Kopp B, Pan L, Saberi FA. The natural course of idiopathic cervical dystonia. J Neural Transm (Vienna) 2024; 131:245-252. [PMID: 38244034 PMCID: PMC10874318 DOI: 10.1007/s00702-023-02736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024]
Abstract
Idiopathic cervical dystonia (ICD) is by far the largest subgroup of dystonia. Still, its natural course is largely unknown. We studied the natural course of 100 ICD patients from our botulinum toxin clinics (age at ICD onset 45.8 ± 13.5 years, female/male ratio 2.0) over a period of 17.5 ± 11.5 years with follow-ups during botulinum toxin therapy and with semi-structured interviews. Two courses of ICD could be distinguished by symptom development of more or less than 6 months. ICD-type 2 was less frequent (19% vs 81%, p < 0.001), had a more rapid onset (8.7 ± 8.0 weeks vs 3.8 ± 3.5 years), a higher remission rate (92% vs 5%, p < 0.001) and a higher prevalence of excessive psychological stress preceding ICD (63% vs 1%, p < 0.001). In both ICD-types, the plateau phase was non-progressive. Significant differences in patient age at ICD onset, latency and extent of remission, female/male ratio and prevalence of family history of dystonia could not be detected. ICD is a non-progressive disorder. ICD-type 1 represents the standard course. ICD-type 2 features rapid onset, preceding excessive psychological stress and a high remission rate. These findings will improve prognosis, treatment strategies and understanding of underlying disease mechanisms. They contradict the widespread fear of patients of a constant and continued decline of their condition. Excessive psychological stress may be an epigenetic factor triggering the manifestation of genetically predetermined dystonia.
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Affiliation(s)
- Dirk Dressler
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Bruno Kopp
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Lizhen Pan
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Department of Neurology, Neurotoxin Research Center, Tongji University School of Medicine, Shanghai, China
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Tietze H, Pott V, Kanzelmeyer N, Memaran N, Baumann U, Mindermann C, Suhlrie A, Drube J, Melk A, Das AM, Schnabel D, Haffner D, Leifheit-Nestler M. LMS-based continuous pediatric reference values for soluble receptor activator of nuclear factor kappa B ligand (sRANKL) and osteoprotegerin (OPG) in the HARP cohort. Osteoporos Int 2024; 35:533-542. [PMID: 37940696 PMCID: PMC10866762 DOI: 10.1007/s00198-023-06959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
Soluble RANKL (sRANKL) and osteoprotegerin (OPG) are regulators of osteoclast differentiation and activation, but adequate pediatric reference values are lacking. Here we provide LMS (Lambda-Mu-Sigma)-based continuous pediatric reference percentiles for sRANKL, OPG and sRANKL/OPG ratio that will allow calculation of standardized patient z-scores to assess bone modeling in children. PURPOSE Soluble receptor activator of nuclear factor kappa B ligand (sRANKL) and osteoprotegerin (OPG) are regulators of osteoclast differentiation and activation and thus bone metabolic turnover in children. Adequate pediatric reference values for their serum/plasma concentrations are lacking. The development of Lambda-Mu-Sigma (LMS)-based continuous reference percentiles for laboratory parameters allow improved data interpretation in clinical practice. METHODS A total of 300 children aged 0.1-18 years (166 boys) were enrolled in the HAnnover Reference values for Pediatrics (HARP) study. sRANKL and OPG were assessed by ELISA. LMS-based continuous reference percentiles were generated using RefCurv software. RESULTS LMS-based percentiles were established for sRANKL, OPG and sRANKL/OPG ratio, which were all found to be age-dependent. sRANKL and sRANKL/OPG associated with sex. In boys, sRANKL percentiles were highest during infancy, followed by a continuous decline until the age of 7 years and a second peak around age 12-13 years. In girls, a continuous, slow decline of sRANKL percentiles was noticed from infancy onwards until the age of 13 years, followed by a rapid decline until adulthood. OPG percentiles continuously declined from infancy to adulthood. The percentiles for sRANKL/OPG ratio paralleled those of sRANKL. Serum concentrations of sRANKL correlated with OPG and serum phosphate z-scores, while OPG concentrations inversely associated with standardized body weight, BMI, and urinary phosphate to creatinine ratio (each p < 0.05). CONCLUSION This is the first report of LMS-based continuous pediatric reference percentiles for sRANKL, OPG and sRANKL/OPG ratio that allows calculation of standardized patient z-scores to assess bone metabolic turnover in children.
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Affiliation(s)
- Helene Tietze
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Veronika Pott
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nele Kanzelmeyer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nima Memaran
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ulrich Baumann
- Department of Pediatric Pneumology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
| | - Charlotte Mindermann
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Adriana Suhlrie
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jens Drube
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anibh M Das
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Dirk Schnabel
- Center for Chronically Sick Children, Pediatric Endocrinology, University Medicine Charité Berlin, Berlin, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Dziadosz M, Rosenberger W, Klintschar M, Teske J. The analysis of ramipril/ramiprilat concentration in human serum with liquid chromatography-tandem mass spectrometry - interpretation of high concentrations for the purposes of forensic toxicology. Forensic Sci Med Pathol 2024; 20:100-105. [PMID: 37060536 PMCID: PMC10944385 DOI: 10.1007/s12024-023-00621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 04/16/2023]
Abstract
Ramipril is a popular angiotensin-converting enzyme inhibitor applied in the treatment of hypertension. Its therapeutic effect is oriented on the concentration of the active metabolite ramiprilat. The information about toxic drug levels is missing in the literature. Therefore, the aim of this work was an indication of possible toxic ranges based on the analysis of real samples with high ramiprilat concentrations. For these purposes, an appropriate analytical LC-MS/MS method was developed and validated according to forensic guidelines and applied in the routine. Most real samples targeted for ramipril/ramiprilat were associated with the typical therapeutic drug range of 1-40 ng/mL described in the literature. However, higher drug levels with ramiprilat concentrations above 100 ng/mL could also be observed infrequently in cases of driving under the influence of drugs or attempted suicides. To the best of the author's knowledge, this is the first time antemortem ramipril and ramiprilat concentrations associated with driving under the influence of drugs and suicide attempts were discussed from a forensic point of view. The collected data enabled an indication of the ramiprilat toxic concentration range from about 600 ng/mL to at least 3500 ng/mL. The toxic concentration range discussed can be applied in the forensic practice as a reference for future cases.
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Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Wolfgang Rosenberger
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Klintschar
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jörg Teske
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Zöllner H, Seifert R. How do German pharmacologists publish in the non-peer-reviewed science magazine Biospektrum? Naunyn Schmiedebergs Arch Pharmacol 2024; 397:1889-1900. [PMID: 37776381 PMCID: PMC10858829 DOI: 10.1007/s00210-023-02740-x] [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] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/02/2023]
Abstract
Publications in peer-reviewed journals are the most important currency in science. But what about publications in non-peer-reviewed magazines? The objective of this study was to analyze the publications of scientists, with a focus on pharmacologists, in the non-peer-reviewed German science magazine Biospektrum from 1999 to 2021. Biospektrum is edited by five scientific societies in Germany including the Society for Experimental and Clinical Society Pharmacology and Toxicology (DGPT) and provides opportunities to researchers to showcase their research to a broad audience. We analyzed 3197 authors of 1326 articles. Compared to the fields of biochemistry, microbiology, and genetics, pharmacology was largely underrepresented. Just three institutions in Germany contributed most papers to Biospektrum. Researchers with a doctoral degree were the largest author group, followed by researchers with a habilitation degree. Among all major fields, women were underrepresented as authors, particularly as senior authors. The Covid pandemic leads to a drop of publications of female first authors but not last authors. Compared to publications in the peer-reviewed journal Naunyn-Schmiedeberg's Archives of Pharmacology (Zehetbauer et al., Naunyn-Schmiedebergs Arch Pharmacol 395:39-50 (2022)), female pharmacologists were underrepresented in the Biospektrum. Thus, German pharmacologists as a group do not value investing in "social impact" gained by publications in Biospektrum, and this attitude is even more prominent among female pharmacologists. Investing less in "social impact" by female pharmacologists may result in reduced visibility on the academic job market and may contribute to reduced opportunities to achieve high academic positions.
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Affiliation(s)
- Helena Zöllner
- Department of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Roland Seifert
- Department of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
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Beller J, Safieddine B, Sperlich S, Tetzlaff J, Geyer S. Time trends in limited lung function among German middle-aged and older adults. Sci Rep 2024; 14:5036. [PMID: 38424128 PMCID: PMC10904379 DOI: 10.1038/s41598-024-55624-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Limited lung function represents a serious health impairment. However, studies investigating changes in limited lung function over time are rare. Thus, the current study investigates time-related changes in limited lung function and potential social inequalities. Data from the 2008 and 2017 waves of the population-based German Aging Survey were used in a repeated cross-sectional study design (N = 8778), including participants aged 40 years and older. Lung function was assessed by the peak flow test. Socio-economic indicators included educational attainment, income and occupational group. Additionally, smoking history, occupational exposure to fumes and gases, and physical exercise were used as potentially explanatory variables for the observed changes. We found that the prevalence of limited lung function decreased strongly over time on a descriptive level from 9.0 to 5.4%. In line with these results, a decreasing trend emerged (OR = 0.48) when controlling for age and gender differences. When additionally controlling for changes in socio-economic indicators and explanatory variables there were still significant decreases over time, but the decline was slightly reduced (OR = 0.57). Moreover, similar significant relative decreases over time occurred for middle-aged and older participants, female and male participants, and those belonging to the different socio-economic groups. Thus, limited lung function generally decreased over time. This decrease could partially be explained by beneficial developments in socio-economic indicators, smoking, occupational exposures, and physical exercise. Future studies might investigate how changes in medicinal treatment and prevention efforts have contributed to the observed beneficial trends in lung health.
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Affiliation(s)
- Johannes Beller
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Batoul Safieddine
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefanie Sperlich
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Juliane Tetzlaff
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Siegfried Geyer
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Kenneweg F, Hobohm L, Bang C, Gupta SK, Xiao K, Thum S, Ten Cate V, Rapp S, Hasenfuß G, Wild P, Konstantinides S, Wachter R, Lankeit M, Thum T. Circulating miR-let7a levels predict future diagnosis of chronic thromboembolic pulmonary hypertension. Sci Rep 2024; 14:4514. [PMID: 38402278 PMCID: PMC10894210 DOI: 10.1038/s41598-024-55223-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 02/26/2024] Open
Abstract
Distinct patterns of circulating microRNAs (miRNAs) were found to be involved in misguided thrombus resolution. Thus, we aimed to investigate dysregulated miRNA signatures during the acute phase of pulmonary embolism (PE) and test their diagnostic and predictive value for future diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH). Microarray screening and subsequent validation in a large patient cohort (n = 177) identified three dysregulated miRNAs as potential biomarkers: circulating miR-29a and miR-720 were significantly upregulated and miR-let7a was significantly downregulated in plasma of patients with PE. In a second validation study equal expression patterns for miR-29a and miR-let7a regarding an acute event of recurrent venous thromboembolism (VTE) or deaths were found. MiR-let7a concentrations significantly correlated with echocardiographic and laboratory parameters indicating right ventricular (RV) dysfunction. Additionally, circulating miR-let7a levels were associated with diagnosis of CTEPH during follow-up. Regarding CTEPH diagnosis, ROC analysis illustrated an AUC of 0.767 (95% CI 0.54-0.99) for miR-let7a. Using logistic regression analysis, a calculated patient-cohort optimized miR-let7a cut-off value derived from ROC analysis of ≥ 11.92 was associated with a 12.8-fold increased risk for CTEPH. Therefore, miR-let7a might serve as a novel biomarker to identify patients with haemodynamic impairment and as a novel predictor for patients at risk for CTEPH.
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Affiliation(s)
- Franziska Kenneweg
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
- REBIRTH Excellence Cluster, Hannover Medical School, Hannover, Germany
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
| | - Claudia Bang
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Shashi K Gupta
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Ke Xiao
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Sabrina Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Vincent Ten Cate
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), Mainz, Germany
| | - Steffen Rapp
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- German Cardiovascular Research Centre (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Gerd Hasenfuß
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Philipp Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), Mainz, Germany
- German Cardiovascular Research Centre (DZHK), Partner Site Rhine Main, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
| | - Rolf Wachter
- Clinic of Cardiology and Pneumology, Heart Center, University Medical Center, Goettingen, Germany
- Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Mareike Lankeit
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
- Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité-University Medicine Berlin, Berlin, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.
- REBIRTH Excellence Cluster, Hannover Medical School, Hannover, Germany.
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Walther W, Ptok M, Hager K, Miller S. Study protocol of the OrkA project: orofacial and communicative activation in old age- a cluster randomized prevention study in long-term care facilities in Lower Saxony, Germany. BMC Geriatr 2024; 24:179. [PMID: 38388406 PMCID: PMC10882768 DOI: 10.1186/s12877-024-04809-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The process of aging involves numerous changes in the body, influencing physical, mental, and emotional well-being. Age-related changes and degradation can impact various functions of the swallowing process and lead to delayed word retrieval. Individuals with limited linguistic stimulation may experience a more rapid decline in cognitive performance. Thus, this project explores a preventive training program targeting swallowing and linguistic-communicative skills, aimed at preserving the social participation of older individuals residing in nursing homes. METHODS A preventive intervention program, combining orofaciopharyngeal and linguistic-communicative components, will be offered twice weekly over 12 weeks in long-term care facilities in the greater Hanover area. The program will aim at: (a) activating sensitive and motor skills in the orofaciopharyngeal area to counter age-related swallowing disorders, and (b) enhancing communicative abilities through semantic-lexical activation. A cluster randomized controlled trial will be conducted to investigate whether the intervention program improves swallowing skills in older adults. Additionally, a secondary analysis will explore the impact on language skills and social participation, as well as program acceptance. DISCUSSION The results will provide valuable insight into the effectiveness of preventive measures addressing swallowing and speech issues in older individuals. TRIAL REGISTRATION The trial was registered with DRKS (German register for clinical trials) in June 2023 (study ID: DRKS00031594) and the WHO International Clinical Trail Registry Platform (secondary register).
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Affiliation(s)
- Wenke Walther
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Martin Ptok
- Emeritus of the Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, Germany
| | - Klaus Hager
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Simone Miller
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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Bjelica B, Wohnrade C, Cespedes I, Osmanovic A, Schreiber-Katz O, Petri S. Risdiplam therapy in adults with 5q-SMA: observational study on motor function and treatment satisfaction. BMC Neurol 2024; 24:67. [PMID: 38368338 PMCID: PMC10873992 DOI: 10.1186/s12883-024-03562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND We aimed to describe the experience of a single neuromuscular center in Germany in treating adult spinal muscular atrophy (SMA) patients with risdiplam and to analyze motor function and treatment satisfaction during a follow-up period up to 20 months. METHODS Fourteen patients with type 2 or 3 SMA (seven with SMA type 2, six with SMA type 3; age range: 18-51) were included. The Revised Upper Limb Module (RULM) and the Hammersmith Functional Motor Scale Expanded (HFMSE) were recorded at baseline and at follow-up (month 4, 8, 12, 16, 20). Treatment adverse events were collected at every follow-up visit. Patients' treatment satisfaction was assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM). RESULTS Half of the patients reached the 20-month follow-up. Based on the HFMSE score, no patients had clinically meaningful improvement. Twelve remained stable (92.3%), two showed transient clinically meaningful deterioration (15.4%) and one experienced lasting clinically meaningful deterioration (7.7%). Based on the RULM scores, seven patients were either stable or demonstrated clinically meaningful improvement (53.8%) and six showed clinically meaningful deterioration (46.2%). There was no treatment withdrawal during the follow-up. The most common adverse events were skin rash/increased skin sensitivity to sunlight (n = 3), diarrhea (n = 3), aphthous ulcer (n = 3) and abdominal pain (n = 2). Most patients stated to be at least "satisfied" with the medication. CONCLUSIONS Risdiplam was well tolerated. Half of the patients remained stable or improved after risdiplam initiation. Larger and multicentric studies are needed to better understand the long-term effects of risdiplam in adult SMA.
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Affiliation(s)
- Bogdan Bjelica
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany.
| | - Camilla Wohnrade
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany
| | - Iraima Cespedes
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, Essen, Germany
| | - Olivia Schreiber-Katz
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Straße, Hannover, 30625, Germany
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Hirsch S, Pöhler GH, Seeliger B, Prasse A, Witte T, Thiele T. Treatment strategies in MDA5-positive clinically amyopathic dermatomyositis: a single-center retrospective analysis. Clin Exp Med 2024; 24:37. [PMID: 38367089 PMCID: PMC10874312 DOI: 10.1007/s10238-024-01300-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/19/2024] [Indexed: 02/19/2024]
Abstract
Melanoma differentiation-associated protein 5 (MDA5) antibody positive amyopathic dermatomyositis (DM) is a rare inflammatory disease. So far, there is no official treatment guideline in MDA5 amyopathic dermatomyositis, but early and aggressive immunosuppressive combination treatment can induce a stable remission. We retrospectively analyzed a cohort of eight patients (male n = 5) that were diagnosed with MDA5-positive amyopathic DM. Patient data comprised demographics, CT-guided diagnosis of pulmonary involvement, pulmonary function testing including forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) data on baseline and mean long-term follow-up of 51 months (24-92 months) to evaluate treatment strategies. Depending on severity of organ involvement treatments were individualized including cyclophosphamide, immunoglobulins and plasmapheresis. Simultaneously, oral treatment with tacrolimus was commenced in four of the eight patients. Most patients received remission maintenance therapy with a combination of tacrolimus, rituximab and low dose steroids. In all patients, improvement in FVC was recorded and five patients achieved an improvement in DLCO. An improvement in the CT imaging morphological findings was observed in four patients. Awareness for the entirety of all clinical and disease-related findings of amyopathic DM is crucial, and remission maintenance is often achieved with a combination of tacrolimus and rituximab.
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Affiliation(s)
- Stefanie Hirsch
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Gesa Helen Pöhler
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Benjamin Seeliger
- Department of Pneumology and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Antje Prasse
- Department of Pneumology and Infectious Diseases, Hannover Medical School, Hannover, Germany
| | - Torsten Witte
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thea Thiele
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Budde S, Derksen A, Hurschler C, Fennema P, Windhagen H, Plagge J, Flörkemeier T, von Lewinski G, Noll Y, Schwarze M. Very early migration of a calcar-guided short stem: a randomized study of early mobilization and the influence of a calcium phosphate coating with 60 patients. Sci Rep 2024; 14:3837. [PMID: 38360840 PMCID: PMC10869691 DOI: 10.1038/s41598-023-50829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024] Open
Abstract
This study analyzed the migration of a calcar-guided short stem to determine the course of very early migration, as well as evaluated the effect of an additional calcium phosphate (CP) coating on a titanium plasma spray (TPS) coating, which has not been analyzed previously. Sixty patients were enrolled in this study and were treated with the A2 calcar-guided short stem. The implant coating was randomized with either the TPS or an additional CP coating, and radiostereometric analysis was performed with the baseline measurement before initial weight-bearing, along with follow-up examinations at 1 week, 6 weeks, 3 months, and 6 months. Implant migrations were 0.27 mm (standard deviation [SD], 0.13 mm) and 0.74 mm (SD, 1.11 mm) at 1 week and 6 months post-surgery, respectively, and 65% and 87% of the implants reached their final position 1 week and 6 weeks after surgery, respectively. After 6 weeks, 3 months, and 6 months, a significant increase was noted in the migration of the CP coating group vs. that of the TPS coating group. Upon the final observation at 6 months, the groups displayed on average a 0.74-mm migration. Most of the analyzed implants ceased migration within the first week post-surgery, but the CP coating demonstrated a higher and more prolonged migration compared to the TPS coating.
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Affiliation(s)
- Stefan Budde
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
- Evangelisches Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Burgsteig 13, 33617, Bielefeld, Germany
| | - Alexander Derksen
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Christof Hurschler
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Peter Fennema
- AMR Advanced Medical Research, Männedorf, Switzerland
| | - Henning Windhagen
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Jochen Plagge
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Thilo Flörkemeier
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Gabriela von Lewinski
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Yvonne Noll
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany
| | - Michael Schwarze
- Hannover Medical School, Department of Orthopaedic Surgery, Diakovere Annastift, Anna Von Borries Str. 1-6, 30625, Hannover, Germany.
- Department for Medical Technology, Hochschule Bremerhaven, An Der Karlstraße 8, 27568, Bremerhaven, Germany.
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Derda AA, Abelmann M, Sieweke JT, Waleczek FJG, Weber N, Zehrfeld N, Bär C, Duncker D, Bavendiek U, Berliner D, Bauersachs J, Sonnenschein K, Thum T. A pilot study for risk stratification of ventricular tachyarrhythmia in hypertrophic cardiomyopathy with routine echocardiography parameters. Sci Rep 2024; 14:3799. [PMID: 38360886 PMCID: PMC10869710 DOI: 10.1038/s41598-024-54153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
Ventricular tachyarrhythmia (VTA) are frequent arrhythmias in patients with hypertrophic cardiomyopathy (HCM). Representing a major risk factor for sudden cardiac death, Holter ECG at first clinical presentation appears insufficient. This study aims to investigate the ability of routinely obtained parameters associated with myocardial remodeling in stratifying for VTA in HCM. In this monocentric analysis, patients with HCM underwent 12-channel electrocardiography and echocardiography, including tissue doppler imaging. The study's primary endpoint was the documentation of non-sustained and sustained ventricular tachycardia-summarized as ventricular tachyarrhythmias (VTA) on Holter ECG or active devices. The occurrence of VTA was exploratory. Based on our collective, we developed a risk model regarding VTA. Of 140 HCM patients, 38 (27.1%) had an episode of VTA. Patients with VTA were likelier to have a history of atrial fibrillation (p < 0.001), a thicker interventricular septum (p < 0.001) and lower peak systolic mitral annular velocity (p < 0.001). The parameters were independently associated with endpoint in univariate and multivariate logistic regression. We created a logistic equation and calculated a cut-off value. The resulting ROC curve revealed a discriminative ability with AUC of 0.80 (sensitivity, 63%; specificity, 88%). Our risk model including these widely available parameters is able to distinguish low and high-risk of VTA in patients with HCM.
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Affiliation(s)
- Anselm A Derda
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Malin Abelmann
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jan-Thorben Sieweke
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Florian J G Waleczek
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
| | - Natalie Weber
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nadine Zehrfeld
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
| | - David Duncker
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Udo Bavendiek
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Dominik Berliner
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Kristina Sonnenschein
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany.
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Heine N, Doll-Nikutta K, Stein F, Jakobi J, Ingendoh-Tsakmakidis A, Rehbock C, Winkel A, Barcikowski S, Stiesch M. Anti-biofilm properties of laser-synthesized, ultrapure silver-gold-alloy nanoparticles against Staphylococcus aureus. Sci Rep 2024; 14:3405. [PMID: 38336925 PMCID: PMC10858226 DOI: 10.1038/s41598-024-53782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
Staphylococcus aureus biofilm-associated infections are a common complication in modern medicine. Due to inherent resilience of biofilms to antibiotics and the rising number of antibiotic-resistant bacterial strains, new treatment options are required. For this purpose, ultrapure, spherical silver-gold-alloy nanoparticles with homogenous elemental distribution were synthesized by laser ablation in liquids and analyzed for their antibacterial activity on different stages of S. aureus biofilm formation as well as for different viability parameters. First, the effect of nanoparticles against planktonic bacteria was tested with metabolic activity measurements. Next, nanoparticles were incubated with differently matured S. aureus biofilms, which were then analyzed by metabolic activity measurements and three dimensional live/dead fluorescent staining to determine biofilm volume and membrane integrity. It could be shown that AgAu NPs exhibit antibacterial properties against planktonic bacteria but also against early-stage and even mature biofilms, with a complete diffusion through the biofilm matrix. Furthermore, AgAu NPs primarily targeted metabolic activity, to a smaller extend membrane integrity, but not the biofilm volume. Additional molecular analyses using qRT-PCR confirmed the influence on different metabolic pathways, like glycolysis, stress response and biofilm formation. As this shows clear similarities to the mechanism of pure silver ions, the results strengthen silver ions to be the major antibacterial agent of the synthesized nanoparticles. In summary, the results of this study provide initial evidence of promising anti-biofilm characteristics of silver-gold-alloy nanoparticles and support the importance of further translation-oriented analyses in the future.
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Affiliation(s)
- Nils Heine
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
- Lower Saxony Centre of Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany.
| | - Katharina Doll-Nikutta
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Lower Saxony Centre of Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Frederic Stein
- Technical Chemistry I, University of Duisburg Essen, Universitaetsstr. 7, 45141, Essen, Germany
| | - Jurij Jakobi
- Technical Chemistry I, University of Duisburg Essen, Universitaetsstr. 7, 45141, Essen, Germany
| | - Alexandra Ingendoh-Tsakmakidis
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Lower Saxony Centre of Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Christoph Rehbock
- Technical Chemistry I, University of Duisburg Essen, Universitaetsstr. 7, 45141, Essen, Germany
| | - Andreas Winkel
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Lower Saxony Centre of Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany
| | - Stephan Barcikowski
- Technical Chemistry I, University of Duisburg Essen, Universitaetsstr. 7, 45141, Essen, Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
- Lower Saxony Centre of Biomedical Engineering, Implant Research and Development, Stadtfelddamm 34, 30625, Hannover, Germany.
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Kerling A, Beyer S, Dirks M, Scharbau M, Hennemann AK, Dopfer-Jablonka A, Lampe V, Salzmann JHW, Tegtbur U, Drick N, Pink I, Haufe S. Effects of a randomized-controlled and online-supported physical activity intervention on exercise capacity, fatigue and health related quality of life in patients with post-COVID-19 syndrome. BMC Sports Sci Med Rehabil 2024; 16:33. [PMID: 38308307 PMCID: PMC10835885 DOI: 10.1186/s13102-024-00817-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/17/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND The Post-COVID-19 syndrome (PCS), which can occur after acute respiratory syndrome coronavirus 2 infection, leads to restrictions in everyday activity. Our study assessed the impact of an online-guided intervention which intended to facilitate physical activity on the mental and physical capability of PCS patients. METHODS We randomized 62 patients with PCS (20 male/ 42 female; age: 46 ± 12 years; body mass index: 28.7 ± 6.7 kg/m2) with a score ≥ 22 in the fatigue assessment scale (FAS) to a 3-month exercise-focused intervention (IG n = 30) or control period (CG n = 32). We assessed changes in exercise capacity (bicycle exercise test with measurements of gas exchange), fatigue, markers of health-related quality of life (HrQoL) and mental health. RESULTS The FAS score decreased significantly in both study groups (IG: 35.1 ± 7.4 to 31.8 ± 8.5 points; CG: 35.6 ± 7.4 to 32.6 ± 7.5 points, both p < 0.01). Exercise capacity did not increase in the CG or IG (within-group changes for IG: peak oxygen uptake: 0.9 ± 2.6 ml/min/kg, p = 0.098; peak power output: 6.1 ± 17.8 W, p = 0.076) with no significant changes in HrQoL and work ability. Patients with a FAS score at baseline ≥ 35 (severe fatigue) showed no change in exercise capacity with the 3-month intervention whereas the sub-group of patients with FAS < 35 points (moderate fatigue) showed improvements, independent of the study group. CONCLUSIONS Our 3-month intervention seems appropriate for patients with moderate fatigue, whereas those with more severe fatigue appear to be too restricted with respect to their mental or physical health status to perform exercise at a level which is sufficient to improve markers of physical performance. TRIAL REGISTRATION German Clinical Trials Register (registration trial number: DRKS00026245) on September 2 2021.
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Affiliation(s)
- Arno Kerling
- Clinic for Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Sebastian Beyer
- Clinic for Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Meike Dirks
- Clinic for Neurology, Hannover Medical School, Hannover, Germany
| | - Michèle Scharbau
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | | | | | - Viktoria Lampe
- Clinic for Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Uwe Tegtbur
- Clinic for Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nora Drick
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Isabell Pink
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Sven Haufe
- Clinic for Rehabilitation and Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Liodakis E, Giannoudis VP, Harwood PJ, Giannoudis PV. Docking site interventions following bone transport using external fixation: a systematic review of the literature. Int Orthop 2024; 48:365-388. [PMID: 38148379 PMCID: PMC10799803 DOI: 10.1007/s00264-023-06062-8] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Although bone transport is a well-recognised technique to address segmental bone defects, optimal management of docking sites is not absolutely determined. Some surgeons routinely intervene in all cases, and others prefer to observe and intervene only if spontaneous union does not occur. Primary aim of the study was to compare rates of docking site union between patients who underwent routine docking site intervention and those who did not. METHODS A systematic literature review using the keywords "bone transport", "docking", "tibia", and "femur" was performed in PubMed using PRISMA guidelines. Studies published in English from January 2000 to August 2022 were included and assessed independently by two reviewers. Pooled analysis was undertaken dividing patients into two groups: those managed by routine intervention and those initially observed. RESULTS Twenty-three clinical studies met the eligibility criteria for pooled analysis, including 1153 patients, 407 in the routine intervention and 746 in the observed group. The rate of union after initial treatment was 90% in the routine intervention group and 66% in the observed group (p < 0.0001). Overall union rates at the end of treatment were similar at 99% in both groups. Patients in the observed group required an average of 2.2 procedures to achieve union overall compared with 3.8 in the routine intervention group. Time in frame was similar between groups. CONCLUSION Based on the current literature, routine docking site interventions cannot be recommended, since this may lead to unnecessary interventions in two thirds of patients. Timely selective intervention in those at high risk or after a defined period of observation would appear to be a logical approach.
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Affiliation(s)
- E Liodakis
- Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - V P Giannoudis
- Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Leeds, UK
| | - P J Harwood
- Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Leeds, UK
| | - P V Giannoudis
- Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Leeds, UK
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Greten S, Wegner F, Jensen I, Krey L, Rogozinski S, Fehring M, Heine J, Doll-Lee J, Pötter-Nerger M, Zeitzschel M, Hagena K, Pedrosa DJ, Eggers C, Bürk K, Trenkwalder C, Claus I, Warnecke T, Süß P, Winkler J, Gruber D, Gandor F, Berg D, Paschen S, Classen J, Pinkhardt EH, Kassubek J, Jost WH, Tönges L, Kühn AA, Schwarz J, Peters O, Dashti E, Priller J, Spruth EJ, Krause P, Spottke A, Schneider A, Beyle A, Kimmich O, Donix M, Haussmann R, Brandt M, Dinter E, Wiltfang J, Schott BH, Zerr I, Bähr M, Buerger K, Janowitz D, Perneczky R, Rauchmann BS, Weidinger E, Levin J, Katzdobler S, Düzel E, Glanz W, Teipel S, Kilimann I, Prudlo J, Gasser T, Brockmann K, Hoffmann DC, Klockgether T, Krause O, Heck J, Höglinger GU, Klietz M. The comorbidity and co-medication profile of patients with progressive supranuclear palsy. J Neurol 2024; 271:782-793. [PMID: 37803149 PMCID: PMC10827866 DOI: 10.1007/s00415-023-12006-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Progressive supranuclear palsy (PSP) is usually diagnosed in elderly. Currently, little is known about comorbidities and the co-medication in these patients. OBJECTIVES To explore the pattern of comorbidities and co-medication in PSP patients according to the known different phenotypes and in comparison with patients without neurodegenerative disease. METHODS Cross-sectional data of PSP and patients without neurodegenerative diseases (non-ND) were collected from three German multicenter observational studies (DescribePSP, ProPSP and DANCER). The prevalence of comorbidities according to WHO ICD-10 classification and the prevalence of drugs administered according to WHO ATC system were analyzed. Potential drug-drug interactions were evaluated using AiDKlinik®. RESULTS In total, 335 PSP and 275 non-ND patients were included in this analysis. The prevalence of diseases of the circulatory and the nervous system was higher in PSP at first level of ICD-10. Dorsopathies, diabetes mellitus, other nutritional deficiencies and polyneuropathies were more frequent in PSP at second level of ICD-10. In particular, the summed prevalence of cardiovascular and cerebrovascular diseases was higher in PSP patients. More drugs were administered in the PSP group leading to a greater percentage of patients with polypharmacy. Accordingly, the prevalence of potential drug-drug interactions was higher in PSP patients, especially severe and moderate interactions. CONCLUSIONS PSP patients possess a characteristic profile of comorbidities, particularly diabetes and cardiovascular diseases. The eminent burden of comorbidities and resulting polypharmacy should be carefully considered when treating PSP patients.
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Affiliation(s)
- Stephan Greten
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Ida Jensen
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Lea Krey
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sophia Rogozinski
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Meret Fehring
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Johanne Heine
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Johanna Doll-Lee
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Molly Zeitzschel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Keno Hagena
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - David J Pedrosa
- Department of Neurology, University Hospital of Marburg and Gießen, 35043, BaldingerstraßeMarburg, Germany
| | - Carsten Eggers
- Department of Neurology, Knappschaftskrankenhaus Bottrop, Osterfelder Str. 157, 46242, Bottrop, Germany
| | - Katrin Bürk
- Kliniken Schmieder Stuttgart-Gerlingen, Solitudestraße 20, 70839, Gerlingen, Germany
| | | | - Inga Claus
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Tobias Warnecke
- Department of Neurology and Neurorehabilitation, Klinikum Osnabrueck-Academic Teaching Hospital of the WWU Muenster, Am Finkenhügel 1, 49076, Osnabrueck, Germany
| | - Patrick Süß
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schloßplatz 4, 91054, Erlangen, Germany
- Center of Rare Diseases Erlangen (ZSEER), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schloßplatz 4, 91054, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schloßplatz 4, 91054, Erlangen, Germany
- Center of Rare Diseases Erlangen (ZSEER), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schloßplatz 4, 91054, Erlangen, Germany
| | - Doreen Gruber
- Movement Disorders Hospital, Beelitz-Heilstätten, Straße Nach Fichtenwalde 16, 14547, Beelitz-Heilstätten, Germany
| | - Florin Gandor
- Movement Disorders Hospital, Beelitz-Heilstätten, Straße Nach Fichtenwalde 16, 14547, Beelitz-Heilstätten, Germany
| | - Daniela Berg
- Department of Neurology, Kiel University, Christian-Albrechts-Platz 4, 24118, Kiel, Germany
| | - Steffen Paschen
- Department of Neurology, Kiel University, Christian-Albrechts-Platz 4, 24118, Kiel, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig Medical Center, Liebigstraße, 18, 04103, Leipzig, Germany
| | - Elmar H Pinkhardt
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Oberer Eselsberg, 89081, Ulm, Germany
| | - Wolfgang H Jost
- Parkinson-Klinik Ortenau, Kreuzbergstraße 12, 77709, Wolfach, Germany
| | - Lars Tönges
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
- Protein Research Unit Ruhr (PURE), Neurodegeneration Research, Ruhr University Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| | - Andrea A Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité, University Medicine Berlin, Charitépl. 1, 10117, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Charitépl. 1, 10117, Berlin, Germany
| | - Johannes Schwarz
- Department of Neurology, Klinik Haag I. OB, Krankenhausstraße 1, 84453, Mühldorf a. Inn, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Charitépl. 1, 10117, Berlin, Germany
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Charitépl. 1, 10117, Berlin, Germany
| | - Eman Dashti
- Department of Neurology, Charité-Universitätsmedizin Berlin, Charitépl. 1, 10117, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Charitépl. 1, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitépl. 1, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE), Charitépl. 1, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Charitépl. 1, 10117, Berlin, Germany
| | - Patricia Krause
- German Center for Neurodegenerative Diseases (DZNE), Charitépl. 1, 10117, Berlin, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Aline Beyle
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Okka Kimmich
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Markus Donix
- German Center for Neurodegenerative Diseases (DZNE), Tatzberg 41, 01307, Dresden, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Robert Haussmann
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Moritz Brandt
- German Center for Neurodegenerative Diseases (DZNE), Tatzberg 41, 01307, Dresden, Germany
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Elisabeth Dinter
- German Center for Neurodegenerative Diseases (DZNE), Tatzberg 41, 01307, Dresden, Germany
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Björn H Schott
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Inga Zerr
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany
- Department of Neurology, University Medical Center, Georg August University, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Mathias Bähr
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075, Göttingen, Germany
- Department of Neurology, University Medical Center, Georg August University, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Daniel Janowitz
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Exhibition Rd, South Kensington, London, SW7 2BX, UK
| | - Boris-Stephan Rauchmann
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Endy Weidinger
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Sabrina Katzdobler
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Leipziger Straße 44, 39120, Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Universitätspl. 2, 39106, Magdeburg, Germany
- Institute of Cognitive Neuroscience, University College London, Gower St, London, WC1E 6BT, UK
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Leipziger Straße 44, 39120, Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Universitätspl. 2, 39106, Magdeburg, Germany
- Clinic for Neurology, Medical Faculty, University Hospital Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Straße 20, 18147, Rostock-GreifswaldRostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Straße 20, 18147, Rostock-GreifswaldRostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany
| | - Johannes Prudlo
- German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Straße 20, 18147, Rostock-GreifswaldRostock, Germany
- Department of Neurology, University Medical Center, Schillingallee 35, 18057, Rostock, Germany
| | - Thomas Gasser
- German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076, Tübingen, Germany
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Kathrin Brockmann
- German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076, Tübingen, Germany
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Daniel C Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
| | - Thomas Klockgether
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Olaf Krause
- Center for Medicine of the Elderly, DIAKOVERE Henriettenstift and Department of General Medicine and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Center for Geriatric Medicine, Hospital DIAKOVERE Henriettenstift, Schwemannstrasse 19, 30559, Hannover, Germany
| | - Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Günter U Höglinger
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Strasse 17, 81377, Munich, Germany
- Department of Neurology, University Hospital of Munich, Ludwig-Maximilians-Universität (LMU) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Martin Klietz
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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Sansonetti M, Al Soodi B, Thum T, Jung M. Macrophage-based therapeutic approaches for cardiovascular diseases. Basic Res Cardiol 2024; 119:1-33. [PMID: 38170281 PMCID: PMC10837257 DOI: 10.1007/s00395-023-01027-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
Despite the advances in treatment options, cardiovascular disease (CVDs) remains the leading cause of death over the world. Chronic inflammatory response and irreversible fibrosis are the main underlying pathophysiological causes of progression of CVDs. In recent decades, cardiac macrophages have been recognized as main regulatory players in the development of these complex pathophysiological conditions. Numerous approaches aimed at macrophages have been devised, leading to novel prospects for therapeutic interventions. Our review covers the advancements in macrophage-centric treatment plans for various pathologic conditions and examines the potential consequences and obstacles of employing macrophage-targeted techniques in cardiac diseases.
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Affiliation(s)
- Marida Sansonetti
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, 30625, Hannover, Germany
| | - Bashar Al Soodi
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, 30625, Hannover, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, 30625, Hannover, Germany.
- REBIRTH-Center for Translational Regenerative Medicine, Hannover Medical School, 30625, Hannover, Germany.
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), 30625, Hannover, Germany.
| | - Mira Jung
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, 30625, Hannover, Germany.
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Hounchonou HF, Bajgora G, Esmaeilzadeh M, Hartmann C, Krauss JK. Surgical site infections after glioblastoma surgery: boon or bane? J Cancer Res Clin Oncol 2024; 150:36. [PMID: 38279060 PMCID: PMC10817840 DOI: 10.1007/s00432-023-05528-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/13/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Surgical site infections (SSIs) are among the most common postoperative complications. Glioblastoma multiforme is the most frequent malignant brain tumor with a dismal prognosis despite combined treatment. The effect of SSIs on the course of glioblastoma patients has not been fully clarified since available data are limited and partially contradictory. The aim of this study is to investigate the impact of SSIs on the course of patients with glioblastoma. METHODS The medical records of all patients undergoing surgery for glioblastoma between 2010 and 2020 in our institution were scanned and those with surgical site infections after glioblastoma resection were identified and compared to an age-matched control group. Overall survival and progression-free survival were the primary endpoints followed by the number of hospitalizations and the length of stay in hospital. RESULTS Out of 305 patients undergoing surgery for glioblastoma, 38 patients with postoperative surgical site infection after resection were identified and 15 (5 men and 10 women aged between 9 and 72) were included in this study. 23 patients were excluded. The control group consisted of 30 age-matched patients without SSI (18 men and 12 women). There were no significant differences in median overall survival. Progression-free survival was higher in the SSI group. The number of hospitalizations and the length of stay were significantly higher in the SSI group. CONCLUSION Our data suggest that SSIs might reduce early recurrences without affecting overall survival. Furthermore, they might decrease health-related quality of life by doubling the total length of hospital stay.
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Affiliation(s)
- Harold F Hounchonou
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Genis Bajgora
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Majid Esmaeilzadeh
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christian Hartmann
- Department of Neuropathology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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Schwarze S, Schaadt NS, Sobotta VMG, Spicher N, Skripuletz T, Esmaeilzadeh M, Krauss JK, Hartmann C, Deserno TM, Feuerhake F. Task design for crowdsourced glioma cell annotation in microscopy images. Sci Rep 2024; 14:1965. [PMID: 38263411 PMCID: PMC10805723 DOI: 10.1038/s41598-024-51995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
Crowdsourcing has been used in computational pathology to generate cell and cell nuclei annotations for machine learning. Herein, we broaden its scope to the previously unsolved challenging task of glioma cell detection. This requires multiplexed immunofluorescence microscopy due to diffuse invasiveness and exceptional similarity between glioma cells and reactive astrocytes. In four pilot experiments, we iteratively developed a task design enabling high-quality annotations by crowdworkers on Amazon Mechanical Turk. We applied majority or weighted vote and validated them against ground truth in the final setting. On the base of a YOLO convolutional neural network architecture, we used these consensus labels for training with different image representations regarding colors, intensities, and immmunohistochemical marker combinations. A crowd of 712 workers defined aggregated point annotations in 235 images with an average [Formula: see text] score of 0.627 for majority vote. The networks resulted in acceptable [Formula: see text] scores up to 0.69 for YOLOv8 on average and indicated first evidence for transferability to images lacking tumor markers, especially in IDH-wildtype glioblastoma. Our work confirms feasibility of crowdsourcing to generate labels suitable for training of machine learning tools in the challenging and clinically relevant use case of glioma microenvironment.
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Affiliation(s)
- Svea Schwarze
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Nadine S Schaadt
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Viktor M G Sobotta
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Nicolai Spicher
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | | | | | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Thomas M Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Friedrich Feuerhake
- Department of Neuropathology, Institute for Pathology, Hannover Medical School, Hannover, Germany.
- Institute of Neuropathology, University Clinic Freiburg, Freiburg, Germany.
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Stahl K, Bode C, Seeliger B, Wendel-Garcia PD, David S. Current clinical practice in using adjunctive extracorporeal blood purification in sepsis and septic shock: results from the ESICM "EXPLORATION" survey. Intensive Care Med Exp 2024; 12:5. [PMID: 38238627 PMCID: PMC10796869 DOI: 10.1186/s40635-023-00592-6] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/22/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Despite a lack of clear evidence extracorporeal blood purification (EBP) is increasingly used as an adjunctive treatment in septic shock based on its biological plausibility. However, current state of praxis and believes in both efficacy and level of evidence are very heterogeneous. METHODS The "EXPLORATION" (Current Clinical Practice in using adjunctive extracorporeal blood purification in septic shock), a web-based survey endorsed by the European Society of Intensive Care Medicine (ESICM), questioned both the current local clinical practices as well as future perspectives of EBP in sepsis and septic shock. RESULTS One hundred and two people participated in the survey. The majority of three quarters of participants (74.5%) use adjunctive EBP in their clinical routine with a varying frequency of description. Unselective cytokine adsorption (CA) (37.5%) and therapeutic plasma exchange (TPE) (34.1%) were by far the most commonly used modalities. While the overall theoretical rational was found to be moderate to high by the majority of the participants (74%), the effectively existing clinical evidence was acknowledged to be rather low (66%). Although CA was used most frequently in clinical practice, both the best existing clinical evidence endorsing its current use (45%) as well the highest potential to be explored in future clinical trials (51.5%) was attributed to TPE. CONCLUSIONS Although the majority of participants use EBP techniques in their clinical practice and acknowledge a subjective good theoretical rationale behind it, the clinical evidence is assessed to be limited. While both CA and TPE are by far the most common used technique, both clinical evidence as well as future potential for further exploration in clinical trials was assessed to be the highest for TPE.
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Affiliation(s)
- Klaus Stahl
- Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology, Hannover Medical School, Carl-Neuberg Straße 1, 30163, Hannover, Germany.
| | - Christian Bode
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Benjamin Seeliger
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), Hannover Medical School (MHH), German Center for Lung Research (DZL), Hannover, Germany
| | | | - Sascha David
- Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland
- Department of Nephrology, Hannover Medical School, Hannover, Germany
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Stritzel J, Ebrahimzadeh AH, Büchner A, Lanfermann H, Marschollek M, Wolff D. Landmark-based registration of a cochlear model to a human cochlea using conventional CT scans. Sci Rep 2024; 14:1115. [PMID: 38212412 PMCID: PMC10784596 DOI: 10.1038/s41598-023-50632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024] Open
Abstract
Cochlear implants can provide an advanced treatment option to restore hearing. In standard pre-implant procedures, many factors are already considered, but it seems that not all underlying factors have been identified yet. One reason is the low quality of the conventional computed tomography images taken before implantation, making it difficult to assess these parameters. A novel method is presented that uses the Pietsch Model, a well-established model of the human cochlea, as well as landmark-based registration to address these challenges. Different landmark numbers and placements are investigated by visually comparing the mean error per landmark and the registrations' results. The landmarks on the first cochlear turn and the apex are difficult to discern on a low-resolution CT scan. It was possible to achieve a mean error markedly smaller than the image resolution while achieving a good visual fit on a cochlear segment and directly in the conventional computed tomography image. The employed cochlear model adjusts image resolution problems, while the effort of setting landmarks is markedly less than the segmentation of the whole cochlea. As a next step, the specific parameters of the patient could be extracted from the adapted model, which enables a more personalized implantation with a presumably better outcome.
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Affiliation(s)
- Jenny Stritzel
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany.
| | - Amir Hossein Ebrahimzadeh
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Andreas Büchner
- German Hearing Center, Hannover Medical School, Hannover, Germany
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
| | - Heinrich Lanfermann
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Michael Marschollek
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Dominik Wolff
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
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Heise KM, Miller S, Ptok M, Jungheim M. [Prevalence of mucosal injuries during flexible endoscopic evaluation of swallowing in the presence of a nasogastric tube]. HNO 2024; 72:25-31. [PMID: 37796338 PMCID: PMC10781840 DOI: 10.1007/s00106-023-01361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The flexible endoscopic evaluation of swallowing (FEES) is an established low-risk examination method to assess the risk of penetration or aspiration in patients with dysphagia. FEES might be more difficult or of higher-risk when a nasogastric tube is in place. OBJECTIVE This study aims to identify whether the prevalence of mucosal lesions is higher when the endoscopy is carried out with a nasogastric tube in place. Pre-existing mucosal lesions were also documented. METHODS In a retrospective, monocentric study, a total of 918 FEES procedures routinely performed in hospitalized patients of a university hospital from January 2014 to March 2019 were evaluated. Mucosal lesions were identified and characterized for descriptive statistics. RESULTS In the video material analysed here, no endoscopy-related injuries were identified. However, pre-existing mucosal lesions, which often occurred as multiple lesions, were detected in 48.6% of the endoscopies. Further analysis showed that these pre-existing lesions were not worsened by the endoscopy performed. CONCLUSION The results demonstrate that transnasal flexible endoscopy is a safe, low-risk examination method, even in patients with a nasogastric tube. A very high number of pre-existing mucosal lesions were found, which is probably related to the previous insertion of the nasogastric tube. Due to the high number of pre-existing lesions, strategies should be developed to minimize injuries when placing nasogastric tubes.
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Affiliation(s)
- Kira-Milena Heise
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Simone Miller
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Martin Ptok
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Michael Jungheim
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Amann E, Schwarze M, Noll Y, Windhagen H, Radtke K. [Evaluation of care for slipped capital femoral epiphysis (SCFE) in Germany]. Orthopadie (Heidelb) 2024; 53:11-22. [PMID: 37964106 PMCID: PMC10781806 DOI: 10.1007/s00132-023-04455-6] [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] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 11/16/2023]
Abstract
INTRODUCTION The treatment concept for slipped capital femoral epiphysis is still controversial. According to studies, there is currently no recommendation for a universal approach. Therefore, the aim of this study is to analyze the care reality of children with ECF in Germany. METHODS The evaluation of the study is performed based on a questionnaire sent to physicians tending to ECF in 2021. Data is compared to the literature. RESULTS 36 of 47 questionnaires sent out were included. Overall, no significant difference in ECF care was proven in terms of annual caseload or the size of hospital. CONCLUSION A high variance in operative SCFE treatment is reported. According to current literature, the modified Dunn procedure is considered the best therapeutic option to date, especially for patients with severe or chronic ECF. However, compared with alternative care options, this is not feasible in every hospital due to its complicating and challenging nature. Central registration, minimum volume regulation, and expansion of continuing education measures can contribute to optimization.
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Affiliation(s)
- Elea Amann
- Department Kinder- und Neuroorthopädie, Orthopädische Klinik, Medizinische Hochschule Hannover (MHH) im DIAKOVERE Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland
| | - Michael Schwarze
- Labor für Biomechanik und Biomaterialien, Orthopädische Klinik, Medizinische Hochschule Hannover (MHH) im DIAKOVERE Annastift, Hannover, Deutschland
| | - Yvonne Noll
- Klinisches Studienmanagement der Orthopädischen Klinik, Medizinische Hochschule Hannover (MHH) im DIAKOVERE Annastift, Hannover, Deutschland
| | - Henning Windhagen
- Orthopädische Klinik, Medizinische Hochschule Hannover (MHH) im DIAKOVERE Annastift, Hannover, Deutschland
| | - Kerstin Radtke
- Department Kinder- und Neuroorthopädie, Orthopädische Klinik, Medizinische Hochschule Hannover (MHH) im DIAKOVERE Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.
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Trabert M, Seifert R. Critical analysis of ginkgo preparations: comparison of approved drugs and dietary supplements marketed in Germany. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:451-461. [PMID: 37470803 PMCID: PMC10771617 DOI: 10.1007/s00210-023-02602-6] [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] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/24/2023] [Indexed: 07/21/2023]
Abstract
Demographic change is taking place in the population of western industrialized countries, and the population is aging constantly. As a result, the mortality rate of patients due to dementia is rising steadily. To counteract this, the relevance of neuroprotective agents is increasing. Preparations from the medicinal tree species Ginkgo biloba ("gingko") are becoming increasingly popular. In this study, 63 ginkgo preparations marketed in Germany were analyzed. The following data were collected from the package inserts of the preparations: Country of manufacture, approval as a drug, compliance to target values of flavone glycosides, compliance to target values of terpene lactones, compliance to target values of ginkgolic acids, dosage per unit in milligrams (mg), duration of use, interactions with other drugs, contraindications, adverse effects and daily defined dose costs. In the next step, these data were compared in the following form: Total preparations versus preparations with drug approval versus dietary supplements. Almost without exception, the results indicate a pharmaceutical reliability of the preparations with drug approval and a dubious reliability of the preparations marketed as dietary supplements. Thus, ginkgo preparations marketed as dietary supplements appear to have an economic rather than a medical focus. We discuss the evidence of efficacy, and other criteria mentioned above, to evaluate the adequacy of the costs for the statutory health insurance that pay for preparations with drug approval in Germany. From the analysis of our results it is very doubtful that ginkgo biloba extract preparations of the food industry have any health benefit. It must be evaluated whether prohibition of selling ginkgo biloba extract as a dietary supplement is an option.
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Affiliation(s)
- Milan Trabert
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hanover, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hanover, Germany.
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