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Schaefers A.T.U.,Bielefeld University | Grafen K.,Bielefeld University | Teuchert-Noodt G.,Bielefeld University | Winter Y.,Bielefeld University | And 2 more authors.
Neural Plasticity | Year: 2010

Hippocampal cell proliferation is strongly increased and synaptic turnover decreased after rearing under social and physical deprivation in gerbils (Meriones unguiculatus). We examined if a similar epigenetic effect of rearing environment on adult neuroplastic responses can be found in mice (Mus musculus). We examined synaptic turnover rates in the dentate gyrus, CA3, CA1, subiculum, and entorhinal cortex. No direct effects of deprived rearing on rates of synaptic turnover were found in any of the studied regions. However, adult wheel running had the effect of leveling layer-specific differences in synaptic remodeling in the dentate gyrus, CA3, and CA1, but not in the entorhinal cortex and subiculum of animals of both rearing treatments. Epigenetic effects during juvenile development affected adult neural plasticity in mice, but seemed to be less pronounced than in gerbils. Copyright © 2010 Andrea T. U. Schaefers et al. Source

Beinder E.,Charit Universittsmedizin Berlin
Zeitschrift fur Geburtshilfe und Neonatologie | Year: 2011

The incidence of premature births is not decreasing in developed countries, but rather shows a tendency to increase. This rise is primarily due to an increase in the number iatrogenic late preterm births at a gestational age between 34+0 and 36+6 weeks. Late preterm births account for up to 80% of all preterm births and these newborns have higher morbidity and mortality rates and a higher rate in neurodevelopmental long-term impairment in comparison to term infants. In order to reduce iatrogenic preterm birth, it is necessary to apply standardised treatment algorithms especially in cases of mild preeclampsia and intrauterine growth restriction. © Georg Thieme Verlag KG Stuttgart New York. Source

Meisel A.,NeuroCure Clinical Research Center | Meisel C.,Charit Universittsmedizin Berlin | Harms H.,NeuroCure Clinical Research Center | Hartmann O.,Thermo Fisher Scientific | Ulm L.,NeuroCure Clinical Research Center
Cerebrovascular Diseases | Year: 2012

About one third of early deaths and poor outcomes after acute stroke are caused by potentially preventable stroke-associated complications, especially infections. Early identification of patients at high risk of infections and poor prognosis with biomarkers might help to initiate adequate therapies and guide treatment decisions. Acute injury of the central nervous system, including stroke, disturbs the normally well-balanced interplay between the sympathetic nervous system and the immune system, thereby impairing the antibacterial immune response in stroke patients. Changes in immune and stress markers, for example a reduction in HLA-DR expression on monocytes or an increase in serum catecholamine levels, occur very early after stroke onset, explain the high susceptibility of stroke patients to bacterial infections, and are predictive of infectious complications occurring up to 2 weeks after stroke. Outcome prediction is of utmost importance for decision-making in stroke units as well as in neurological intensive care units. However, to date the accuracy of outcome prediction by physicians and clinical scoring systems is only moderate. So far, only two blood-based biomarkers have been identified as independent predictors of outcome and mortality after stroke: the stress marker copeptin and midregional pro-atrial natriuretic peptide. Careful evaluation of prognostic markers is needed to prevent the occurrence of self-fulfilling prophecy. © 2012 S. Karger AG, Basel. Source

Perings C.,Ruhr University Bochum | Rudolf Bauer W.,University of Wrzburg | Bondke H.-J.,Charit Universittsmedizin Berlin | Mewis C.,Saarland University | And 8 more authors.
Europace | Year: 2011

Aims Intracardiac electrograms (IEGMs) recorded by implantable cardioverter-defibrillators (ICDs) are essential for arrhythmia diagnosis and ICD therapy assessment. Short IEGM snapshots showing 310 s before arrhythmia detection were added to the Biotronik Home Monitoring system in 2005 as the first-generation IEGM Online. The RIONI study tested the primary hypothesis that experts' ratings regarding the appropriateness of ICD therapy based on IEGM Online and on standard 30 s IEGM differ in <10 of arrhythmia events. Methods and results A total of 619 ICD patients were enrolled and followed for 1 year. According to a predefined procedure, 210 events recorded by the ICDs were selected for evaluation. Three expert board members rated the appropriateness of ICD therapy and classified the underlying arrhythmia using coded IEGM Online and standard IEGM to avoid bias. The average duration of IEGM Online was 4.4 ± 1.5 s. According to standard IEGM, the underlying arrhythmia was ventricular in 135 episodes (64.3), supraventricular in 53 episodes (25.2), oversensing in 17 episodes (8.1), and uncertain in 5 episodes (2.4). The expert boards rating diverged between determinable IEGM Online tracings and standard IEGM in 4.6 of episodes regarding the appropriateness of ICD therapy (95 CI up to 8.0) and in 6.6 of episodes regarding arrhythmia classification (95 CI up to 10.5). Conclusion By enabling accurate evaluation of the appropriateness of ICD therapy and the underlying arrhythmia, the first-generation IEGM Online provided a clinically effective basis for timely interventions and for optimized patient management schemes, which was comparable with current IEGM recordings. © 2010 The Author. Source

Gutzwiller F.S.,University of Basel | Schwenkglenks M.,University of Basel | Schwenkglenks M.,University Zrich | Blank P.R.,University of Basel | And 8 more authors.
European Journal of Heart Failure | Year: 2012

Aims The purpose of this study was to evaluate the cost-effectiveness of iron repletion using intravenous (i.v.) ferric carboxymaltose (FCM) in chronic heart failure (CHF) patients with iron deficiency with or without anaemia. Cost-effectiveness was studied from the perspective of the National Health Service in the UK. Methods and Results A model-based cost-effectiveness analysis was used to compare iron repletion with FCM with no iron treatment. Using data from the FAIR-HF trial and publicly available sources and publications, per patient costs and clinical effectiveness of FCM were estimated compared with placebo. Cost assessment was based on study drug and administration costs, cost of CHF treatment, and hospital length of stay. The incremental cost-effectiveness ratio (ICER) of FCM use was expressed as cost per quality-adjusted life year (QALY) gained, and sensitivity analyses were performed on the base case. The time horizon of the analysis was 24 weeks. Mean QALYs were higher in the FCM arm (difference 0.037 QALYs; bootstrap-based 95 confidence interval 0.0170.060). The ICER of FCM compared with placebo was €4414 per QALY gained for the FAIR-HF dosing regimen. Sensitivity analyses confirmed the base case result to be robust. Conclusion From the UK payers' perspective, managing iron deficiency in CHF patients using i.v. FCM was cost-effective in this analysis. The base case ICER was clearly below the threshold of €22 200€33 300/QALY gained (£20 000£30 000) typically used by the UK National Institute for Health and Clinical Excellence and proved to be robust in sensitivity analysis. Improved symptoms and better quality of life contributed to this result. © 2012 The Author. Source

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