Markovic D.S.,Max Delbrück Center for Molecular Medicine |
Vinnakota K.,Max Delbrück Center for Molecular Medicine |
van Rooijen N.,VU University Amsterdam |
Kiwit J.,Helios Clinic |
And 4 more authors.
Brain, Behavior, and Immunity | Year: 2011
Glioma cells release soluble factors, which induce the expression of membrane type 1 matrix metalloprotease (MT1-MMP) in tumor associated microglia and then exploit MT1-MMP mediated matrix degradation for invasion. Here, we show that minocycline blocked the increase in MT1-MMP expression and activity in cultivated microglia stimulated with glioma conditioned medium. Glioma growth within an organotypic brain slice preparation was reduced by minocycline and this reduction depended on the presence of microglia. Glioma growth in an experimental mouse model was strongly reduced by the addition of minocycline to drinking water, compared to untreated controls. Coherently, we observed in our orthotopic glioma implantation model, that MT1-MMP was abundantly expressed in glioma associated microglia in controls, but was strongly attenuated in tumors of minocycline treated animals. Overall, our study indicates that the clinically approved antibiotic minocycline is a promising new candidate for adjuvant therapy against malignant gliomas. © 2011 Elsevier Inc.
PubMed | Otto Von Guericke University of Magdeburg, Martin Luther University of Halle Wittenberg, Manouba University, Illinois State University and Helios Clinic
Type: | Journal: The Journal of sports medicine and physical fitness | Year: 2017
The primary aim of the study was to examine the anthropometric characteristics as well as throwing and sprinting performance of professional handball players classified by playing position and competition level.21 male players (age: 25.2 5.1 years) from the first German handball league (FGL) and 34 male players (age: 26.1 4.1 years) from the third German handball league (TGL) were categorized as backs, pivots, wings and goalkeepers. Measurements included anthropometric data (height, mass and body mass index (BMI)), throwing and sprinting performance selected out of a complex handball test (HBCT), which was conducted twice (2 rounds). During the HBCT, the subjects performed two sprints (10, 20 m), two standing throws with run-up (ST) and four vertical jump throws (VJT) over a hurdle (20 cm) with and without precision for goal shot.The anthropometric data revealed a significantly (p=0.038 and n2=0.079)) shorter body height for TGL than for FGL players. In the cohort of first league athletes the pivots were the tallest (1.98 0.04 m), backs in the third league showed the maximum body height (1.90 0.05 m). Regarding body mass, pivots were the heaviest players independent from the league membership. The FGL players showed a significantly (p<0.05 and n2>0.10) higher throwing velocity in all type of throws. Body height was significantly related to ST (r=0.53) and VJT (r=0.52) in the first round of HBCT but only for the FGL athletes. Throwing velocity was also correlated with BMI (r=-0.50) among the TGL players.Substantial differences of body characteristics, throwing and sprinting performance between playing positions and competitive levels underline the importance of a careful scouting and position-specific training for professional handball players.
Gerretsen S.,Maastricht University |
Kessels A.G.,Maastricht University |
Nelemans P.J.,Maastricht University |
Dijkstra J.,Leiden University |
And 9 more authors.
European Radiology | Year: 2013
Objectives: Compared with X-ray coronary angiography (CAG), magnetic resonance imaging of the coronary vessel wall (MR-CVW) may provide more information about plaque burden and coronary remodelling. We compared MR-CVW with intravascular ultrasound (IVUS), the standard of reference for coronary vessel wall imaging, with regard to plaque detection and wall thickness measurements. Methods: In this study 17 patients with chest pain, who had been referred for CAG, were included. Patients underwent IVUS and MR-CVW imaging of the right coronary artery (RCA). Subsequently, the coronary vessel wall was analysed for the presence and location of coronary plaques. Results: Fifty-two matching RCA regions of interest were available for comparison. There was good agreement between IVUS and MR-CVW for qualitative assessment of presence of disease, with a sensitivity of 94% and specificity of 76%. Wall thickness measurements demonstrated a significant difference between mean wall thickness on IVUS and MR-CVW (0.48 vs 1.24mm, P < 0.001), but great heterogeneity between wall thickness measurements, resulting in a low correlation between IVUS and MR-CVW. Conclusions: MR-CVW has high sensitivity for the detection of coronary vessel wall thickening in the RCA compared with IVUS. However, the use of MRI for accurate absolute wall thickness measurements is not supported when a longitudinal acquisition orientation is used. Key Points: • Both MRI and IVUS can assess coronary vessels • Both MRI and IVUS can identify coronary vessel wall thickening. • MRI provides more information about the coronary plaque burden than conventional angiography. • However, MRI overestimates absolute coronary wall thickness when compared with IVUS. © 2012 European Society of Radiology.
Dissemond J.,University of Duisburg - Essen |
Kroger K.,HELIOS Clinic |
Storck M.,University Hospital Freiburg |
Risse A.,Clinic Center North |
Journal of Wound Care | Year: 2015
Chronic wounds are an increasing problem in our ageing population and can arise in many different ways. Over the past decades it has become evident that sufficient oxygen supply is an essential factor of appropriate wound healing. Sustained oxygen deficit has a detrimental impact on wound healing, especially for patients with chronic wounds. This has been proven for wounds associated with peripheral arterial occlusive disease (PAOD) and diabetic foot ulcers (particularly in combination with PAOD). However, this is still under debate for other primary diseases. In the past few years several different new therapeutic approaches for topical oxygen therapies have been developed to support wound healing. These tend to fall into one of four categories: (1) delivery of pure oxygen either under pressurised or (2) ambient condition, (3) chemical release of oxygen via an enzymatic reaction or (4) increase of oxygen by facilitated diffusion using oxygen binding and releasing molecules. In this review article, the available therapeutic topical oxygen-delivering approaches and their impact on wound healing are presented and critically discussed. A summary of clinical data, daily treatment recommendations and practicability is provided. © 2015 MA Healthcare Ltd.
Kuhn A.,University of Munster |
Gensch K.,Heinrich Heine University Düsseldorf |
Haust M.,Heinrich Heine University Düsseldorf |
Meuth A.-M.,University of Munster |
And 5 more authors.
Journal of the American Academy of Dermatology | Year: 2011
Objective: We sought to assess if the exclusive use of a broad-spectrum sunscreen can prevent skin lesions in patients with different subtypes of cutaneous lupus erythematosus (CLE) induced by ultraviolet (UV) irradiation under standardized conditions. Methods: A total of 25 patients with a medical history of photosensitive CLE were included in this monocentric, randomized, vehicle-controlled, double-blind, intraindividual study. The test product and its vehicle were applied 15 minutes before UVA and UVB irradiation of uninvolved skin areas on the upper aspect of the back in a random order, and standardized phototesting was performed daily for 3 consecutive days. Results: Characteristic skin lesions were induced by UVA and UVB irradiation in 16 patients with CLE in the untreated area, and 14 patients showed a positive test result in the vehicle-treated area. In contrast, no eruptions compatible with CLE were observed in the sunscreen-treated area in any of the 25 patients. This resulted in significant differences (P < .001) between UV-irradiated sunscreen-treated versus vehicle-treated areas, and between UV-irradiated sunscreen-treated versus untreated areas. Furthermore, a significant difference (P < .05) was observed concerning the age of disease onset and the patient history of photosensitivity. Patients who were younger than 40 years at onset of CLE reported photosensitivity significantly more often than patients with a higher age of disease onset. None of the patients showed any adverse events from application of the test product or the vehicle. Limitations: Data resulting from standardized experimental phototesting might not be transferable to a clinical setting. Conclusion: These results indicate clearly that the use of a highly protective broad-spectrum sunscreen can prevent skin lesions in photosensitive patients with different subtypes of CLE. © 2009 by the American Academy of Dermatology, Inc.
Rickert A.,University of Mannheim |
Kienle P.,University of Mannheim |
Kuthe A.,DRK Hospital Clementinenhaus |
Baumann P.,Aesculap AG |
And 5 more authors.
Langenbeck's Archives of Surgery | Year: 2012
Background: The implantation of a polymer mesh is considered as the standard treatment for incisional hernia. It leads to lower recurrence rates compared to suture techniques without mesh implantation; however, there are also some drawbacks to mesh repair. The operation is more complex and peri-operative infectious complications are increased. Yet it is not clear to what extent a mesh implantation influences quality of life or leads to chronic pain or discomfort. The influence of the material, textile structure and size of the mesh remain unclear. The aim of this study was to evaluate if a non-absorbable, large pore-sized, lightweight polypropylene (PP) mesh leads to a better health outcome compared to a partly absorbable mesh. Methods/design: In this randomised, double-blinded study, 80 patients with incisional hernia after a median laparotomy received in sublay technique either a non-absorbable mesh (Optilene® Mesh Elastic) or a partly absorbable mesh (Ultrapro® Mesh). Primary endpoint was the physical health score from the SF-36 questionnaire 21 days post-operatively. Secondary variables were patients' daily activity score, pain score, wound assessment and post-surgical complications until 6 months post-operatively. Results: SF-36, daily activity and pain scores were similar in both groups after 21 days and 6 months, respectively. No hernia recurrence was observed during the observation period. Post-operative complication rates also showed no difference between the groups. Conclusion: The implantation of a non-absorbable, large pore-sized, lightweight PP mesh for incisional hernia leads to similar patient-related outcome parameters, recurrence and complication rates as a partly absorbable mesh. © 2012 The Author(s).
Reissig A.,Friedrich - Schiller University of Jena |
Mempel C.,Helios Clinic |
Schumacher U.,Friedrich - Schiller University of Jena |
Copetti R.,Latisana General Hospital |
And 2 more authors.
Lung | Year: 2013
Background: The aim of this secondary analysis was to evaluate current microbiological approaches, microbiology, and antibiotic therapy in patients with community-acquired pneumonia (CAP) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in clinical practice and to compare them with current international guidelines. Methods: A total of 362 patients with suspected CAP were enrolled in 14 European centers in a prospective multicenter study. Results: A total of 279 inpatients (CAP, n = 222; AECOPD, n = 57) were evaluated. A total of 83 (37 %) CAP patients and 25 (44 %) AECOPD patients did not undergo any microbiological tests. In patients with CAP/AECOPD, blood culture was performed in 109 (49 %)/16 (28.1 %), urinary antigen tests for Legionella pneumophila in 67 (30 %)/9 (16 %), and sputum investigation in 55 (25 %)/17 (30 %), respectively. The most frequent pathogens in CAP were Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, L. pneumophila, Staphylococcus aureus, and Enterobacter cloacae; in AECOPD they were Escherichia coli, Haemophilus haemolyticus, Haemophilus influenzae, and Moraxella catarrhalis. All CAP patients (mean = 11.1 days) and 35 (61.4 %) of AECOPD patients (mean = 8.9 days) received antibiotics. CAP patients were given mostly aminopenicillin with β-lactamase inhibitors and AECOPD patients were given mostly cephalosporins. Conclusions: Pathogens isolated in CAP and AECOPD and the antibiotic therapy used are in good accordance with the guidelines. Blood culture, recommended for all CAP patients, was performed in only 50 % of the cases and antibiotic therapy lasted longer than the suggested 5-7 days. Therefore, international guidelines regarding performance of blood culture and duration of antibiotic therapy should be adopted more often. This duration was independent of the number of isolated pathogens and number of symptoms on admission. Therefore, the question arises as to whether microbiological data are necessary only for patients who are resistant to initial therapy. © 2013 Springer Science+Business Media New York.
Reissig A.,Friedrich - Schiller University of Jena |
Copetti R.,Latisana General Hospital |
Mathis G.,Medical Practice |
Mempel C.,Helios Clinic |
And 6 more authors.
Chest | Year: 2012
Background: The aim of this prospective, multicenter study was to define the accuracy of lung ultrasound (LUS) in the diagnosis of community-acquired pneumonia (CAP). Methods: Three hundred sixty-two patients with suspected CAP were enrolled in 14 European centers. At baseline, history, clinical examination, laboratory testing, and LUS were performed as well as the reference test, which was a radiograph in two planes or a low-dose CT scan in case of inconclusive or negative radiographic but positive LUS findings. In patients with CAP, follow-up between days 5 and 8 and 13 and 16 was scheduled. Results: CAP was confirmed in 229 patients (63.3%). LUS revealed a sensitivity of 93.4% (95% CI, 89.2%-96.3%), specificity of 97.7% (95% CI, 93.4%-99.6%), and likelihood ratios (LRs) of 40.5 (95% CI, 13.2-123.9) for positive and 0.07 (95% CI, 0.04-0.11) for negative results. A combination of auscultation and LUS increased the positive LR to 42.9 (95% CI, 10.8-170.0) and decreased the negative LR to 0.04 (95% CI, 0.02-0.09). We found 97.6% (205 of 211) of patients with CAP showed breath-dependent motion of infiltrates, 86.7% (183 of 211) an air bronchogram, 76.5% (156 of 204) blurred margins, and 54.4% (105 of 193) a basal pleural effusion. During follow-up, median C-reactive protein levels decreased from 137 mg/dL to 6.3 mg/dL at days 13 to 16 as did signs of CAP; median area of lesions decreased from 15.3 cm2 to 0.2 cm2 and pleural effusion from 50 mL to 0 mL. Conclusions: LUS is a noninvasive, usually available tool used for high-accuracy diagnosis of CAP. This is especially important if radiography is not available or applicable. About 8% of pneumonic lesions are not detectable by LUS; therefore, an inconspicuous LUS does not exclude pneu monia. Trial registry: ClinicalTrials.gov; No.: NCT00808457; URL: www.clinicaltrials.gov. © 2012 American College of Chest Physicians.
Safak E.,Charité - Medical University of Berlin |
Wilke C.,Experimental and Clinical Research Center |
Derer W.,HELIOS Clinic |
Busjahn A.,Experimental and Clinical Research Center |
And 5 more authors.
Journal of the American Society of Hypertension | Year: 2013
Atherosclerotic renal artery stenosis (ARAS) is a predictor of increased morbidity and mortality. However, whether ARAS itself accelerates the arteriosclerotic process or whether ARAS is solely the consequence of atherosclerosis is unclear. We imaged renal arteries of 1561 hypertensive patients undergoing coronary angiography and followed this cohort for 9 years (range, 2.4-15.1 years; median, 31.2 months, interquartile range, 13.4/52.9 months). All patients received aspirin, renin-angiotensin system blockade, statins, and beta blockade as indicated. One hundred seventy-one patients had ARAS >50% diameter stenosis and 126 patients an arteriosclerotic plaque (ARAP) without significant stenosis. Blood pressures were not different in ARAS, ARAP, and non-ARAS patients. After adjustment for cardiovascular risk factors by propensity scores and matched pair analysis, ARAS patients had a lower ejection fraction and more coronary artery disease (CAD) than non-ARAS patients. The same was true for brain natriuretic peptide values, troponin I, and highly sensitive C-reative protein. Over 9 years, more ARAS patients died of any cause (34% vs 23%; P <.05). The prevalence of CAD in ARAP patients was higher than in non-ARAS patients and lower than in ARAS patients. The mortality of the ARAP patients at 9 years was 37%, not different from the ARAS patients. Atherosclerotic renal artery disease appears to be a marker for the severity of atherosclerosis rather than a causative factor for atherosclerosis progression. © 2013 American Society of Hypertension. All rights reserved.
Neumann G.,HELIOS Clinic |
Schaadt A.-K.,Saaland University |
Reinhart S.,Saaland University |
Kerkhoff G.,Saaland University
Neurorehabilitation and Neural Repair | Year: 2016
Background. Cerebral vision disorders (CVDs) are frequent after brain damage and impair the patient's outcome. Yet clinically and psychometrically validated procedures for the anamnesis of CVD are lacking. Objective. To evaluate the clinical validity and psychometric qualities of the Cerebral Vision Screening Questionnaire (CVSQ) for the anamnesis of CVD in individuals poststroke. Methods. Analysis of the patients' subjective visual complaints in the 10-item CVSQ in relation to objective visual perimetry, tests of reading, visual scanning, visual acuity, spatial contrast sensitivity, light/dark adaptation, and visual depth judgments. Psychometric analyses of concurrent validity, specificity, sensitivity, positive/negative predictive value, and interrater reliability were also done. Results. Four hundred sixty-one patients with unilateral (39.5% left, 47.5% right) or bilateral stroke (13.0%) were included. Most patients were assessed in the chronic stage, on average 36.7 (range = 1-620) weeks poststroke. The majority of all patients (96.4%) recognized their visual symptoms within 1 week poststroke when asked for specifically. Mean concurrent validity of the CVSQ with objective tests was 0.64 (0.54-0.79, P <.05). The mean positive predictive value was 80.1%, mean negative predictive value 82.9%, mean specificity 81.7%, and mean sensitivity 79.8%. The mean interrater reliability was 0.76 for a 1-week interval between both assessments (all P <.05). Conclusion. The CVSQ is suitable for the anamnesis of CVD poststroke because of its brevity (10 minute), clinical validity, and good psychometric qualities. It, thus, improves neurovisual diagnosis and guides the clinician in the selection of necessary assessments and appropriate neurovisual therapies for the patient. © American Society of Neurorehabilitation.