Fischer-Betz R.,Universitatsklinikum Dusseldorf
Tagliche Praxis | Year: 2016
Treating the rheumatology patient with wish to conceive or during pregnancy can be chal-lenging but extremely rewarding. While not all medications can be used safely during pregnancy, most disease flares can be adequately managed during pregnancy. If possible, pregnancies should always be planned so that the underlying rheu- matologic disease is under good control and med-ications can be appropriately adjusted. DMARDS considered safe during pregnancy should be con-tinued. Ideally, pre-pregnancy evaluation with both the rheumatologist and obstetrician should be done. This pre-conception counseling is also an ideal time to discuss and formulate a plan in case of flares.
Huber-van der Velden K.K.,Universitatsklinikum Dusseldorf
Klinische Monatsblatter fur Augenheilkunde | Year: 2016
The term “luxury foodstuffs” refers to foods which are not consumed because of their nutritional value. Classic modern luxury foodstuffs are alcohol, caffeine-containing drinks, cocoa, sugar and tobacco. The following review article examines some of these modern luxury foodstuffs in detail, as well as their influence on glaucoma. Thus, small quantities of alcohol lower high intraocular pressure and have a positive influence on the blood circulation of the optic nerve. In addition, red wine polyphenols exert vasoprotective effects. In general, however, alcohol consumption appears to have no significant effect on the prevalence of glaucoma. The most important source of caffeine intake is coffee consumption. In some studies, coffee consumption caused no changes in intraocular pressure, while others reported a rise. A large study showed a connection between heavy coffee consumption and the risk of pseudoexfoliation glaucoma. Green and black teas are rich sources of flavonoids with antioxidant activity. In addition, a slight trend for lowering the intraocular pressure has been measured. As regards chocolate, flavonoid-rich dark chocolate should be favoured, due to its antioxidant activity. It lowers blood pressure and improves endothelium-dependent vascular relaxation. Excessive sugar consumption over many years can lead to increased body mass index (BMI) and type 2 diabetes. Many studies show a positive relationship between BMI and intraocular pressure. Some studies have identified significant correlations between type 2 diabetes and the risk of glaucoma. Smoking is a very widespread stimulant; it narrows the blood vessels and thus reduces the blood circulation of the optic nerve. Otherwise, studies on the role of smoking as a risk factor for glaucoma have been very inconsistent. Luxury foodstuffs may effect glaucoma and should be included in the medical history. Copyright © 2016, Georg Thieme Verlag. All rights reserved.
Petermann U.,University of Bremen |
Petermann F.,University of Bremen |
Franz M.,Universitatsklinikum Dusseldorf
Kindheit und Entwicklung | Year: 2010
Inadequate parenting competencies/skills are considered to be a high developmental risk. This especially applies to extreme family conditions (e. g., physical illness of a parent). As a consequence, preventive parent training programs (Triple P) and child-parent training programs were developed. There are now also evaluated training programs for risk groups (e.g., PALME, a program for single mothers) in German-speaking countries. © Hogrefe Verlag, Göttingen 2010.
Marker-Hermann E.,Klinik Innere Medizin IV Rheumatologie Klinische Immunologie Nephrologie |
Fischer-Betz R.,Universitatsklinikum Dusseldorf
Current Opinion in Obstetrics and Gynecology | Year: 2010
Purpose Of Review: This review discusses how inflammatory rheumatic diseases [rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE)] of the mother can influence the course of pregnancy and the development of the fetus. Antirheumatic drug therapy of the mother and strategies to prevent fetal complications namely in SLE must be considered with care. Recent Findings: The current literature is presented discussing hypotheses about the immunologic mechanisms leading to amelioration or exacerbation of the rheumatic symptoms in rheumatoid arthritis and ankylosing spondylitis during pregnancy. In SLE, several recent studies have been published concerning fetal complications in the antiphospholipid syndrome and in Ro/SSA-positive and La/SSB-positive mothers and how to diagnose, treat, or prevent these. Summary: Today, women with inflammatory rheumatic diseases are normally fertile and can be encouraged to become pregnant, when there is a stable and quiescent phase of the disease. This is in particular important for patients with SLE, although pregnancy outcome in SLE has improved over the last decades. Pregnancy in SLE is still a high-risk period during the disease course with the highest risk in women with active lupus nephritis. In contrast, women with rheumatoid arthritis develop amelioration of the rheumatic symptoms during the course of pregnancy in most cases; female ankylosing spondylitis patients are likely to show unaltered or aggravated symptoms of back pain and impaired function. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Schror K.,UniversitatsKlinikum Dusseldorf |
Thrombosis and Haemostasis | Year: 2015
Taken together, current evidence suggests that conventional antiplatelet drugs, such as aspirin, clopidogrel, prasugrel and ticagrelor also have antiinflammatory actions in different experimental settings and clinical conditions. These actions are thought to be primarily related to their antiplatelet effect. While there is significant evidence for aspirin-related antiinflammatory antiplatelet actions, the situation with ADP-antagonists is less clear, as it has been reported (28) that treatment with ticagrelor and clopidogrel did not lead to significant differences regarding the inflammatory biomarkers CRP, IL-6, and sCD40L in patients with NSTE-ACS among treatment groups at baseline, discharge, and at four weeks (23). However, these actions will be seen during DAPT and likely the anti - aggregatory effect might also be stronger with combined use. © Schattauer 2015.
Karger A.,Universitatsklinikum Dusseldorf
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2014
Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor-patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system. © 2014 Springer-Verlag Berlin Heidelberg.
Hufeland M.,Universitatsklinikum Dusseldorf
Journal of Pediatric Orthopaedics | Year: 2014
The trichorhinophalangeal syndrome is a rare genetic syndrome with characteristic craniofacial and skeletal abnormalities including hip pathology in variable manifestation. We describe hip involvement with Perthes-like changes and a novel mutation of the TRPSI gene in a family with 4 affected individuals. This case series underlines the clinical significance of rare genetic disorders such as TRPS that among other differential diagnoses should be kept in mind when children present with Perthes-like changes of the hip joint. © 2014 by Lippincott Williams & Wilkins
Schott M.,Universitatsklinikum Dusseldorf
Internist | Year: 2013
Thyrotoxicosis is mainly caused by autonomous adenomas of the thyroid gland and by Graves' disease. A less frequent cause for thyrotoxicosis is Hashimoto's thyroiditis. Thyrotoxicosis in autonomous adenomas and Graves' disease is caused by an increased thyroid hormone production whereas hyperthyroidism in Hashimoto's thyroiditis results from destruction of the thyroid gland. Drug therapy depends on the cause of the disease. Autonomous adenomas and Graves' disease are treated with methimazole and potentially with β-blockers. Regarding thyroid ablative therapy, radioiodine is mostly preferred compared to thyroidectomy. Drug therapy of Hashimoto's thyroiditis is purely symptomatic using β-blockers and rarely corticosteroids. Hyperthyroidism in pregnancy is a major issue and pregnant women in the first trimester are treated with propylthiouracil (PTU) whereas women in the second and third trimesters are treated with methimazole. The aim is to maintain the serum fT4 levels within the upper normal range. © 2013 Springer-Verlag Berlin Heidelberg.
Reinehr R.,Universitatsklinikum Dusseldorf |
Sommerfeld A.,Universitatsklinikum Dusseldorf |
Haussinger D.,Universitatsklinikum Dusseldorf
Journal of Biological Chemistry | Year: 2010
The aim of the study was to analyze whether the proliferative effects of insulin in rat liver involve cross-signaling toward the epidermal growth factor receptor (EGFR) and whether this is mediated by insulin-induced hepatocyte swelling. Studies were performed in the perfused rat liver and in primary rat hepatocytes. Insulin (35 nmol/liter) induced phosphorylation of the EGFR at position Tyr845 and Tyr1173, but not at Tyr 1045, suggesting that EGF is not involved in insulin-induced EGFR activation. Insulin-induced EGFR phosphorylation and subsequent ERK1/2 phosphorylation were sensitive to bumetanide, indicating an involvement of insulin-induced hepatocyte swelling. In line with this, hypoosmotic (225 mosmol/liter) hepatocyte swelling also induced EGFR and ERK1/2 activation. Insulin- and hypoosmolarity-induced EGFR activation were sensitive to inhibition by an integrin-antagonistic RGD peptide, an integrin β1 subtype-blocking antibody, and the c-Src inhibitor PP-2, indicating the involvement of the recently described integrin-dependent osmosensing/signaling pathway (Schliess, F., Reissmann, R., Reinehr, R., vom Dahl, S., and Häussinger, D. (2004) J. Biol. Chem. 279, 21294-21301). As shown by immunoprecipitation studies, insulin and hypoosmolarity induced a rapid, RGD peptide-, integrin β1-blocking antibody and PP-2-sensitive association of c-Src with the EGFR. As for control, insulin-induced insulin receptor substrate-1 phosphorylation remained unaffected by the RGD peptide, PP-2, or inhibition of the EGFR tyrosine kinase activity by AG1478. Both insulin and hypoosmolarity induced a significant increase in BrdU uptake in primary rat hepatocytes, which was sensitive to RGD peptide-, integrin β1-blocking antibody, PP-2, AG1478, and PD098059. It is concluded that insulin- or hypoosmolarity-induced hepatocyte swelling triggers an integrin- and c-Src kinase-dependent EGFR activation, which may explain the proliferative effects of insulin. © 2010 by The American Society for Biochemistry and Molecular Biology, Inc.
Diehl N.,Universitatsklinikum Dusseldorf |
Schaal H.,Universitatsklinikum Dusseldorf
Viruses | Year: 2013
As viruses do not possess genes encoding for proteins required for translation, energy metabolism or membrane biosynthesis, they are classified as obligatory intracellular parasites that depend on a host cell to replicate. This genome limitation forces them to gain control over cellular processes to ensure their successful propagation. A diverse spectrum of virally encoded proteins tackling a broad spectrum of cellular pathways during most steps of the viral life cycle ranging from the host cell entry to viral protein translation has evolved. Since the host cell PI3K/Akt signaling pathway plays a critical regulatory role in many cellular processes including RNA processing, translation, autophagy and apoptosis, many viruses, in widely varying ways, target it. This review focuses on a number of remarkable examples of viral strategies, which exploit the PI3K/Akt signaling pathway for effective viral replication. © 2013 by the authors; licensee MDPI, Basel, Switzerland.