bluuebunny/crossref_metadata_2025 huggingface dataset:
Potentially Important MicroRNAs in Form-Deprivation Myopia Revealed by Bioinformatics Analysis of MicroRNA Profiling
Authors: Mei Fang , Wang Junguo , Chen Zhijun , Yuan Zhilan
Published: February 2017

Objective: This study aimed to identify differentially expressed microRNAs (miRNAs) and to explore their potential roles in form-deprivation myopia. Methods: The microarray data set GSE58124 of miRNAs was downloaded from the Gene Expression Omnibus, and form-deprivation myopia was induced in C57BL/6J mice over the right eye; the contralateral, left eyes were used as controls. Differential expression analysis was done using the LIMMA package. miRDB was used to predict targets for miRNAs. The target genes were put into DAVID to identify significant pathways and biological processes of miRNAs. A functionally collaborative network was constructed using Cytoscape. Result: In total, 24 and 20 upregulated miRNAs, respectively, were screened out in retina and whole-eye tissue. However, there was no dramatic expression change of miRNAs in sclera tissue. By taking intersections, 8 common upregulated miRNAs were obtained in both the retina and the whole-eye samples. According to miRDB, 1,805 target genes were screened out for the 8 differentially expressed miRNAs, including MAPK10 (mitogen-activated protein kinase 10). The functionally collaborative network revealed that “regulation of transcription” was significantly enriched. The pathways “Axon guidance” and “TGF-β signaling pathway” were also enriched. Importantly, miR-466h-5p and miR-466j were significantly enriched in some synaptic transmission-related biological processes. Conclusion: This study identified an upregulation of 8 miRNAs, which may function by disturbing their enriched pathways or biological processes in the progression of myopia.
Cytomorphological Analysis of Lymph Node Lesions in HIV-Positive Patients with CD4 Count Correlation: A Cross-Sectional Study
Authors: Nasser Sadia Siddiqa , Patil Rashmi K. , Kittur Shreekanth K.
Published: February 2017

Objectives: To study the cytomorphological spectrum of lymph node lesions in HIV-positive patients and correlate the cytological findings with the CD4 count. Study Design: This was a cross-sectional study of 23 months' duration which included 110 HIV-positive cases proved according to the guidelines of the National AIDS Control Organisation. Fine-needle aspiration cytology (FNAC) was done on clinically palpable lymph nodes. Special stains and culture were done wherever necessary. CD4 count was done by flow cytometry and subsequently correlated with the cytological findings. Results: Our study included 110 cases, ranging in age from 6 to 70 years, peaking in the 3rd to 4th decade (n = 46). The male-to-female ratio was 1.75:1 and the predominant site was the cervical group of lymph nodes (n = 71). Each lesion was correlated with CD4 count, laboratory and clinical findings, and was further segregated based on WHO and CDC staging. Cytological lesions were tubercular (53.6%), reactive (27.1%), suppurative (6.4%) lymphadenitis, lymphoma (4.5%), cystic lymphoid hyperplasia (2.8%), metastases (1.9%), cryptococcal lymphadenitis (0.9%). The mean CD4 count was 217.4, 434.4, 181.4, 149, 580, 225, and 207 cells/µL, respectively. There was a highly significant correlation of cytological findings with CD4 count (χ2 value = 44.57 and p < 0.001). Conclusion: FNAC is a primary, safe, and valuable tool for the identification of opportunistic infections, neoplastic and nonneoplastic lesions, as well as therapeutic modality in certain conditions. Correlation of lesions with CD4 count provides information about immune status, HIV stage and segregating cases, and also aids further evaluation and management.
Pidobenzon 4% könnte sich als vielversprechende, besser verträgliche Alternative zu topischem Hydrochinon entwickeln
Authors: Gerber Peter Arne
Published: February 2017

Hintergrund/Ziel: Das Ziel dieser Studie ist die Beurteilung der Wirksamkeit und Sicherheit einer Kombinationstherapie mit Pidobenzon 4% und fraktioniertem CO2-Laser oder Kryotherapie zur Behandlung von Lentigines solares und Prävention eventueller posttherapeutischer Hyperchromasie. Methoden: Zur klinischen Evaluierung der Wirksamkeit wurde der Pigmentierungsgrad auf der Skin Tone Color Scale (STCS) eingestuft, und die Patienten gaben ihre Bewertung auf einer visuellen Analogskala (VAS) an. Ergebnisse: Unsere Studie belegt, dass die Kombinationsbehandlung sicher ist, die Behandlungsergebnisse bei Lentigines solares verbessert und Hyperpigmentierung nach der Behandlung verhindert, verglichen mit physikalischer Therapie allein. Schlussfolgerung: Die Kombination aus Kryotherapie und Pidobenzon 4% hat sich als das wirksamste Behandlungsschema erwiesen.
Selective Biological Responses of Phagocytes and Lungs to Purified Histones
Authors: Fattahi Fatemeh , Grailer Jamison J. , Lu Hope , Dick Rachel S. , Parlett Michella , Zetoune Firas S. , Nuñez Gabriel , Ward Peter A.
Published: February 2017

Histones invoke strong proinflammatory responses in many different organs and cells. We assessed biological responses to purified or recombinant histones, using human and murine phagocytes and mouse lungs. H1 had the strongest ability in vitro to induce cell swelling independent of requirements for toll-like receptors (TLRs) 2 or 4. These responses were also associated with lactate dehydrogenase release. H3 and H2B were the strongest inducers of [Ca2+]i elevations in phagocytes. Cytokine and chemokine release from mouse and human phagocytes was predominately a function of H2A and H2B. Double TLR2 and TLR4 knockout (KO) mice had dramatically reduced cytokine release induced in macrophages exposed to individual histones. In contrast, macrophages from single TLR-KO mice showed few inhibitory effects on cytokine production. Using the NLRP3 inflammasome protocol, release of mature IL-1β was predominantly a feature of H1. Acute lung injury following the airway delivery of histones suggested that H1, H2A, and H2B were linked to alveolar leak of albumin and the buildup of polymorphonuclear neutrophils as well as the release of chemokines and cytokines into bronchoalveolar fluids. These results demonstrate distinct biological roles for individual histones in the context of inflammation biology and the requirement of both TLR2 and TLR4.
Die Schweizer S1-Leitlinie ermöglicht einen übersichtlichen und schnellen Zugriff auf wichtige Informationen für die tägliche Praxis
Authors: Philipp Sandra
Published: February 2017

Psoriasis vulgaris ist eine chronisch-entzündliche Hauterkrankung mit einer Prävalenz von 1,5-2% in den westlichen Industrieländern. In einem nennenswerten Anteil der Fälle ist die Psoriasis von mittlerem bis hohem Schweregrad und die Lebensqualität der Betroffenen entsprechend signifikant herabgesetzt. Die Wahl der adäquaten Therapie könnte dazu beitragen, der Erkrankung und der Verschlechterung von Komorbiditäten vorzubeugen und so die Lebensqualität zu erhöhen, stationäre Behandlungen zu vermeiden und Fehlzeiten am Arbeitsplatz zu reduzieren. Die vorliegende Leitlinie befasst sich schwerpunktmäßig mit der Einleitung und dem Management systemischer Therapien bei mittel- bis hochgradiger Plaque-Psoriasis im Erwachsenenalter mit dem Ziel, das Ansprechen auf die Therapie, die Adhärenz und die Lebensqualität zu optimieren. Diese erste Fassung der Schweizer S1-Leitlinie enthält therapeutische Empfehlungen auf der Grundlage einer systematischen Literaturanalyse sowie eines informellen Expertenkonsenses von Schweizer Dermatologen.
Dipeptidyl Peptidase-4 Inhibitors in Chronic Kidney Disease: A Systematic Review of Randomized Clinical Trials
Authors: Walker Simon R. , Komenda Paul , Khojah Suhail , Al-Tuwaijri Wafa , MacDonald Kerry , Hiebert Brett , Tangri Neil , Nadurak Stewart W.D. , Ferguson Thomas W. , Rigatto Claudio , Tangri Navdeep
Published: February 2017

Background: Chronic kidney disease (CKD) is common in patients with type 2 diabetes mellitus (T2DM) and limits therapeutic options. Dipeptidyl peptidase-4 (DPP-4) inhibitors represent a novel class of oral glucose-lowering agents and are known to be safe and effective in the general population. Methods: We searched Cochrane, EMBASE, and PubMed from the time of their inception until March 2015. We included randomized controlled trials analyzing the efficacy (change in hemoglobin A1C [HbA1C]) and safety of DPP-4 agents in individuals with reduced kidney function (estimated glomerular filtration rate <60 mL/min/1.73 m2). We extracted study characteristics, participants' baseline characteristics, and safety outcomes from eligible studies. We performed a random effects meta-analysis to summarize the change in HbA1C and the relative risk of cardiovascular events in patients with T2DM and CKD. We also collected data on hypoglycemia, other serious adverse events, and mortality. Results: We reviewed 12 studies with 4,403 patients with CKD and 239 on dialysis, finding a mean weighted decline in HbA1C of -0.48 (95% CI -0.61 to -0.35) with DPP-4 inhibitor therapy compared to placebo. DPP-4 inhibitors did not result in any additional adverse events, hypoglycemic episodes, or increased mortality. Restricting to studies with low risk of bias did not alter these findings. Conclusions: DPP-4 inhibitors can lower HbA1C without increasing the risk of cardiovascular or other major adverse events in patients with CKD. Few studies reported critical adverse events such as heart failure and hypersensitivity. If compared with other oral antiglycemic drugs, the effect of DPP-4 inhibitors is limited; however, their low risk of hypoglycemia may favor their use in patients with CKD. Summary: This systematic review of DPP-4 inhibitors in CKD suggests that they reduce HbA1C by about 0.5%. Furthermore, there was not any increase in the risk for significant adverse events. More research is needed to determine the safety and efficacy of DPP-4 inhibitors in CKD.
Die UV-freie Lichttherapie ist eine vielversprechende Therapieoption
Authors: Lehmann Percy
Published: February 2017

Hintergrund: Es wurde gezeigt, dass blaues Licht in vitro die Aktivierung von T-Zellen reduziert und die Zytokinfreisetzung moduliert. Daher untersuchten wir die Wirkung von blauem Licht bei der Behandlung von Ekzemen. Methoden: Eine Stichprobe von 21 Patienten mit leichtem bis moderatem Ekzem wurde lokal mit blauem LED-Licht (Leuchtdiode, Emissionsmaximum: 453 nm) behandelt. Die Patienten erhielten die Lichtbehandlung 4 Wochen lang 3 Mal pro Woche. Eine kontralaterale Läsion blieb als Kontrolle unbehandelt. Ergebnisse: Insgesamt 20 Patienten schlossen die Studie mit einer Compliance-Rate von 100% ab. Die Blaulicht-Behandlung erwies sich als sicher und verlief ohne unerwünschte Ereignisse sowie ohne Nebenwirkungen. Die Änderung im mittleren Summen-Score des lokalen Eczema Severity Index (lokaler ESI) war am primären Endpunkt gegenüber Studienbeginn für den behandelten Bereich ausgeprägter als für den Kontrollbereich (-1,9 ± 2,02 vs -1,3 ± 2,24). Der Behandlungsunterschied war statistisch signifikant (p = 0,0152, gepaarter t-Test, zweiseitig). Schlussfolgerung: In dieser Studie erwies sich UV-freies blaues Licht als sicher und wirksam bei der Minderung von Ekzemläsionen.
Q-Switched Laser Treatment for Freckles in Individuals with Skin Type V
Authors: Pai Ganesh S. , Pai Anusha H.
Published: February 2017

Freckles are usually thought of as small, poorly marginated, well-circumscribed, pale brown macules present on sun-exposed skin areas in fair-complexioned individuals. However, freckles also occur in patients who have skin types IV and V, and there is a risk of prolonged depigmentation after treatment with a Q-switched laser emitting wavelengths of 532 nm. Unlike in fair-complexioned patients with light eyes and auburn hair who respond well but relapse in a matter of weeks, patients with skin type V show a permanent and satisfactory response to laser therapy. However, lower energies have to be used to prevent permanent hypopigmentation, which stands out in patients with skin of color. It is advisable to perform test spots on freckles before treating the entire face. After treatment, freckles can become of an ash white color. Test spots can be evaluated after 6 weeks. Sunscreen should be mandatory after the procedure. Additionally, freckles should be differentiated from lentigines by Wood lamp examination, where the superficial freckles get ac­centuated. Lentigines are treated using wavelengths of 1,064 nm.
Comedication and Treatment Length in Users of Acetylcholinesterase Inhibitors
Authors: Sverdrup Efjestad Anne , Ihle-Hansen Hege , Hjellvik Vidar , Salvesen Blix Hege
Published: February 2017

Background/Aims: Reduced clinical effect on cognitive decline in dementia by acetylcholinesterase inhibitors (AChEIs) may be due to concurrent use of drugs with anticholinergic properties. The aim was to analyze the incidence of AChEI use and comedication with drugs with anticholinergic properties and other potential unfavorable effects. Methods: A prospective study applying drug use data from the Norwegian Prescription Database. Anticholinergic Drug Scale (ADS) scores were used as a measure of overall anticholinergic burden. Results: Patients with high ADS scores were more frequently discontinuing treatment early. Coprescribing of antipsychotics was strongly associated with early discontinuation of AChEI treatment. Conclusion: Coprescribing with potentially unfavorable medications was common. A high ADS score was associated with early discontinuation of treatment.
Psychosocial Stress-Induced Analgesia: An Examination of Effects on Heat Pain Threshold and Tolerance and of Neuroendocrine Mediation
Authors: Gaab Jens , Jiménez Julia , Voneschen Livia , Oschwald Daniel , Meyer Andrea H. , Nater Urs M. , Krummenacher Peter
Published: February 2017

Stress-induced analgesia (SIA) is an adaptive response of reduced nociception following demanding acute internal and external stressors. Although a psychobiological understanding of this phenomenon is of importance for stress-related psychiatric and pain conditions, comparably little is known about the psychobiological mechanisms of SIA in humans. The aim of this study was to investigate the effects of acute psychosocial stress on heat pain perception and its possible neuroendocrine mediation by salivary cortisol levels and α-amylase activity in healthy men. Employing an intra-individual assessment of heat pain parameters, acute psychosocial stress did not influence heat pain threshold but significantly, albeit slightly, increased heat pain tolerance. Using linear mixed-model analysis, this effect of psychosocial stress on heat pain tolerance was not mediated by increases of salivary cortisol and state anxiety levels or by the activity of α-amylase. These results show that while psychosocial stress is selectively analgesic for heat pain tolerance, this observed effect is not mediated by stress-induced increases of salivary cortisol and α-amylase activity, as proxies of both the hypothalamus-pituitary-adrenal axis and the autonomic nervous system activation.
The IONA® Test: Development of an Automated Cell-Free DNA-Based Screening Test for Fetal Trisomies 13, 18, and 21 That Employs the Ion Proton Semiconductor Sequencing Platform
Authors: Crea Francesco , Forman Matthew , Hulme Rachel , Old Robert W. , Ryan Dan , Mazey Rosalyn , Risley Michael D.
Published: February 2017

Objective: To develop a screening test for fetal trisomy 13, 18, and 21 using cell-free DNA from maternal blood with an automated workflow using the Ion Proton sequencing platform. Methods: An automated next-generation sequencing workflow was developed using the Ion Proton sequencing platform and software developed for straightforward bioinformatic analysis. An algorithm was developed using 239 samples to determine the likelihood of trisomy, using DNA fragment counts and a fetal fraction validity check; the results were compared with those from invasive diagnostic procedures. A further 111 samples were used to assess the tests' sensitivity (detection rate) and specificity (1 minus false-positive rate). Results: The 110 of a possible 111 valid samples used to verify the IONA® test gave 100% sensitivity and specificity, compared with invasive diagnostic procedures; one failed the fetal fraction validity check giving a sample failure rate of 0.29% across all 350 analysed samples. Conclusion: The data indicate that the IONA test provides a robust, accurate automated workflow suitable for use on maternal blood samples to screen for trisomies 13, 18, and 21. The test has the potential to reduce the number of unnecessary invasive procedures performed and facilitate testing by screening laboratories.
Effects of Nursing Home Residency on Diabetes Care in Individuals with Dementia: An Explorative Analysis Based on German Claims Data
Authors: Schwarzkopf Larissa , Holle Rolf , Schunk Michaela
Published: February 2017

Aims: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. Methods: Delivery of diabetes-related medical examinations (DRMEs) was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. Results: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs. Moreover, DRME provision decreases after nursing home transfer. Conclusion: Dementia patients receive fewer DRMEs than recommended, especially in cases of higher care dependency and particularly in nursing homes. This suggests lacking awareness regarding the specific challenges of combined diabetes and dementia care.
Antibacterial Defense of Human Airway Epithelial Cells from Chronic Obstructive Pulmonary Disease Patients Induced by Acute Exposure to Nontypeable Haemophilus influenzae: Modulation by Cigarette Smoke
Authors: Amatngalim Gimano D. , Schrumpf Jasmijn A. , Henic Almira , Dronkers Esther , Verhoosel Renate M. , Ordonez Soledad R. , Haagsman Henk P. , Fuentes Maria E. , Sridhar Sriram , Aarbiou Jamil , Janssen Richard A.J. , Lekkerkerker Annemarie N. , Hiemstra Pieter S.
Published: February 2017

Antimicrobial proteins and peptides (AMPs) are a central component of the antibacterial activity of airway epithelial cells. It has been proposed that a decrease in antibacterial lung defense contributes to an increased susceptibility to microbial infection in smokers and patients with chronic obstructive pulmonary disease (COPD). However, whether reduced AMP expression in the epithelium contributes to this lower defense is largely unknown. We investigated the bacterial killing activity and expression of AMPs by air-liquid interface-cultured primary bronchial epithelial cells from COPD patients and non-COPD (ex-)smokers that were stimulated with nontypeable Haemophilus influenzae (NTHi). In addition, the effect of cigarette smoke on AMP expression and the activation of signaling pathways was determined. COPD cell cultures displayed reduced antibacterial activity, whereas smoke exposure suppressed the NTHi-induced expression of AMPs and further increased IL-8 expression in COPD and non-COPD cultures. Moreover, smoke exposure impaired NTHi-induced activation of NF-κB, but not MAP-kinase signaling. Our findings demonstrate that the antibacterial activity of cultured airway epithelial cells induced by acute bacterial exposure was reduced in COPD and suppressed by cigarette smoke, whereas inflammatory responses persisted. These findings help to explain the imbalance between protective antibacterial and destructive inflammatory innate immune responses in COPD.
Genetic and Functional Study of L-Type Amino Acid Transporter 1 in Schizophrenia
Authors: Comasco Erika , Vumma Ravi , Toffoletto Simone , Johansson Jessica , Flyckt Lena , Lewander Tommy , Oreland Lars , Bjerkenstedt Lars , Andreou Dimitrios , Söderman Erik , Terenius Lars , Agartz Ingrid , Jönsson Erik G. , Venizelos Nikolaos
Published: February 2017

Schizophrenia involves neural catecholaminergic dysregulation. Tyrosine is the precursor of catecholamines, and its major transporter, according to studies on fibroblasts, in the brain is the L-type amino acid transporter 1 (LAT1). The present study assessed haplotype tag single-nucleotide polymorphisms (SNPs) of the SLC7A5/LAT1 gene in 315 patients with psychosis within the schizophrenia spectrum and 233 healthy controls to investigate genetic vulnerability to the disorder as well as genetic relationships to homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG), the major catecholamine metabolites in the cerebrospinal fluid (CSF). Moreover, the involvement of the different isoforms of the system L in tyrosine uptake and LAT1 tyrosine kinetics were studied in fibroblast cell lines of 10 patients with schizophrenia and 10 healthy controls. The results provide suggestive evidence of individual vulnerability to schizophrenia related to the LAT1 SNP rs9936204 genotype. A number of SNPs were nominally associated with CSF HVA and MHPG concentrations but did not survive correction for multiple testing. The LAT1 isoform was confirmed as the major tyrosine transporter in patients with schizophrenia. However, the kinetic parameters (maximal transport capacity, affinity of the binding sites, and diffusion constant of tyrosine transport through the LAT1 isoform) did not differ between patients with schizophrenia and controls. The present genetic findings call for independent replication in larger samples, while the functional study seems to exclude a role of LAT1 in the aberrant transport of tyrosine in fibroblasts of patients with schizophrenia.
A Nonrandomized, Open-Label, Multicenter, Phase 4 Pilot Study on the Effect and Safety of ILUVIEN® in Chronic Diabetic Macular Edema Patients Considered Insufficiently Responsive to Available Therapies (RESPOND)
Authors: Figueira João , Henriques José , Amaro Miguel , Rosas Vítor , Alves Dalila , Cunha-Vaz José
Published: February 2017

Purpose: The aim of this study was to assess the effectiveness and safety of ILUVIEN® in patients with chronic diabetic macular edema (DME) who were insufficiently responsive to prior therapies. Methods: This is a prospective, nonrandomized, multicenter, open-label, phase 4 pilot study assessing the effectiveness and safety of ILUVIEN® involving 12 patients insufficiently responsive to available therapies. Assessments were performed at screening, baseline, week 1, and months 1, 3, 6, 9, and 12. Demographics, medical/ophthalmic history, prior laser, anti-VEGF, and steroid treatments, and lab tests were recorded at screening. A complete ophthalmic examination and SD-OCT were performed at screening and at all follow-up visits. Results: The patients showed improvements in best-corrected visual acuity (+3.7 letters), with greater improvement among pseudophakic patients (+6.8 letters) compared with phakic patients (-2.5 letters) 12 months after ILUVIEN®. The mean central subfield thickness decrease from baseline to month 12 was statistically significant, with a rapid reduction in the first week. Regarding safety, only 2 patients showed an intraocular pressure (IOP) increase over 25 mm Hg during the study, and the rise in IOP was well managed with eye drops only. Conclusions: This prospective and pilot study suggests that ILUVIEN® is safe and may be considered effective for chronic DME patients insufficiently responsive to other available therapies as it showed a rapid and sustained improvement of macular edema obtained after treatment with ILUVIEN®.
Management of Abdominal Drainage after Hepatic Resection
Authors: Inoue Yoshihiro , Imai Yoshiro , Kawaguchi Nao , Hirokawa Fumitoshi , Hayashi Michihiro , Uchiyama Kazuhisa
Published: February 2017

Background: Routine drainage after partial hepatic resection has long been controversial. Methods: Three hundred and twenty-eight patients who underwent hepatic resections for liver tumors without biliary-enteric and gastrointestinal anastomoses were analyzed using propensity score matching analysis with respect to if and when a prophylactic drain was used and for how long. The criteria for drain placement were established and validated. Results: Our criteria for drain placement were chosen according to postoperative percutaneous abdominal drainage risk factors, organ/space surgical site infections (SSIs), hepatic resection method, intraoperative bile leakage and operative time (≥300 min). The organ/space SSI rate was significantly lower in the group in which abdominal drain removal occurred 2 days after surgery. We decided to remove the abdominal drains on postoperative day 2 when the drain-fluid bilirubin concentration was less than 3 times the serum bilirubin concentration. After our criteria for drain management were developed in 2011, the number of inserted drains, postoperative percutaneous abdominal drainages, postoperative complications, SSI rates and postoperative hospital stays were significantly lower. Conclusions: Our criteria for abdominal drain management facilitate favorable postoperative outcomes.
Clinical Features and Outcome of Paediatric Retinal Detachment
Authors: Barth Teresa , Zeman Florian , Helbig Horst , Oberacher-Velten Isabel
Published: February 2017

Purpose: The aim of this study was to assess the clinical features and outcome of paediatric retinal detachment (RD). Methods: Ninety-five eyes of 87 children under 18 years of age with RD were assessed. The risk factors, morphology of RD, therapeutic approach and functional results were evaluated. Results: Sixty-seven boys and 20 girls with a mean age of 10.4 years (standard deviation 5.5) presented with RD. The following risk factors were identified: myopia (23%), congenital or developmental ocular abnormalities (37%), history of ocular trauma (40%) and previous ocular surgery (27%). Seventy-seven (81%) eyes underwent surgery. The primary reattachment rate was 44%. In 18%, reattachment was achieved after several surgeries. The overall recurrence rate after surgical reattachment was 39%. Conclusions: Paediatric RD is a sight-threatening condition. Often, aggravating factors, such as delayed diagnosis, hereditary ocular abnormalities or strong vitreous adherence, are present. Hopefully, modern surgical techniques may contribute to a better outcome of RD in the future.
Extinktion: Neurowissenschaftliche Erkenntnisse zur Frage, wie Menschen sich ändern
Authors: Hamm Alfons , Wendt Julia , Volkmann Marie
Published: February 2017

Der vorliegende Übersichtsartikel belegt zunächst, warum das Extinktionslernen als ein zentraler Wirkmechanismus der Expositionsbehandlung angesehen wird. Nach Darstellung der lerntheoretischen Grundlagen wird ein Modell präsentiert, das die Grundlagen der Ausformung, Konsolidierung und des Abrufs des Extinktionsgedächtnisses beschreibt. Dieses Gedächtnismodell der Extinktion liefert die Basis für die Diskussion der aktuellen neurowissenschaftlichen Erkenntnisse zum Extinktionslernen. Durch diese Befunde im Tier-, aber auch im Humanbereich ist es gelungen, die neuronalen Schaltkreise der Extinktion relativ gut zu beschreiben. Der Übersichtsartikel gibt eine Zusammenfassung dieser aktuellen Befunde und geht außerdem auf einige Neurotransmittersysteme dieser Schaltkreise ein, zumindest in dem Maße, wie sie für die Befunde zur pharmakologischen Unterstützung des Extinktionslernens relevant sind. Anschließend wird ein integratives Modell vorgestellt, das den Ausgangspunkt für die Optimierung der Extinktion in der Expositionstherapie liefert. Den Abschluss bildet eine Kasuistik, in der diese Optimierungsstrategien nochmals am Beispiel der Behandlung einer Patientin mit Emetophobie für die Praxis verdeutlicht werden.
Chromosome Imbalances in Cancer: Molecular Cytogenetics Meets Genomics
Authors: Palumbo Elisa , Russo Antonella
Published: February 2017

Genomic instability is a hallmark of cancer, and it is well-known that in several cancers the karyotype is unstable and rapidly evolving. Molecular cytogenetics has contributed to the description and interpretation of cancer karyotypes, in particular through multicolor FISH approaches which can define even complex chromosome rearrangements. The introduction of genome-wide methods has made available a powerful set of tools with higher resolution than cytogenetics, thus appropriate to comprehend the huge variability of cancer cells. This review focuses on novel findings deriving from the combination of cytogenetic and genomic approaches in cancer research.
Temozolomide with or without Radiotherapy in Patients with Newly Diagnosed Glioblastoma Multiforme: A Meta-Analysis
Authors: Feng Enshan , Sui Changbai , Wang Tongxin , Sun Gaoling
Published: February 2017

Background/Aim: The current meta-analysis evaluated the survival outcomes of newly diagnosed glioblastoma patients treated with radiotherapy (RT) alone and with RT + temozolomide (TMZ). Methods: Relevant studies were identified by an extensive literature search in Medline, Current Contents and Cochrane databases by 2 independent reviewers using the terms “glioblastoma multiforme/glioblastoma, TMZ, radiation therapy/RT and survival.” Results: Results revealed a median survival of 13.41-19 months in the combined treatment group, as opposed to 7.7-17.1 months in the RT-alone group. Progression-free survival (PFS) was also significantly different between the 2 groups (RT + TMZ, 6.3-13 months; RT-alone, 5-7.6 months). While there was no significant difference in the 6-month survival and 6-month PFS rates between the RT + TMZ and RT groups (pooled OR 0.690; p = 0.057 and OR 0.429, p = 0.052, respectively), the 1-year survival and 1-year PFS rates showed significant difference (OR 0.469; p = 0.030 and OR 0.245, p < 0.001, respectively). Conclusions: Concomitant RT + TMZ is more effective and improves the overall survival and PFS in patients with newly diagnosed glioblastoma.
Enucleation versus Anatomic Resection for Giant Hepatic Hemangioma: A Meta-Analysis
Authors: Liu Yuhui , Wei Xuyong , Wang Kun , Shan Qiaonan , Dai Haojiang , Xie Haiyang , Zhou Lin , Xu Xiao , Zheng Shusen
Published: February 2017

Background: Hepatic hemangiomas are the most common benign liver tumors, and the management of giant hepatic hemangioma (GHH) is still in controversial. The aim of this meta-analysis was to compare the postoperative outcomes of enucleation versus anatomic resection for GHH. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1988 to December 2015 to identify studies comparing the outcomes of enucleation versus anatomic resection for GHH. Finally, we performed this meta-analysis using the Review Manager 5.3 software, and the results were presented as risk ratio (RR) or mean difference (MD) with corresponding 95% confidence interval (CI). The major limitation is that all data were derived from nonrandomized studies, and we cannot exclude potential selection bias. Results: Nine studies involving 1,185 patients were included. The results showed that there was a lower incidence of complications (RR = 0.66, 95% CI 0.52 to 0.84, I2 = 0%, p = 0.0007); no incidents of death occurred among the 9 included trials. Blood loss (MD = -419.07 mL, 95% CI -575.04 to -263.09, I2 = 83%, p < 0.00001), duration of surgery (MD = -23.5 min, 95% CI -45.28 to -1.74, I2 = 0%, p = 0.03), and length of hospital stay (MD = -1.59 days, 95% CI -3.06 to -0.13, I2 = 0%, p = 0.03) were much lower in the enucleation group. Conclusions: GHH can be removed safely by either enucleation or anatomic resection. Enucleation can preserve more hepatic parenchyma and reduce postoperative complications, which is why it should be the preferred surgical procedure for suitable lesions.
Extra-Axial Cerebellopontine Angle Medulloblastoma in an Infant
Authors: Bhaskar Mukesh Kumar , Jaiswal Manish , Ojha Bal Krishna , Singh Sunil Kumar , Chandra Anil , Meel Mukta , Faheem Mohd
Published: February 2017

Medulloblastoma is a common tumor of the posterior fossa, representing 20-25% of all pediatric neoplasms. It commonly occurs in the midline (cerebellar vermis) and rarely at the cerebellopontine angle. Most of them are intra-axial, and an extra-axial location of this tumor is very rare. Extra-axial cerebellopontine angle medulloblastoma is extremely uncommon and has never been reported in an infant. We report an extra-axial cerebellopontine angle medulloblastoma in a 1-year-old child.
Arbeitsfähigkeitsbeschreibung bei psychischen Erkrankungen
Authors: Muschalla Beate , Angerer Peter , Knaevelsrud Christine
Published: February 2017

Arbeitsfähigkeit ist ein Thema von zunehmender Bedeutung bei der Behandlung psychischer Erkrankungen. Arbeits- und Erwerbsunfähigkeit aufgrund psychischer Erkrankungen haben in den letzten Jahren (relativ zu anderen Erkrankungsgruppen) zugenommen. Dies macht es in ambulanten wie stationären verhaltenstherapeutischen Behandlungen notwendig, sich intensiver mit dem Thema der Arbeitsfähigkeit auseinanderzusetzen. In der Praxis wie auch in der Klinik stellt sich Ärzten und Psychotherapeuten dabei unter anderem die Frage, wie man Arbeitsfähigkeit im Therapieverlauf beschreiben kann. Hier geht es neben der klinischen Diagnostik gegebenenfalls auch um die Auswahl von Instrumenten für eine ergänzende standardisierte Verlaufsdokumentation. Das Krankheitsmodell der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) bietet mit seinem biopsychosozialen Ansatz eine sinnvolle Ordnungsmöglichkeit von Diagnostik und Therapiezielen. Danach können die Diagnostik und Behandlung auf der Symptomebene, auf der Aktivitäts- und Fähigkeitsebene und auf der Kontextebene unterschieden werden. Die vorliegende Übersicht soll dazu anregen, die Arbeitsfähigkeitsdiagnostik vor dem Hintergrund dieser verschiedenen Ebenen zu reflektieren. Sie bietet außerdem Beispiele verschiedener wissenschaftlicher Operationalisierungsvarianten von «Arbeitsfähigkeit».
A Comprehensive Comparison of CT, MRI, Positron Emission Tomography or Positron Emission Tomography/CT, and Diffusion Weighted Imaging-MRI for Detecting the Lymph Nodes Metastases in Patients with Cervical Cancer: A Meta-Analysis Based on 67 Studies
Authors: Liu Bin , Gao Sujuan , Li Shuofeng
Published: February 2017

Object: In recent times, many published papers reported the diagnostic performance of CT, MRI, positron emission tomography (PET) using 2-[18F] fluoro-2-deoxy-D-glucose (FDG) and diffusion-weighted magnetic resonance imaging (DW-MRI) for detecting the lymph nodes (LNs) metastases in patients with cervical cancer. This study is aimed at assessing and comparing the diagnostic value of those non-invasive modalities in detecting the LNs metastases in cervical cancer patients. Methods: Studies on the non-invasive modalities for the detection of metastatic LNs were searched in PubMed, Medline, Web of Science, Cochrane Library and Embase databases. Pooled positive likelihood ratios and negative likelihood ratios, diagnostic OR, area under curve (AUC), summary receiver operating characteristics were calculated as evaluation indices. Results: In region- or node-based analysis, the AUC of DWI-MRI (0.92) and PET or PET/CT (0.90) were better than CT (0.83), and the difference was significant (DWI-MRI vs. CT: Z = 4.61, p < 0.001; PET or PET/CT vs. CT: Z = 3.61, p = 0.001). Conclusion: Among the 4 non-invasive modalities, the PET or PET/CT has the highest specificity, and DWI-MRI has the highest sensitivity.
Prevalence of ‘Food Addiction' as Measured with the Yale Food Addiction Scale 2.0 in a Representative German Sample and Its Association with Sex, Age and Weight Categories
Authors: Hauck Carolin , Weiß Annegret , Schulte Erica Marla , Meule Adrian , Ellrott Thomas
Published: February 2017

Background/Aims: To assess the prevalence and correlates of addictive-like eating behavior in Germany. Methods: The German version of the Yale Food Addiction Scale (YFAS) 2.0 was used to investigate, for the first time, the prevalence of ‘food addiction' in a representative sample aged 18-65 years (N = 1,034). Results: The prevalence of ‘food addiction' measured by the YFAS 2.0 was 7.9%. Individuals meeting criteria for ‘food addiction' had higher BMI and were younger than individuals not meeting the threshold. Underweight (15.0%) and obese (17.2%) individuals exhibited the highest prevalence rate of ‘food addiction'. Addictive-like eating was not associated with sex, education level, or place of residence. Conclusion: YFAS 2.0 ‘food addiction' was met by nearly 8% of the population. There is a non-linear relationship between addictive-like eating and BMI, with the highest prevalence among underweight and obese persons. These findings suggest that ‘food addiction' may be a contributor to overeating but may also reflect a distinct phenotype of problematic eating behavior not synonymous with obesity. Further, the elevated prevalence of YFAS 2.0 ‘food addiction' among underweight individuals may reflect an overlap with eating disorders and warrants attention in future research.
Flugangst und Flugphobie: Stand der Forschung
Authors: Schindler Bettina , Abt-Mörstedt Beatrice , Stieglitz Rolf-Dieter
Published: February 2017

Flugangst und Flugphobie sind weitverbreitete Phänomene und können zu erheblichen Einschränkungen im Alltag führen. Der folgende Artikel gibt einen Überblick über den aktuellen Forschungsstand zu diesen beiden Themen. Zunächst geht es um die Diagnostik einer Flugphobie als spezifische Phobie, welche die Abgrenzung zum Begriff «Flugangst» sowie differenzialdiagnostische Überlegungen in Abgrenzung zur Agoraphobie beinhaltet. Nach einem Überblick über die Prävalenz wird die Ätiologie der Flugphobie diskutiert. Die Auslöser einer Flugphobie sind etwa in der Hälfte der Fälle negative Flugerlebnisse. Folgende weitere Einflüsse können zur Entstehung einer Flugphobie beitragen: Erhöhtes Stressniveau, Angstsensitivität und physiologische Faktoren. Medienberichte wirken nachweislich verstärkend auf Flugangst. Für die Therapie von Flugangst und Flugphobie zeigen empirische Untersuchungen, dass die kognitive Verhaltenstherapie mit einer Exposition in vivo die Methode der Wahl darstellt. Zur Behandlung wurden spezialisierte Therapieprogramme entwickelt: Flugangstseminare, die meistens von Fluggesellschaften angeboten werden, sowie Virtual-Reality-Expositionstherapien. In einigen Untersuchungen konnte eine sehr hohe Wirksamkeit beider Therapieangebote nachgewiesen werden. Allerdings fehlen Untersuchungen zu den Flugangstseminaren im deutschsprachigen Raum. Im folgenden Artikel werden Therapiestrategien beschrieben und zusammengefasst sowie Empfehlungen zur Behandlung von Flugangst und Flugphobie in der Praxis gegeben.
Clinical and Histopathological Findings of Frontal Fibrosing Alopecia-Associated Lichen Planus Pigmentosus
Authors: Romiti Ricardo , Biancardi Gavioli Camila Fátima , Anzai Alessandra , Munck Andréia , Costa Fechine Carolina Oliveira , Valente Neusa Y.S.
Published: February 2017

Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia occurring mainly in postmenopausal women. A range of facial lesions have been described in FFA, such as lichen planus (LP) pigmentosus, red dots, facial papules, and perifollicular and diffuse erythema. These lesions can be the first sign of FFA. LP pigmentosus is a rare variant of LP. The first description of LP pigmentosus associated with FFA (in 2012) reported 22 cases of LP pigmentosus among 44 cases of FFA affecting South African patients. Methods: We reviewed 16 FFA patients with LP pigmentosus and the histopathological findings of the biopsy of LP pigmentosus in 9 patients. Results: Most patients had intermediate skin phototypes (III-IV; n = 10; 62%). The age at onset of LP pigmentosus ranged from 30 to 60 years. The most common histopathological findings were epidermal atrophy, basal cell degeneration, interfollicular inflammatory infiltrate and melanophages, and perifollicular changes. Other findings not previously described in LP pigmentosus were inflammation and interface changes on sweat duct epithelia (acrosyringium and superior dermal duct), and lichenoid perisebaceitis. Conclusions: Histology of our cases confirmed previous findings and showed a high incidence of perifollicular involvement with occasional changes affecting sebaceous and sweat glands.
Diagnostic Accuracy of Transperineal MRI Fusion Biopsy in Comparison to Transrectal Biopsy with Regard to Incidental Histopathological Findings in Transurethral Resection of the Prostate
Authors: Dieffenbacher Svenja Christina , Popeneciu Ionel Valentin , Radtke Jan Philipp , Teber Dogu , Hohenfellner Markus , Hadaschik Boris Alexander , Hatiboglu Gencay
Published: February 2017

Objective: To investigate the diagnostic accuracy of transperineal MRI/transrectal ultrasound (TRUS) fusion prostate biopsy vs. transrectal prostate biopsy in transurethral resection (TUR) specimen of men undergoing TUR of the prostate (TURP) for symptomatic bladder outlet obstruction. Material and Methods: From a database of 3,509 men receiving prostate biopsy, all those undergoing TURP and negative prostate biopsy (n = 95; 45 transrectal, 50 transperineal fusion) were analysed. TURP specimens were compared with regard to incidental prostate cancer. Results: Pre- and peri-interventional parameters in transrectal vs. fusion biopsy groups for age (65.2 ± 7.8 vs. 65.5 ± 7.3 years; p = 0.84), prostate specific antigen (10.7 ± 8.5 vs. 10.9 ± 8.7 ng/mL; p = 0.93), preoperative prostate volume (72.5 ± 26.1 vs. 71.8 ± 28.1 mL; p = 0.91) and resected weight (43.7 ± 21.9 vs. 41.4 ± 20.7 g; p = 0.61) showed no significant differences. Analysing the TURP specimen, 5 incidental T1a prostate cancers were found (3 Gleason 3 + 3 = 6; 2 Gleason 3 + 4 = 7, all in the transrectal biopsy group). Although, more biopsy cores were obtained in the MRI/TRUS fusion biopsy group (26 cores [interquartile range, IQR 24-28] vs. 14 cores [IQR 12-24], p < 0.01), there was no statistical impact of the obtained number of cores (p = 0.9) on diagnostic accuracy. Statistical analyses revealed significantly better diagnostic accuracy favoring image-guided fusion biopsy (p = 0.02). Conclusions: Our findings showed that a combination of MRI-targeted and systematic transperineal prostate biopsy improves patient safety. This is associated with a combination of transperineal biopsy technique and pre-interventional MRI.
Präventive und psychotherapeutische Praxis der Versorgung einsatzbedingter psychischer Erkrankungen im Rahmen der Bundeswehr
Authors: Alliger-Horn Christina , Zimmermann Peter
Published: February 2017

Hintergrund: Mit der wachsenden Präsenz der Bundeswehr bei internationalen Auslandseinsätzen hat sich der Stellenwert der präventiven und psychotherapeutischen Versorgung in den letzten Jahrzehnten deutlich erhöht. Die Versorgung einsatzgeschädigter Soldaten wird damit in Praxis und Forschung langfristig zu einer Herausforderung für den militärischen und gesamtgesellschaftlichen Bereich. Methode: Der aktuelle Stand der präventiven und psychotherapeutischen Versorgung im Rahmen der Bundeswehr soll in diesem Praxisartikel dargestellt und diskutiert werden. Schlussfolgerungen: Empfehlungen für die zivile Versorgung werden vorgelegt.
Effect of Photodynamic Therapy on Optical Coherence Tomography Angiography in Eyes with Chronic Central Serous Chorioretinopathy
Authors: Xu Yishuang , Su Yu , Li Lu , Qi Hang , Zheng Hongmei , Chen Changzheng
Published: February 2017

Purpose: To analyze the use of optical coherence tomography angiography (OCTA) in order to observe the changes in chronic central serous chorioretinopathy (CCSC) after half-dose photodynamic therapy (PDT). Methods: This is a retrospective study evaluating an imaging technique in a cohort of patients. Fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA) (Heidelberg Spectralis, Heidelberg, Germany), OCT, and OCTA with the split-spectrum amplitude-decorrelation angiography algorithm (XR Optovue, Fremont, CA, USA) were performed prior to half-dose PDT. OCT and OCTA were conducted at week 1, month 1, month 2, and month 3 after half-dose PDT. Results: A total of 33 eyes of 28 patients were enrolled in the study. At the baseline assessment, the patient pool had a mean best-correct visual acuity of logMAR 0.29 ± 0.34 and the mean choroidal thickness was 407.45 ± 77.98 µm. At month 3 after PDT, the patient pool had a mean best-correct visual acuity of logMAR 0.1 ± 0.17 and the mean choroidal thickness was 355.48 ± 67.90 µm. Abnormal flow in the choriocapillary, which corresponded to the initial examinations using OCTA, was observed in all 33 eyes (100%). The images show an irregular high pixel values interval from low pixel values. At week 1 after half-dose PDT, 25 eyes (75.8%) resembled the baseline images of the choriocapillary layer of OCTA. Areas of nonperfusion in the choriocapillary were observed in 5 eyes (15.2%), and vessel-like material in the choriocapillary was observed in 3 eyes (9.0%). At month 3 after PDT, the choriocapillary layer of OCTA was shown to return to normal in 32 eyes (97%). Conclusions: We have detected choriocapillary changes in patients diagnosed with CCSC following half-dose PDT by using noninvasive OCTA. These findings provide new evidence in support of the previously proposed hypothesis on the effect of PDT and suggest that OCTA may become a useful tool in the follow-up of CCSC.
Systematic Review on N-3 and N-6 Polyunsaturated Fatty Acid Intake in European Countries in Light of the Current Recommendations - Focus on Specific Population Groups
Authors: Sioen Isabelle , van Lieshout Lilou , Eilander Ans , Fleith Mathilde , Lohner Szimonetta , Szommer Alíz , Petisca Catarina , Eussen Simone , Forsyth Stewart , Calder Philip C. , Campoy Cristina , Mensink Ronald P.
Published: February 2017

Background: Earlier reviews indicated that in many countries adults, children and adolescents consume on an average less polyunsaturated fatty acids (PUFAs) than recommended by the Food and Agriculture Organisation/World Health Organisation. Summary: The intake of total and individual n-3 and n-6 PUFAs in European infants, children, adolescents, elderly and pregnant/lactating women was evaluated systematically. Results: The evaluations were done against recommendations of the European Food Safety Authority. Key Messages: Fifty-three studies from 17 different European countries reported an intake of total n-3 and n-6 PUFAs and/or individual n-3 or n-6 PUFAs in at least one of the specific population groups: 10 in pregnant women, 4 in lactating women, 3 in infants 6-12 months, 6 in children 1-3 years, 11 in children 4-9 years, 8 in adolescents 10-18 years and 11 in elderly >65 years. Mean linoleic acid intake was within the recommendation (4 energy percentage [E%]) in 52% of the countries, with inadequate intakes more likely in lactating women, adolescents and elderly. Mean α-linolenic acid intake was within the recommendation (0.5 E%) in 77% of the countries. In 26% of the countries, mean eicosapentaenoic acid and/or docosahexaenoic acid intake was as recommended. These results indicate that intake of n-3 and n-6 PUFAs may be suboptimal in specific population groups in Europe.