bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autoimmunkrankheiten und Allergien – ganzheitliche Diagnostik und Therapie
Authors: Schmiedel Volker 
Published: April 2021

ZusammenfassungDie Grundlage für eine erfolgreiche Therapie von Autoimmunkrankheiten ist die Messung einiger Laborwerte und deren anschließende Optimierung. Die Basis stellen Vitamin D, Fettsäuren (Omega-6, Omega-3 etc.), Selen, Zink, Eisen (Serumeisen, Ferritin) sowie Entzündungsmarker (z. B. BSG, CRP) dar. Die Therapie einer komplexen Erkrankung, wie sie eine chronische Entzündung darstellt, sollte auch komplex erfolgen – ein „Wundermittel“ gibt es leider nicht. Die Basis besteht dabei – wie bei vielen anderen Krankheiten auch – aus Ernährung, Bewegung und Entspannung. Praktisch immer liegen aber trotz ausgewogener Ernährung bei Entzündungen Mangelzustände vor, die es mit den richtigen Nährstoffen in einer adäquaten Dosis zu behandeln gilt. Weitere optionale Verfahren werden ebenfalls kurz dargestellt.
Den Kopf über Wasser halten
Authors: Nagersheth Kalyani , Mittwede Martin 
Published: April 2021

ZusammenfassungIn Stresssituationen kommen bei Menschen laut Ayurveda die Eigenschaften stärker zum Vorschein, die den vorherrschenden Doshas entsprechen. Der Ayurveda kennt bei Stress und Stresssymptomen sowohl konstitutionstypische als auch allgemeine Maßnahmen der Therapie und Prophylaxe. Der zentrale Punkt der ayurvedischen Tagesroutine ist die Selbsteinölung. Sie wirkt unter anderem stärkend, schützend und entgiftend.
Phytotherapeutische Behandlung entzündlicher Leiden von Haut und Schleimhaut in der Hausarztpraxis
Authors: Jobst Detmar 
Published: April 2021

ZusammenfassungEtwa 9 % aller Beratungsanlässe in der allgemeinmedizinischen Praxis erfolgen aufgrund von Hauterscheinungen 1. Es sind sicherlich einige mehr, nimmt man die Schleimhautbeschwerden an Mund und Nase, an Darmausgang und Genitalien dazu. Diese Hautprobleme bereiten z. T. erhebliche Beschwerden. Etliche Patienten fragen explizit nach Behandlungsmöglichkeiten ohne Kortison und ohne Antibiotika.Der Beitrag stellt Behandlungsmöglichkeiten mit Phytotherapeutika bei häufigen entzündlichen Beschwerden von Haut und Schleimhaut vor.
Comparison of Different Nutritional and Lifestyle Factors between Glaucoma Patients and an Age-Matched Normal Population
Authors: Waibel Sören , Thomaschewski Gregor , Herber Robert , Pillunat Lutz E. , Pillunat Karin R. 
Published: April 2021

Abstract
Purpose To compare nutritional and lifestyle factors between glaucoma patients and an age-matched control group.
Methods One hundred and ninety (190) glaucoma patients were enrolled in this study. The control group comprised 97 age-matched participants. Data on physical activity, nicotine smoking, and several nutritional habits like coffee and alcohol consumption as well as high-salt and high-protein intake were collected using a standardised questionnaire.
Results Age and gender were not statistically significantly different between the groups. There was a tendency for higher physical activity in the glaucoma group in comparison to the control group (47.3 vs. 35.4%; p = 0.056). Statistically significantly more glaucoma patients were nonsmokers (n = 169; 89.4%) compared to the control group (n = 64; 66.7%; p = 0.001). Glaucoma patients were also more often teetotal compared to the control group (21.6% compared to 14.4%; p < 0.001). Similarly, more glaucoma patients drank larger amounts of coffee in comparison to the control group (p = 0.001). One hundred and seventy-six (96.7%) glaucoma patients and 88 (90.7%) control subjects had high-protein intake (p = 0.035). High-salt intake was significantly lower in the glaucoma group (69.3 vs. 73.2%; p = 0.018). Of the 190 glaucoma patients, 81 had early visual field impairments (MD > − 6 dB) and 109 patients had moderate (MD between − 6 dB and − 12 dB) to severe
(MD < − 12 dB) visual field defects. The severity of visual field defects, whether early, moderate, or severe, had no statistically significant impact on lifestyle parameters.
Conclusion Contrary to our original hypothesis that glaucoma patients would tend to follow an unhealthier lifestyle than the control group, the opposite was seen. Presumably, the cause of this healthier lifestyle is the desire to contribute positively through the course of the disease.
Large-Diameter Penetrating Keratoplasties are Mostly Due to Very Severe Infectious Keratitis and Cannot Always Prevent Secondary Enucleation
Authors: Alfaro Rangel Raul , Szentmáry Nóra , Lepper Sabine , Milioti Georgia , Daas Loay , Langenbucher Achim , Seitz Berthold 
Published: April 2021

Abstract
Purpose To report the indications and outcomes of penetrating keratoplasties with a graft diameter > 8.5 mm in severe corneal diseases at the Department of Ophthalmology at Saarland University Medical Centre.
Study Design Retrospective (6 years), descriptive, and observational.
Methods Thirty-five large-diameter penetrating keratoplasties (LDPKPs) in 27 patients (mean age, 62 ± 22 years) were performed from March 2010 to December 2016. The indication for surgery, number of previous corneal transplantations, best-corrected visual acuity (BCVA) before surgery, intraocular pressure, graft status, and BCVA at last follow-up were recorded.
Results Infectious keratitis represented 83% of the indications (of those, 45% fungal). The mean corneal graft diameter was 10.8 ± 1.7 (min 8.75, max 15.0) mm. Twenty-three eyes (65% absolute) had at least one previous penetrating keratoplasty (mean graft size, 9.2 ± 1.6 mm). The mean pre-surgery BCVA was 1.96 ± 0.23 logMAR. With a mean follow-up period of 20.2 ± 13.4 months, the mean BCVA was 1.57 ± 0.57 logMAR at last follow-up. Overall, 12 grafts (35%) remained clear until the last follow-up, and in 23 grafts (65%), the primary disease recurred, or corneal decompensation developed. Up to the last follow-up, 6 eyes (17%) had to be enucleated.
Conclusions In complex cases of infectious keratitis requiring a LDPKP to remove the complete pathology and preserve eye integrity, the visual outcomes are generally expected to be poor, not only because of the well-known risks of LDPKP but also because of the consequences of the infectious disease itself. This knowledge is important for adequate counselling of the patient preoperatively.
Establishing Prediction Intervals for the SpeedWheel Acuity Test in Adults and Children
Authors: Luethy Magdalena Laura , Schötzau Andreas , Palmowski-Wolfe Anja 
Published: April 2021

Abstract
Background The SpeedWheel (SW) test is an objective test of visual acuity (VA) using suppression of the optokinetic nystagmus (OKN). Here, we established prediction intervals of the SW measures compared to Snellen acuity in adults and children.
Subjects and Methods In this prospective, single center study, subjects aged at least 4 years underwent testing of VA with SW, Landolt-C, and Tumbling-E symbols (Freiburg acuity test: FrACT-C, FrACT-E). Prediction intervals were established for SW compared to FrACT-C or -E and for FrACT-E compared to FrACT-C. Mixed linear effect models were applied for statistical analysis.
Results From 241 subjects, 471 eyes were included: median age 36 years, range 4 – 88 years, 43.6% male, 56.4% female. Eyes included were either healthy or had various underlying ophthalmic conditions. Prediction intervals for SW to estimate FrACT-C or -E acuity showed a similar range compared to the prediction interval of FrACT-C for the estimation of FrACT-E acuity. For each acuity step, there was no influence of age. Up to an SW acuity of 0.7 logMAR, 80% of the subjects had a FrACT-C acuity that was at most 1.6 logMAR lines below, and for an SW acuity of 1.0 logMAR, FrACT-C acuity was not worse than 4 logMAR lines. Prediction intervals for eyes with refractive error, cataract, visual field loss and retinal disease did not differ significantly from healthy eyes in contrast to eyes with amblyopia or multiple ophthalmic disorders. SW correlated well to FrACT tests and results of a previous study fell within our prediction estimates.
Conclusion Our prediction intervals for SW acuity may be used to estimate Snellen acuity (FrACT-C and -E) in the clinic in adults and children unable to cooperate in other acuity testing.
Patientensicherheit: Die Lasertherapie gehört zu den risikoreicheren Therapieoptionen in der Dermatologie
Authors: Lehmann L. , Hofmann S. , Dirschka T. , Lehmann P. 
Published: April 2021

ZusammenfassungSeit der Erstbeschreibung von Lasern und den ersten Anwendungen in der Dermatologie hat die Lasertherapie innerhalb des dermatologischen therapeutischen Armamentariums enorm an Bedeutung zugenommen.Da sie häufig bei ästhetischen Indikationen Anwendung findet, sind hohe Sicherheitsanforderungen zu gewährleisten, ansonsten kommt es zu unangenehmen juristischen Streitigkeiten. Eine retrospektive Analyse anhand der Fälle der Gutachterkammer für ärztliche Behandlungsfehler hat gezeigt, dass Lasertherapien zu den risikoreicheren therapeutischen Optionen in der Dermatologie gehören.
Cannabis sativa and Skin Health: Dissecting the Role of Phytocannabinoids
Authors: Martinelli Giulia , Magnavacca Andrea , Fumagalli Marco , DellʼAgli Mario , Piazza Stefano , Sangiovanni Enrico 
Published: April 2021

AbstractThe use of Cannabis sativa is currently recognized to ease certain types of chronic pain, reduce chemotherapy-induced nausea, and improve anxiety. Nevertheless, few studies highlighted the therapeutic potential of C. sativa extracts and related phytocannabinoids for a variety of widespread skin disorders including acne, atopic dermatitis, psoriasis, pruritus, and pain. This review summarized the current evidence on the effects of phytocannabinoids at the cutaneous level through the collection of in vitro, in vivo, and clinical studies published on PubMed, Scopus, Embase, and Web of Science until October 2020. Phytocannabinoids have demonstrated potential anti-inflammatory, antioxidant, anti-aging, and anti-acne properties by various mechanisms involving either CB1/2-dependent and independent pathways. Not only classical immune cells, but also several skin-specific actors, such as keratinocytes, fibroblasts, melanocytes, and
sebocytes, may represent a target for phytocannabinoids. Cannabidiol, the most investigated compound, revealed photoprotective, antioxidant, and anti-inflammatory mechanisms at the cutaneous level, while the possible impact on cell differentiation, especially in the case of psoriasis, would require further investigation. Animal models and pilot clinical studies supported the application of cannabidiol in inflammatory-based skin diseases. Also, one of the most promising applications of non-psychotropic phytocannabinoids is the treatment of seborrheic disorders, especially acne. In conclusion, the incomplete knowledge of the role of the endocannabinoid system in skin disorders emerged as an important limit for pharmacological investigations. Moreover, the limited studies conducted on C. sativa extracts suggested a higher potency than single phytocannabinoids, thus stimulating new research on phytocannabinoid interaction.
Association between Adherence to SSRI Treatment and Mortality among Individuals with Metabolic Syndrome Components
Authors: Avrahamy Hamutal , Shoval Gal , Hoshen Moshe , Balicer Ran D. , Kamhi-Nesher Shiri , Zalsman Gil , Weizman Abraham , Krivoy Amir 
Published: April 2021

ABSTRACT
Introduction Depression and anxiety have been associated with type 2 diabetes mellitus and metabolic syndrome, major causes of cardiovascular morbidity and mortality. The effect of antidepressants in this association is unknown. This study aimed to examine the association between adherence to selective serotonin receptor inhibitors (SSRIs) and all-cause mortality among individuals with metabolic syndrome components (hypertension, obesity, and diabetes mellitus).
Methods Data on 201 777 patients who were prescribed SSRIs during the years 2008–2011 were analyzed retrospectively. Adherence was measured using prescription purchase records. The moderating effect of SSRI and statin adherence on the association between metabolic syndrome load and mortality hazard risk (HR) during the study period were analyzed. The Cox-proportional hazard model adjusted to background variables was used to this end.
Results During the study period, the maximal metabolic load was associated with mortality HR=1.89 (95% CI: 1.79–2) compared to participants without metabolic risk factors. A slight reduction in mortality HR was demonstrated among those with low and moderate SSRI adherence rates. Adherence to statins was negatively associated with the risk of mortality across all levels of adherence. A significant association (r=0.214, p<0.01) was found between adherence to statins and adherence to SSRIs, with higher rates of adherence to statins across all metabolic load categories.
Discussion While a high metabolic load is associated with a higher risk of mortality, adherence to SSRIs only partially moderated the risk of mortality, in contrast to the protective effect of statins. Adherence differences to statins and SSRIs among individuals prescribed both medications merit further investigation.
Cognitive Retraining in Traumatic Brain Injury: Experience from Tertiary Care Center in Southern India
Authors: Afsar Mohammed , Shukla Dhaval , Bhaskarapillai Binukumar , Rajeswaran Jamuna 
Published: April 2021

Abstract

Objective Traumatic brain injury (TBI) is a leading cause of mortality and chronic disability across the globe. This study aimed to understand the effects of cognitive retraining (CR) intervention on neuropsychological functions, symptom reporting, and quality of life in patients with moderate to severe TBI.

Materials and Methods The present single-group intervention study with a pre–post design included 12 patients diagnosed with moderate to severe TBI within 3–24 months post injury. Outcome measures included National Institute of Mental Health and Neuro Sciences (NIMHANS) Neuropsychology Battery, Perceived Stress Scale, Rivermead Post-Concussion Symptom Questionnaire, World Health Organization Quality of Life Scale—Brief, and Visual Analogue Scale. All patients underwent a total of 20 sessions of hospital-based CR, spanning over a period of 2 months. The CR included tasks targeting to enhance processing speed, attention, executive function, learning, and memory. Outcome assessments were conducted at baseline and immediately at post intervention.

Statistical Analysis Mean, standard deviation, frequency, and percentage were used as measures of descriptive statistics. Pre- and post-intervention scores were compared using Wilcoxon signed-rank test.

Results The results showed that at post intervention, significant improvements were found in processing speed, working memory, planning, visuo-spatial construction, visual memory, and verbal encoding. Subjective symptom reporting, perceived stress, and quality of life in psychological domain also improved.

Conclusion CR can be helpful in improving not only cognition but also symptom reporting and quality of life in moderate to severe TBI.
Traumatic Brachial Plexus Palsy in Children: Long-Term Outcome and Strategy of Reconstruction
Authors: El-Gammal Tarek A. , El-Sayed Amr , Kotb Mohamed M. , Saleh Waleed Riad , Ragheb Yasser Farouk , El-Refai Omar , Romeih Mohamed Abdel-Hameed , El-Gammal Yousif T. 
Published: April 2021

Abstract
Background Traumatic brachial plexus injuries in children represent a definite spectrum of injuries between adult and neonatal brachial plexus injuries. Their characteristics have been scarcely reported in the literature. The priority of functional restoration is not clear.
Methods In total, 52 children with surgically treated traumatic brachial plexus injuries, excluding Erb's palsy, were reviewed after a minimum follow-up of 2 years. All children except nine were males, with an average age at surgery of 8 years. Forty-five children had exclusive supraclavicular plexus injuries. Twenty-one of them (46%) had two or more root avulsions. Seven children (13.5%) had infraclavicular plexus injuries. Time from trauma to surgery varied from 1 to 15 months (mean = 4.7 months). Extraplexal neurotization was the most common surgical technique used.
Results Shoulder abduction and external rotation were restored to an average of 83 and 26 degrees, respectively. Elbow flexion and extension were restored to grade ≥3 in 96 and 91.5% of cases, respectively. Finger flexion and extension were restored to grade ≥4 in 29 and 32% of cases, respectively. Wrist flexion and extension were restored to grade ≥4 in 21 and 27% of cases, respectively. Results of neurotization were superior to those of neurolysis and nerve grafting. Among the 24 children with insensate hands, 20 (83.3%) recovered S3 sensation, 3 recovered S2, and 1 recovered S1. No case complained of neuropathic pain. Functional recovery correlated negatively but insignificantly with the age at surgery and time from injury to surgery.
Conclusion Brachial plexus injuries in children are associated with a high incidence root avulsions and no pain. Neurotization is frequently required and the outcome is not significantly affected by the delay in surgery. In total plexus injuries, some useful hand function can be restored, and management should follow that of obstetric palsy and be focused on innervating the medial cord.
Platelet Function in Viral Immunity and SARS-CoV-2 Infection
Authors: Allaoui Afaf , Khawaja Akif A. , Badad Oussama , Naciri Mariam , Lordkipanidzé Marie , Guessous Fadila , Zaid Younes 
Published: April 2021

AbstractPlatelets, as nonnucleated blood components, are classically recognized for their pivotal role in hemostasis. In recent years, however, accumulating evidence points to a nonhemostatic role for platelets, as active participants in the inflammatory and immune responses to microbial organisms in infectious diseases. This stems from the ability of activated platelets to secrete a plethora of immunomodulatory cytokines and chemokines, as well as directly interplaying with viral receptors. While much attention has been given to the role of the cytokine storm in the severity of the coronavirus disease 2019 (COVID-19), less is known about the contribution of platelets to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we give a brief overview on the platelet contribution to antiviral immunity and response during SARS-CoV-2 infection.
Different Anticoagulant Regimens, Mortality, and Bleeding in Hospitalized Patients with COVID-19: A Systematic Review and an Updated Meta-Analysis
Authors: Parisi Roberta , Costanzo Simona , Di Castelnuovo Augusto , de Gaetano Giovanni , Donati Maria Benedetta , Iacoviello Licia 
Published: April 2021

AbstractWe conducted a systematic review and a meta-analysis to assess the association of anticoagulants and their dosage with in-hospital all-cause mortality in COVID-19 patients. Articles were retrieved until January 8, 2021, by searching in seven electronic databases. The main outcome was all-cause mortality occurred during hospitalization. Data were combined using the general variance-based method on the effect estimate for each study. Separate meta-analyses according to type of COVID-19 patients (hospitalized or intensive care unit [ICU] patients), anticoagulants (mainly heparin), and regimens (therapeutic or prophylactic) were conducted. A total of 29 articles were selected, but 23 retrospective studies were eligible for quantitative meta-analyses. No clinical trial was retrieved. The majority of studies were of good quality; however, 34% did not distinguish heparin from other anticoagulants. Meta-analysis on 25,719 hospitalized COVID-19 patients showed that anticoagulant use was associated with 50% reduced in-hospital mortality risk (pooled risk ratio [RR]: 0.50, 95% confidence interval [CI]: 0.40–0.62; I
2: 87%). Both anticoagulant regimens (therapeutic and prophylactic) reduced in-hospital all-cause mortality, compared with no anticoagulation. Particularly in ICU patients, the anticoagulant therapeutic regimen was associated with a reduced in-hospital mortality risk (RR: 0.30, 95% CI: 0.15–0.60; I
2: 58%) compared with the prophylactic one. However, the former was also associated with a higher risk of bleeding (RR: 2.53, 95% CI: 1.60–4.00; I
2: 65%). Anticoagulant use, mainly heparin, reduced all-cause mortality in COVID-19 patients during hospitalization. Due to the higher risk of bleeding at therapeutic doses, the use of prophylactic dosages of anticoagulant is probably to be preferred in noncritically ill COVID-19 patients.
Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Authors: Seol Hyeyoung , Kim Jong S. 
Published: April 2021

AbstractHeart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Recently, researchers have identified patients with HF at a particularly high risk for stroke who may benefit from anticoagulation therapy. Based on stroke-risk prediction models, it may be possible to make better stroke prevention decisions for patients with HF. Moreover, non-vitamin K oral anticoagulants have emerged as anticoagulants with a more favorable risk–benefit profile than warfarin. Future studies on selecting high-risk patients and using more appropriate antithrombotics will lead to improved management of patients with HF.
The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis
Authors: Kim Kevin G. , Tirrell Abigail R. , Dekker Paige K. , Haffner Zoe , Attinger Christopher E. , Fan Kenneth L. , Evans Karen K. 
Published: April 2021

Abstract
Introduction Research in lower extremity (LE) wound management involving flap reconstruction has primarily focused on surgeon-driven metrics. There has been a paucity in research that evaluates patient-centered outcomes (PCO). This systematic review and meta-analysis examines articles published between 2012 and 2020 to assess whether reporting of functional and quality of life (QOL) outcomes have increased in frequency and cohesiveness, compared with the previous two decades.
Methods PubMed and Ovid were queried with appropriate Medical Subject Heading (MeSH) terms for studies published between June 2012 and July 2020. For inclusion, each study had to report any outcome of any tissue transfer procedure to the LE in comorbid patients, including complication rates, ambulation rates, flap success rates, and/or QOL measures. The PCO reporting prevalence was compared with a previous systematic review by Economides et al which analyzed papers published between 1990 and June 2012, using a Pearson's Chi-squared test.
Results The literature search yielded 40 articles for inclusion. The proportion of studies reporting PCO was greater for literature published between 1990 and 2012 compared with literature published between 2012 and 2020 (86.0 vs. 50.0%, p < 0.001). Functional outcomes were more commonly reported between 1990 and 2012 (78.0 vs. 47.5%, p = 0.003); similarly, ambulatory status was reported more often in the previous review (70.0 vs. 40.0%, p = 0.004). This study solely examined the rate at which PCO were reported in the literature; the individual importance and effect on medical outcomes of each PCO was not evaluated.
Conclusion Less than 50% of the literature report functional outcomes in comorbid patients undergoing LE flap reconstruction. Surprisingly, PCO reporting has seen a downward trend in the past 8 years relative to the preceding two decades. Standardized inclusion of PCO in research regarding this patient population should be established, especially as health care and governmental priorities shift toward patient-centered care.