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  • Georg Thieme Verlag KG  (120)
  • 2020-2024  (120)
  • 1
    Online Resource
    Online Resource
    P2Y12 Inhibition Suppresses Proinflammatory Platelet–Monocyte Interactions
    Georg Thieme Verlag KG ; 2023
    In:  Thrombosis and Haemostasis Vol. 123, No. 02 ( 2023-02), p. 231-244
    Details
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 123, No. 02 ( 2023-02), p. 231-244
    Abstract: Background Monocyte–platelet aggregates (MPAs) represent the crossroads between thrombosis and inflammation, and targeting this axis may suppress thromboinflammation. While antiplatelet therapy (APT) reduces platelet–platelet aggregation and thrombosis, its effects on MPA and platelet effector properties on monocytes are uncertain. Objectives To analyze the effect of platelets on monocyte activation and APT on MPA and platelet-induced monocyte activation. Methods Agonist-stimulated whole blood was incubated in the presence of P-selectin, PSGL1, PAR1, P2Y12, GP IIb/IIIa, and COX-1 inhibitors and assessed for platelet and monocyte activity via flow cytometry. RNA-Seq of monocytes incubated with platelets was used to identify platelet-induced monocyte transcripts and was validated by RT-qPCR in monocyte-PR co-incubation ± APT. Results Consistent with a proinflammatory platelet effector role, MPAs were increased in patients with COVID-19. RNA-Seq revealed a thromboinflammatory monocyte transcriptome upon incubation with platelets. Monocytes aggregated to platelets expressed higher CD40 and tissue factor than monocytes without platelets (p  〈  0.05 for each). Inhibition with P-selectin (85% reduction) and PSGL1 (87% reduction) led to a robust decrease in MPA. P2Y12 and PAR1 inhibition lowered MPA formation (30 and 21% reduction, p  〈  0.05, respectively) and decreased monocyte CD40 and TF expression, while GP IIb/IIIa and COX1 inhibition had no effect. Pretreatment of platelets with P2Y12 inhibitors reduced the expression of platelet-mediated monocyte transcription of proinflammatory SOCS3 and OSM. Conclusions Platelets skew monocytes toward a proinflammatory phenotype. Among traditional APTs, P2Y12 inhibition attenuates platelet-induced monocyte activation.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    URL: Article
    DOI: 10.1055/s-0042-1758655
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
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  • 2
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    Administration of Antenatal Corticosteroids: Current State of Knowledge
    Georg Thieme Verlag KG ; 2022
    In:  Geburtshilfe und Frauenheilkunde Vol. 82, No. 03 ( 2022-03), p. 287-296
    Details
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 82, No. 03 ( 2022-03), p. 287-296
    Abstract: Die einmalige Gabe von Kortikosteroiden vor 34 + 0 SSW bei drohender Frühgeburt ist ein Standard in der heutigen Geburtshilfe und in den Leitlinien der verschiedensten Länder fest verankert. Trotz der anscheinend überzeugenden Datenlage sind allerdings zahlreiche Teilaspekte zu dieser Intervention nur wenig geklärt. So war bisher offen, welches Kortikosteroid die optimale Wirkung erzielt. Es gibt kaum Studien zur Dosierung, zur zirkadianen Rhythmik, zum Zeitfenster der Wirksamkeit oder zur Nutzen-Schaden-Bilanz einer wiederholten Gabe. Da in den vorliegenden Studien selten Patientinnen vor 24 + 0 SSW eingeschlossen wurden, haben wir nur wenig Information zum möglichen Nutzen einer Kortikosteroid-Applikation vor diesem Zeitpunkt. Bei einer antenatalen Gabe von Kortikosteroiden nach 34 + 0 SSW stehen dem kurzfristigen Nutzen möglicherweise langfristige Beeinträchtigungen in der psychomotorischen Entwicklung gegenüber. Die vorliegende Arbeit fasst den derzeitigen Wissensstand zu diesen Fragen zusammen.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    URL: Article
    DOI: 10.1055/a-1555-3444
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2026496-3
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    BTU Cottbus
    Wissenschaftspark Albert Einstein
    EUV Frankfurt
    TH Wildau
    FH Potsdam
  • 3
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    Validierung der deutschen Version der Pediatric Self-Efficacy for Diabetes-Type-1 Scale
    Georg Thieme Verlag KG ; 2020
    In:  PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie Vol. 70, No. 08 ( 2020-08), p. 349-357
    Details
    In: PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, Georg Thieme Verlag KG, Vol. 70, No. 08 ( 2020-08), p. 349-357
    Abstract: Einleitung Da für den deutschen Sprachraum kein geeignetes Instrument zur Erfassung der spezifischen, diabetesbezogenen Selbstwirksamkeit bei Kindern mit Typ-1-Diabetes vorliegt, wird in dieser Arbeit die Konstruktion und Validierung der deutschsprachigen Pediatric Self-Efficacy for Diabetes Type-1 Scale (PSEDT-1) dargestellt. Auf der Grundlage der Self-Efficacy for Diabetes Scale (SED) von Grossman, Brink & Hauser sollte eine leitlinienkonforme, pädiatrische, revidierte Selbstwirksamkeitsskala entwickelt und validiert werden. Design & Methoden Es wurden N=221 Kinder mit Typ-1-Diabetes (12–17 Jahre) in eine klinische, multizentrische Validierungsstudie eingeschlossen. Zur Beurteilung der Veränderungssensitivität füllten davon 58 Kinder mit Typ-1-Diabetes jeweils vor, unmittelbar nach der Beendigung und 6 Monate nach der stationären Diabetesschulung die PSEDT-1 Skala aus. Um die Konstruktvalidität zu überprüfen, wurde die PSEDT-1 mit anderen Skalen in Verbindung gebracht, die inhaltlich ähnliche und inhaltlich entfernte Konstrukte messen (Multidimensionale Selbstwertskala – MSWS, Kontrollüberzeugungen zu Krankheit und Gesundheit – KKG). Ergebnisse Die Reliabilitäts-Ergebnisse zeigten eine gute interne Konsistenz der 20 Items mit Cronbachs α=0,87. Die Trennschärfen der Items waren akzeptabel. Es ließen sich mittels explorativer Faktorenanalyse 4 Faktoren identifizieren, die 54% der Varianz erklären: 1) Diabetes-Selbstmanagement-Kompetenz, 2) (medizinische) Insulin-Management-Kompetenz, 3) (generelle) Selbstbehauptungskompetenz und 4) autonome Selbstregulation. Die theoretisch erwarteten Korrelationsmuster konnten belegt werden. Zudem zeigten die Verlaufsergebnisse Hinweise auf eine ausreichend hohe Veränderungssensitivität. Diskussion Die Ergebnisse sprechen dafür, dass es sich bei der PSEDT-1 um ein valides und reliables deutschsprachiges Instrument handelt, das zusätzlich zu den Skalenwerten der Kompetenzbereiche Diabetesselbstmanagement, Medizinisches Management und generelle Selbstbehauptung auch den Skalenwert der autonomen Selbstregulation zur Erfassung der diabetesbezogenen Selbstwirksamkeit bestimmt.
    Type of Medium: Online Resource
    ISSN: 0937-2032 , 1439-1058
    URL: Article
    DOI: 10.1055/a-1088-1316
    RVK:
    CL 1000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    detail.hit.zdb_id: 800571-0
    SSG: 2,1
    SSG: 5,2
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  • 4
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    Therapeutic Effects of Manual Therapy on Lateral Epicondylitis: A Randomised Controlled Trial
    Georg Thieme Verlag KG ; 2023
    In:  Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin Vol. 33, No. 02 ( 2023-04), p. 79-86
    Details
    In: Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, Georg Thieme Verlag KG, Vol. 33, No. 02 ( 2023-04), p. 79-86
    Abstract: Background Epicondylopathia humeri radialis is often diagnosed by general practitioners. Usually, the therapy comprises transcutaneous electrical nerve stimulation using a forearm brace. Manual therapy, performed by specialised physiotherapists, is prescribed before transcutaneous electrical nerve stimulation and forearm brace use. However, studies comparing the effectiveness of all methods are scarce. Objective To compare the therapeutic effects of manual therapy, transcutaneous electrical nerve stimulation, and forearm brace use, as well as the combination of all three. Methods Fifty-two patients diagnosed with epicondylopathia humeri radialis were randomised into three treatment arms: a comb ination of manual therapy, transcutaneous nerve stimulation, and forearm brace use (n=19); manual therapy only (n=18); and a combination of forearm brace use and transcutaneous nerve stimulation (n=15). All measurements and therapies, excluding manual therapy, were performed at the first author’s practice premises. The primary outcomes included range of motion and pain intensity; the secondary outcomes were elbow function and psychological well-being. Primary and secondary outcomes were measured before and at 4 and 8 weeks after treatment using the Patient Rated Tennis Elbow Evaluation Questionnaire and the Short Form Health Survey Questionnaire. Results The range of motion and pain intensity did not differ among the groups. Conclusion Manual therapy alone was as effective as the combination of transcutaneous nerve stimulation and forearm brace use for epicondylopathia humeri radialis. Our findings support the inclusion of manual therapy as a stand-alone therapy option in the guidelines for treating patients with epicondylopathia humeri radialis.
    Type of Medium: Online Resource
    ISSN: 0940-6689 , 1439-085X
    URL: Article
    DOI: 10.1055/a-1870-3073
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2072467-6
    SSG: 31
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  • 5
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    Lymphovenous Coupler-Assisted Bypass (CAB) for Immediate Lymphatic Reconstruction
    Georg Thieme Verlag KG ; 2023
    In:  Journal of Reconstructive Microsurgery
    Details
    In: Journal of Reconstructive Microsurgery, Georg Thieme Verlag KG
    Abstract: Background: Breast cancer-related lymphedema is the most common cause of lymphedema in the United States and occurs in up to 50% of individuals receiving axillary lymph node dissection (ALND). Lymphovenous bypass (LVB) at the time of ALND may prevent lymphedema, but long-term results and anastomotic patency are unclear. This study evaluates the feasibility and outcomes of performing immediate lymphatic reconstruction via coupler-assisted bypass (CAB). Methods: This is a retrospective review of all patients undergoing prophylactic LVB following ALND at two tertiary care centers between 2018-2022. Patients were divided into cohorts based on whether they received the ‘standard’ end-to-end (E-E) suturing or CAB t echnique. The primary outcome of interest was development of lymphedema. Quantitative and qualitative assessments for lymphedema were performed preoperatively and at 3, 6, 12, and 24 months postoperatively. Results: Overall, 63 lymphovenous bypasses were performed, of which 24 lymphatics underwent immediate reconstruction via “CAB” and 39 lymphatics via “standard” end-to-end suture. Patient characteristics, including BMI, and treatment characteristics, including radiation therapy, did not significantly differ between groups. CAB was associated with a greater mean number of lymphatics bypassed per vein (standard 1.7 vs. CAB 2.6 p=0.0001) and bypass to larger veins (standard 1.2 vs. CAB 2.2 mm, p 〈 0.0001). At a median follow-up of 14.7 months, 9.1% (1/11) of individuals receiving CAB developed lymphedema. These rates were similar to those seen following standard bypass at 4.8% (1/21), although within a significantly shorter follow-up duration (standard 7.8 vs. CAB 14.7 months, p=0.0170). Conclusion: The CAB technique is a viable, effective technical alternative to the standard LVB technique. This comparative study of techniques in prophylactic LVB suggests that coupler-assisted bypasses maintain long-term patency, possibly due to the ease of anastomosing several lymphatics to single large caliber veins while reducing the technical demands of the procedure.
    Type of Medium: Online Resource
    ISSN: 0743-684X , 1098-8947
    URL: Article
    DOI: 10.1055/a-2181-7559
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2072341-6
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  • 6
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    Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction
    Georg Thieme Verlag KG ; 2023
    In:  Ultraschall in der Medizin - European Journal of Ultrasound Vol. 44, No. 01 ( 2023-02), p. 56-67
    Details
    In: Ultraschall in der Medizin - European Journal of Ultrasound, Georg Thieme Verlag KG, Vol. 44, No. 01 ( 2023-02), p. 56-67
    Abstract: Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32+ 0–36+ 6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] 〈  10th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of 〉  40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal ( 〈  0.9) or abnormal (≥ 0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. Results 856 women had 2770 measurements; 696 (81 %) had more than one measurement (median 3 (IQR 2–4). At inclusion, 63 (7 %) a UCR ≥ 0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30 % vs. 9 %, relative risk 3.2; 95 %CI 2.1–5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67 % (95 %CI 55–80), but after a normal UCR the chance of finding an abnormal UCR was 6 % (95 %CI 5–7 %). The risk of composite adverse outcome was similar using the first or subsequent UCR values. Conclusion An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5–7 % when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.
    Type of Medium: Online Resource
    ISSN: 0172-4614 , 1438-8782
    URL: Article
    DOI: 10.1055/a-1511-8293
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2028670-3
    SSG: 12
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  • 7
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    Recurrent Filamentous Fungal Keratitis Caused When the Primarily Selected Graft Diameter was Too Small
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 09 ( 2023-09), p. 1098-1102
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 09 ( 2023-09), p. 1098-1102
    Abstract: Purpose To establish the importance of using a sufficiently large corneal graft in primary penetrating keratoplasty in order to prevent recurrence of fungal keratitis. Oberservations A 58-year-old female patient underwent emergency penetrating keratoplasty (diameter 7.0 mm, double running suture) for therapy-resistant fungal keratitis (Fusarium solani) at an external eye clinic. Despite intensive antifungal therapy, new fungal infiltrates appeared in the host cornea after a few days. The patient was referred to our department for further treatment. On first presentation, circular infiltrates were seen around the corneal graft with anterior chamber involvement and therapy-resistant hypopyon. We performed an emergency penetrating repeat keratoplasty (diameter of 13.0 mm, 32 interrupted sutures) combined with anterior chamber lavage and intracameral and intrastromal drug injection. Conclusion and Importance Fungal keratitis sometimes has a frustrating clinical course. Therefore, early diagnosis with effective therapy initiation is of the utmost importance. In cases of penetrating keratoplasty, optimal planning and timing (before anterior chamber involvement) should be provided. Sufficient safety distance must be ensured in the choice of graft diameter, fixation with multiple interrupted sutures, and anterior chamber lavage, as well as intracameral and intrastromal drug administration. Incomplete excision carries a risk of recurrence and endophthalmitis in the course. Close postoperative control is necessary to detect early recurrences.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-1756-5147
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2039754-9
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  • 8
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    Descemet Membrane Endothelial Keratoplasty (DMEK) for Severe Verrucous Posterior Polymorphous Corneal Dystrophy with Uncommon Clinical and Ultrastructural Findings
    Georg Thieme Verlag KG ; 2022
    In:  Klinische Monatsblätter für Augenheilkunde
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG
    Abstract: Purpose To report a case of severe verrucous posterior polymorphous corneal dystrophy (PPCD) and cataract, which was treated with Descemet membrane endothelial keratoplasty (DMEK) and simultaneous cataract surgery as a triple procedure (Triple-DMEK). Methods A 62-year-old female patient presented to our department for co-evaluation of advanced PPCD with cataract and progressive light sensitivity in both eyes. The clinical examination demonstrated unusual clinical findings with prominent verrucous lesions on the posterior surface of the cornea without corneal decompensation. We performed a Triple-DMEK in case of simultaneous cataract. The corneal tissue was examined by light and transmission electron microscopy. Results Intraoperatively, it was difficult to remove the verrucous structures completely after classical descemetorhexis. Light microscopic examination demonstrated epithelium-like transformation of the corneal endothelium by immunostaining (cytokeratin AE1/3 staining). Transmission electron microscopy revealed thickening of Descemetʼs membrane (18.5 to 30.0 µm). The anterior banded layer had a normal structure and was slightly thickened (3.5 to 5.5 µm). A normal posterior non-banded layer (PNBL) was observed but thinned (2.5 to 4.0 µm) or missing. It was followed by an altered PNBL with abnormal fibrillary inclusions, which was strongly and variably thickened (11.0 to 24.5 µm). The corneal endothelium was degenerated, partially absent, and epithelial-like altered. The nodular lesions were found to consist of a few degenerated cells that were embedded in an amorphous extracellular matrix interspersed with collagen fibers, which were not arranged in regular lamellae, forming the corneal stroma. The occurrence of pigment granules among the cellular debris suggested that the cells were endothelial cells. The corrected distance visual acuity improved from 20/50 to 20/30 in the right eye (+ 0.00/− 1.75/157°) and from 20/60 to 20/30 in the left eye (+ 0.00/− 1.75/33°), with significant improvement in light sensitivity. Conclusion The clinical and ultrastructural findings seem to be an unusual variant of the typical characteristic appearance of a PPCD. This case demonstrates that Triple-DMEK is feasible even in very advanced dystrophic changes of the posterior corneal surface, with good morphological and functional results.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-1862-8403
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2039754-9
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  • 9
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    Traumatische Zyklodialyse – von der Zyklopexie ab interno bis zur DMEK: ein Fallbericht
    Georg Thieme Verlag KG ; 2023
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 240, No. 03 ( 2023-03), p. 278-282
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 240, No. 03 ( 2023-03), p. 278-282
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-1651-0587
    RVK:
    XA 10000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2039754-9
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  • 10
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    Central Serous Chorioretinopathy – an Overview
    Georg Thieme Verlag KG ; 2021
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 238, No. 09 ( 2021-09), p. 971-979
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 238, No. 09 ( 2021-09), p. 971-979
    Abstract: Die Chorioretinopathia centralis serosa (CCS) ist durch eine seröse Abhebung der Netzhaut in der Makula charakterisiert. Es sind meist Männer zwischen 30 und 50 Jahren betroffen. Es wird eine akute Form (Krankheitsdauer kürzer als 4 – 6 Monate) von einer chronischen Form (länger als 4 – 6 Monate) unterschieden. Die Pathogenese ist multifaktoriell, es wird aktuell von einer lokalen Hyperpermeabilität der Chorioidea mit sekundären Veränderungen der Photorezeptoren und des retinalen Pigmentepithels (RPE) ausgegangen. Symptome einer akuten CCS sind ein zentrales Verschwommensehen bei häufig geringer Visusverschlechterung. Die optische Kohärenztomografie (OCT) zeigt subretinale Flüssigkeit mit oder ohne einzelne Pigmentepithelabhebungen, in der Fluoresceinangiografie (FAG) findet man meist einen Quellpunkt, die Indocyaningrünangiografie (ICG) zeigt umschriebene Areale verdickter chorioidaler Gefäße. Die akute Form kann spontan abheilen, aber auch rezidivieren und/oder in eine chronische Form übergehen. Nach Erstdiagnose zeigt sich in ca. 70 – 80% der Fälle eine spontane Remission, in ca. 50% kommt es zu einem Rezidiv. Aufgrund des guten Spontanverlaufes sollte bei Erstmanifestation in den ersten 4 – 6 Monaten zugewartet werden. Steroidtherapie gilt als Hauptrisikofaktor. Bei der chronischen Form tritt eine langsame Visusverschlechterung mit vermindertem Kontrastsehen und Farbsehen ein. Es imponieren flächige Veränderungen im RPE mit sekundären degenerativen Veränderungen der Photorezeptoren. Als Komplikation, besonders bei älteren Patienten, kann eine chorioidale Neovaskularisation (CNV) auftreten. Mögliche Therapien sind: Eine fokale Lasertherapie des in der FAG sichtbaren Quellpunktes kann mit Mikropulslaser- oder bei ausreichender Entfernung zur Fovea mit Argonlaserkoagulation behandelt werden. Bei der chronischen CCS belegen Studien, dass die photodynamische Therapie (PDT) gute Resultate zeigt. Für die Therapie mit Mineralkortikoid-Antagonisten gibt es Fallserienberichte mit einer Evidenz der Behandlung für einen Beobachtungszeitraum von 3 – 6 Monaten. Bei Vorliegen einer sekundären CNV sollte eine Anti-VEGF-Therapie erfolgen. Es ist unklar, ob dabei eine Kombinationstherapie mit PDT sinnvoll ist.
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/a-1531-5605
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2039754-9
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