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  • 1
    Language: English
    In: BMC medical education, 17 April 2014, Vol.14, pp.82
    Description: Nursing staff are often involved in counseling patients with regard to health behavior. Although care promoting healthy lifestyle choices is included in the curriculum of nursing students in Germany, several studies of nursing students have reported a high prevalence of unhealthy behavior. This paper focuses on the behavior of female nursing students with regard to body mass index (BMI), physical activity, and cigarette and alcohol consumption. It describes trends through the comparison of results from 2008 and 2013. Data was collected in two waves at a regional medical training college. First, 301 nursing students were asked to fill out a 12 page questionnaire on health behavior in 2008. The questioning was repeated in 2013 with 316 participating nursing students using the previous questionnaire. 259 female nursing students completed the questionnaire in 2013. 31.6% of them were either overweight or obese, 28.5% exercised less than once a week, 42.9% smoked between 10 and 20 cigarettes a day and 72.6% drank alcohol, wherefrom 19.7% consumed alcohol in risky quantities. In comparison to the data of 266 female nursing students from 2008, there were significant differences in the BMI and alcohol consumption: The percentage of overweight and obese students and the percentage of alcohol consumers at risk increased significantly. Health behavior of female nursing students is often inadequate especially in regard to weight and cigarette and alcohol consumption. Strategies are required to promote healthy lifestyle choices.
    Keywords: Body Mass Index ; Sedentary Behavior ; Alcohol Drinking -- Epidemiology ; Smoking -- Epidemiology ; Students, Nursing -- Statistics & Numerical Data
    E-ISSN: 1472-6920
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  • 2
    In: International Wound Journal, December 2011, Vol.8(6), pp.578-584
    Description: We analysed the effect of different body features on contact area, interface pressure and pressure distribution of three different mattresses. Thirty‐eight volunteers (age ranged from 17 to 73 years, 23 females) were asked to lie on three different mattresses in a random order: I, standard hospital foam mattresses; II, higher specification foam mattresses (Viscorelax Sure); III, constant low pressure devices (CareMedx, AirSystems). Measurements were performed in supine position and in a 90° left‐ and right‐sided position, respectively, using a full‐body mat (pressure mapping device Xsensor X2‐Modell). Outcome variables were contact area (CA) in cm, mean interface pressure (IP) in mmHg and pressure distribution (PD) estimated as rate of low pressures between 5 and 33 mmHg on each mattress in percent. Mean CA was lowest in the standard hospital foam mattresses and increased in the higher specification foam mattresses and was highest in the constant low pressure device (supine position: 491 ± 86 cm, 615 ± 95 cm, 685 ± 116 cm). Mean IP was highest in the standard hospital foam mattresses and lower but similar in the higher specification foam mattresses and the constant low pressure devices (supine position: 22·3 ± 1·5 mmHg, 17·6 ± 1·7 mmHg, 17·6 ± 2·2 mmHg). Models were estimated for CA, IP and PD including the independent variables height, weight and waist‐to‐hip‐ratio (WHR). They show that body morphology seems to play a minor role for CA, IP and PD, but very thin and tall patients and very small and obese people might benefit from different mattresses. Our data show that CA increases with increasing specification of mattresses. Higher specification foam mattresses and constant low pressure devices show similar IP, but constant low pressure devices show a wider pressure distribution. Body morphology should be considered to optimise prevention for single patients.
    Keywords: Interface Pressure ; Mattresses ; Pressure Ulcer ; Waist‐To‐Hip‐Ratio
    ISSN: 1742-4801
    E-ISSN: 1742-481X
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  • 3
    Language: English
    In: Clinical Research in Cardiology, 2013, Vol.102(8), pp.607-614
    Description: Byline: Undine Pittl (1), Alexandra Schratter (2), Steffen Desch (1), Raluca Diosteanu (1), Denise Lehmann (1), Katharina Demmin (1), Jacqueline Horig (3), Gerhard Schuler (1), Thorsten Klemm (4), Meinhard Mende (5), Holger Thiele (1) Keywords: Resuscitation; Cardiac arrest; Hypothermia; Neuron-specific enolase; Outcome; Cooling-associated complications Abstract: Introduction Mild induced hypothermia (MIH) is indicated for comatose survivors of sudden cardiac arrest (SCA) to improve clinical outcome. In this study, we compared the efficacy of two different cooling devices for temperature management in SCA survivors. Methods Between April 2008 and August 2009, 80 patients after survived in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) were included in this prospective, randomized, single center study. Hypothermia was induced after randomization by either invasive Coolgard.sup.(r) cooling or non-invasive ArcticSun.sup.(r) surface cooling at 33.0 degC core body temperature for 24 h followed by active rewarming. The primary endpoint was defined as the efficacy of both cooling systems, measured by neuron-specific enolase (NSE) levels as a surrogate parameter for brain damage. Secondary efficacy endpoints were the clinical and neurological outcome, time to start of cooling and reaching the target temperature, target temperature-maintenance and hypothermia-associated complications. Results NSE at 72 h did not differ significantly between the 2 groups with 16.5 ng/ml, interquartile range 11.8--46.5 in surface-cooled patients versus 19.0 ng/ml, interquartile range 11.0--42.0 in invasive-cooled patients, p = 0.99. Neurological and clinical outcome was similar in both groups. Target temperature of 33.0 degC was maintained more stable in the invasive group (33.0 versus 32.7 degC, p 〈 0.001). Bleeding complications were more frequent with invasive cooling (n = 17 [43.6 %] versus n = 7 [17.9 %] p = 0.03). Conclusion Invasive cooling has advantages with respect to temperature management over surface cooling however, did not result in different outcome as measured by NSE release in SCA survivors. Bleeding complications were more frequently encountered by invasive cooling. Author Affiliation: (1) Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Strumpellstr. 39, 04289, Leipzig, Germany (2) Hospital Hietzing, Vienna, Austria (3) Hospital Freudenstadt, Freudenstadt, Germany (4) MVZ Laboratory Dr. Reising-Ackermann and Colleagues, Leipzig, Germany (5) University of Leipzig, Coordination Centre for Clinical Trials, Leipzig, Germany Article History: Registration Date: 17/04/2013 Received Date: 09/03/2013 Accepted Date: 17/04/2013 Online Date: 05/05/2013 Article note: Trial registration: ClinicalTrials.gov NCT: 00843297.
    Keywords: Resuscitation ; Cardiac arrest ; Hypothermia ; Neuron-specific enolase ; Outcome ; Cooling-associated complications
    ISSN: 1861-0684
    E-ISSN: 1861-0692
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  • 4
    Language: English
    In: Virchows Archiv, 2010, Vol.457(3), pp.369-380
    Description: Obliterative airway remodelling is a morphological sequence in a variety of pulmonary diseases. Notably, bronchiolitis obliterans represents one of the key complications of lung transplantation, induced by (immigrating) myofibroblasts. A comparative expression analysis of obliterative airway remodelling in transplanted and non-transplanted patients has not been reported so far. Obliterated and unremodelled airways from explanted lungs ( n  = 19) from patients suffering from chronic allograft dysfunction, infection, graft-versus-host disease and toxic exposure were isolated by laser-assisted microdissection. Airways from lung allografts harvested shortly before and after transplantation ( n  = 4) as well as fibroblastic foci from lungs with interstitial pulmonary fibrosis ( n  = 4) served as references. Pre-amplified cDNA was analysed by quantitative real-time RT-PCR for expression of fibrosis, inflammation and apoptosis-associated genes. Composition of infiltrating cells and protein expression were assessed by conventional histology and immunohistochemistry. Bronchiolitis obliterans in transplanted patients showed a significant increase of BMP-7 expression ( p  = 0.0141 compared with controls), while TGF-β1 and FGF-2 as well as BMP-4 and BMP-7 were up-regulated in fibroblastic foci in interstitial pulmonary fibrosis ( p  〈 0.0424 compared with controls). Regarding other fibrosis-associated genes (BMP-6, SMAD-3, CASP-3 and CASP-9, FASLG, NF-KB1, IL-1 and IL-2) as well as cellularity and cellular composition, no significant differences between obliterative airway remodelling in transplanted and non-transplanted patients could be shown. Obliterative airway remodelling in lung allografts and in non-transplanted patients share many morphological and genetic traits. BMPs, especially BMP-7, warrant further investigation as possible markers for the aggravation of airway remodelling.
    Keywords: Bronchiolitis obliterans ; Lung transplantation ; Fibrosis ; Airway remodelling
    ISSN: 0945-6317
    E-ISSN: 1432-2307
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  • 5
    Language: English
    In: PLoS ONE, April 12, 2017, Vol.12(4), p.e0175563
    Description: VEGFA is an angiogenic factor secreted by tumors, in particular those with VEGFA amplification, as well as by macrophages and lymphocytes in the tumor microenvironment. Here we sought to define the presence of M1/M2 macrophages, PD-1-positive lymphocytes and PD-L1 tumoral and stromal expression in colorectal cancers harboring VEGFA amplification or chromosome 6 polysomy. 38 CRCs of which 13 harbored VEGFA amplification, 6 with Chr6 polysomy and 19 with neutral VEGFA copy number were assessed by immunohistochemistry for CD68 (marker for M1/M2 macrophages), CD163 (M2 macrophages), programmed death 1(PD-1)- tumor infiltrating and stromal lymphocytes as well as tumoral and stromal PD-1 ligand (PD-L1) expression. CRCs with VEGFA amplification or Chr6 polysomy were associated with decreased M1/M2 macrophages, reduced PD-1-expressing lymphocyte infiltration, as well as reduced stromal expression of PD-L1 at the tumor front. Compared to intermediate-grade CRCs, high-grade CRCs were associated with increased M1/M2 macrophages and increased tumoral expression of PD-L1. Our results suggest that VEGFA amplification or Chr6 polysomy is associated with an altered tumor immune microenvironment.
    Keywords: Tumors -- Genetic Aspects ; Colorectal Cancer -- Genetic Aspects ; Vascular Endothelial Growth Factor ; B Cells ; Immunohistochemistry ; Macrophages
    ISSN: 1932-6203
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  • 6
    In: Journal of Computer Assisted Tomography, 2017, Vol.41(1), pp.121-124
    Description: OBJECTIVE: The aims were to study the acromion parameters in the population and to assess the extremity or sex variation in the acromion morphology. METHODS: The lateral acromion angle (LAA) and the acromion index (AI) were assessed in a computed tomographic scan database of 250 individuals in the age group of 20 to 49 years. For the analysis of LAA and AI, 286 and 234 shoulders were available, respectively. RESULTS: The LAA was 73.6 ± 6.6 degrees; 73.7 ± 6.9 and 72.5 ± 6.1 degrees for the right and left shoulder, respectively. The AI was 0.755 ± 0.12; 0.82 ± 0.12 and 0.69 ± 0.12 for the left and the right shoulder, respectively. The AI of the right shoulder was significantly different between the 2 sexes (P = 0.04). The difference in the AI and the LAA of the right and left shoulders was significant (P 〈 0.0001, P = 0.04). CONCLUSIONS: The morphology of the acromion differs between the right and the left shoulders as well as between sexes.
    Keywords: Acromion–Anatomy & Histology ; Adult–Diagnostic Imaging ; Female–Epidemiology ; Germany–Statistics & Numerical Data ; Humans–Statistics & Numerical Data ; Male–Statistics & Numerical Data ; Middle Aged–Statistics & Numerical Data ; Reproducibility of Results–Statistics & Numerical Data ; Sensitivity and Specificity–Statistics & Numerical Data ; Sex Distribution–Statistics & Numerical Data ; Sex Factors–Statistics & Numerical Data ; Tomography, X-Ray Computed–Statistics & Numerical Data;
    ISSN: 0363-8715
    E-ISSN: 15323145
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  • 7
    In: PLoS ONE, 2017, Vol.12(4)
    Description: Aims In infective endocarditis (IE), a severe inflammatory disease of the endocardium with an unchanged incidence and mortality rate over the past decades, only 1% of the cases have been described as polymicrobial infections based on microbiological approaches. The aim of this study was to identify potential biodiversity of bacterial species from infected native and prosthetic valves. Furthermore, we compared the ultrastructural micro-environments to detect the localization and distribution patterns of pathogens in IE. Material and methods Using next-generation sequencing (NGS) of 16S rDNA, which allows analysis of the entire bacterial community within a single sample, we investigated the biodiversity of infectious bacterial species from resected native and prosthetic valves in a clinical cohort of 8 IE patients. Furthermore, we investigated the ultrastructural infected valve micro-environment by focused ion beam scanning electron microscopy (FIB-SEM). Results Biodiversity was detected in 7 of 8 resected heart valves. This comprised 13 bacterial genera and 16 species. In addition to 11 pathogens already described as being IE related, 5 bacterial species were identified as having a novel association. In contrast, valve and blood culture-based diagnosis revealed only 4 species from 3 bacterial genera and did not show any relevant antibiotic resistance. The antibiotics chosen on this basis for treatment, however, did not cover the bacterial spectra identified by our amplicon sequencing analysis in 4 of 8 cases. In addition to intramural distribution patterns of infective bacteria, intracellular localization with evidence of bacterial immune escape mechanisms was identified. Conclusion The high frequency of polymicrobial infections, pathogen diversity, and intracellular persistence of common IE-causing bacteria may provide clues to help explain the persistent and devastating mortality rate observed for IE. Improved bacterial diagnosis by 16S rDNA NGS that increases the ability to tailor antibiotic therapy may result in improved outcomes.
    Keywords: Research Article ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Research And Analysis Methods ; Biology And Life Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences
    E-ISSN: 1932-6203
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  • 8
    Language: English
    In: Developmental and Comparative Immunology, December 2014, Vol.47(2), pp.254-263
    Description: Polymorph-nuclear neutrophils (PMN) in cattle exhibit unique features when compared to human or murine PMN and are of particular interest concerning the risk of post-partum mammary gland or extra-mammary infections related to the periparturient suppression of neutrophil functions. Former studies could show that effects of IL-2 on innate immune cells such as PMN were mediated by the interleukin-2 receptor (IL-2R) β and γ chains. In the current study we could detect IL-2Rα (CD25) expression on bovine PMN using flow-cytometric analysis. CD25 was detected on granulocytes from post-partum and early lactating cows with different inflammatory conditions. The expression of CD25 on PMN in blood and raw milk increased with disease severity. Our results suggest CD25 expression on PMN as a potential biomarker for acute infections in cattle. Furthermore, our data provide a basis to better understanding of the periparturient functional suppressions of PMN that might reveal new molecular targets for therapy or prevention of disease.
    Keywords: Cd25 ; Interleukin-2 Receptor ; Pmn ; Bovine Neutrophil ; Biomarker ; Medicine ; Biology
    ISSN: 0145-305X
    E-ISSN: 1879-0089
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  • 9
    Language: English
    In: Clinical chemistry, November 2018, Vol.64(11), pp.1646-1656
    Description: Measurements of plasma or urinary metanephrines are recommended for diagnosis of pheochromocytoma and paraganglioma (PPGL). What test offers optimal diagnostic accuracy for patients at high and low risk of disease, whether urinary free metanephrines offer advantages over deconjugated metanephrines, and what advantages are offered by including methoxytyramine in panels all remain unclear. A population of 2056 patients with suspected PPGLs underwent prospective screening for disease using mass spectrometric-based measurements of plasma free, urinary deconjugated, and urinary free metanephrines and methoxytyramine. PPGLs were confirmed in 236 patients and were excluded in others on follow-up evaluation. Measurements of plasma free metabolites offered higher ( 〈 0.01) diagnostic sensitivity (97.9%) than urinary free (93.4%) and deconjugated (92.9%) metabolites at identical specificities for plasma and urinary free metabolites (94.2%) but at a lower ( 〈 0.005) specificity for deconjugated metabolites (92.1%). The addition of methoxytyramine offered little value for urinary panels but provided higher ( 〈 0.005) diagnostic performance for plasma measurements than either urinary panel according to areas under ROC curves (0.991 vs 0.972 and 0.964). Diagnostic performance of urinary and plasma tests was similar for patients at low risk of disease, whereas plasma measurements were superior to both urinary panels for high-risk patients. Diagnosis of PPGLs using plasma or urinary free metabolites provides advantages of fewer false-positive results compared with commonly measured deconjugated metabolites. The plasma panel offers better diagnostic performance than either urinary panel for patients at high risk of disease and, with appropriate preanalytics, provides the test of choice. Measurements of methoxytyramine in urine show limited diagnostic utility compared with plasma.
    Keywords: Metanephrine ; Adrenal Gland Neoplasms -- Diagnosis ; Chromaffin Cells -- Metabolism ; Dopamine -- Analogs & Derivatives ; Paraganglioma -- Diagnosis
    ISSN: 00099147
    E-ISSN: 1530-8561
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  • 10
    Language: English
    In: Toxicology, 01 November 2018, Vol.409, pp.80-90
    Description: Polycyclic aromatic hydrocarbons such as benzo( )pyrene (BaP) are environmental contaminants known to be immunosuppressive. Most effects of BaP towards immune cells are thought to be mediated through activation of the aryl hydrocarbon receptor (AhR). The AhR is a ligand-activated transcription factor, which plays a critical modulatory role in various cells during immune response. Macrophages are key players in innate immunity against intracellular bacteria and are discussed to be a target of AhR-mediated immune regulation. However, so far there is only incomplete knowledge about the effects of BaP on activated macrophages and whether these effects are AhR-dependent in each case. Using murine bone marrow-derived macrophages (BMMs) stimulated with heat-killed salmonellae as a source of different pathogen-associated molecular patterns (PAMPs) for stimulation of different pattern recognition receptors (PRRs) as an model, we studied the immunomodulatory effects of low-dose BaP exposure. PRR-activated BMMs produced nitric oxide (NO) and a spectrum of proinflammatory cytokines, i.e. tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-12 but also the anti-inflammatory cytokine IL-10. While BaP exposure suppressed the production of proinflammatory cytokines, the secretion of IL-10 was augmented. Moreover, BaP exposure increased the expression of major histocompatibility complex class II (MHC-II), CD14, Fcγ receptor I (FcγRI/CD64), or CD86, enhanced NO production and phagocytosis what may be beneficial for phagocytosis and killing of microbial pathogens. Of note, without PRR activation low-dose BaP exposure has little influence on the macrophage phenotype. BMMs from AhR-deficient ( ) mice were widely refractory to BaP-induced modulation of cytokine production, surface marker expression, and functional properties in response to PAMPs stimulation, indicating that these effects are dependent on AhR. In summary, these data suggest that induction of AhR-mediated signalling pathways by BaP may attenuate the proinflammatory phenotype of PRR-activated BMMs, while activating IL-10-mediated anti-inflammatory properties but also enhancing uptake and killing of pathogens as well as antigen presentation. Together these features imply a favourable role of BaP exposure for macrophage functions in an ongoing immune response. However, the strong induction of IL-10 may lead to defective pathogen clearance and subsequently to chronic persistent infection. This concept suggests an inhibitory rather than a supporting influence of environmental BaP on immunity to infection or cancer and also emphasises the important regulatory role of AhR in immunity and inflammation.
    Keywords: Benzo(a)Pyrene (Bap) ; Aryl Hydrocarbon Receptor (Ahr) ; Macrophage ; Immunomodulation ; Pharmacy, Therapeutics, & Pharmacology ; Public Health
    ISSN: 0300-483X
    E-ISSN: 1879-3185
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