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  • 1
    Language: English
    In: Intensive Care Medicine, 2004, Vol.30(3), pp.430-436
    Description: Byline: Peter Schellongowski (1), Michael Benesch (2), Thomas Lang (2), Friederike Traunmuller (1), Christian Zauner (3), Klaus Laczika (1), Gottfried J. Locker (1), Michael Frass (1), Thomas Staudinger (1) Keywords: Scoring; Cancer; Critical care; Acute Physiology and Chronic Health Evaluation (APACHE) II; Simplified Acute Physiology Score (SAPS) II; Mortality Probability Model II Abstract: Objective To compare three scoring systems, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Simplified Acute Physiology Score (SAPS) II and a modified Mortality Probability Model II (ICU cancer mortality model, ICMM) for their prognostic value for mortality during hospital stay in a group of cancer patients admitted to a medical ICU. Design Prospective cohort study. Setting Medical ICU of a tertiary care hospital. Patients Two hundred forty-two consecutive cancer patients admitted to the ICU. Measurements and results Variables included in APACHE II, SAPS II and the ICMM scores as well as demographic data were assessed during the first 24 h of stay in the ICU. Hospital mortality was measured it was 44%. Calibration for all three scoring systems was acceptable, SAPS II yielded a significantly superior discrimination between survivors and non-survivors. The areas under the receiver operating characteristic curves were 0.776 for APACHE II, 0.825 for SAPS II and 0.698 for the ICMM. Conclusion The SAPS II was superior to APACHE II and ICMM. The newly developed ICMM does not improve mortality prediction in critically ill cancer patients. Author Affiliation: (1) Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18--20, 1090, Vienna, Austria (2) Institute for Medical Statistics, University of Vienna, Schwarzspanierstrasse 17, 1090, Vienna, Austria (3) Department of Internal Medicine IV, University of Vienna, Waehringer Guertel 18--20, 1090, Vienna, Austria Article History: Registration Date: 01/01/2003 Received Date: 03/04/2003 Accepted Date: 29/09/2003 Online Date: 04/11/2003
    Keywords: Scoring ; Cancer ; Critical care ; Acute Physiology and Chronic Health Evaluation (APACHE) II ; Simplified Acute Physiology Score (SAPS) II ; Mortality Probability Model II
    ISSN: 0342-4642
    E-ISSN: 1432-1238
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  • 2
    In: Neurology, 2016, Vol.87(2), pp.168-177
    Description: OBJECTIVE:: This was a longitudinal single-center cohort study to comprehensively explore multimodal progression markers for Parkinson disease (PD) in patients with recently diagnosed PD (n = 123) and age-matched, neurologically healthy controls (HC; n = 106). METHODS:: Thirty tests at baseline and after 24 months covered nonmotor symptoms (NMS), cognitive function, and REM sleep behavior disorder (RBD) by polysomnography (PSG), voxel-based morphometry (VBM) of the brain by MRI, and CSF markers. Linear mixed-effect models were used to estimate differences of rates of change and to provide standardized effect sizes (d) with 95% confidence intervals (CI). RESULTS:: A composite panel of 10 informative markers was identified. Significant relative worsening (PD vs HC) was seen with the following markers: the Unified Parkinsonʼs Disease Rating Scale I (d 0.39; CI 0.09–0.70), the Autonomic Scale for Outcomes in Parkinsonʼs Disease (d 0.25; CI 0.06–0.46), the Epworth Sleepiness Scale (d 0.47; CI 0.24–0.71), the RBD Screening Questionnaire (d 0.44; CI 0.25–0.64), and RBD by PSG (d 0.37; CI 0.19–0.55) as well as VBM units of cortical gray matter (d −0.2; CI −0.3 to −0.09) and hippocampus (d −0.15; CI −0.27 to −0.03). Markers with a relative improvement included the Nonmotor Symptom (Severity) Scale (d −0.19; CI −0.36 to −0.02) and 2 depression scales (Beck Depression Inventory d −0.18; CI −0.36 to 0; Montgomery-Åsberg Depression Rating Scale d −0.26; CI −0.47 to −0.04). Unexpectedly, cognitive measures and select laboratory markers were not significantly changed in PD vs HC participants. CONCLUSIONS:: Current CSF biomarkers and cognitive scales do not represent useful progression markers. However, sleep and imaging measures, and to some extent NMS, assessed using adequate scales, may be more informative markers to quantify progression.
    Keywords: Neurologi ; Neurology ; Psykiatri ; Psychiatry ; Geriatrik ; Geriatrics;
    ISSN: 0028-3878
    E-ISSN: 1526632X
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  • 3
    In: Neurology, 2013, Vol.81(14), pp.1226-1234
    Description: OBJECTIVE:: To determine nonmotor signs (NMS) and evaluate the utility of several diagnostic tools in patients with de novo Parkinson disease (PD). METHODS:: This is a large single-center study of the DeNoPa cohort, including frequency-matched healthy controls. This study covers motor signs, NMS, and a combination of diagnostic tests including olfactory testing, transcranial sonography of substantia nigra (TCS), and polysomnography (PSG). We report the frequency and characteristics of NMS and the outcomes of nonmotor tests at the time of diagnosis. RESULTS:: Cross-sectional analyses of baseline investigations identified significant differences in the NMS Questionnaire (NMSQuest) and the Scopa-AUT Gastrointestinal score in 159 drug-naïve PD patients vs 110 controls. In addition, patients with PD showed reduced olfactory function, hyperechogenicity on TCS, and higher frequency of REM sleep behavior disorder (RBD). In exploring predictive markers, we found that the combination of several investigations, i.e., the NMSQuest, Scopa-AUT Gastrointestinal score, and Smell Identification Test reached an area under the receiver operating characteristic curve (AUC) of 0.913 (95% confidence interval [CI] 0.878–0.948). With the addition of serum cholesterol and mean heart rate values, the AUC value reached 0.919 (95% CI 886–0.953); when TCS and PSG were added, the AUC increased to 0.963 (95% CI 0.943–0.982). CONCLUSIONS:: We show feasibility and utility of standardized data acquisition in a large, single-center cohort of patients with de novo PD and matched healthy controls. The baseline results from our prospective investigations reached a value of 〉0.9 sensitivity and specificity for biological markers when we added routine laboratory investigations and quantified nonmotor features including sleep.
    Keywords: Substantia Nigra ; Inventories ; Neurodegenerative Diseases ; Sleep (Rem) ; Movement Disorders ; Parkinson'S Disease ; Heart Rate ; Cholesterol ; Biomarkers ; Data Acquisition ; Olfaction ; Neurology & Neuropathology;
    ISSN: 0028-3878
    E-ISSN: 1526632X
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  • 4
    Language: English
    In: International Journal of Oncology, August 2011, Vol.39(2), pp.515-520
    Description: We performed this study in order to evaluate the impact of the chemokine CXCL12 and its single-nucleotide polymorphism (SNP) rs1801157 on clinicopathological parameters and survival in patients undergoing surgery for esophagogastric cancer. The expression pattern of CXCL12 and its polymorphisms were analyzed by RT-PCR and PCR-RFLP in 69 consecutive fresh-frozen samples of human esophagogastric junction and gastric adenocarcinomas and statistically analyzed. Expression of the CXCL12 (SNP rs1801157) polymorphisms GA/AA significantly correlated with distant metastasis (P=0.026), but not with prognosis. However, CXCL12 expression was not significantly associated with the tumor infiltration depth, lymphatic metastasis and grading. As CXCL12 polymorphisms mediate tumor cell dissemination in esophagogastric cancer, they could represent a marker indicating advanced disease. Antagonists targeting the CXCL12/ CXCR4 axis may be a novel therapeutic option in this entity.
    Keywords: Medicine;
    ISSN: 1019-6439
    E-ISSN: 17912423
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  • 5
    Language: English
    In: European Archives of Oto-Rhino-Laryngology, 2018, Vol.275(10), pp.2507-2513
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00405-018-5105-2 Byline: Kerstin Stahr (1), Laura Holtmann (1), Anke Schluter (1), Friederike Kaster (1), Michael Oeverhaus (2), Stephan Lang (1), Anja Eckstein (2), Stefan Mattheis (1) Keywords: Graves' orbitopathy; Orbital decompression; Nasal airflow; Olfactory performance; Surgical outcome Abstract: Purpose To determine the influence of anatomical changes after orbital decompression to nasal function. Methods We examined postoperative nasal function after orbital decompression in patients with GO in a prospective study. 25 patients were enrolled between 2014 and 2016. Sense of smell (Sniffin' Test) and nasal airflow (anterior rhinomanometry) were tested pre- and 6 weeks postoperatively. In addition, postoperative incidence of sinus infections, persistent pressure pain, and infraorbital hypoesthesia were assessed by means of a questionnaire. Results The olfactory performance showed a significant increase (p〈0.05) after surgery, while the nasal airflow significantly decreased (p〈0.05). Acute sinus infection occurred in three, infraorbital sensibility disorders in eight cases within the first 6 weeks after surgery. No persistent pain was recorded. Conclusion We demonstrate that decompression of the medial orbital wall leads to a decrease in nasal airflow, whereof patients should be informed before the procedure. This is most likely due to a medialization of the medial turbinate and the prolapse of orbital content into the nasal cavity. The increase of the olfactory performance is, in our opinion, more likely due to variation within the standard deviation than to anatomical changes. Author Affiliation: (1) 0000 0001 0262 7331, grid.410718.b, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany (2) 0000 0001 0262 7331, grid.410718.b, Department of Ophthalmology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany Article History: Registration Date: 21/08/2018 Received Date: 08/06/2018 Accepted Date: 21/08/2018 Online Date: 30/08/2018
    Keywords: Graves’ orbitopathy ; Orbital decompression ; Nasal airflow ; Olfactory performance ; Surgical outcome
    ISSN: 0937-4477
    E-ISSN: 1434-4726
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  • 6
    In: Medicine, 2016, Vol.95(38), pp.e4602-e4602
    Description: ABSTRACT: We aimed to validate the liver fibrosis index FIB-4 as a model for risk stratification of hepatocellular carcinoma development in predominantly non-Asian patients with chronic hepatitis B infection seen at a tertiary referral center in Germany.We retrospectively analyzed 373 adult patients with chronic hepatitis B infection. Patient demographics, hepatitis B markers, antiviral treatment, laboratory parameters, results from liver imaging and histology were recorded. Patients were divided into 2 groups according to their FIB-4 levels and their hazard ratios for developing hepatocellular carcinoma were analyzed adjusted for age, sex, body mass index, alcohol consumption, and antiviral medication.Median follow-up was 8.7 years (range 1–21.3 years), 93% of patients were of non-Asian origin, and 64% were male. Compared with patients with a low FIB-4 (〈1.25) patients with FIB-4 ≥1.25 showed a hazard ratio for incidence of hepatocellular carcinoma of 3.03 (95% confidence interval (CI): 1.24–7.41) and an adjusted hazard ratio of 1.75 (95% CI: 0.64–4.74). Notably, 68% of patients with liver cirrhosis and 68% of those who developed HCC during observation had a low FIB-4 (〈1.25).We could not confirm that a FIB-4 value ≥1.25 is a reliable clinical indicator for incidence of hepatocellular carcinoma in predominantly non-Asian patients with chronic hepatitis B. Further studies in geographically and ethnically diverse populations are needed to prove its utility as a predictive tool.
    Keywords: Medicine;
    ISSN: 0025-7974
    E-ISSN: 15365964
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  • 7
    Language: English
    In: World Journal of Surgery, 2011, Vol.35(5), pp.1010-1016
    Description: BACKGROUNDThe present study was designed to evaluate the impact of the tyrosine kinase ligands VEGF-A/C/D, PDGF-A/B on tumor dissemination and survival in gastric cancer. This is the first study analyzing all these parameters in a homogeneous patient population undergoing surgery. METHODSThe expression pattern of VEGF-A/C/D and PDGF-A/B was analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) in 69 samples of human gastric adenocarcinoma and correlated with tumor stage and survival. RESULTSExpression of the ligand VEGF-D significantly correlated with distant metastatic disease (P=0.00001) but not with patient survival. However, VEGF-A inversely correlated with M1 and grading, PDGF-A inversely correlated with pT and pN category. In contrast, VEGF-C and PDGF-B did not have an impact on clinicopathological parameters. CONCLUSIONSThe ligand VEGF-D, rather than the other ligands or tyrosine kinase receptors analyzed, is associated with progressive disease in gastric cancer patients undergoing surgery. The VEGF-D ligand might be a helpful marker indicating disseminated disease, and targeting VEGF-D may be a potential therapeutic strategy, although limitations imposed by the selected sample population have to be considered critically.
    Keywords: Adenocarcinoma–Mortality ; Adult–Pathology ; Aged–Surgery ; Aged, 80 and Over–Metabolism ; Female–Mortality ; Humans–Pathology ; Immunohistochemistry–Surgery ; Male–Metabolism ; Middle Aged–Metabolism ; Neoplasm Metastasis–Metabolism ; Platelet-Derived Growth Factor–Metabolism ; Reverse Transcriptase Polymerase Chain Reaction–Metabolism ; Stomach Neoplasms–Metabolism ; Vascular Endothelial Growth Factor A–Metabolism ; Vascular Endothelial Growth Factor C–Metabolism ; Vascular Endothelial Growth Factor D–Metabolism ; Platelet-Derived Growth Factor ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor D;
    ISSN: 0364-2313
    E-ISSN: 1432-2323
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  • 8
    Language: English
    In: American Journal of Hematology, May 2008, Vol.83(5), pp.382-386
    Description: In patients with acute leukemia, Wilms' tumor gene 1 (WT1) has been used as a target for the detection of minimal residual disease (MRD) by PCR techniques. The expression of WT1 protein, however, has not been extensively studied. To determine the relation between expression of WT1 transcripts and of the encoded protein, we examined leukemic cell lines and primary childhood leukemia samples using both real‐time quantitative PCR (RQ‐PCR) and flow cytometry. WT1 protein was highly expressed in the leukemic cell lines K562, HL‐60, PLB 985, KG‐1a and CEM. By contrast, 40 primary samples of acute lymphoblastic leukemia (ALL; B‐ALL, = 15 and T‐ALL, = 10) and acute myeloid leukemia ( = 15) expressed low levels of WT1 protein. RQ‐PCR detected WT1 transcript levels in the same range as reported in earlier studies in childhood acute leukemia. The results of this study indicate the following: (i) there are considerable discrepancies between WT1 transcripts and protein expression; (ii) WT1 is not a suitable marker for flow cytometric MRD detection in childhood acute leukemia. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.
    Keywords: Gene Expression Regulation, Leukemic ; Neoplasm Proteins -- Analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma -- Metabolism ; Wt1 Proteins -- Analysis;
    ISSN: 0361-8609
    E-ISSN: 1096-8652
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