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1.
Langmuir ; 40(11): 5606-5616, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38501265

RESUMEN

The motion of partly gold (Au)-coated Janus particles under laser irradiation is caused by self-thermophoresis. Despite numerous studies addressing this topic, the impact of the preparation method and the degree of coverage of the particle with Au on the resulting thermophoretic velocity has not yet been fully understood. A detailed understanding of the most important tuning parameters during the preparation process is crucial to design Janus particles that are optimized for Au coverage to receive a high thermophoretic velocity. In this study, we explore the influence of the fabrication process, which changes the Au cap size, on the resulting self-propulsion behavior of partly Au-coated polystyrene particles (Au-PS). Additionally, the impact of an underlying adhesion chromium layer is investigated. In addition to the most commonly used qualitative SEM and EDX measurements, we propose a novel and fast technique utilizing AFM studies to quantify the cap size. This non-invasive technique can be used to determine both the size and the maximum thickness of the Au cap. The Au cap size was systematically varied in a range between about 36 and 74% by different preparation strategies. Nevertheless, we showed that the differing Au cap sizes of the Janus particles in this range have no obvious effect on the thermophoretic velocity. This is a surprising result since one would expect an effect of the Au cap size due to different solvent flows around the Janus particles and is attributed to an additional torque near the surface of the measuring cell.

2.
Surg Endosc ; 37(10): 7803-7811, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37605011

RESUMEN

INTRODUCTION: Radiofrequency ablation (RFA) and hybrid argon plasma coagulation (H-APC) are established thermal ablation techniques for eradicating Barrett's esophagus after endoscopic resection. This study aimed to compare RFA with H-APC in relation to safety, effectiveness and eradication rates. METHODS: After endoscopic resection, patients were randomly assigned to H-APC or RFA. A simplified H-APC technique was applied at 60 W. RFA was used with a 90° focal catheter and a simplified protocol of 12 J/cm2 × 3 or with a Halo 360° balloon and 10 J/cm2/cleaning/10 J/cm2. Eradication rates and adverse events were recorded. Patients received follow-up examinations after 3, 6, 12 and 24 months. RESULTS: One hundred and one patients were finally included in the study (RFA N = 47, H-APC N = 54). The median follow-up period for short-term was 6.0 (CI 5.4-6.9) months and for long term 21 (CI 19.2.5-22.7) months. In total 211 ablations were performed. The eradication rates after long-term follow-up were 74.2% in the RFA group and 82.9% in the H-APC group. Post-interventional pain was significantly greater in the RFA group, with a mean score of 4.56/10 and duration of 7.54 days, in comparison with a mean score of 2.07/10 over 3.59 days in the H-APC group. Stenoses requiring intervention were noted in 3.7% of patients in the H-APC arm and 14.9% of those in the RFA arm. CONCLUSIONS: Both ablation techniques have good results in relation to the eradication rate, with a slightly better outcome in the H-APC group. The severity and duration of pain were significantly greater in the RFA group.


Asunto(s)
Esófago de Barrett , Ablación por Catéter , Ablación por Radiofrecuencia , Humanos , Esófago de Barrett/terapia , Coagulación con Plasma de Argón , Estudios Prospectivos , Resultado del Tratamiento , Ablación por Radiofrecuencia/efectos adversos , Ablación por Catéter/métodos , Esofagoscopía/métodos
3.
Ann Vasc Surg ; 73: 417-422, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33383136

RESUMEN

BACKGROUND: Endovascular aortic aneurysm repair (EVAR) has become the treatment of choice for most patients with abdominal aortic aneurysm (AAA). Open aneurysm repair (OAR) is still being used in a number of patients for specific reasons. The aim of the present study was to investigate the reasons and perioperative outcomes of OAR in a high-volume endovascular center. METHODS: All patients who underwent OAR in a single center institution during the period April 2010 to July 2019 were retrospectively analyzed. RESULTS: During the study period, 222 patients underwent OAR. One hundred and forty-one (63.5%) patients underwent elective surgery, and eighty-one (36.5%) patients were treated acutely. The reasons for the decision to perform OAR instead of EVAR were as follows: anatomical in 89 (40.1%) cases, rupture in unstable patient in 57 (25.7%) cases, AAA with concomitant iliac arterial occlusive disease in 44 (19.8%) cases, previous EVAR with complications in 14 (6.3%) cases, large pararenal aneurysm considered risky to wait for a customized fenestrated stent graft in 7 (3.2%) cases, young patient age in 4 (1.8%) cases, the patient's preference in 3 (1.4%) cases, infected/mycotic AAA in 2 (0.9%) cases, and simultaneous OAR with colon cancer resection (n = 1, 0.5%) and renal transplantation (n = 1, n = 0.5). Thirty-day mortality in elective cases was 5% (7/141) and in acute cases 34.6% (28/81). CONCLUSIONS: This study shows that OAR is still used for selected patients despite improvements in EVAR technology. The most common reason for OAR was an unsuitable anatomy for EVAR. Perioperative mortality of OAR both for acute and elective cases as observed in this study is in line with published outcomes of other centers.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Rotura de la Aorta/cirugía , Procedimientos Quirúrgicos Vasculares , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/mortalidad , Aneurisma de la Aorta Abdominal/fisiopatología , Rotura de la Aorta/diagnóstico por imagen , Rotura de la Aorta/mortalidad , Rotura de la Aorta/fisiopatología , Toma de Decisiones Clínicas , Procedimientos Quirúrgicos Electivos , Femenino , Alemania , Hospitales de Alto Volumen , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/efectos adversos , Procedimientos Quirúrgicos Vasculares/mortalidad
4.
J Clin Monit Comput ; 35(5): 1085-1092, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-32734356

RESUMEN

Standard monitoring of heart rate, blood pressure and arterial oxygen saturation during endoscopy is recommended by current guidelines on procedural sedation. A number of studies indicated a reduction of hypoxic (art. oxygenation < 90% for > 15 s) and severe hypoxic events (art. oxygenation < 85%) by additional use of capnography. Therefore, U.S. and the European guidelines comment that additional capnography monitoring can be considered in long or deep sedation. Integrated Pulmonary Index® (IPI) is an algorithm-based monitoring parameter that combines oxygenation measured by pulse oximetry (art. oxygenation, heart rate) and ventilation measured by capnography (respiratory rate, apnea > 10 s, partial pressure of end-tidal carbon dioxide [PetCO2]). The aim of this paper was to analyze the value of IPI as parameter to monitor the respiratory status in patients receiving propofol sedation during PEG-procedure. Patients reporting for PEG-placement under sedation were randomized 1:1 in either standard monitoring group (SM) or capnography monitoring group including IPI (IM). Heart rate, blood pressure and arterial oxygen saturation were monitored in SM. In IM additional monitoring was performed measuring PetCO2, respiratory rate and IPI. Capnography and IPI values were recorded for all patients but were only visible to the endoscopic team for the IM-group. IPI values range between 1 and 10 (10 = normal; 8-9 = within normal range; 7 = close to normal range, requires attention; 5-6 = requires attention and may require intervention; 3-4 = requires intervention; 1-2 requires immediate intervention). Results on capnography versus standard monitoring of the same study population was published previously. A total of 147 patients (74 in SM and 73 in IM) were included in the present study. Hypoxic events occurred in 62 patients (42%) and severe hypoxic events in 44 patients (29%), respectively. Baseline characteristics were equally distributed in both groups. IPI = 1, IPI < 7 as well as the parameters PetCO2 = 0 mmHg and apnea > 10 s had a high sensitivity for hypoxic and severe hypoxic events, respectively (IPI = 1: 81%/81% [hypoxic/severe hypoxic event], IPI < 7: 82%/88%, PetCO2: 69%/68%, apnea > 10 s: 84%/84%). All four parameters had a low specificity for both hypoxic and severe hypoxic events (IPI = 1: 13%/12%, IPI < 7: 7%/7%, PetCO2: 29%/27%, apnea > 10 s: 7%/7%). In multivariate analysis, only SM and PetCO2 = 0 mmHg were independent risk factors for hypoxia. IPI (IPI = 1 and IPI < 7) as well as the individual parameters PetCO2 = 0 mmHg and apnea > 10 s allow a fast and convenient conclusion on patients' respiratory status in a morbid patient population. Sensitivity is good for most parameters, but specificity is poor. In conclusion, IPI can be a useful metric to assess respiratory status during propofol-sedation in PEG-placement. However, IPI was not superior to PetCO2 and apnea > 10 s.


Asunto(s)
Gastrostomía , Propofol , Capnografía , Sedación Consciente , Humanos , Monitoreo Fisiológico , Estudios Prospectivos , Respiración
5.
J Gastroenterol Hepatol ; 35(3): 401-407, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31222832

RESUMEN

BACKGROUND AND AIM: A number of studies were able to show a reduction of hypoxemia episodes during procedural sedation through the use of capnography (CA). The present study investigates the number of episodes of hypoxemia during percutaneous endoscopic gastrostomy (PEG) placement with propofol sedation comparing standard monitoring (SM) versus SM with additional CA surveillance. METHODS: In this single center randomized controlled trial, 150 patients were prospectively randomized 1:1 in either the SM group or the CA group after stratification for ASA class, PEG method (push or pull method), presence of head and neck tumor, and tracheostomy. CA analysis was performed for all patients but was blinded for the endoscopic team in the SM group. RESULTS: In the SM group, 57% episodes of hypoxemia (SpO2  < 90% for > 15 s) and 41% episodes of severe hypoxemia (SpO2  < 85% for > 15 s) were observed in comparison with 28% and 20% in the CA group, respectively. Odds ratios for hypoxemia and severe hypoxemia were 0.29 (confidence interval 0.15-0.57; P = 0.0005) and 0.35 (confidence interval 0.17-0.73; P = 0.008) in favor of the CA group. On average, CA was able to detect imminent mild and severe hypoxemia 83 and 99 s before standard monitoring. Standard monitoring represented an independent risk factor for hypoxemia and severe hypoxemia. CONCLUSIONS: Respiratory complications of sedation during PEG placement are frequent events. CA is able to detect imminent hypoxemia at an early time point. This allows an early intervention and consecutively the avoidance of mild and severe hypoxemia. Therefore, CA monitoring can be recommended particularly during PEG insertion procedures.


Asunto(s)
Capnografía , Sedación Consciente/métodos , Endoscopía Gastrointestinal/métodos , Gastrostomía/métodos , Hipoxia/diagnóstico , Complicaciones Intraoperatorias/diagnóstico , Monitoreo Fisiológico/métodos , Anciano , Femenino , Humanos , Hipoxia/prevención & control , Complicaciones Intraoperatorias/prevención & control , Masculino , Persona de Mediana Edad , Estudios Prospectivos
6.
Sante Publique ; 30(1): 105-113, 2018.
Artículo en Francés | MEDLINE | ID: mdl-29589682

RESUMEN

INTRODUCTION: Organizational culture, a frequently ignored concept, affects job satisfaction and productivity in organizations. OBJECTIVE: To determine the factors associated with the strength of organizational culture (OC) in Mono / Couffo regional hospital in Lokossa in Benin. METHODS: This cross-sectional and analytical study involved 121 workers of Mono/Couffo hospital in March 2015. Data on the strength of OC was collected using a questionnaire based on the validated tool proposed by Cameron and Quinn (2006). Logistic regression was performed to explore the nature of the relationship between the independent variables and OC using Odds ratios. RESULTS: 62% of the surveyed subjects had a positive perception of organizational culture. This perception was statistically associated with managerial factors (moral support of workers and type of relationship with the executive staff). The risk of perceiving a low strength of OC was sixfold higher OR = 3.78, 95% CI (1.08 - 13.22) among subjects who felt they did not have moral support from executive staff than in those who perceived this moral support. The risk of perceiving a weak OC was higher among subjects who considered relations with the staff to be uncordial [OR = 14.32, 95% CI (4.35 - 47.11)] compared to those who considered these relations to be cordial. CONCLUSION: Human resource management factors were more closely associated with the strength of organizational culture. Hospital managers should pay more attention to these factors in their hospitals to promote better institutional performance.


Asunto(s)
Actitud del Personal de Salud , Cultura Organizacional , Adulto , Benin , Estudios Transversales , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad
8.
Chromosome Res ; 23(1): 69-76, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25596821

RESUMEN

Engineered minimal chromosomes with sufficient mitotic and meiotic stability have an enormous potential as vectors for stacking multiple genes required for complex traits in plant biotechnology. Proof of principle for essential steps in chromosome engineering such as truncation of chromosomes by T-DNA-mediated telomere seeding and de novo formation of centromeres by cenH3 fusion protein tethering has been recently obtained. In order to generate robust protocols for application in plant biotechnology, these steps need to be combined and supplemented with additional methods such as site-specific recombination for the directed transfer of multiple genes of interest on the minichromosomes. At the same time, the development of these methods allows new insight into basic aspects of plant chromosome functions such as how centromeres assure proper distribution of chromosomes to daughter cells or how telomeres serve to cap the chromosome ends to prevent shortening of ends over DNA replication cycles and chromosome end fusion.


Asunto(s)
Biotecnología/métodos , Centrómero/genética , Inestabilidad Cromosómica/genética , Cromosomas de las Plantas/genética , Ingeniería Genética/métodos , Vectores Genéticos/genética , Modelos Genéticos , Biotecnología/tendencias
9.
BMC Genomics ; 16: 430, 2015 06 05.
Artículo en Inglés | MEDLINE | ID: mdl-26044734

RESUMEN

BACKGROUND: Fusarium head blight (FHB) and Septoria tritici blotch (STB) severely impair wheat production. With the aim to further elucidate the genetic architecture underlying FHB and STB resistance, we phenotyped 1604 European wheat hybrids and their 135 parental lines for FHB and STB disease severities and determined genotypes at 17,372 single-nucleotide polymorphic loci. RESULTS: Cross-validated association mapping revealed the absence of large effect QTL for both traits. Genomic selection showed a three times higher prediction accuracy for FHB than STB disease severity for test sets largely unrelated to the training sets. CONCLUSIONS: Our findings suggest that the genetic architecture is less complex and, hence, can be more properly tackled to perform accurate prediction for FHB than STB disease severity. Consequently, FHB disease severity is an interesting model trait to fine-tune genomic selection models exploiting beyond relatedness also knowledge of the genetic architecture.


Asunto(s)
Ascomicetos/fisiología , Resistencia a la Enfermedad/genética , Fusarium/fisiología , Enfermedades de las Plantas/genética , Triticum/genética , Mapeo Cromosómico , Europa (Continente) , Genotipo , Fenotipo , Enfermedades de las Plantas/etiología , Enfermedades de las Plantas/microbiología , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Triticum/microbiología
10.
J Exp Bot ; 66(11): 3275-84, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25873667

RESUMEN

Improving phenotypic stability of crops is pivotal for coping with the detrimental impacts of climate change. The goal of this study was to gain first insights into the genetic architecture of phenotypic stability in cereals. To this end, we determined grain yield, thousand kernel weight, test weight, falling number, and both protein and soluble pentosan content for two large bi-parental rye populations connected through one common parent and grown in multi-environmental field trials involving more than 15 000 yield plots. Based on these extensive phenotypic data, we calculated parameters for static and dynamic phenotypic stability of the different traits and applied linkage mapping using whole-genome molecular marker profiles. While we observed an absence of large-effect quantitative trait loci (QTLs) underlying yield stability, large and stable QTLs were found for phenotypic stability of test weight, soluble pentosan content, and falling number. Applying genome-wide selection, which in contrast to marker-assisted selection also takes into account loci with small-effect sizes, considerably increased the accuracy of prediction of phenotypic stability for all traits by exploiting both genetic relatedness and linkage between single-nucleotide polymorphisms and QTLs. We conclude that breeding for crop phenotypic stability can be improved in related populations using genomic selection approaches established upon extensive phenotypic data.


Asunto(s)
Genómica , Sitios de Carácter Cuantitativo/genética , Secale/genética , Mapeo Cromosómico , Cambio Climático , Análisis por Conglomerados , Grano Comestible/genética , Grano Comestible/fisiología , Ambiente , Ligamiento Genético , Genotipo , Endogamia , Fenotipo , Polimorfismo de Nucleótido Simple/genética , Secale/fisiología
11.
BMC Genomics ; 15: 556, 2014 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-24997166

RESUMEN

BACKGROUND: Marker-assisted selection (MAS) and genomic selection (GS) based on genome-wide marker data provide powerful tools to predict the genotypic value of selection material in plant breeding. However, case-to-case optimization of these approaches is required to achieve maximum accuracy of prediction with reasonable input. RESULTS: Based on extended field evaluation data for grain yield, plant height, starch content and total pentosan content of elite hybrid rye derived from testcrosses involving two bi-parental populations that were genotyped with 1048 molecular markers, we compared the accuracy of prediction of MAS and GS in a cross-validation approach. MAS delivered generally lower and in addition potentially over-estimated accuracies of prediction than GS by ridge regression best linear unbiased prediction (RR-BLUP). The grade of relatedness of the plant material included in the estimation and test sets clearly affected the accuracy of prediction of GS. Within each of the two bi-parental populations, accuracies differed depending on the relatedness of the respective parental lines. Across populations, accuracy increased when both populations contributed to estimation and test set. In contrast, accuracy of prediction based on an estimation set from one population to a test set from the other population was low despite that the two bi-parental segregating populations under scrutiny shared one parental line. Limiting the number of locations or years in field testing reduced the accuracy of prediction of GS equally, supporting the view that to establish robust GS calibration models a sufficient number of test locations is of similar importance as extended testing for more than one year. CONCLUSIONS: In hybrid rye, genomic selection is superior to marker-assisted selection. However, it achieves high accuracies of prediction only for selection candidates closely related to the plant material evaluated in field trials, resulting in a rather pessimistic prognosis for distantly related material. Both, the numbers of evaluation locations and testing years in trials contribute equally to prediction accuracy.


Asunto(s)
Secale/genética , Estudios de Evaluación como Asunto , Mejoramiento Genético , Marcadores Genéticos , Genoma de Planta , Hibridación Genética , Fenotipo , Reproducibilidad de los Resultados , Selección Genética
12.
Chromosoma ; 122(3): 233-41, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23525657

RESUMEN

Artificial minichromosomes are highly desirable tools for basic research, breeding, and biotechnology purposes. We present an option to generate plant artificial minichromosomes via de novo engineering of plant centromeres in Arabidopsis thaliana by targeting kinetochore proteins to tandem repeat arrays at non-centromeric positions. We employed the bacterial lactose repressor/lactose operator system to guide derivatives of the centromeric histone H3 variant cenH3 to LacO operator sequences. Tethering of cenH3 to non-centromeric loci led to de novo assembly of kinetochore proteins and to dicentric carrier chromosomes which potentially form anaphase bridges. This approach will be further developed and may contribute to generating minichromosomes from preselected genomic regions, potentially even in a diploid background.


Asunto(s)
Arabidopsis/genética , Centrómero/genética , Secuencias Repetidas en Tándem , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Secuencia de Bases , Centrómero/metabolismo , Cromosomas de las Plantas/genética , Cromosomas de las Plantas/metabolismo , Ingeniería Genética , Histonas/genética , Histonas/metabolismo
14.
Endosc Int Open ; 12(1): E78-E89, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38205218

RESUMEN

Background and study aims There is still a lack of evidence-based recommendations concerning endoscopic bougienage in benign esophageal strictures. Our study aimed to assess the relevance of the time interval between endoscopic dilation (ED) sessions with regard to endoscopic and clinical response. Patients and methods We performed a retrospective study including patients treated with endoscopic bougienage for a benign esophageal stricture in two German centers. Primary endpoint was the number of ED until freedom from dysphagia was achieved. Secondary endpoints were analyses on reaching a diameter of 15 mm and on achieving clinical freedom from symptoms. Results Between April 2014 and March 2020, bougienage was used as the primary treatment for benign esophageal strictures in 238 patients (194 patients in Center 1; 44 patients in Center 2). Both centers differed in their endoscopic bougienage regime: Center 1 was characterized by a higher frequency of interventions compared to Center 2 (median: 2 days [range 1-28] vs. 10 days [range 1-41]; P <0.001). Clinical response was achieved significantly earlier using the high-frequency regimen in all patients except for those with post-radiogen strictures, who clinically benefited from a low-frequency ED program. Accordingly, patients receiving higher-frequency ED reached a significantly larger post-dilation diameter and considerably larger diameter differences. Conclusions The results of our study demonstrate that a treatment concept consisting of higher-frequency bougienages seems to be more effective in treating most types of esophageal stricture. Radiogenic strictures were the only types of stenoses that benefited from a lower frequency ED program.

15.
Chromosoma ; 121(2): 181-90, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22080935

RESUMEN

Engineered minichromosomes offer an enormous opportunity to plant biotechnology as they have the potential to simultaneously transfer and stably express multiple genes. Following a top-down approach, we truncated endogenous chromosomes in barley (Hordeum vulgare) by Agrobacterium-mediated transfer of T-DNA constructs containing telomere sequences. Blocks of Arabidopsis-like telomeric repeats were inserted into a binary vector suitable for stable transformation. After transfer of these constructs into immature embryos of diploid and tetraploid barley, chromosome truncation by T-DNA-induced de novo formation of telomeres could be confirmed by fluorescent in situ hybridisation, primer extension telomere repeat amplification and DNA gel blot analysis in regenerated plants. Telomere seeding connected to chromosome truncation was found in tetraploid plants only, indicating that genetic redundancy facilitates recovery of shortened chromosomes. Truncated chromosomes were transmissible in sexual reproduction, but were inherited at rates lower than expected according to Mendelian rules.


Asunto(s)
Cromosomas de las Plantas/genética , Técnicas de Transferencia de Gen , Ingeniería Genética/métodos , Hordeum/genética , Telómero/genética , Agrobacterium , Cartilla de ADN/genética , ADN Bacteriano/genética , Hibridación Fluorescente in Situ , Plásmidos/genética , Reacción en Cadena de la Polimerasa , Transformación Genética/genética
16.
J Clin Med ; 12(13)2023 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-37445409

RESUMEN

We performed a retrospective single-center analysis to investigate the diagnostic yield of bone marrow puncture in patients with liver cirrhosis and cytopenia. Liver cirrhosis patients receiving bone marrow aspiration or biopsy for the diagnostic work-up of otherwise unexplained peripheral blood cytopenia at our institution between 2004 and 2020 were enrolled in this study. We evaluated findings from cytologic, histologic and immunologic assessment and final diagnostic outcomes. A total of 118 patients with a median age of 55 years and a median Child-Pugh score of B (8 points) were enrolled. The main etiologies of liver cirrhosis were viral hepatitis (B and C) or chronic alcohol consumption. The majority of patients (60%) exhibited concurrent anemia, leukocytopenia and thrombocytopenia. Bone marrow assessment revealed normal, unspecific or reactive alterations in 117 out of 118 patients (99%). One patient was diagnosed with myelodysplastic syndrome. Our findings suggest that peripheral blood cytopenia in patients with liver cirrhosis is rarely associated with a primary bone marrow pathology.

17.
J Clin Med ; 12(9)2023 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-37176604

RESUMEN

BACKGROUND: Genesis and the prognostic value of olfactory dysfunction (OD) in COVID-19 remain partially described. The objective of our study was to characterize OD during SARS-CoV-2 infection and to examine whether testing of OD may be a useful tool in clinical practice in order to early identify patients with SARS-CoV-2 infection. METHODS: Olfactory function assessment was objectively carried out using the u-Smell-it® test. In a cross-sectional study part, we evaluated this test in a control cohort of SARS-CoV-2 negative tested patients, who attended the University Hospital Frankfurt between May 2021 and March 2022. In a second longitudinal study part, sensitivity and specificity of OD was evaluated as a diagnostic marker of a SARS-CoV-2 infection in Frankfurt am Main, Germany in SARS-CoV-2 infected patients and their close contacts. RESULTS: Among 494 SARS-CoV-2 negative tested patients, OD was detected in 45.7% and was found to be significantly associated with the male gender (p < 0.001), higher age (p < 0.001), cardiovascular and pulmonary comorbidities (p < 0.001; p = 0.03). Among 90 COVID-19 positive patients, OD was found in 65.6% and was significantly associated with male gender and positive smoking status (p = 0.04 each). Prevalence and severity of OD were significantly increased in infections with the Delta variant (B.1.617.2) compared to those with the Omicron variant (BA.1.1.529). Diagnostic sensitivity and specificity of OD for diagnosis of SARS-CoV-2 infection were 69% and 64%, respectively. CONCLUSION: OD is common in COVID-19 negative and positive tested patients with significantly different prevalence rates observed between different variants. Diagnostic accuracy of OD is not high enough to implement olfactory testing as a tool in diagnostic routine to early identify patients with a SARS-CoV-2 infection.

18.
J Clin Med ; 12(9)2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37176616

RESUMEN

BACKGROUND AND STUDY AIM: The incidence of wound infections after percutaneous endoscopic gastrostomy (PEG) varies widely in recent studies. The present study systematically investigates the underlying risk factors for the development of wound infections in a large cohort of patients over a long-term follow-up period. PATIENTS AND METHODS: A retrospective cohort study of patients undergoing PEG insertion using either the pull or push technique was conducted and patients followed up for 3 years. Tube-related wound infections were identified, and pathogens regularly cultured from wound swabs. Adjusted analysis was performed via univariate and multivariate logistic regression analysis. RESULTS: 616 patients were included in this study. A total of 25% percent of patients developed wound infections upon PEG tube insertion and 6.5% showed recurrent infections. Nicotine abuse (p = 0.01), previous ischemic stroke (p = 0.01) and head and neck cancer (p < 0.001) showed an increased risk for wound infection after PEG placement. Moreover, radio-chemotherapy was associated with the occurrence of wound infections (p < 0.001). Infection rates were similar between pull and push cohorts. The most common bacterial pathogen detected was Enterobacterales (19.2%). Staphylococcus aureus, Pseudomonas aeruginosa and enterococci were frequently detected in recurrent infection (14.2%, 11.4% and 9.6%, respectively). Antibiotic prophylaxis showed no effect on infection rates. CONCLUSIONS: Wound infections after PEG placement are common and occasionally occur as recurrent infections. There is potential for improvement in everyday clinical practice, particularly regarding antibiotic prophylaxis in accordance with guidelines.

19.
J Clin Med ; 12(22)2023 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-38002661

RESUMEN

INTRODUCTION: Standardization of diagnostic criteria of autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) variant syndrome (AIH-PBC VS) has not been achieved so far and evidence-based recommendations for monitoring and treatment of the disease are still lacking. Our study aimed to assess the prevalence, biochemical, and serological features, as well as the clinical course, of VS. METHODS: We performed a retrospective study including all patients with VS between 1999 and 2020 in four German centers. Data on demographic parameters, biochemical and serological tests, treatment, and outcome were collected. RESULTS: Of 90 patients (3.1%) meeting Paris criteria for VS diagnosis, 65.6% showed AIH and PBC histological features, while biochemical Paris criteria were observed comparatively rarely. Further antibodies, which were not part of the diagnostic criteria of VS, were found in a subgroup of patients with available data (ACA: 30.0%; anti-CENP-A: 25.0%; anti-CENP-B: 33.3%; anti-SP100: 21.4%). Biochemical response was more frequently observed in patients treated with a combined therapy of ursodeoxycholic acid (UDCA) and immunosuppression (IS). Liver cirrhosis was detected in 31 patients (34.4%) and 25 patients (27.8%) developed clinical manifestations of portal hypertension. CONCLUSIONS: Biochemical Paris criteria of VS were rarely detected, thus implying that these cut-off values should be redefined. Regarding pharmacological treatment, combined therapy of UDCA and IS appeared to be more effective than monotherapy with UDCA.

20.
RSC Adv ; 13(7): 4721-4728, 2023 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-36760287

RESUMEN

We report the catalytic performance of networks of highly interconnected Au nanowires with diameters tailored between 80 and 170 nm. The networks were synthesized by electrodeposition in etched ion-track polymer templates, and the synthesis conditions were developed for optimal wire crystallinity and network homogeneity. The nanowire networks were self-supporting and could be easily handled as electrodes in electrochemical cells or other devices. The electrochemically active surface area of the networks increased systematically with increasing the wire diameter. They showed a very stable performance during 200 CV cycles of methanol oxidation reactions, with the peak current density reaching up to 200 times higher than that of a flat reference electrode, with only a 5% drop in the peak current density. The Au nanowire networks proved to be excellent model systems for investigation of the performance of porous catalysts and very promising nanosystems for application in direct alcohol fuel cell catalysts.

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