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1.
Occup Environ Med ; 76(4): 269-278, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30804164

RESUMEN

OBJECTIVES: To determine the test performance parameters for the retrievable range of high-molecular-weight (HMW) and low-molecular-weight (LMW) occupational allergens and to evaluate the impact of allergenic components and the implementation of measures for test validation. METHODS: A protocol with predefined objectives and inclusion criteria was the basis of an electronic literature search of MEDLINE and EMBASE (time period 1967-2016). The specific inhalation challenge and serial peak flow measurements were the reference standards for the specific IgE (sIgE) test parameters. All of the review procedures were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS: Seventy-one studies were selected, and 62 entered meta-analysis. Pooled pairs analysis indicated a sensitivity of 0.74(95% CI 0.66 to 0.80) and specificity of 0.71(95% CI 0.63 to 0.77) for HMW allergens and a sensitivity of 0.28(95% CI 0.18 to 0.40) and specificity of 0.89(95% CI 0.77 to 0.95) for LMW allergens. Component-specific analysis improved the test parameters for some allergens. Test validation was handled heterogeneously among studies. CONCLUSION: sIgE test performance is rather satisfactory for a wide range of HMW allergens with the potential for component-specific approaches, whereas sensitivity for LMW allergens is considerably lower, indicating methodological complications and/or divergent pathomechanisms. A common standard for test validation is needed.


Asunto(s)
Alérgenos/inmunología , Asma Ocupacional/sangre , Asma Ocupacional/diagnóstico , Inmunoglobulina E/análisis , Alérgenos/metabolismo , Animales , Área Bajo la Curva , Biomarcadores/análisis , Bovinos , Grano Comestible/inmunología , Grano Comestible/metabolismo , Humanos , Inmunoglobulina E/sangre , Hipersensibilidad al Látex/diagnóstico , Hipersensibilidad al Látex/inmunología , Curva ROC
2.
Catheter Cardiovasc Interv ; 92(2): 327-333, 2018 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-29737618

RESUMEN

BACKGROUND: Left atrial appendage closure (LAAC) for stroke prevention is an increasingly performed intervention. AIMS: This prospective study aims to evaluate the incidence of long-term magnetic resonance imaging (MRI)-detected brain lesions as well as potential changes of neurocognitive function after percutaneous LAAC. METHODS: Brain MRI at 3 T was performed within 24 hr before and after LAAC. A follow-up MRI was carried out after three months. Neuro-cognitive examination using the National Institutes of Health Stroke Scale (NIHSS) score and the Montreal Cognitive Assessment (MoCA) Test was performed. RESULTS: Successful device implantation was achieved in all 25 patients (age 74.6 ± 10.2 years, male = 17) using the Amulet (n = 20), Occlutech (n = 3), or a Lambre (n = 2) device. In 12/25 (48%) patients, acute brain lesions (ABL) were detected after LAAC. A three-month follow-up MRI was performed in seven patients, and no new ABLs were seen. In 5/7 (71%) patients, there were no residual changes from the ABLs detectable. However, the FLAIR sequence was still positive in two patients. After LAAC, there were no significant differences in the MoCA-test (mean 24.3 ± 4.5 vs. 23.5 ± 4.5; P = 0.1) and the NIHSS-score (mean 0.9 ± 1.6 vs. 1.2 ± 1.8; P = 0.1). This was the same at the three-month follow-up (MoCA-test 23.5 ± 4.5 vs. 23.8 ± 2.7; P = 0.3; NIHSS-score 1.2 ± 1.8 vs. 1.0 ± 0.8; P = 0.4). CONCLUSION: While new MRI-detected brain lesions are commonly observed after percutaneous LAAC, ABLs were no longer detectable in 71% of the patients at the three-month follow-up. There were no significant changes in neurocognitive function after LAAC and at the three-month follow-up.


Asunto(s)
Apéndice Atrial , Fibrilación Atrial/terapia , Encéfalo/diagnóstico por imagen , Cateterismo Cardíaco , Trastornos Cerebrovasculares/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética , Anciano , Anciano de 80 o más Años , Apéndice Atrial/diagnóstico por imagen , Fibrilación Atrial/complicaciones , Fibrilación Atrial/diagnóstico por imagen , Encéfalo/fisiopatología , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/instrumentación , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/fisiopatología , Trastornos Cerebrovasculares/psicología , Cognición , Ecocardiografía Transesofágica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Proyectos Piloto , Valor Predictivo de las Pruebas , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
3.
Europace ; 20(5): 772-777, 2018 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-29741689

RESUMEN

Aims: The efficacy of the second-generation cryoballoon (CB) ablation in patients with atrial fibrillation (AF) has been demonstrated previously. Data on the efficacy of CB ablation in elderly patients is missing. The aim of this study was to evaluate the long-term success rate of pulmonary vein isolation (PVI) in patients ≥75 years vs. <75 years using the second-generation 28mm CB. Methods and results: Eighty patients [n = 40 ≥75 years (Group 1); n = 40 <75 years (Group 2)] with paroxysmal [n = 37 (46%) or persistent (n = 43 (54%)] AF were included. Median follow-up was 12 [6;18] months (Group 1 vs. 13 [6;27]) months (Group 2; P = 0.8). PVI was performed in all patients using cryoablation. Follow-up was obtained using 24h-Holter monitoring or via an implanted loop recorder or pacemaker. CHA2DS2VASc-Score (Group 1: 4 [4;5] vs. Group 2: 2 [1;3], P < 0.001) and HASBLED-Score (Group 1: 2 [2;3] and Group 2: 2 [1;3], (P = 0.009)) differed significantly between the two groups. Mean fluoroscopy time was 22.9 [16.3;31.9] in Group 1 and 24.5 [19.1;30.6] in Group 2 (P = 0.75), and mean procedure time was 125 min [105;151] in Group 1 and 130.5 min [117.5;147.3] in Group 2 (P = 0.66). Arrhythmia recurrence was similar in Group 1 and Group 2 (12/40 (30%) vs. 10/40 (25%) (P = 0.62). One transient ischaemic attack occurred in Group 2. No further major complications were documented in this patients cohort. Conclusion: CB ablation in patients ≥75 years has favourable success rates and similar complication rates compared with patients <75 years.


Asunto(s)
Fibrilación Atrial/cirugía , Ablación por Catéter , Criocirugía , Efectos Adversos a Largo Plazo , Factores de Edad , Anciano , Fibrilación Atrial/diagnóstico , Ablación por Catéter/efectos adversos , Ablación por Catéter/instrumentación , Ablación por Catéter/métodos , Criocirugía/efectos adversos , Criocirugía/métodos , Electrocardiografía Ambulatoria/métodos , Femenino , Estudios de Seguimiento , Humanos , Efectos Adversos a Largo Plazo/diagnóstico , Efectos Adversos a Largo Plazo/etiología , Masculino , Persona de Mediana Edad , Recurrencia , Resultado del Tratamiento
4.
Prax Kinderpsychol Kinderpsychiatr ; 67(1): 2-17, 2018 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-29347897

RESUMEN

Effects of Bilingualism on Cognitive Functions in Early Childhood Studies have revealed advantages in cognitive functions among children with bilingualism. In this study we investigate cognitive functions in monolingual and bilingual preschool children taking socioeconomic status into account. The study population consists of 40 monolingual (German) children (Mage = 5.0 ± 0.4) and 23 bilingual (German/English) children (Mage = 5.1 ± 0.6). A neuropsychological test battery was conducted. The analyses revealed better performance for bilingual children. However, significant group differences were only found with respect to phonological short-term memory. Controlling for socioeconomic status, intelligence and balanced bilingualism, only slight advantages in cognitive performance were found for bilingual children. Due to high socioeconomic status in both groups, we suppose a ceiling effect. Children's development might be extensively promoted in upper class families and therefore bilingualism may not have additional impact on cognitive functions in these children.


Asunto(s)
Cognición , Multilingüismo , Preescolar , Estudios Transversales , Femenino , Alemania , Humanos , Masculino , Psicometría , Valores de Referencia , Clase Social , Vocabulario , Escalas de Wechsler/estadística & datos numéricos
5.
Eur Spine J ; 25(4): 1204-10, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26337926

RESUMEN

PURPOSE: The cross-sectional study evaluates the incidence, localization, treatment, and influencing factors of back pain (BP) in Germany's elite athletes. METHODS: An online questionnaire was sent out to 3564 top athletes. We used the VAS to identify the intensity of BP and SPSS for statistical analyses. RESULTS: 929 athletes responded. 514 (55.3%) had BP within the last 12 months, mainly located in the lumbar spine (n = 293, 56.1%). The average pain intensity was 5.75/10. Back-affecting exercise and additional burdens (e.g. at their place of work) did not increase the intensity of BP. When dividing the athletes into two groups according to the BP intensity, BP did not correlate with gender, age or BMI. CONCLUSION: At least every tenth athlete suffers temporarily from low BP at a level at which spine surgery could be the only option to relieve the pain. BP occurs independently of back-affecting training and additional stress. Further evaluation is needed to identify factors for avoiding severe BP in top athletes.


Asunto(s)
Atletas/estadística & datos numéricos , Dolor de la Región Lumbar/epidemiología , Adolescente , Adulto , Dolor de Espalda/epidemiología , Niño , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Incidencia , Vértebras Lumbares , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto Joven
6.
Eur Arch Otorhinolaryngol ; 273(8): 2157-69, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26227616

RESUMEN

Data indicate a better prognosis for human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC). HPV and p16 detection are established markers for HPV-related HNSCC. Both are accepted as survival-independent predictors. Previous studies investigating the survival in HNSCC patients depending on HPV(+/-) and p16(+/-) status consistently found discordant results with p16(-)/HPV(+) and p16(+)/HPV(-). However, no meta-analysis regarding the survival according to combined HPV/p16 status has been performed yet. The objective of this study was to discriminate the impact of combined HPV(+/-) and p16(+/-) status on survival. Data sources were identification and review of publications assessing survival of the distinct subgroups with both p16 and HPV investigated in HNSCC until February, 2015. A meta-analysis was performed to classify survival and clinical outcomes. 18 out of 397 articles (4424 patients) were eligible for the meta-analysis. The percent proportion of the subgroups was 25 % for HPV(+)/p16(+), 61.2 % for HPV(-)/p16(-), 7.1 % for HPV(-)/p16(+) and 6.8 % for HPV(+)/P16(-). The meta-analysis showed a significantly improved 5-year overall survival (OS), 5-year disease-free survival and their corresponding hazard ratio for HPV(+)/p16(+) HNSCC in comparison to HPV(-)/p16(-), HPV(+)/p16(-) and HPV(-)/p16(+). The 5-year OS of the HPV(-)/p16(+) subgroup was intermediate while HPV(+)/p16(-) and HPV(-)/p16(-) HNSCC had the shortest survival. With current therapeutic strategies, survival of patients with HNSCC is better if associated with HPV(+)/p16(+) or HPV(-)/p16(+). Clinical trials are needed to confirm the distinct survival pattern and to investigate possible differences in survival for HPV(+)/p16(-) and HPV(-)/p16(+) HNSCC. To further differentiate p16(+) HNSCC, HPV testing may be advisable.


Asunto(s)
Carcinoma de Células Escamosas/mortalidad , Genes p16 , Neoplasias de Cabeza y Cuello/mortalidad , Infecciones por Papillomavirus/complicaciones , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/virología , Supervivencia sin Enfermedad , Femenino , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/virología , Humanos , Masculino , Papillomaviridae , Infecciones por Papillomavirus/virología , Pronóstico , Sesgo de Publicación , Riesgo
7.
Ann Occup Hyg ; 59(4): 467-80, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25512666

RESUMEN

OBJECTIVES: The uptake and elimination of metals from welding fumes is currently not fully understood. In the Aachen Workplace Simulation Laboratory (AWSL) it is possible to investigate the impact of welding fumes on human subjects under controlled exposure conditions. In this study, the uptake and elimination of chromium or chromium (VI) respectively as well as nickel was studied in subjects after exposure to the emissions of a manual metal arc welding process using low or high alloyed steel. METHODS: In this present study 12 healthy male non-smokers, who never worked as welders before, were exposed for 6h to welding fumes of a manual metal arc welding process. In a three-fold crossover study design, subjects were exposed in randomized order to either clean air, emissions from welding low alloyed steel, and emissions from welding high alloyed steel. Particle mass concentration of the exposure aerosol was 2.5mg m(-3). The content of chromium and nickel in the air was determined by analysing air filter samples on a high emission scenario. Urine analysis for chromium and nickel was performed before and after exposure using methods of human biomonitoring. RESULTS: There were significantly elevated chromium levels after exposure to welding fumes from high alloyed steel compared to urinary chromium levels before exposure to high alloyed welding fumes, as well as compared to the other exposure scenarios. The mean values increased from 0.27 µg l(-1) to 18.62 µg l(-1). The results were in good agreement with already existing correlations between external and internal exposure (German exposure equivalent for carcinogenic working materials EKA). The variability of urinary chromium levels was high. For urinary nickel no significant changes could be detected at all. CONCLUSIONS: Six-hour exposure to 2.5mg m(-3) high alloyed manual metal arc welding fumes lead to elevated urinary chromium levels far higher (7.11-34.16 µg l(-1)) than the German biological exposure reference value (BAR) of 0.6 µg l(-1) directly after exposure. On the other hand mean urinary nickel concentrations slightly increased, but did not exceed background levels due to lower bioavailability. We could underline with our single exposure experiment that a welding work related chromium exposure can be measured immediately after the work shift, while the same is not possible for nickel exposure due to lower nickel bioavailability. The data provide useful information for real occupational welding work places.


Asunto(s)
Contaminantes Ocupacionales del Aire/análisis , Cromo/análisis , Monitoreo del Ambiente/métodos , Níquel/análisis , Exposición Profesional/análisis , Soldadura , Adulto , Aerosoles/análisis , Aleaciones/análisis , Cromo/orina , Estudios Cruzados , Gases , Humanos , Masculino , Níquel/orina , Material Particulado/análisis , Acero/análisis , Adulto Joven
8.
Int Arch Occup Environ Health ; 88(7): 913-23, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25596709

RESUMEN

PURPOSE: Several existing field studies evaluate aluminium welding works but no thoroughly controlled exposure scenario for welding fume has been described yet. This study provides information about the uptake and elimination of aluminium from welding fumes under controlled conditions. METHODS: In the Aachen Workplace Simulation Laboratory, we are able to generate welding fumes of a defined particle mass concentration. We exposed 12, until then occupationally unexposed participants with aluminium-containing welding fumes of a metal inert gas (MIG) welding process of a total dust mass concentration of 2.5 mg/m(3) for 6 h. Room air filter samples were collected, and the aluminium concentration in air derived. Urine and plasma samples were collected directly before and after the 6-h lasting exposure, as well as after 1 and 7 days. Human biomonitoring methods were used to determine the aluminium content of the samples with high-resolution continuum source atomic absorption spectrometry. RESULTS: Urinary aluminium concentrations showed significant changes after exposure compared to preexposure levels (mean t(1) (0 h) 13.5 µg/L; mean t(2) (6 h) 23.5 µg/L). Plasma results showed the same pattern but pre-post comparison did not reach significance. CONCLUSIONS: We were able to detect a significant increase of the internal aluminium burden of a single MIG aluminium welding process in urine, while plasma failed significance. Biphasic elimination kinetic can be observed. The German BAT of 60 µg/g creatinine was not exceeded, and urinary aluminium returned nearly to baseline concentrations after 7 days.


Asunto(s)
Aluminio/análisis , Aluminio/sangre , Aluminio/orina , Polvo/análisis , Exposición Profesional/análisis , Soldadura/estadística & datos numéricos , Adulto , Contaminantes Ocupacionales del Aire/análisis , Monitoreo del Ambiente/métodos , Monitoreo del Ambiente/estadística & datos numéricos , Voluntarios Sanos , Humanos , Masculino , Gases Nobles/toxicidad , Espectrofotometría Atómica/métodos , Soldadura/métodos , Adulto Joven
9.
Skin Pharmacol Physiol ; 27(6): 293-302, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24969699

RESUMEN

BACKGROUND: The antioxidant status of the human skin provides protection against the destructive action of free radicals. Most antioxidants cannot be synthesized by the human organism itself, but have to be ingested with a healthy nutrition rich in fruit and vegetables. The Korean cuisine is known to be one of the healthiest worldwide. This binational study investigated the cutaneous carotenoid concentrations in German subjects, South Korean subjects and immigrant Korean subjects resident in Germany and examined whether dietary- and lifestyle-related differences are reflected in the cutaneous carotenoid concentrations. METHODS: Measurements of the carotenoid concentrations of 714 healthy volunteers were performed using a non-invasive spectroscopic measurement system based on reflectance spectroscopy. RESULTS: In the present study South Korean residents showed a significantly higher antioxidant status than both native German residents and Korean immigrants living in Germany (p < 0.001). The first generation of Korean immigrants to Germany over the age of 50 mostly preserved Korean dietary habits, showing significantly higher concentrations (p < 0.001) than the German-born second and third Korean generations under the age of 50. CONCLUSION: The results of the study indicate that a healthy nutrition alone does not provide a high antioxidant status unless the stress exposure can be reduced simultaneously.


Asunto(s)
Pueblo Asiatico , Carotenoides/metabolismo , Dieta/etnología , Piel/metabolismo , Estrés Psicológico/metabolismo , Población Blanca , Adolescente , Adulto , Anciano , Antioxidantes , Niño , Emigrantes e Inmigrantes , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional/etnología , República de Corea , Estrés Psicológico/etnología , Adulto Joven
10.
Ann Occup Hyg ; 57(3): 305-13, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23028013

RESUMEN

Studies in the field of environmental epidemiology indicate that for the adverse effect of inhaled particles not only particle mass is crucial but also particle size is. Ultrafine particles with diameters below 100 nm are of special interest since these particles have high surface area to mass ratio and have properties which differ from those of larger particles. In this paper, particle size distributions of various welding and joining techniques were measured close to the welding process using a fast mobility particle sizer (FMPS). It turned out that welding processes with high mass emission rates (manual metal arc welding, metal active gas welding, metal inert gas welding, metal inert gas soldering, and laser welding) show mainly agglomerated particles with diameters above 100 nm and only few particles in the size range below 50 nm (10 to 15%). Welding processes with low mass emission rates (tungsten inert gas welding and resistance spot welding) emit predominantly ultrafine particles with diameters well below 100 nm. This finding can be explained by considerably faster agglomeration processes in welding processes with high mass emission rates. Although mass emission is low for tungsten inert gas welding and resistance spot welding, due to the low particle size of the fume, these processes cannot be labeled as toxicologically irrelevant and should be further investigated.


Asunto(s)
Contaminantes Atmosféricos/química , Nanoestructuras/análisis , Material Particulado/análisis , Soldadura/métodos , Contaminantes Ocupacionales del Aire/análisis , Contaminantes Ocupacionales del Aire/toxicidad , Contaminación del Aire Interior/análisis , Óxido de Aluminio/efectos adversos , Óxido de Aluminio/análisis , Monitoreo del Ambiente/métodos , Humanos , Exposición por Inhalación/análisis , Exposición Profesional/análisis , Material Particulado/efectos adversos , Material Particulado/química , Siliconas , Acero/efectos adversos , Acero/análisis , Zinc/efectos adversos , Zinc/análisis
11.
Artículo en Alemán | MEDLINE | ID: mdl-24428081

RESUMEN

Somatoform disorders in children and adolescents are common and can cause significantly reduced wellbeing and quality of life. Considerable subjective impairment leads to a high number of doctors' visits, which along with a reoccurrence of negative findings, often results in a sense of helplessness in the patient and a lack of trust towards the physician. The criteria for somatoform disorders are illustrated based on the classification scheme ICD-10 and in consideration of the DSM-V. Referring to Noeker (2008) the special role of the parents for the development of somatoform disorders is explained. The typical clinical profile of somatoform disorders in children and adolescents is described. As a diagnostic instrument the newly developed Screening for Somatoform Disorders in Children and Adolescents (SOMS-CA) (Winter, Pfeiffer, Köberle, Lenz, Lehmkuhl, 2008) is introduced. Furthermore it is demonstrated that patients with somatoform disorders are seen predominantly within consulting and liaison services of the paediatric clinic. The importance of interdisciplinary cooperation between paediatrics and child and adolescent psychiatry and -psychotherapy in early diagnosis and introduction of appropriate treatment is highlighted.


Asunto(s)
Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/psicología , Adolescente , Niño , Conducta Cooperativa , Diagnóstico Diferencial , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Alemania , Hospitales Pediátricos , Humanos , Comunicación Interdisciplinaria , Clasificación Internacional de Enfermedades , Tamizaje Masivo , Responsabilidad Parental/psicología , Relaciones Médico-Paciente , Psicometría/estadística & datos numéricos , Psicoterapia , Reproducibilidad de los Resultados , Trastornos Somatomorfos/clasificación , Trastornos Somatomorfos/terapia , Encuestas y Cuestionarios
12.
Artículo en Alemán | MEDLINE | ID: mdl-23720994

RESUMEN

32 clinical patients (5-15 years) were diagnosed with an OPD-CA interview-manual (Winter, 2004). To investigate practicability of OPD-CA for patients with migration background (N = 14) a comparison with patients without migration background (N = 18) was carried out. There were patients with different ethnical backgrounds. The OPD-CA covers the axes prerequisites for treatment, interpersonal relation, structure and conflicts. Both groups showed equal prerequisites for treatment, interpersonal relation and conflicts. Significant differences were rated in structure: Patients with migration background have fewer skills in control as well as self- and object-perception. The interpretation of these results remained unsettled and suggested a careful use of the axis structure of OPD-CA for patients with migration background. The replication with a larger sample in a multicultural team of therapists and raters would be important.


Asunto(s)
Emigrantes e Inmigrantes , Manuales como Asunto , Trastornos Mentales/diagnóstico , Psicoanálisis , Terapia Psicoanalítica , Adolescente , Niño , Conflicto Psicológico , Competencia Cultural , Femenino , Alemania , Humanos , Control Interno-Externo , Relaciones Interpersonales , Entrevista Psicológica , Masculino , Trastornos Mentales/etnología , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Apego a Objetos , Reproducibilidad de los Resultados , Autoimagen
13.
Psychother Psychosom Med Psychol ; 62(7): 259-65, 2012 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-22777904

RESUMEN

Psychodynamic findings based on the Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-CA) in patients with Anorectal Malformations (ARM) in comparison to psychiatric patients were presented focussing the psychic structure. Patients with ARM had significant better psychic structure especially with regard to coping with conflicts and communication of affects. Furthermore typical findings were generated: Patients with ARM had better treatment conditions and more positive relationships. Still they had fewer hypotheses about their disease and greater living burden. Structural strengthes facilitate acceptance and integration of the disease. Nonetheless more attention should be paid to child-oriented psychoeducation for development of age-appropriate hypotheses about the disease. Facing living burden, psychological-psychiatric support should be offered to patients with ARM.


Asunto(s)
Canal Anal/anomalías , Trastornos Mentales/psicología , Enfermedades del Recto/psicología , Recto/anomalías , Adolescente , Niño , Preescolar , Costo de Enfermedad , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Pruebas Neuropsicológicas , Educación del Paciente como Asunto , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/etiología , Adulto Joven
14.
ALTEX ; 39(3): 388­404, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35288757

RESUMEN

The application of in vitro biological assays as new approach methodologies (NAMs) to support grouping of UVCB (unknown or variable composition, complex reaction products, and biological materials) substances has recently been demonstrated. In addition to cell-based phenotyping as NAMs, in vitro transcriptomic profiling is used to gain deeper mechanistic understanding of biological responses to chemicals and to support grouping and read-across. However, the value of gene expression profiling for characterizing complex substances like UVCBs has not been explored. Using 141 petroleum substance extracts, we performed dose-response transcriptomic profiling in human induced pluripotent stem cell (iPSC)-derived hepatocytes, cardiomyocytes, neurons, and endothelial cells, as well as cell lines MCF7 and A375. The goal was to determine whether transcriptomic data can be used to group these UVCBs and to further characterize the molecular basis for in vitro biological responses. We found distinct transcriptional responses for petroleum substances by manufacturing class. Pathway enrichment informed interpretation of effects of substances and UVCB petroleum-class. Transcriptional activity was strongly correlated with concentration of polycyclic aromatic compounds (PAC), especially in iPSC-derived hepatocytes. Supervised analysis using transcriptomics, alone or in combination with bioactivity data collected on these same substances/cells, suggest that transcriptomics data provide useful mechanistic information, but only modest additional value for grouping. Overall, these results further demonstrate the value of NAMs for grouping of UVCBs, identify informative cell lines, and provide data that could be used for justifying selection of substances for further testing that may be required for registration.


Asunto(s)
Células Madre Pluripotentes Inducidas , Petróleo , Bioensayo , Células Endoteliales , Humanos , Transcriptoma
15.
J Child Psychol Psychiatry ; 52(6): 686-95, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21039485

RESUMEN

BACKGROUND: Recently, a highly heritable behavioral phenotype of simultaneous deviance on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndrome scales has been identified on the Child Behavior Checklist (CBCL-Dysregulation Profile, CBCL-DP). This study aims to investigate psychosocial adversity and impairment of the CBCL-DP. METHODS: A total of 9024 patients aged 4-18 years were assessed using the CBCL, and the axes V and VI of ICD-10. RESULTS: ANOVA revealed significant differences regarding psychosocial adversity and impairment between patients with CBCL-DP phenotype and the clinical control group, patients with attention problems, and patients with attention problems and additional anxious/depressed symptoms as assessed by the CBCL. Patients with CBCL-DP showed significant psychosocial adversity and impairment. However, in most cases patients with aggressive behavior showed equal psychosocial adversity as patients with CBCL-DP. CONCLUSIONS: Findings suggest the CBCL-DP phenotype to be associated with significant psychosocial adversity and impairment either as a cause or an effect of the syndrome. Clinicians should carefully address psychosocial adversity and impairment with particular attention to the adversity and impairment of adolescents with CBCL-DP.


Asunto(s)
Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/psicología , Acontecimientos que Cambian la Vida , Trastornos del Humor/diagnóstico , Trastornos del Humor/psicología , Adolescente , Agresión/psicología , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/genética , Trastornos de Ansiedad/psicología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/genética , Trastorno por Déficit de Atención con Hiperactividad/psicología , Lista de Verificación , Niño , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/genética , Preescolar , Estudios Transversales , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Trastorno Depresivo/genética , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Trastornos del Humor/epidemiología , Trastornos del Humor/genética , Responsabilidad Parental/psicología , Determinación de la Personalidad/estadística & datos numéricos , Psicometría , Factores de Riesgo , Medio Social , Factores Socioeconómicos
16.
J Chem Phys ; 134(7): 074703, 2011 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-21341865

RESUMEN

The dissociation of hydrogen at atomic surface defects is the strongly dominant, if not the decisive, step in the chain of events eventually leading to chemisorbed H-atoms on Pt(111). This holds for perpendicular kinetic energies of the gas phase molecules from 8 to 60 meV, i.e., covering the range relevant to hydrogenation reactions. This insight has been gained in the present study in which we reversibly varied the defect density on one and the same crystal in a controlled way. Information has been derived from measuring the adsorption kinetics as a function of coverage. Two distinct adsorption channels are distinguished. The first, indirect one, prevails at lower H-coverage and involves capture into a non-accommodated molecular precursor state followed by dissociation at step sites as described in our recent paper. The second one, dominant at higher coverage and non-negligible defect densities, obeys second order Langmuir kinetics. Here the dissociative adsorption takes place directly at step sites with a cross section of 0.24 unit cells (initial sticking probability 24% of the step density). These results are consistent with thermally programmed desorption data: the direct channel is responsible for the emergence of the low temperature peak in thermal desorption spectroscopy, usually denoted with ß(1), while the indirect channel is represented by the ß(2) state. The dependence on the perpendicular component of the hydrogen kinetic energy is distinctly different for the two channels: the indirect one shows power law behavior with an exponent 1.9 ± 0.1, while the direct one shows no perpendicular energy dependence at all.

18.
Artículo en Alemán | MEDLINE | ID: mdl-21381387

RESUMEN

60 clinical patients (5-17 years) were diagnosed with an interview-manual of OPD-CA (Winter, 2004). For clinical validity a comparison of patients with internal (N=17) and external disorders (N=19) was shown. References for clinical validity resulted from the comparison of the groups, especially for the axes "conflict" and "prerequisites for treatment". Patients with internal disorders showed the conflict desire for care versus autarchy significantly more often than patients with external disorders. On the other hand patients with external disorders displayed the conflict submission versus control significantly more often. Significant differences were also found for the axis "prerequisites for treatment". Patients with internal disorders had better "prerequisites for treatment" in the domains experience of illness and the prerequisites for therapy. For the axes "interpersonal relation", "structure" and "prerequisites for treatment" satisfactory data for validity and reliability were found. The clinical validity points to the usefulness of OPD-CA-manual for psychodynamic diagnostics in childhood and adolescence.


Asunto(s)
Trastornos de la Conducta Infantil/clasificación , Trastornos de la Conducta Infantil/diagnóstico , Control Interno-Externo , Manuales como Asunto , Psicoanálisis , Adolescente , Niño , Preescolar , Conflicto Psicológico , Femenino , Humanos , Entrevista Psicológica , Masculino , Motivación , Teoría Psicoanalítica , Terapia Psicoanalítica
19.
ALTEX ; 38(1): 123-137, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33086383

RESUMEN

One of the most challenging areas in regulatory science is assessment of the substances known as UVCB (unknown or variable composition, complex reaction products and biological materials). Because the inherent complexity and variability of UVCBs present considerable challenges for establishing sufficient substance similarity based on chemical characteristics or other data, we hypothesized that new approach methodologies (NAMs), including in vitro test-derived biological activity signatures to characterize substance similarity, could be used to support grouping of UVCBs. We tested 141 petroleum substances as representative UVCBs in a compendium of 15 human cell types representing a variety of tissues. Petroleum substances were assayed in dilution series to derive point of departure estimates for each cell type and phenotype. Extensive quality control measures were taken to ensure that only high-confidence in vitro data were used to determine whether current groupings of these petroleum substances, based largely on the manufacturing process and physico-chemical properties, are justifiable. We found that bioactivity data-based groupings of petroleum substances were generally consistent with the manufacturing class-based categories. We also showed that these data, especially bioactivity from human induced pluripotent stem cell (iPSC)-derived and primary cells, can be used to rank substances in a manner highly concordant with their expected in vivo hazard potential based on their chemical compositional profile. Overall, this study demonstrates that NAMs can be used to inform groupings of UVCBs, to assist in identification of repre­sentative substances in each group for testing when needed, and to fill data gaps by read-across.


Asunto(s)
Alternativas a las Pruebas en Animales/métodos , Sustancias Peligrosas/química , Células Madre Pluripotentes Inducidas/efectos de los fármacos , Petróleo/análisis , Petróleo/toxicidad , Pruebas de Toxicidad/métodos , Sustancias Peligrosas/toxicidad , Humanos
20.
Z Kinder Jugendpsychiatr Psychother ; 38(1): 51-7, 2010 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-20047176

RESUMEN

OBJECTIVE: The subjective evaluation of a psychotherapeutic treatment may be an essential aspect of the recovery from an eating disorder. Our study investigates the subjective treatment evaluation by patients with eating disorders and the accordance with their parents' and psychotherapist's evaluation. METHOD: In a sample of 41 eating-disorder patients (M(Age) = 16.3; SD = 1.26), their parents and psychotherapists, we used a questionnaire (FBB) to assess satisfaction with Dialectical Behavioral Therapy treatment. RESULTS: Our results show good ratings, as well as good correlations between patients and parents. CONCLUSIONS: The findings implicate the importance of assessing a subjective therapy rating in addition to objective parameters.


Asunto(s)
Anorexia Nerviosa/terapia , Bulimia Nerviosa/terapia , Terapia Cognitivo-Conductual/métodos , Meditación , Padres/psicología , Satisfacción del Paciente , Prueba de Realidad , Adolescente , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Bulimia Nerviosa/diagnóstico , Bulimia Nerviosa/psicología , Femenino , Humanos , Admisión del Paciente , Inventario de Personalidad , Estadística como Asunto , Encuestas y Cuestionarios , Resultado del Tratamiento
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