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1.
Med Image Anal ; 90: 102913, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37660483

RESUMO

Neuroimaging markers based on Magnetic Resonance Imaging (MRI) combined with various other measures (such as genetic covariates, biomarkers, vascular risk factors, neuropsychological tests etc.) might provide useful predictions of clinical outcomes during the progression towards Alzheimer's disease (AD). The use of multiple features in predictive frameworks for clinical outcomes has become increasingly prevalent in AD research. However, many studies do not focus on systematically and accurately evaluating combinations of multiple input features. Hence, the aim of the present work is to explore and assess optimal combinations of various features for MR-based prediction of (1) cognitive status and (2) biomarker positivity with a multi-kernel learning Gaussian process framework. The explored features and parameters included (A) combinations of brain tissues, modulation, smoothing, and image resolution; (B) incorporating demographics & clinical covariates; (C) the impact of the size of the training data set; (D) the influence of dimensionality reduction and the choice of kernel types. The approach was tested in a large German cohort including 959 subjects from the multicentric longitudinal study of cognitive impairment and dementia (DELCODE). Our evaluation suggests the best prediction of memory performance was obtained for a combination of neuroimaging markers, demographics, genetic information (ApoE4) and CSF biomarkers explaining 57% of outcome variance in out-of-sample predictions. The highest performance for Aß42/40 status classification was achieved for a combination of demographics, ApoE4, and a memory score while usage of structural MRI further improved the classification of individual patient's pTau status.

2.
Int J Oral Maxillofac Surg ; 51(11): 1454-1461, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35288012

RESUMO

Secondary alveolar bone grafting (SABG) using autologous iliac crest cancellous bone is a standard procedure for patients with cleft lip and palate (CLP). The aim of this study was to evaluate patient satisfaction after bone grafting of the alveolar cleft. Patients who underwent SABG between 2000 and 2010 in one surgical centre were included in this cross-sectional study. Three questionnaires were used, one addressing functional and aesthetic outcomes (nine items), the second being the 14-item Oral Health Impact Profile (OHIP-G14), and the third addressing donor site morbidity. A total of 103 patients fulfilled the inclusion criteria, of whom 71 could be contacted, and 52 completed the questionnaires. The majority of the patients (98%) were satisfied with the aesthetic and functional results and reported low donor site morbidity. A significant correlation was found between scores from the patient satisfaction questionnaire and the OHIP-G14. Regarding overall patient satisfaction, the manifestation of the cleft had no significant influence. The questionnaires used allowed the assessment of subjective outcome parameters, but might not be absolutely specific and exclusive for the SABG procedure in the framework of comprehensive CLP therapy. Nevertheless, SABG using autologous iliac crest cancellous bone can be considered a highly satisfactory procedure.


Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Humanos , Enxerto de Osso Alveolar/métodos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Qualidade de Vida , Satisfação Pessoal , Estudos Transversais , Satisfação do Paciente , Estética Dentária , Transplante Ósseo/métodos
3.
Eur J Nutr ; 60(2): 849-860, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32472387

RESUMO

PURPOSE: To investigate cross-sectional associations between dietary patterns and cognitive functioning in elderly free of dementia. METHODS: Data of 389 participants from the German DELCODE study (52% female, 69 ± 6 years, mean Mini Mental State Score 29 ± 1) were included. The sample was enriched with elderly at increased risk for Alzheimer's disease (AD) by including participants with subjective cognitive decline, mild cognitive impairment (MCI) and siblings of AD patients. Mediterranean and MIND diets were derived from 148 Food Frequency Questionnaire items, and data-driven patterns by principal component analysis (PCA) of 39 food groups. Associations between dietary patterns and five cognitive domain scores were analyzed with linear regression analyses adjusted for demographics (model 1), and additionally for energy intake, BMI, other lifestyle variables and APOe4-status (model 2). For PCA-derived dietary components, final model 3 included all other dietary components. RESULTS: In fully adjusted models, adherence to Mediterranean and MIND diet was associated with better memory. The 'alcoholic beverages' PCA component was positively associated with most cognitive domains. Exclusion of MCI subjects (n = 60) revealed that Mediterranean and MIND diet were also related to language functions; associations with the alcoholic beverages component were attenuated, but most remained significant. CONCLUSION: In line with data from elderly population samples, Mediterranean and MIND diet and some data-derived dietary patterns were related to memory and language function. Longitudinal data are needed to draw conclusions on the putative effect of nutrition on the rate of cognitive decline, and on the potential of dietary interventions in groups at increased risk for AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Dieta Mediterrânea , Idoso , Doença de Alzheimer/epidemiologia , Cognição , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Estudos Transversais , Feminino , Humanos , Masculino
4.
Neurol Res Pract ; 2: 8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33324914

RESUMO

INTRODUCTION: Cerebrospinal fluid (CSF) analysis is important for detecting inflammation of the nervous system and the meninges, bleeding in the area of the subarachnoid space that may not be visualized by imaging, and the spread of malignant diseases to the CSF space. In the diagnosis and differential diagnosis of neurodegenerative diseases, the importance of CSF analysis is increasing. Measuring the opening pressure of CSF in idiopathic intracranial hypertension and at spinal tap in normal pressure hydrocephalus constitute diagnostic examination procedures with therapeutic benefits.Recommendations (most important 3-5 recommendations on a glimpse): The indications and contraindications must be checked before lumbar puncture (LP) is performed, and sampling CSF requires the consent of the patient.Puncture with an atraumatic needle is associated with a lower incidence of postpuncture discomfort. The frequency of postpuncture syndrome correlates inversely with age and body mass index, and it is more common in women and patients with a history of headache. The sharp needle is preferably used in older or obese patients, also in punctures expected to be difficult.In order to avoid repeating LP, a sufficient quantity of CSF (at least 10 ml) should be collected. The CSF sample and the serum sample taken at the same time should be sent to a specialized laboratory immediately so that the emergency and basic CSF analysis program can be carried out within 2 h.The indication for LP in anticoagulant therapy should always be decided on an individual basis. The risk of interrupting anticoagulant therapy must be weighed against the increased bleeding risk of LP with anticoagulant therapy.As a quality assurance measure in CSF analysis, it is recommended that all cytological, clinical-chemical, and microbiological findings are combined in an integrated summary report and evaluated by an expert in CSF analysis. CONCLUSIONS: In view of the importance and developments in CSF analysis, the S1 guideline "Lumbar puncture and cerebrospinal fluid analysis" was recently prepared by the German Society for CSF analysis and clinical neurochemistry (DGLN) and published in German in accordance with the guidelines of the AWMF (https://www.awmf.org). /uploads/tx_szleitlinien/030-141l_S1_Lumbalpunktion_und_Liquordiagnostik_2019-08.pdf). The present article is an abridged translation of the above cited guideline. The guideline has been jointly edited by the DGLN and DGN.

5.
Neuropathol Appl Neurobiol ; 46(7): 673-685, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32497293

RESUMO

AIMS: The deposition of amyloid-ß (Aß) peptides in the form of extracellular plaques in the brain represents one of the classical hallmarks of Alzheimer's disease (AD). In addition to 'full-length' Aß starting with aspartic acid (Asp-1), considerable amounts of various shorter, N-terminally truncated Aß peptides have been identified by mass spectrometry in autopsy samples from individuals with AD. METHODS: Selectivity of several antibodies detecting full-length, total or N-terminally truncated Aß species has been characterized with capillary isoelectric focusing assays using a set of synthetic Aß peptides comprising different N-termini. We further assessed the N-terminal heterogeneity of extracellular and vascular Aß peptide deposits in the human brain by performing immunohistochemical analyses using sporadic AD cases with antibodies targeting different N-terminal residues, including the biosimilar antibodies Bapineuzumab and Crenezumab. RESULTS: While antibodies selectively recognizing Aß1-x showed a much weaker staining of extracellular plaques and tended to accentuate cerebrovascular amyloid deposits, antibodies detecting Aß starting with phenylalanine at position 4 of the Aß sequence showed abundant amyloid plaque immunoreactivity in the brain parenchyma. The biosimilar antibody Bapineuzumab recognized Aß starting at Asp-1 and demonstrated abundant immunoreactivity in AD brains. DISCUSSION: In contrast to other studied Aß1-x -specific antibodies, Bapineuzumab displayed stronger immunoreactivity on fixed tissue samples than with sodium dodecyl sulfate-denatured samples on Western blots. This suggests conformational preferences of this antibody. The diverse composition of plaques and vascular deposits stresses the importance of understanding the roles of various Aß variants during disease development and progression in order to generate appropriate target-developed therapies.


Assuntos
Doença de Alzheimer/metabolismo , Anticorpos Monoclonais Humanizados/farmacologia , Encéfalo/metabolismo , Placa Amiloide/metabolismo , Idoso , Idoso de 80 Anos ou mais , Peptídeos beta-Amiloides/metabolismo , Animais , Modelos Animais de Doenças , Humanos , Fragmentos de Peptídeos/metabolismo
6.
Int J Oral Maxillofac Surg ; 49(2): 272-283, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31227276

RESUMO

Biodegradable magnesium alloys are suitable osteosynthesis materials. Despite the alloy composition, surface modifications appear to have an influence on the degradation process and biocompatibility. The aim of this study was to investigate the impact of hydrogenation and fluoridation of the surface in a mandibular osteotomy model. Standard-sized plates and screws were implanted in an osteotomy at the mandibular angle in nine miniature pigs. The plates and screws were harvested together with the adjacent tissues at 8 weeks after surgery and were investigated by micro-computed tomography and histological analysis. The bone healing of the osteotomy was undisturbed, independent of the surface properties. The adjacent bone tissue showed new bone formation at the implant surface; however, formation of some lacunae could be observed. The corrosion was between 9.8% and 11.6% (fluoridated

Assuntos
Magnésio , Osteotomia Mandibular , Ligas , Animais , Parafusos Ósseos , Teste de Materiais , Suínos , Porco Miniatura , Microtomografia por Raio-X
7.
Int J Oral Maxillofac Surg ; 49(1): 135-142, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31053519

RESUMO

The in vivo regeneration of bone flaps might be an alternative to autogenous bone grafting. The first human case of mandibular reconstruction using the greater omentum as a bioreactor was reported in 2016. However, whether engineered bone will support the osseointegration of dental implants has not yet been investigated. In this study, bone tissue engineering was performed in the greater omentum of nine miniature pigs using bone morphogenetic protein 2, bone marrow aspirate, and three different scaffolds: hydroxyapatite, biphasic calcium phosphate (BCP), and titanium. After 8 weeks, two implants were placed in each scaffold; after another 8 weeks, the bone blocks were harvested for radiographic, histological, and histomorphometric analysis. All implants exhibited sufficient primary stability, and the success rate was 100%. The bone-to-implant contact ratios (BICs) were 38.2%, 68.5%, and 42.9%; the inter-thread bone densities were 29.4%, 64.9%, and 33.5%; and the peri-implant bone-scaffold densities were 56.4%, 87.6%, and 68.6% in the hydroxyapatite, BCP, and titanium groups, respectively. The BIC showed a strong correlation (r = 0.76) with the peri-implant bone-scaffold density. This study shows that de novo engineered bone leads to successful osseointegration and therefore may allow implant-based prosthodontic rehabilitation.


Assuntos
Implantes Dentários , Osseointegração , Animais , Osso e Ossos , Implantação Dentária Endóssea , Planejamento de Prótese Dentária , Humanos , Propriedades de Superfície , Suínos , Engenharia Tecidual , Titânio
8.
Community Dent Health ; 36(3): 181-186, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31436926

RESUMO

Initial impetus for action: Oral cancer is still an underestimated disease in terms of incidence as well as mortality rates; it requires urgent prevention and early detection. At present, there is no best-practice systematic approach to raising awareness and informing the public about about this type of cancer in Germany. This article describes a framework that covers the significant stages of conceptual development and campaign design to promote oral cancer awareness in Germany. Solution: The challenges of the development, as well as evaluation of an oral cancer awareness campaign are shared in this article. Four key stages of the campaign are defined: (1) mass media, (2) target groups, (3) health care professionals, and (4) epidemiology. For each section, the following levels of assessment are proposed: (a) campaign development (formative assessment), (b) controlling and optimising campaign implementation (process assessment) and (c) measuring outcomes (summative assessment). Outcome: A process-oriented assessment concept for each of the four campaign sections was developed and merged to form a matrix, which includes each of the above sections regarding the prevention and early detection of oral cancer, as well as the three stages of campaign assessment. Future implications and learning points: The conceptual framework demonstrated that systematic planning and evaluation of different components helped to describe and evaluate an oral cancer campaign: For future campaigns, the use of a matrix covering different campaign targets as well as the entire campaign process, is recommended as a basis for campaign design and evaluation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Meios de Comunicação de Massa , Neoplasias Bucais , Alemanha , Humanos , Incidência , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde
10.
Clin Transl Oncol ; 21(8): 1052-1060, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30632010

RESUMO

BACKGROUND: Integrins are highly attractive targets in oncology due to their involvement in angiogenesis in a wide spectrum of cancer entities. Among several integrin inhibitors, cilengitide is suggested to be one of the most promising inhibitors. However, little is known about the cellular processes induced during cilengitide chemotherapy in head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: For the current study, 3 HNSCC cell lines, SCC4, SCC15 and SCC25; and 3 primary culture cells, TU53, TU57, and TU63 were used. CD90, cytokeratin, and vimentin were stained immunohistochemically to identify the biological characteristics of these cell lines and primary culture cells and the cytostatic effect of cilengitide was evaluated. Quantitative polymerase chain reaction (qPCR) arrays were applied to evaluate target protein genes ITGAV, ITGB3, and ITGB5 of integrin αvß3 and αvß5 at respective concentrations of 50 and 100 µM cilengitide for 72 h. RESULTS: Cilengitide has significantly inhibited the proliferation of HNSCC cells in a dose-dependent way. At the same concentration, cilengitide suppressed the proliferation of primary culture cells even more strongly than it did that of cell lines, suggesting that primary culture cells retain more of their internal biological characteristics than do cell lines. qPCR assay detected downregulation of ITGAV, ITGB3, and ITGB5 gene expression after exposure to 50 µM of cilengitide. However, after exposure to 100-µM cilengitide, expression of these genes significantly increased both in cell lines and primary culture cells. CONCLUSIONS: RGD-containing small-molecule synthetic peptides might be considered in tumor chemotherapy in the near future. The different reactions of primary culture cells and cell lines demonstrated that individualized chemotherapy plans may be a feasible option. However, research on the role of cilengitide in HNSCC therapy is still in its early stages, and further investigations are required.


Assuntos
Proliferação de Células/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Neoplasias de Cabeça e Pescoço/patologia , Cadeias beta de Integrinas/química , Integrina beta3/química , Venenos de Serpentes/farmacologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Apoptose/efeitos dos fármacos , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Cadeias beta de Integrinas/genética , Cadeias beta de Integrinas/metabolismo , Integrina beta3/genética , Integrina beta3/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Células Tumorais Cultivadas
11.
Int J Oral Maxillofac Surg ; 48(1): 9-16, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30057238

RESUMO

Beckwith-Wiedemann syndrome is a rare congenital overgrowth disorder with macroglossia being one of the cardinal symptoms. In pronounced cases, macroglossia can lead to airway obstruction, musculoskeletal alterations and functional deficits. Surgical tongue reduction is performed at varying ages and with different techniques. This study evaluated perioperative complications, as well as long-term aesthetic and functional outcomes, in a large cohort. A total of 68 patients, treated either surgically or conservatively, were included. Depending on the severity of macroglossia, patients were divided into three groups to determine the treatment algorithm. Complications after surgical tongue reduction were prolonged intubation and revision due to dehiscence or haematoma. In the long term, no patient suffered from impaired sense of taste or paresthesia, although the shape of the tongue was disproportional in 85%. With the present treatment algorithm, operative tongue reduction exerts a positive influence on skeletal, dentoalveolar and functional development with sufficient long-term outcome and high grade of satisfaction of the patients. Supportive therapy in an interdisciplinary centre is of fundamental importance for both surgical and conservative treatment.


Assuntos
Algoritmos , Síndrome de Beckwith-Wiedemann/terapia , Glossectomia/métodos , Macroglossia/congênito , Complicações Pós-Operatórias/epidemiologia , Criança , Pré-Escolar , Tratamento Conservador , Estudos Transversais , Estética , Feminino , Humanos , Lactente , Macroglossia/cirurgia , Masculino , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
12.
HNO ; 67(1): 36-44, 2019 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30324556

RESUMO

BACKGROUND: Hearing-impairment can lead to a reduced quality of life and thus represents a vulnerability factor for mental disorders. OBJECTIVE: This study represents the first psychiatric analysis of subjective quality of life and depression in people with hearing-impairment in Germany. MATERIALS AND METHODS: The patient group included 30 hearing-impaired participants (27 women, 3 men) with a current or previous mental disorder and/or psychiatric/psychotherapeutic treatment (age: mean, M = 49.67 years; standard deviation, SD = 13.54 years). The control group consisted of 22 hearing-impaired participants (16 women, 6 men) without mental disorders or treatment (age: M = 52.41 years, SD = 17.30 years). Besides sociodemographic variables, we registered onset/extent of the various hearing-impairments and hearing aid provision. Both groups underwent extensive diagnostic assessment comprising subjective functional impairment (Sheehan Disability Scale, SDS), health-related quality of life (SF-36 Health Survey), and depressive symptoms (Beck Depression Inventory, BDI-II). RESULTS: Groups did not differ significantly in terms of sociodemographic variables such as age, gender, or intelligence. Participants of the patient group had a significantly greater subjective impairment, a lower quality of life, and more pronounced symptoms of depression. The invasiveness of the hearing aid (i. e., cochlear implant) as well as the timepoint of hearing-impairment onset (postlingually) appear to serve as vulnerability factors for mental health problems in this group. CONCLUSION: Our results indicate that besides delivering high-quality acoustic care, practitioners should continuously check patients' requirements for psychosocial treatment due to a loss of quality of life. The development of a specific psychotherapeutic treatment for hearing-impaired clients requires additional research focused on protective and vulnerability factors which may influence the emergence of mental disorders in these patients.


Assuntos
Depressão , Pessoas com Deficiência Auditiva/psicologia , Qualidade de Vida , Depressão/epidemiologia , Feminino , Alemanha , Auxiliares de Audição , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
13.
J Prev Alzheimers Dis ; 5(3): 202-206, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29972214

RESUMO

BACKGROUND: In several randomized controlled trials (RCT) acetylcholinesterase-inhibitors (AChE-I) were tested in patients with mild cognitive impairment (MCI) but were ineffective in delaying disease progression as determined by neuropsychological testing only. Here we present data from an open label observational extension of a multicenter RCT in order to assess if biomarkers are providing useful additional information about a drug's efficacy. We followed 83 amnestic MCI patients and performed correlational analyses of Aß 1-42 and total-Tau in the cerebrospinal fluid (CSF), hippocampal and amygdala volume at baseline, the total duration of blinded and open label AChE-I treatment and the outcome 24 months after inclusion into the RCT. Twelve out of 83 amnestic MCI (14%) had progressed to Alzheimer's disease (AD). Overall, worsening and disease progression as measured by the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) and Clinical Dementia Rating (CDR) did not correlate with the duration of AChE-I treatment. However, a specific multidimensional biomarker profile at baseline indicated more reliably than cognitive testing alone progression to AD. We conclude that pharmacological RCTs testing symptomatic treatment effects in MCI should include biomarker assessment.


Assuntos
Tonsila do Cerebelo/patologia , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Disfunção Cognitiva/líquido cefalorraquidiano , Disfunção Cognitiva/patologia , Hipocampo/patologia , Fragmentos de Peptídeos/líquido cefalorraquidiano , Ensaios Clínicos Controlados Aleatórios como Assunto/psicologia , Proteínas tau/líquido cefalorraquidiano , Atividades Cotidianas , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/tratamento farmacológico , Progressão da Doença , Método Duplo-Cego , Feminino , Galantamina/efeitos adversos , Galantamina/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Masculino , Memantina/efeitos adversos , Memantina/uso terapêutico , Neuroimagem , Testes Neuropsicológicos , Suspensão de Tratamento
14.
Int J Oral Maxillofac Surg ; 47(11): 1481-1487, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29843951

RESUMO

In 2016, we reported the world's first reconstruction of a mandibular discontinuity defect using a custom-made bone transplant that had been prefabricated in the gastrocolic omentum using tissue engineering strategies. However, the tissue of an engineered human neomandible has not been evaluated histologically until now. The current study assessed the long-term histological characteristics of biopsies of the neomandible 9months after transplantation. Histological analysis showed an increased amount of vital mineralized bone tissue after 10months, in comparison to biopsies obtained earlier. The engineered bone covered the surface of the bone substitute material but also grew out typical structures of cancellous bone tissue without a core of BioOss. The amount of induced bone tissue was 32% in the biopsy. In addition, the soft tissue showed an alignment of the connective tissue fibres parallel to the trabecular bone. Increasing time and mechanical forces at the mandible led to an increased amount of mineralized tissue and remodelling of the connective tissue fibres after transplantation. Further research should focus on developing advanced scaffold materials, as the outer titanium mesh cage leads to complications.


Assuntos
Reatores Biológicos , Mandíbula/crescimento & desenvolvimento , Osteogênese/fisiologia , Engenharia Tecidual/métodos , Biópsia , Transplante Ósseo , Desenho Assistido por Computador , Humanos , Masculino , Pessoa de Meia-Idade
15.
Int J Oral Maxillofac Surg ; 46(10): 1291-1297, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28566140

RESUMO

Intraoperative navigation is a helpful tool in complex anatomical regions or procedures. The mobility of the mandible in relation to the skull base limits the use of navigation tools on the lower jaw if the reference device is installed on the forehead. A new workflow that allows navigation-assisted sagittal split osteotomy in orthognathic surgery using a separate non-invasive mandibular registration technique has been developed. An evaluation of accuracy in different anatomical regions and with different registration techniques was performed on skull models and skulls with movable mandibles. The mean inaccuracy was 1.51mm, with no significant difference between anatomical sites. Using a splint-based reference device allows the movable mandible to be registered independently from the midface. Registration using metal points in the splint provides higher accuracy than using interdental anatomical landmarks. The workflow could be transferred successfully to patient treatment. Navigation-assisted osteotomy by Obwegeser-Dal Pont technique was performed without any complication in six patients. The mean deviation from the planned osteotomy line was 1.52mm. The navigated sagittal split ramus osteotomy seems to be a suitable technique to increase patient safety.


Assuntos
Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe II de Angle/cirurgia , Mandíbula/cirurgia , Modelos Anatômicos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Cirurgia Assistida por Computador/métodos , Pontos de Referência Anatômicos , Tomografia Computadorizada de Feixe Cônico , Humanos , Técnicas In Vitro , Osteotomia de Le Fort , Impressão Tridimensional , Estudos Prospectivos
17.
Acta Psychiatr Scand ; 135(6): 506-514, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28276052

RESUMO

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is associated with social conflicts. The purpose of this study was to explore domains of social cognition in adult patients with ADHD. METHODS: The assessment of social cognition was based on established neuropsychological tests: the Tübinger Affect Battery (TAB) for prosody and the Cambridge Behaviour Scale (CBS) for empathy. The performance of adults with ADHD (N = 28) was compared with the performance of a control group (N = 29) matched according to basic demographic variables. RESULTS: Treatment-naïve adults with ADHD showed deficits in emotional prosody (P = 0.02) and in the ability to empathize (P < 0.02) independent of executive functioning. In particular, their ability to perceive angry feelings was found to be compromised (P = 0.04). When emotional prosody was considered in relation to facial expressions, patients and controls showed no impairments (P > 0.2). No gender differences concerning social cognitive skills were detected. CONCLUSIONS: ADHD is associated with social cognition impairments involving both emotional prosody and empathy.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Inteligência Emocional , Adulto , Estudos de Casos e Controles , Empatia , Função Executiva , Expressão Facial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Percepção Social , Adulto Jovem
18.
Int J Oral Maxillofac Surg ; 46(5): 655-661, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28209379

RESUMO

The continuous presence of recombinant human bone morphogenetic protein 2 (rhBMP-2) inside a scaffold may be crucial to the outcome in bone tissue engineering. This study investigated whether the release of the growth factor rhBMP-2 via different continuous application schemes influences histomorphological aspects of the hard and soft tissues induced. Three-dimensionally printed hydroxyapatite scaffolds were implanted into one latissimus dorsi muscle of 42 female Lewis rats. Simultaneously implanted mini-osmotic pumps were used to provide a continuous application of rhBMP-2 over 1, 2, or 4 weeks (total dose 200µg). A reference group received rhBMP-2 at the time of implantation only, and a control group received only block implantation. Bone density and histological examinations were performed after 8 weeks. No significant difference in bone density was found between the groups; however, the blood vessel count differed significantly between the groups receiving continuous treatments and both the control group and simultaneous rhBMP-2 treatment group (P<0.0001). Soft tissue types were distributed differently among the study groups. RhBMP-2 application via mini-osmotic pumps is as suitable for inducing bone formation as a single application at the time of implantation. The time interval over which rhBMP-2 was administered had no impact on the amount of new bone formation, probably due to the study duration and low local concentrations of growth factor.


Assuntos
Proteína Morfogenética Óssea 2/farmacologia , Sistemas de Liberação de Medicamentos , Osteogênese/efeitos dos fármacos , Engenharia Tecidual/métodos , Fator de Crescimento Transformador beta/farmacologia , Animais , Disponibilidade Biológica , Densidade Óssea , Durapatita/farmacologia , Feminino , Modelos Animais , Osmose , Ratos , Ratos Endogâmicos Lew , Proteínas Recombinantes/farmacologia , Tecidos Suporte
19.
Nervenarzt ; 88(9): 1010-1019, 2017 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-27581115

RESUMO

BACKGROUND: Dementia is of increasing medical and societal relevance. Hospitalization of dementia patients is mostly due to behavioral and psychological symptoms of dementia (BPSD). There is a need for sufficient qualified personnel in hospitals in order to be able to effectively treat these symptoms. OBJECTIVES: This study aims at identifying the personnel requirements for guideline-conform, evidence-based inpatient treatment concepts for patients with BPSD and to compare these with the resources defined by the German psychiatric personnel regulations (Psych-PV). Furthermore, it was the aim to identify how often patients with dementia received non-pharmacological therapy during inpatient treatment. METHODS: Based on the current scientific evidence for treatment of BPSD, a schedule for a multimodal non-pharmacological treatment was defined and based on this the corresponding personnel requirements were calculated. Using the treatment indicators in psychiatry and psychosomatics (VIPP) database as a reference, it was calculated on what proportion of treatment days patients were classified into G1 according to the German Psych-PV and at least once received more than two treatment units per week. RESULTS: For the implementation of a guideline-oriented and evidence-based treatment plan, a higher need for personnel resources than that provided by the Psych-PV was detected in all areas. Currently patients with dementia who received at least more than two treatment units per week during inpatient hospitalization, were classified into G1 according to German Psych-PV on 17.9 % of treatment days. CONCLUSION: Despite evidence for the efficacy of non-pharmacological treatment measures on BPSD, these forms of treatment cannot be sufficiently provided under the current conditions. The realization of a new quality controlled therapeutic concept is necessary to enable optimized treatment of patients with BPSD.


Assuntos
Doença de Alzheimer/terapia , Fidelidade a Diretrizes , Transtornos Mentais/terapia , Admissão do Paciente , Psicoterapia/métodos , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Terapia Combinada , Estudos Transversais , Medicina Baseada em Evidências/organização & administração , Feminino , Alemanha , Fidelidade a Diretrizes/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/organização & administração , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Programas Nacionais de Saúde/organização & administração , Psicoterapia/organização & administração
20.
Mol Psychiatry ; 22(1): 153-160, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-26976043

RESUMO

Few data are available concerning the role of risk markers for Alzheimer's disease (AD) in progression to AD dementia among subjects with mild cognitive impairment (MCI). We therefore investigated the role of well-known AD-associated single-nucleotide polymorphism (SNP) in the progression from MCI to AD dementia. Four independent MCI data sets were included in the analysis: (a) the German study on Aging, Cognition and Dementia in primary care patients (n=853); (b) the German Dementia Competence Network (n=812); (c) the Fundació ACE from Barcelona, Spain (n=1245); and (d) the MCI data set of the Amsterdam Dementia Cohort (n=306). The effects of single markers and combined polygenic scores were measured using Cox proportional hazards models and meta-analyses. The clusterin (CLU) locus was an independent genetic risk factor for MCI to AD progression (CLU rs9331888: hazard ratio (HR)=1.187 (1.054-1.32); P=0.0035). A polygenic score (PGS1) comprising nine established genome-wide AD risk loci predicted a small effect on the risk of MCI to AD progression in APOE-ɛ4 (apolipoprotein E-ɛ4) carriers (HR=1.746 (1.029-2.965); P=0.038). The novel AD loci reported by the International Genomics of Alzheimer's Project were not implicated in MCI to AD dementia progression. SNP-based polygenic risk scores comprising currently available AD genetic markers did not predict MCI to AD progression. We conclude that SNPs in CLU are potential markers for MCI to AD progression.


Assuntos
Doença de Alzheimer/genética , Idoso , Idoso de 80 Anos ou mais , Apolipoproteína E4/genética , Biomarcadores , Clusterina/genética , Disfunção Cognitiva/genética , Demência/genética , Progressão da Doença , Feminino , Seguimentos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Fatores de Risco
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