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Abstract A joint analysis of five paternal half-sib Holstein families that were part of two different granddaughter designs (ADR- or Inra-design) was carried out for five milk production traits and somatic cell score in order to conduct a QTL confirmation study and to increase the experimental power. Data were exchanged in a coded and standardised form. The combined data set (JOINT-design) consisted of on average 231 sires per grandsire. Genetic maps were calculated for 133 markers distributed over nine chromosomes. QTL analyses were performed separately for each design and each trait. The results revealed QTL for milk production on chromosome 14, for milk yield on chromosome 5, and for fat content on chromosome 19 in both the ADR- and the Inra-design (confirmed within this study). Some QTL could only be mapped in either the ADR- or in the Inra-design (not confirmed within this study). Additional QTL previously undetected in the single designs were mapped in the JOINT-design for fat yield (chromosome 19 and 26), protein yield (chromosome 26), protein content (chromosome 5), and somatic cell score (chromosome 2 and 19) with genomewide significance. This study demonstrated the potential benefits of a combined analysis of data from different granddaughter designs.

Abstract Background In a previous study in the Fleckvieh dual purpose cattle breed, we mapped a quantitative trait locus (QTL) affecting milk yield (MY1), milk protein yield (PY1) and milk fat yield (FY1) during first lactation to the distal part of bovine chromosome 5 (BTA5), but the confidence interval was too large for positional cloning of the causal gene. Our objective here was to refine the position of this QTL and to define the candidate region for high-throughput sequencing. Methods In addition to those previously studied, new Fleckvieh families were genotyped, in order to increase the number of recombination events. Twelve new microsatellites and 240 SNP markers covering the most likely QTL region on BTA5 were analysed. Based on haplotype analysis performed in this complex pedigree, families segregating for the low frequency allele of this QTL (minor allele) were selected. Single- and multiple-QTL analyses using combined linkage and linkage disequilibrium methods were performed. Results Single nucleotide polymorphism haplotype analyses on representative family sires and their ancestors revealed that the haplotype carrying the minor QTL allele is rare and most probably originates from a unique ancestor in the mapping population. Analyses of different subsets of families, created according to the results of haplotype analysis and availability of SNP and microsatellite data, refined the previously detected QTL affecting MY1 and PY1 to a region ranging from 117.962 Mb to 119.018 Mb (1.056 Mb) on BTA5. However, the possibility of a second QTL affecting only PY1 at 122.115 Mb was not ruled out. Conclusion This study demonstrates that targeting families segregating for a less frequent QTL allele is a useful method. It improves the mapping resolution of the QTL, which is due to the division of the mapping population based on the results of the haplotype analysis and to the increased frequency of the minor allele in the families. Consequently, we succeeded in refining the region containing the previously detected QTL to 1 Mb on BTA5. This candidate region contains 27 genes with unknown or partially known function(s) and is small enough for high-throughput sequencing, which will allow future detailed analyses of candidate genes.

A 69-year-old male patient with seropositive erosive rheumatoid arthritis (RA) presented to our clinic due to progressive dyspnea. High-resolution computed tomography (HRCT) and immunological bronchioalveolar lavage revealed ground-glass opacities and a lymphocytic alveolitis caused by interstitial lung disease (ILD) in RA. Considering previous forms of treatment, disease-modifying antirheumatic drug (DMARD) treatment was switched to tofacitinib. Tofacitinib treatment demonstrated a 33% reduction in ground-glass opacities by artificial intelligence-based quantification of pulmonary HRCT over the course of 6 months, which was associated with an improvement in dyspnea symptoms. In conclusion, tofacitinib represents an effective anti-inflammatory therapeutic option in the treatment of RA-ILD., (© 2023. The Author(s).)

Introduction: A number of new, highly effective biologic drugs for psoriasis have been approved over the past few decades, which raises the question whether psoriasis is still a disease that requires inpatient treatment., Methods: We conducted a retrospective analysis of inpatient data between 2010 and 2019 (the last 10 years prior to the coronavirus disease 2019 [COVID-19] pandemic) from three German dermatology departments at university hospitals (Aachen, Bonn, and Essen). The data collected included age, gender, the primary admission diagnosis, length of stay (LOS), and number of all comorbidities recorded during hospitalization., Results: A total of 59,500 patients were admitted to the three dermatological departments in the defined 10-year period. Of these patients, psoriasis (L40.-) was the main diagnosis for 4322 (7.3%). An almost continuous increase was observed in all inpatient dermatological cases, which was as high as 27% in 2016 compared to 2010. For psoriasis patients, the most substantial increase in the number of admissions was reached in 2016 compared to 2010 and was as high as 45%. While there was a statistically significant reduction of the mean LOS for all dermatological inpatient cases from 6.4 ± 6.6 days in 2010 to 5.1 ± 4.6 days in 2019 (p < 0.001), the decrease in 2019 compared to 2010 (from 12.2 ± 5.5 to 8.9 ± 3.3 days) was significantly greater for the inpatient psoriasis patients compared to the inpatient population overall (p < 0.001)., Conclusions: Our data show a stable need for inpatient psoriasis facilities in Germany. Further analysis of hospital admissions after the end of the COVID-19 pandemic is needed to understand the ongoing influence of modern systemic treatment options on inpatient psoriasis care in Germany., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: An open-door policy may help to reduce conflicts, aggression and containment measures in inpatient psychiatric care., Objective: A complex intervention was performed including opening the doors of an acute psychiatric ward. The aim was to deescalate conflicts and reduce containment measures., Methods: Along with opening of the doors, several other measures were taken including intensive training of staff in deescalating techniques and nonviolent communication, review and liberalization of rules of the ward, opening of a time-out room and access to a secure garden., Results: The open-door policy proved to be feasible and was permanently established. Thereafter, incidents involving aggression decreased but containment measures did not. Overall, the staff appreciated the new concept but considered the opening of the doors to be of minor importance., Conclusion: The opening of a closed psychiatric ward should be understood as part of a complex, autonomy focused intervention. Other aspects such as sufficient numbers of well-trained staff and structural architectural features of the ward are possibly more important than opening of the doors.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from exacerbations caused by infections of the bronchial tract., Objective: What effects do hydrotherapeutic applications according to Kneipp have on lung function, blood gases, immune system and quality of life of patients with COPD?, Patients and Methods: 20 patients with COPD (17 males, 3 females); mean age: 64; forced expiratory volume (FEV1): 62 of 100% (on average); no acute exacerbations, no oral corticosteroids. Measurements were performed (I) at 10 weeks pre-treatment, (II) immediately before therapy (I-II: baseline-period), (III) after 10 weeks treatment with 3 cold affusions and 2 cold washings of the upper part of the body (self-treatment) per week each, (IV) 3 months after completion of the treatment (follow- up). The following parameters were measured: lung function, blood gases, routine lab, experimental lab (interleukines, lymphocytes), maximal expiratory flow (PEF), quality of life and respiratory infections., Results: The pH increased over the course of the study. PEF and the number of lymphocytes significantly increased over the treatment (II-III). Intracellular expression of IL-4 by T lymphocytes decreased. However, the expression of IFN-gamma increased. Frequency of infections was lower during follow-up (IV) than before and during therapy. Quality of life after treatment was estimated to be good in all patients., Conclusions: Repeated cold stimulations (affusions) can influence the frequency of respiratory infections and improve subjective well-being. It may cause an immunological modulation in terms of the Th1-type pattern.

History: Two patients, 60 (pat. 1; female) and 30 years of age (pat. 2; male), respectively, suffering from a histologically confirmed Churg-Strauss-syndrome and receiving immunosuppressive therapy were treated with Interferon-alpha., Investigations: Clinical complaints, disease activity, blood eosinophil counts, and lung function were monitored. In patient 1 the differential cell counts and immunocytology of bronchoalveolar lavage cells were assessed using flow cytometry., Treatment and Course: Both patients were treated with interferon-alpha in dosages of 3 million units of IFN-alpha 2b or an equivalent dosage of interferon-acon thrice weekly subcutaneously. The patients were observed for a period of up to 24 months. Interferon-alpha induced remission of disease and allowed discontinuation of oral glucocorticoid therapy in both patients. Treatment also improved the peripheral polyneuropathia in patient 1 as well as the hemorrhagic cystitis and reduction of the Cushing syndrome (weight reduction of 19 kg) in patient 2. In addition, blood eosinophil counts normalised. After 12 months of treatment, the number of bronchoalveolar eosinophils decreased from 61,5% (5.7 x 106 cells/ml) to 7% (1.1 x 106 cells/ml). In addition, the proportion of CD4+ T-lymphocytes and B-cells increased, while CD8+ T-cells and NK cells decreased (pat. 1)., Conclusion: Interferon-alpha may represent an effective alternative to the current treatment of Churg-Strauss syndrome consisting of corticosteroids and immunosuppressives.

Introduction: The aim of this study was to determine how frequently and to what extent facial pain--particularly musculoskeletal and neuropathic pain--has been considered in German-language textbooks on pain published between 1990 and 2002., Methods: Relevant textbooks were identified by hand search and by search in electronic bibliographic databases. A quantitative analysis was carried out by counting and comparing the number of pertinent pages in the textbooks. For the assessment of the medical-scientific quality of the information on musculoskeletal face pain, a checklist was used based on comparisons with the current state of the scientific literature on facial pain., Results: Of 231 textbooks on pain, 28 consider the topic of "facial pain." Of the 1923 pages dedicated to facial pain and headache, musculoskeletal and neuropathic facial pain make up 7% and 17%, respectively. Headache, in contrast, accounts for 71% of all pages. Only ten contributions on musculoskeletal facial pain could be assessed, two of which exhibit a high medical-scientific quality., Conclusions: The data suggest that facial pain is underrepresented in German-language textbooks on pain. In addition, a considerable part of the information given on musculoskeletal facial pain does not correspond to the current state of the scientific literature. This may lead to under- or overdiagnosis and to under- or overtreatment.

Infiltration of eosinophils into the airways plays a central role in the pathophysiology of asthma. Human blood eosinophils express apoptosis-inducing receptors (e.g. CD95R and CD69R) regulating both viability and survival and, thus, the extent of eosinophil infiltration into the airways. Signal transduction processes induced by occupation of the CD69 receptor expressed by eosinophils are insufficiently known. Purified human peripheral blood eosinophils (MACS, purity > 99%) were pre-incubated with a GM-CSF for 18 h and stimulated with alpha-CD69mAb (clon TP1/55), alpha-CD95mAb (clon CH-11), and as a control alpha-CD11bmAb (clon Bear-1). The specificity of receptor ligation was assessed using a blocking mAb (Klon ZB4). Phenotype, viability, apoptosis and bcl-2-expression were measured employing flow cytometry. alpha-CD95mAb (1 microgram/ml) induced apoptosis both in control and GM-CSF (10 ng/ml) treated eosinophils. Similarly, alpha-CD69mAb (10 micrograms/ml) induced apoptosis of GM-CSF-stimulated CD69+ cells after an incubation period of 114 h which was not affected by a CD95 blocking mAb. Naive eosinophils showed a basale, bcl-2-expression, which decreased to 30% after 66 h. In the presence of GM-CSF, intracellular bcl-2-concentration remained unchanged. Following stimulation with alpha-CD69mAb or alpha-CD95mAb, a dose-dependent decline of the bcl-2-expression was detected, whereas alpha-CD11bmAb (10 micrograms/ml) had no effect. The data suggest that both CD95R- and CD69R-induced apoptosis of human eosinophils involves a bcl-2-dependent signal transduction mechanism.

A case of intersexuality in an arabo-haflinger horse is described. The external genitalia consisted of mammary gland, vulva and hypertrophic clitoris; the inner genitalia of rudimental testes. The sexual behaviour was typically male-like. The chromosome analysis showed the female karyotype 64,XX. The presence of testes in a genetically female animal is explained by translocation of an Y-chromosome fragment bearing the gene for the H-Y-antigen.

A case of bilateral complete cryptophthalmos combined with other malformations is described. The clinical appearance, histology, and the results of computed tomography and electro-ophthalmological investigations are communicated.