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1. Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) – short version

Author

DAS-Taskforce, Baron, Ralf, Binder, Andreas, Biniek, Rolf, Braune, Stephan, Buerkle, Hartmut, Dall, Peter, Demirakca, Sueha, Eckardt, Rahel, Eggers, Verena, Eichler, Ingolf, Fietze, Ingo, Freys, Stephan, Fründ, Andreas, Garten, Lars, Gohrbandt, Bernhard, Harth, Irene, Hartl, Wolfgang, Heppner, Hans-Jürgen, Horter, Johannes, Huth, Ralf, Janssens, Uwe, Jungk, Christine, Kaeuper, Kristin Maria, Kessler, Paul, Kleinschmidt, Stefan, Kochanek, Matthias, Kumpf, Matthias, Meiser, Andreas, Mueller, Anika, Orth, Maritta, Putensen, Christian, Roth, Bernd, Schaefer, Michael, Schaefers, Rainhild, Schellongowski, Peter, Schindler, Monika, Schmitt, Reinhard, Scholz, Jens, Schroeder, Stefan, Schwarzmann, Gerhard, Spies, Claudia, Stingele, Robert, Tonner, Peter, Trieschmann, Uwe, Tryba, Michael, Wappler, Frank, Waydhas, Christian, Weiss, Bjoern, and Weisshaar, Guido

Subjects
guideline, evidence, analgesia, sedation, delirium, anxiety, stress, sleep, monitoring, treatment, intensive care, critical care, Germany, Medicine
Abstract

In 2010, under the guidance of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine) and DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine), twelve German medical societies published the “Evidence- and Consensus-based Guidelines on the Management of Analgesia, Sedation and Delirium in Intensive Care”. Since then, several new studies and publications have considerably increased the body of evidence, including the new recommendations from the American College of Critical Care Medicine (ACCM) in conjunction with Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) from 2013. For this update, a major restructuring and extension of the guidelines were needed in order to cover new aspects of treatment, such as sleep and anxiety management. The literature was systematically searched and evaluated using the criteria of the Oxford Center of Evidence Based Medicine. The body of evidence used to formulate these recommendations was reviewed and approved by representatives of 17 national societies. Three grades of recommendation were used as follows: Grade “A” (strong recommendation), Grade “B” (recommendation) and Grade “0” (open recommendation). The result is a comprehensive, interdisciplinary, evidence and consensus-based set of level 3 guidelines. This publication was designed for all ICU professionals, and takes into account all critically ill patient populations. It represents a guide to symptom-oriented prevention, diagnosis, and treatment of delirium, anxiety, stress, and protocol-based analgesia, sedation, and sleep-management in intensive care medicine.

Published
2015
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2. Zur Integration der zahnmedizinischen Versorgung in die akutgeriatrische Rehabilitation

Author

Nitschke, Ina, Stillhart, Angela, Frank, Frederick, Houshmand, Mohammad, Müller-Werdan, Ursula, and Eckardt, Rahel

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Die Vierte Deutsche Mundgesundheitsstudie hat gezeigt, dass immer mehr ältere Menschen eigene Zähne bis ins hohe Alter erhalten können: 78 % der 65- bis 74-Jährigen sind bezahnt, nur 22% zahnlos. Der Erfolg ist auf die lebenslangen oral-präventiven Maßnahmen[zum vollständigen Text gelangen Sie über die oben angegebene URL], 15. Deutscher Kongress für Versorgungsforschung

Published
2016
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3. S3-Leitlinie Analgesie, Sedierung und Delirmanagement in der Intensivmedizin. Revision 2015 (DAS-Leitlinie 2015) - Kurzversion

Author

DAS-Taskforce 2015, Baron, Ralf, Binder, Andreas, Biniek, Rolf, Braune, Stephan, Buerkle, Hartmut, Dall, Peter, Demirakca, Sueha, Eckardt, Rahel, Eggers, Verena, Eichler, Ingolf, Fietze, Ingo, Freys, Stephan, Fründ, Andreas, Garten, Lars, Gohrbandt, Bernhard, Harth, Irene, Hartl, Wolfgang, Heppner, Hans-Jürgen, Horter, Johannes, Huth, Ralf, Janssens, Uwe, Jungk, Christine, Kaeuper, Kristin Maria, Kessler, Paul, Kleinschmidt, Stefan, Kochanek, Matthias, Kumpf, Matthias, Meiser, Andreas, Mueller, Anika, Orth, Maritta, Putensen, Christian, Roth, Bernd, Schaefer, Michael, Schaefers, Rainhild, Schellongowski, Peter, Schindler, Monika, Schmitt, Reinhard, Scholz, Jens, Schroeder, Stefan, Schwarzmann, Gerhard, Spies, Claudia, Stingele, Robert, Tonner, Peter, Trieschmann, Uwe, Tryba, Michael, Wappler, Frank, Waydhas, Christian, Weiss, Bjoern, and Weisshaar, Guido

Subjects
Consensus, Critical Care, Angst, Conscious Sedation, lcsh:Medicine, Anxiety, Article, stress, delirium, Germany, Humans, Hypnotics and Sedatives, sleep, Leitlinie, intensive care, Evidence-Based Medicine, treatment, Intensivmedizin, evidence, lcsh:R, Analgesie, analgesia, 610 Medical sciences, Medicine, Delir, monitoring, ddc: 610, sedation, Sedierung, Deep Sedation, Therapie, guideline, Stress, Psychological, Schlaf
Abstract

In 2010, under the guidance of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine) and DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine), twelve German medical societies published the “Evidence- and Consensus-based Guidelines on the Management of Analgesia, Sedation and Delirium in Intensive Care”. Since then, several new studies and publications have considerably increased the body of evidence, including the new recommendations from the American College of Critical Care Medicine (ACCM) in conjunction with Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) from 2013. For this update, a major restructuring and extension of the guidelines were needed in order to cover new aspects of treatment, such as sleep and anxiety management. The literature was systematically searched and evaluated using the criteria of the Oxford Center of Evidence Based Medicine. The body of evidence used to formulate these recommendations was reviewed and approved by representatives of 17 national societies. Three grades of recommendation were used as follows: Grade “A” (strong recommendation), Grade “B” (recommendation) and Grade “0” (open recommendation). The result is a comprehensive, interdisciplinary, evidence and consensus-based set of level 3 guidelines. This publication was designed for all ICU professionals, and takes into account all critically ill patient populations. It represents a guide to symptom-oriented prevention, diagnosis, and treatment of delirium, anxiety, stress, and protocol-based analgesia, sedation, and sleep-management in intensive care medicine., Die vorherige Version der S3-Leitlinie „Analgesie, Sedierung und Delirmanagement in der Intensivmedizin“ wurde 2010 unter der Federführung der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) und der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI) publiziert. Neue Evidenz aus Studien ebenso wie neue Leitlinien, u.a. die 2013 erschienene Leitlinie der U.S.-amerikanischen Society of Critical Care Medicine (SCCM), des American College of Critical Care Medicine (ACCM) und der American Society of Health-System Pharmacists (ASHP), gaben nicht nur Anlass zu einem Update der deutschen Empfehlungen von 2010. Für die Fortschreibung der S3-Leitlinie wurden eine Neuformulierung von klinisch relevanten Schlüsselfragen und die signifikante Erweiterung der Leitlinie um neue Facetten der Behandlung, wie zum Beispiel das Schlafmanagement, notwendig. Dazu wurde die systematisch gesuchte Literatur nach Kriterien des Oxford Centre of Evidence Based Medicine bewertet. Der enorme Evidenzkörper bildete die Grundlage für die Empfehlungen, die von Mandatsträgern aus 17 Fachgesellschaften konsentiert wurden. In den Empfehlungen wurden die Grade „A“ (starke Empfehlung), „B“ (Empfehlung) und „0“ (offene Empfehlung) gewählt. Als Ergebnis dieses Prozesses liegt nun die weltweit umfassendste, interdisziplinär erarbeitete evidenz- und konsensbasierte Stufe 3 Leitlinie vor. Die Leitlinie richtet sich an alle auf der Intensivstation tätigen Berufsgruppen, die Empfehlungen berücksichtigen alle intensivmedizinisch-behandelten Patientengruppen. Sie stellt einen Leitfaden zur symptomorientierten Prävention, Diagnostik und Therapie von Delir, Angst, Stress und der protokollbasierten Analgesie, Sedierung und dem Schlafmanagement in der Intensivmedizin für Erwachsene und Kinder dar., GMS German Medical Science; 13:Doc19

Published
2015

4. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

Author

Lu, Yingchang, Day, Felix R, Gustafsson, Stefan, Buchkovich, Martin L, Na, Jianbo, Bataille, Veronique, Cousminer, Diana L, Dastani, Zari, Drong, Alexander W, Esko, Tõnu, Evans, David M, Falchi, Mario, Feitosa, Mary F, Ferreira, Teresa, Hedman, Åsa K, Haring, Robin, Hysi, Pirro G, Iles, Mark M, Justice, Anne E, Kanoni, Stavroula, Lagou, Vasiliki, Li, Rui, Li, Xin, Locke, Adam, Lu, Chen, Mägi, Reedik, Perry, John R B, Pers, Tune H, Qi, Qibin, Sanna, Marianna, Schmidt, Ellen M, Scott, William R, Shungin, Dmitry, Teumer, Alexander, Vinkhuyzen, Anna A E, Walker, Ryan W, Westra, Harm-Jan, Zhang, Mingfeng, Zhang, Weihua, Zhao, Jing Hua, Zhu, Zhihong, Afzal, Uzma, Ahluwalia, Tarunveer Singh, Bakker, Stephan J L, Bellis, Claire, Bonnefond, Amélie, Borodulin, Katja, Buchman, Aron S, Cederholm, Tommy, Choh, Audrey C, Choi, Hyung Jin, Curran, Joanne E, de Groot, Lisette C P G M, De Jager, Philip L, Dhonukshe-Rutten, Rosalie A M, Enneman, Anke W, Eury, Elodie, Evans, Daniel S, Forsen, Tom, Friedrich, Nele, Fumeron, Frédéric, Garcia, Melissa E, Gärtner, Simone, Han, Bok-Ghee, Havulinna, Aki S, Hayward, Caroline, Hernandez, Dena, Hillege, Hans, Ittermann, Till, Kent, Jack W, Kolcic, Ivana, Laatikainen, Tiina, Lahti, Jari, Mateo Leach, Irene, Lee, Christine G, Lee, Jong-Young, Liu, Tian, Liu, Youfang, Lobbens, Stéphane, Loh, Marie, Lyytikäinen, Leo-Pekka, Medina-Gomez, Carolina, Michaëlsson, Karl, Nalls, Mike A, Nielson, Carrie M, Oozageer, Laticia, Pascoe, Laura, Paternoster, Lavinia, Polašek, Ozren, Ripatti, Samuli, Sarzynski, Mark A, Shin, Chan Soo, Narančić, Nina Smolej, Spira, Dominik, Srikanth, Priya, Steinhagen-Thiessen, Elisabeth, Sung, Yun Ju, Swart, Karin M A, Taittonen, Leena, Tanaka, Toshiko, Tikkanen, Emmi, van der Velde, Nathalie, van Schoor, Natasja M, Verweij, Niek, Wright, Alan F, Yu, Lei, Zmuda, Joseph M, Eklund, Niina, Forrester, Terrence, Grarup, Niels, Jackson, Anne U, Kristiansson, Kati, Kuulasmaa, Teemu, Kuusisto, Johanna, Lichtner, Peter, Luan, Jian'an, Mahajan, Anubha, Männistö, Satu, Palmer, Cameron D, Ried, Janina S, Scott, Robert A, Stancáková, Alena, Wagner, Peter J, Demirkan, Ayse, Döring, Angela, Gudnason, Vilmundur, Kiel, Douglas P, Kühnel, Brigitte, Mangino, Massimo, Mcknight, Barbara, Menni, Cristina, O'Connell, Jeffrey R, Oostra, Ben A, Shuldiner, Alan R, Song, Kijoung, Vandenput, Liesbeth, van Duijn, Cornelia M, Vollenweider, Peter, White, Charles C, Boehnke, Michael, Boettcher, Yvonne, Cooper, Richard S, Forouhi, Nita G, Gieger, Christian, Grallert, Harald, Hingorani, Aroon, Jørgensen, Torben, Jousilahti, Pekka, Kivimaki, Mika, Kumari, Meena, Laakso, Markku, Langenberg, Claudia, Linneberg, Allan, Luke, Amy, Mckenzie, Colin A, Palotie, Aarno, Pedersen, Oluf, Peters, Annette, Strauch, Konstantin, Tayo, Bamidele O, Wareham, Nicholas J, Bennett, David A, Bertram, Lars, Blangero, John, Blüher, Matthias, Bouchard, Claude, Campbell, Harry, Cho, Nam H, Cummings, Steven R, Czerwinski, Stefan A, Demuth, Ilja, Eckardt, Rahel, Eriksson, Johan G, Ferrucci, Luigi, Franco, Oscar H, Froguel, Philippe, Gansevoort, Ron T, Hansen, Torben, Harris, Tamara B, Hastie, Nicholas, Heliövaara, Markku, Hofman, Albert, Jordan, Joanne M, Jula, Antti, Kähönen, Mika, Kajantie, Eero, Knekt, Paul B, Koskinen, Seppo, Kovacs, Peter, Lehtimäki, Terho, Lind, Lars, Liu, Yongmei, Orwoll, Eric S, Osmond, Clive, Perola, Markus, Pérusse, Louis, Raitakari, Olli T, Rankinen, Tuomo, Rao, D C, Rice, Treva K, Rivadeneira, Fernando, Rudan, Igor, Salomaa, Veikko, Sørensen, Thorkild I A, Stumvoll, Michael, Tönjes, Anke, Towne, Bradford, Tranah, Gregory J, Tremblay, Angelo, Uitterlinden, André G, van der Harst, Pim, Vartiainen, Erkki, Viikari, Jorma S, Vitart, Veronique, Vohl, Marie-Claude, Völzke, Henry, Walker, Mark, Wallaschofski, Henri, Wild, Sarah, Wilson, James F, Yengo, Loïc, Bishop, D Timothy, Borecki, Ingrid B, Chambers, John C, Cupples, L Adrienne, Dehghan, Abbas, Deloukas, Panos, Fatemifar, Ghazaleh, Fox, Caroline, Furey, Terrence S, Franke, Lude, Han, Jiali, Hunter, David J, Karjalainen, Juha, Karpe, Fredrik, Kaplan, Robert C, Kooner, Jaspal S, McCarthy, Mark I, Murabito, Joanne M, Morris, Andrew P, Bishop, Julia A N, North, Kari E, Ohlsson, Claes, Ong, Ken K, Prokopenko, Inga, Richards, J Brent, Schadt, Eric E, Spector, Tim D, Widén, Elisabeth, Willer, Cristen J, Yang, Jian, Ingelsson, Erik, Mohlke, Karen L, Hirschhorn, Joel N, Pospisilik, John Andrew, Zillikens, M Carola, Lindgren, Cecilia, Kilpeläinen, Tuomas Oskari, Loos, Ruth J F, Lu, Yingchang, Day, Felix R, Gustafsson, Stefan, Buchkovich, Martin L, Na, Jianbo, Bataille, Veronique, Cousminer, Diana L, Dastani, Zari, Drong, Alexander W, Esko, Tõnu, Evans, David M, Falchi, Mario, Feitosa, Mary F, Ferreira, Teresa, Hedman, Åsa K, Haring, Robin, Hysi, Pirro G, Iles, Mark M, Justice, Anne E, Kanoni, Stavroula, Lagou, Vasiliki, Li, Rui, Li, Xin, Locke, Adam, Lu, Chen, Mägi, Reedik, Perry, John R B, Pers, Tune H, Qi, Qibin, Sanna, Marianna, Schmidt, Ellen M, Scott, William R, Shungin, Dmitry, Teumer, Alexander, Vinkhuyzen, Anna A E, Walker, Ryan W, Westra, Harm-Jan, Zhang, Mingfeng, Zhang, Weihua, Zhao, Jing Hua, Zhu, Zhihong, Afzal, Uzma, Ahluwalia, Tarunveer Singh, Bakker, Stephan J L, Bellis, Claire, Bonnefond, Amélie, Borodulin, Katja, Buchman, Aron S, Cederholm, Tommy, Choh, Audrey C, Choi, Hyung Jin, Curran, Joanne E, de Groot, Lisette C P G M, De Jager, Philip L, Dhonukshe-Rutten, Rosalie A M, Enneman, Anke W, Eury, Elodie, Evans, Daniel S, Forsen, Tom, Friedrich, Nele, Fumeron, Frédéric, Garcia, Melissa E, Gärtner, Simone, Han, Bok-Ghee, Havulinna, Aki S, Hayward, Caroline, Hernandez, Dena, Hillege, Hans, Ittermann, Till, Kent, Jack W, Kolcic, Ivana, Laatikainen, Tiina, Lahti, Jari, Mateo Leach, Irene, Lee, Christine G, Lee, Jong-Young, Liu, Tian, Liu, Youfang, Lobbens, Stéphane, Loh, Marie, Lyytikäinen, Leo-Pekka, Medina-Gomez, Carolina, Michaëlsson, Karl, Nalls, Mike A, Nielson, Carrie M, Oozageer, Laticia, Pascoe, Laura, Paternoster, Lavinia, Polašek, Ozren, Ripatti, Samuli, Sarzynski, Mark A, Shin, Chan Soo, Narančić, Nina Smolej, Spira, Dominik, Srikanth, Priya, Steinhagen-Thiessen, Elisabeth, Sung, Yun Ju, Swart, Karin M A, Taittonen, Leena, Tanaka, Toshiko, Tikkanen, Emmi, van der Velde, Nathalie, van Schoor, Natasja M, Verweij, Niek, Wright, Alan F, Yu, Lei, Zmuda, Joseph M, Eklund, Niina, Forrester, Terrence, Grarup, Niels, Jackson, Anne U, Kristiansson, Kati, Kuulasmaa, Teemu, Kuusisto, Johanna, Lichtner, Peter, Luan, Jian'an, Mahajan, Anubha, Männistö, Satu, Palmer, Cameron D, Ried, Janina S, Scott, Robert A, Stancáková, Alena, Wagner, Peter J, Demirkan, Ayse, Döring, Angela, Gudnason, Vilmundur, Kiel, Douglas P, Kühnel, Brigitte, Mangino, Massimo, Mcknight, Barbara, Menni, Cristina, O'Connell, Jeffrey R, Oostra, Ben A, Shuldiner, Alan R, Song, Kijoung, Vandenput, Liesbeth, van Duijn, Cornelia M, Vollenweider, Peter, White, Charles C, Boehnke, Michael, Boettcher, Yvonne, Cooper, Richard S, Forouhi, Nita G, Gieger, Christian, Grallert, Harald, Hingorani, Aroon, Jørgensen, Torben, Jousilahti, Pekka, Kivimaki, Mika, Kumari, Meena, Laakso, Markku, Langenberg, Claudia, Linneberg, Allan, Luke, Amy, Mckenzie, Colin A, Palotie, Aarno, Pedersen, Oluf, Peters, Annette, Strauch, Konstantin, Tayo, Bamidele O, Wareham, Nicholas J, Bennett, David A, Bertram, Lars, Blangero, John, Blüher, Matthias, Bouchard, Claude, Campbell, Harry, Cho, Nam H, Cummings, Steven R, Czerwinski, Stefan A, Demuth, Ilja, Eckardt, Rahel, Eriksson, Johan G, Ferrucci, Luigi, Franco, Oscar H, Froguel, Philippe, Gansevoort, Ron T, Hansen, Torben, Harris, Tamara B, Hastie, Nicholas, Heliövaara, Markku, Hofman, Albert, Jordan, Joanne M, Jula, Antti, Kähönen, Mika, Kajantie, Eero, Knekt, Paul B, Koskinen, Seppo, Kovacs, Peter, Lehtimäki, Terho, Lind, Lars, Liu, Yongmei, Orwoll, Eric S, Osmond, Clive, Perola, Markus, Pérusse, Louis, Raitakari, Olli T, Rankinen, Tuomo, Rao, D C, Rice, Treva K, Rivadeneira, Fernando, Rudan, Igor, Salomaa, Veikko, Sørensen, Thorkild I A, Stumvoll, Michael, Tönjes, Anke, Towne, Bradford, Tranah, Gregory J, Tremblay, Angelo, Uitterlinden, André G, van der Harst, Pim, Vartiainen, Erkki, Viikari, Jorma S, Vitart, Veronique, Vohl, Marie-Claude, Völzke, Henry, Walker, Mark, Wallaschofski, Henri, Wild, Sarah, Wilson, James F, Yengo, Loïc, Bishop, D Timothy, Borecki, Ingrid B, Chambers, John C, Cupples, L Adrienne, Dehghan, Abbas, Deloukas, Panos, Fatemifar, Ghazaleh, Fox, Caroline, Furey, Terrence S, Franke, Lude, Han, Jiali, Hunter, David J, Karjalainen, Juha, Karpe, Fredrik, Kaplan, Robert C, Kooner, Jaspal S, McCarthy, Mark I, Murabito, Joanne M, Morris, Andrew P, Bishop, Julia A N, North, Kari E, Ohlsson, Claes, Ong, Ken K, Prokopenko, Inga, Richards, J Brent, Schadt, Eric E, Spector, Tim D, Widén, Elisabeth, Willer, Cristen J, Yang, Jian, Ingelsson, Erik, Mohlke, Karen L, Hirschhorn, Joel N, Pospisilik, John Andrew, Zillikens, M Carola, Lindgren, Cecilia, Kilpeläinen, Tuomas Oskari, and Loos, Ruth J F

Abstract

To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eight were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk.

Published
2016
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5. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

Author

University of Helsinki, Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Clinicum, University of Helsinki, Institute of Behavioural Sciences, University of Helsinki, Hospital for Children and Adolescents, Lu, Yingchang, Day, Felix R., Gustafsson, Stefan, Buchkovich, Martin L., Na, Jianbo, Bataille, Veronique, Cousminer, Diana L., Dastani, Zari, Drong, Alexander W., Esko, Tonu, Evans, David M., Falchi, Mario, Feitosa, Mary F., Ferreira, Teresa, Hedman, Asa K., Haring, Robin, Hysi, Pirro G., Iles, Mark M., Justice, Anne E., Kanoni, Stavroula, Lagou, Vasiliki, Li, Rui, Li, Xin, Locke, Adam, Lu, Chen, Magi, Reedik, Perry, John R. B., Pers, Tune H., Qi, Qibin, Sanna, Marianna, Schmidt, Ellen M., Scott, William R., Shungin, Dmitry, Teumer, Alexander, Vinkhuyzen, Anna A. E., Walker, Ryan W., Westra, Harm-Jan, Zhang, Mingfeng, Zhang, Weihua, Zhao, Jing Hua, Zhu, Zhihong, Afzal, Uzma, Ahluwalia, Tarunveer Singh, Bakker, Stephan J. L., Bellis, Claire, Bonnefond, Amelie, Borodulin, Katja, Buchman, Aron S., Cederholm, Tommy, Choh, Audrey C., Choi, Hyung Jin, Curran, Joanne E., de Groot, Lisette C. P. G. M., De Jager, Philip L., Dhonukshe-Rutten, Rosalie A. M., Enneman, Anke W., Eury, Elodie, Evans, Daniel S., Forsen, Tom, Friedrich, Nele, Fumeron, Frederic, Garcia, Melissa E., Gartner, Simone, Han, Bok-Ghee, Havulinna, Aki S., Hayward, Caroline, Hernandez, Dena, Hillege, Hans, Ittermann, Till, Kent, Jack W., Kolcic, Ivana, Laatikainen, Tiina, Lahti, Jari, Leach, Irene Mateo, Lee, Christine G., Lee, Jong-Young, Liu, Tian, Liu, Youfang, Lobbens, Stephane, Loh, Marie, Lyytikainen, Leo-Pekka, Medina-Gomez, Carolina, Michaelsson, Karl, Nalls, Mike A., Nielson, Carrie M., Oozageer, Laticia, Pascoe, Laura, Paternoster, Lavinia, Polasek, Ozren, Ripatti, Samuli, Sarzynski, Mark A., Shin, Chan Soo, Narancic, Nina Smolej, Spira, Dominik, Srikanth, Priya, Steinhagen-Thiessen, Elisabeth, Sung, Yun Ju, Swart, Karin M. A., Taittonen, Leena, Tanaka, Toshiko, Tikkanen, Emmi, van der Velde, Nathalie, van Schoor, Natasja M., Verweij, Niek, Wright, Alan F., Yu, Lei, Zmuda, Joseph M., Pellikka, Niina, Forrester, Terrence, Grarup, Niels, Jackson, Anne U., Kristiansson, Kati, Kuulasmaa, Teemu, Kuusisto, Johanna, Lichtner, Peter, Luan, Jian'an, Mahajan, Anubha, Mannisto, Satu, Palmer, Cameron D., Ried, Janina S., Scott, Robert A., Stancakova, Alena, Wagner, Peter J., Demirkan, Ayse, Doring, Angela, Gudnason, Vilmundur, Kiel, Douglas P., Kuhnel, Brigitte, Mangino, Massimo, Mcknight, Barbara, Menni, Cristina, O'Connell, Jeffrey R., Oostra, Ben A., Shuldiner, Alan R., Song, Kijoung, Vandenput, Liesbeth, van Duijn, Cornelia M., Vollenweider, Peter, White, Charles C., Boehnke, Michael, Boettcher, Yvonne, Cooper, Richard S., Forouhi, Nita G., Gieger, Christian, Grallert, Harald, Hingorani, Aroon, Jorgensen, Torben, Jousilahti, Pekka, Kivimaki, Mika, Kumari, Meena, Laakso, Markku, Langenberg, Claudia, Linneberg, Allan, Luke, Amy, Mckenzie, Colin A., Palotie, Aarno, Pedersen, Oluf, Peters, Annette, Strauch, Konstantin, Tayo, Bamidele O., Wareham, Nicholas J., Bennett, David A., Bertram, Lars, Blangero, John, Bluher, Matthias, Bouchard, Claude, Campbell, Harry, Cho, Nam H., Cummings, Steven R., Czerwinski, Stefan A., Demuth, Ilja, Eckardt, Rahel, Eriksson, Johan G., Ferrucci, Luigi, Franco, Oscar H., Froguel, Philippe, Gansevoort, Ron T., Hansen, Torben, Harris, Tamara B., Hastie, Nicholas, Heliovaara, Markku, Hofman, Albert, Jordan, Joanne M., Jula, Antti, Kahonen, Mika, Kajantie, Eero, Knekt, Paul B., Koskinen, Seppo, Kovacs, Peter, Lehtimaki, Terho, Lind, Lars, Liu, Yongmei, Orwoll, Eric S., Osmond, Clive, Perola, Markus, Perusse, Louis, Raitakari, Olli T., Rankinen, Tuomo, Rao, D. C., Rice, Treva K., Rivadeneira, Fernando, Rudan, Igor, Salomaa, Veikko, Sorensen, Thorkild I. A., Stumvoll, Michael, Tonjes, Anke, Towne, Bradford, Tranah, Gregory J., Tremblay, Angelo, Uitterlinden, Andre G., van der Harst, Pim, Vartiainen, Erkki, Viikari, Jorma S., Vitart, Veronique, Vohl, Marie-Claude, Volzke, Henry, Walker, Mark, Wallaschofski, Henri, Wild, Sarah, Wilson, James F., Yengo, Loic, Bishop, D. Timothy, Borecki, Ingrid B., Chambers, John C., Cupples, L. Adrienne, Dehghan, Abbas, Deloukas, Panos, Fatemifar, Ghazaleh, Fox, Caroline, Furey, Terrence S., Franke, Lude, Han, Jiali, Hunter, David J., Karjalainen, Juha, Karpe, Fredrik, Kaplan, Robert C., Kooner, Jaspal S., McCarthy, Mark I., Murabito, Joanne M., Morris, Andrew P., Bishop, Julia A. N., North, Kari E., Ohlsson, Claes, Ong, Ken K., Prokopenko, Inga, Richards, J. Brent, Schadt, Eric E., Spector, Tim D., Widen, Elisabeth, Willer, Cristen J., Yang, Jian, Ingelsson, Erik, Mohlke, Karen L., Hirschhorn, Joel N., Pospisilik, John Andrew, Zillikens, M. Carola, Lindgren, Cecilia, Kilpelainen, Tuomas Oskari, Loos, Ruth J. F., University of Helsinki, Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Clinicum, University of Helsinki, Institute of Behavioural Sciences, University of Helsinki, Hospital for Children and Adolescents, Lu, Yingchang, Day, Felix R., Gustafsson, Stefan, Buchkovich, Martin L., Na, Jianbo, Bataille, Veronique, Cousminer, Diana L., Dastani, Zari, Drong, Alexander W., Esko, Tonu, Evans, David M., Falchi, Mario, Feitosa, Mary F., Ferreira, Teresa, Hedman, Asa K., Haring, Robin, Hysi, Pirro G., Iles, Mark M., Justice, Anne E., Kanoni, Stavroula, Lagou, Vasiliki, Li, Rui, Li, Xin, Locke, Adam, Lu, Chen, Magi, Reedik, Perry, John R. B., Pers, Tune H., Qi, Qibin, Sanna, Marianna, Schmidt, Ellen M., Scott, William R., Shungin, Dmitry, Teumer, Alexander, Vinkhuyzen, Anna A. E., Walker, Ryan W., Westra, Harm-Jan, Zhang, Mingfeng, Zhang, Weihua, Zhao, Jing Hua, Zhu, Zhihong, Afzal, Uzma, Ahluwalia, Tarunveer Singh, Bakker, Stephan J. L., Bellis, Claire, Bonnefond, Amelie, Borodulin, Katja, Buchman, Aron S., Cederholm, Tommy, Choh, Audrey C., Choi, Hyung Jin, Curran, Joanne E., de Groot, Lisette C. P. G. M., De Jager, Philip L., Dhonukshe-Rutten, Rosalie A. M., Enneman, Anke W., Eury, Elodie, Evans, Daniel S., Forsen, Tom, Friedrich, Nele, Fumeron, Frederic, Garcia, Melissa E., Gartner, Simone, Han, Bok-Ghee, Havulinna, Aki S., Hayward, Caroline, Hernandez, Dena, Hillege, Hans, Ittermann, Till, Kent, Jack W., Kolcic, Ivana, Laatikainen, Tiina, Lahti, Jari, Leach, Irene Mateo, Lee, Christine G., Lee, Jong-Young, Liu, Tian, Liu, Youfang, Lobbens, Stephane, Loh, Marie, Lyytikainen, Leo-Pekka, Medina-Gomez, Carolina, Michaelsson, Karl, Nalls, Mike A., Nielson, Carrie M., Oozageer, Laticia, Pascoe, Laura, Paternoster, Lavinia, Polasek, Ozren, Ripatti, Samuli, Sarzynski, Mark A., Shin, Chan Soo, Narancic, Nina Smolej, Spira, Dominik, Srikanth, Priya, Steinhagen-Thiessen, Elisabeth, Sung, Yun Ju, Swart, Karin M. A., Taittonen, Leena, Tanaka, Toshiko, Tikkanen, Emmi, van der Velde, Nathalie, van Schoor, Natasja M., Verweij, Niek, Wright, Alan F., Yu, Lei, Zmuda, Joseph M., Pellikka, Niina, Forrester, Terrence, Grarup, Niels, Jackson, Anne U., Kristiansson, Kati, Kuulasmaa, Teemu, Kuusisto, Johanna, Lichtner, Peter, Luan, Jian'an, Mahajan, Anubha, Mannisto, Satu, Palmer, Cameron D., Ried, Janina S., Scott, Robert A., Stancakova, Alena, Wagner, Peter J., Demirkan, Ayse, Doring, Angela, Gudnason, Vilmundur, Kiel, Douglas P., Kuhnel, Brigitte, Mangino, Massimo, Mcknight, Barbara, Menni, Cristina, O'Connell, Jeffrey R., Oostra, Ben A., Shuldiner, Alan R., Song, Kijoung, Vandenput, Liesbeth, van Duijn, Cornelia M., Vollenweider, Peter, White, Charles C., Boehnke, Michael, Boettcher, Yvonne, Cooper, Richard S., Forouhi, Nita G., Gieger, Christian, Grallert, Harald, Hingorani, Aroon, Jorgensen, Torben, Jousilahti, Pekka, Kivimaki, Mika, Kumari, Meena, Laakso, Markku, Langenberg, Claudia, Linneberg, Allan, Luke, Amy, Mckenzie, Colin A., Palotie, Aarno, Pedersen, Oluf, Peters, Annette, Strauch, Konstantin, Tayo, Bamidele O., Wareham, Nicholas J., Bennett, David A., Bertram, Lars, Blangero, John, Bluher, Matthias, Bouchard, Claude, Campbell, Harry, Cho, Nam H., Cummings, Steven R., Czerwinski, Stefan A., Demuth, Ilja, Eckardt, Rahel, Eriksson, Johan G., Ferrucci, Luigi, Franco, Oscar H., Froguel, Philippe, Gansevoort, Ron T., Hansen, Torben, Harris, Tamara B., Hastie, Nicholas, Heliovaara, Markku, Hofman, Albert, Jordan, Joanne M., Jula, Antti, Kahonen, Mika, Kajantie, Eero, Knekt, Paul B., Koskinen, Seppo, Kovacs, Peter, Lehtimaki, Terho, Lind, Lars, Liu, Yongmei, Orwoll, Eric S., Osmond, Clive, Perola, Markus, Perusse, Louis, Raitakari, Olli T., Rankinen, Tuomo, Rao, D. C., Rice, Treva K., Rivadeneira, Fernando, Rudan, Igor, Salomaa, Veikko, Sorensen, Thorkild I. A., Stumvoll, Michael, Tonjes, Anke, Towne, Bradford, Tranah, Gregory J., Tremblay, Angelo, Uitterlinden, Andre G., van der Harst, Pim, Vartiainen, Erkki, Viikari, Jorma S., Vitart, Veronique, Vohl, Marie-Claude, Volzke, Henry, Walker, Mark, Wallaschofski, Henri, Wild, Sarah, Wilson, James F., Yengo, Loic, Bishop, D. Timothy, Borecki, Ingrid B., Chambers, John C., Cupples, L. Adrienne, Dehghan, Abbas, Deloukas, Panos, Fatemifar, Ghazaleh, Fox, Caroline, Furey, Terrence S., Franke, Lude, Han, Jiali, Hunter, David J., Karjalainen, Juha, Karpe, Fredrik, Kaplan, Robert C., Kooner, Jaspal S., McCarthy, Mark I., Murabito, Joanne M., Morris, Andrew P., Bishop, Julia A. N., North, Kari E., Ohlsson, Claes, Ong, Ken K., Prokopenko, Inga, Richards, J. Brent, Schadt, Eric E., Spector, Tim D., Widen, Elisabeth, Willer, Cristen J., Yang, Jian, Ingelsson, Erik, Mohlke, Karen L., Hirschhorn, Joel N., Pospisilik, John Andrew, Zillikens, M. Carola, Lindgren, Cecilia, Kilpelainen, Tuomas Oskari, and Loos, Ruth J. F.

Abstract

To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P <5 x 10(-8)), of which eight were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk.

Published
2016

7. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk

Author

Lu, Yingchang, primary, Day, Felix R., additional, Gustafsson, Stefan, additional, Buchkovich, Martin L., additional, Na, Jianbo, additional, Bataille, Veronique, additional, Cousminer, Diana L., additional, Dastani, Zari, additional, Drong, Alexander W., additional, Esko, Tõnu, additional, Evans, David M., additional, Falchi, Mario, additional, Feitosa, Mary F., additional, Ferreira, Teresa, additional, Hedman, Åsa K., additional, Haring, Robin, additional, Hysi, Pirro G., additional, Iles, Mark M., additional, Justice, Anne E., additional, Kanoni, Stavroula, additional, Lagou, Vasiliki, additional, Li, Rui, additional, Li, Xin, additional, Locke, Adam, additional, Lu, Chen, additional, Mägi, Reedik, additional, Perry, John R. B., additional, Pers, Tune H., additional, Qi, Qibin, additional, Sanna, Marianna, additional, Schmidt, Ellen M., additional, Scott, William R., additional, Shungin, Dmitry, additional, Teumer, Alexander, additional, Vinkhuyzen, Anna A. E., additional, Walker, Ryan W., additional, Westra, Harm-Jan, additional, Zhang, Mingfeng, additional, Zhang, Weihua, additional, Zhao, Jing Hua, additional, Zhu, Zhihong, additional, Afzal, Uzma, additional, Ahluwalia, Tarunveer Singh, additional, Bakker, Stephan J. L., additional, Bellis, Claire, additional, Bonnefond, Amélie, additional, Borodulin, Katja, additional, Buchman, Aron S., additional, Cederholm, Tommy, additional, Choh, Audrey C., additional, Choi, Hyung Jin, additional, Curran, Joanne E., additional, de Groot, Lisette C. P. G. M., additional, De Jager, Philip L., additional, Dhonukshe-Rutten, Rosalie A. M., additional, Enneman, Anke W., additional, Eury, Elodie, additional, Evans, Daniel S., additional, Forsen, Tom, additional, Friedrich, Nele, additional, Fumeron, Frédéric, additional, Garcia, Melissa E., additional, Gärtner, Simone, additional, Han, Bok-Ghee, additional, Havulinna, Aki S., additional, Hayward, Caroline, additional, Hernandez, Dena, additional, Hillege, Hans, additional, Ittermann, Till, additional, Kent, Jack W., additional, Kolcic, Ivana, additional, Laatikainen, Tiina, additional, Lahti, Jari, additional, Leach, Irene Mateo, additional, Lee, Christine G., additional, Lee, Jong-Young, additional, Liu, Tian, additional, Liu, Youfang, additional, Lobbens, Stéphane, additional, Loh, Marie, additional, Lyytikäinen, Leo-Pekka, additional, Medina-Gomez, Carolina, additional, Michaëlsson, Karl, additional, Nalls, Mike A., additional, Nielson, Carrie M., additional, Oozageer, Laticia, additional, Pascoe, Laura, additional, Paternoster, Lavinia, additional, Polašek, Ozren, additional, Ripatti, Samuli, additional, Sarzynski, Mark A., additional, Shin, Chan Soo, additional, Narančić, Nina Smolej, additional, Spira, Dominik, additional, Srikanth, Priya, additional, Steinhagen-Thiessen, Elisabeth, additional, Sung, Yun Ju, additional, Swart, Karin M. A., additional, Taittonen, Leena, additional, Tanaka, Toshiko, additional, Tikkanen, Emmi, additional, van der Velde, Nathalie, additional, van Schoor, Natasja M., additional, Verweij, Niek, additional, Wright, Alan F., additional, Yu, Lei, additional, Zmuda, Joseph M., additional, Eklund, Niina, additional, Forrester, Terrence, additional, Grarup, Niels, additional, Jackson, Anne U., additional, Kristiansson, Kati, additional, Kuulasmaa, Teemu, additional, Kuusisto, Johanna, additional, Lichtner, Peter, additional, Luan, Jian'an, additional, Mahajan, Anubha, additional, Männistö, Satu, additional, Palmer, Cameron D., additional, Ried, Janina S., additional, Scott, Robert A., additional, Stancáková, Alena, additional, Wagner, Peter J., additional, Demirkan, Ayse, additional, Döring, Angela, additional, Gudnason, Vilmundur, additional, Kiel, Douglas P., additional, Kühnel, Brigitte, additional, Mangino, Massimo, additional, Mcknight, Barbara, additional, Menni, Cristina, additional, O'Connell, Jeffrey R., additional, Oostra, Ben A., additional, Shuldiner, Alan R., additional, Song, Kijoung, additional, Vandenput, Liesbeth, additional, van Duijn, Cornelia M., additional, Vollenweider, Peter, additional, White, Charles C., additional, Boehnke, Michael, additional, Boettcher, Yvonne, additional, Cooper, Richard S., additional, Forouhi, Nita G., additional, Gieger, Christian, additional, Grallert, Harald, additional, Hingorani, Aroon, additional, Jørgensen, Torben, additional, Jousilahti, Pekka, additional, Kivimaki, Mika, additional, Kumari, Meena, additional, Laakso, Markku, additional, Langenberg, Claudia, additional, Linneberg, Allan, additional, Luke, Amy, additional, Mckenzie, Colin A., additional, Palotie, Aarno, additional, Pedersen, Oluf, additional, Peters, Annette, additional, Strauch, Konstantin, additional, Tayo, Bamidele O., additional, Wareham, Nicholas J., additional, Bennett, David A., additional, Bertram, Lars, additional, Blangero, John, additional, Blüher, Matthias, additional, Bouchard, Claude, additional, Campbell, Harry, additional, Cho, Nam H., additional, Cummings, Steven R., additional, Czerwinski, Stefan A., additional, Demuth, Ilja, additional, Eckardt, Rahel, additional, Eriksson, Johan G., additional, Ferrucci, Luigi, additional, Franco, Oscar H., additional, Froguel, Philippe, additional, Gansevoort, Ron T., additional, Hansen, Torben, additional, Harris, Tamara B., additional, Hastie, Nicholas, additional, Heliövaara, Markku, additional, Hofman, Albert, additional, Jordan, Joanne M., additional, Jula, Antti, additional, Kähönen, Mika, additional, Kajantie, Eero, additional, Knekt, Paul B., additional, Koskinen, Seppo, additional, Kovacs, Peter, additional, Lehtimäki, Terho, additional, Lind, Lars, additional, Liu, Yongmei, additional, Orwoll, Eric S., additional, Osmond, Clive, additional, Perola, Markus, additional, Pérusse, Louis, additional, Raitakari, Olli T., additional, Rankinen, Tuomo, additional, Rao, D. C., additional, Rice, Treva K., additional, Rivadeneira, Fernando, additional, Rudan, Igor, additional, Salomaa, Veikko, additional, Sørensen, Thorkild I. A., additional, Stumvoll, Michael, additional, Tönjes, Anke, additional, Towne, Bradford, additional, Tranah, Gregory J., additional, Tremblay, Angelo, additional, Uitterlinden, André G., additional, van der Harst, Pim, additional, Vartiainen, Erkki, additional, Viikari, Jorma S., additional, Vitart, Veronique, additional, Vohl, Marie-Claude, additional, Völzke, Henry, additional, Walker, Mark, additional, Wallaschofski, Henri, additional, Wild, Sarah, additional, Wilson, James F., additional, Yengo, Loïc, additional, Bishop, D. Timothy, additional, Borecki, Ingrid B., additional, Chambers, John C., additional, Cupples, L. Adrienne, additional, Dehghan, Abbas, additional, Deloukas, Panos, additional, Fatemifar, Ghazaleh, additional, Fox, Caroline, additional, Furey, Terrence S., additional, Franke, Lude, additional, Han, Jiali, additional, Hunter, David J., additional, Karjalainen, Juha, additional, Karpe, Fredrik, additional, Kaplan, Robert C., additional, Kooner, Jaspal S., additional, McCarthy, Mark I., additional, Murabito, Joanne M., additional, Morris, Andrew P., additional, Bishop, Julia A. N., additional, North, Kari E., additional, Ohlsson, Claes, additional, Ong, Ken K., additional, Prokopenko, Inga, additional, Richards, J. Brent, additional, Schadt, Eric E., additional, Spector, Tim D., additional, Widén, Elisabeth, additional, Willer, Cristen J., additional, Yang, Jian, additional, Ingelsson, Erik, additional, Mohlke, Karen L., additional, Hirschhorn, Joel N., additional, Pospisilik, John Andrew, additional, Zillikens, M. Carola, additional, Lindgren, Cecilia, additional, Kilpeläinen, Tuomas Oskari, additional, and Loos, Ruth J. F., additional

Published
2016
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9. Effekte einer einmaligen Lipidapherese auf die koronare Vasomotion bei Patienten mit Hyperlipoproteinämie(a) und koronarer Herzkrankheit

Author

Eckardt, Rahel

Subjects
lipoprotein(a), lipid-apheresis, magnetic resonance imaging, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit, coronary artery disease, perfusion
Abstract

Ein erhöhter Lp(a)-Spiegel gilt als unabhängiger Risikofaktor für die Entwicklung einer frühzeitigen Arteriosklerose. Zudem konnte ein negativer Einfluss auf das endotheliale System nachgewiesen werden. Die einzige effektive Therapie zur Absenkung erhöhter Lp(a)-Spiegel besteht in der Lipidapherese. Nur wenige Studien lieferten bislang Hinweise darauf, dass vergleichbar mit der Cholesterinabsenkung die Entfernung von Lp(a) aus dem Plasma mittels Lipidapherese die koronare Vasomotion verbessert. Unklar blieb auch, in welchem Zeitraum sich diese Veränderungen entwickeln. Die durchgeführte Studie wurde daher mit dem Ziel angelegt, die These einer Verbesserung der koronaren Vasomotion nach einmaliger Lipidapherese zu überprüfen und durch kurzzeitiges Follow-up an verschiedenen Messpunkten nach Lipidapherese im Verlauf zu beurteilen. Hierfür wurde die kardiale Magnetresonanztomographie als nicht-invasives und nebenwirkungsarmes diagnostisches Verfahren mit einer hohen räumlichen und zeitlichen Auflösung gewählt. Das eingeschlossene Kollektiv bestand aus 25 Patienten mit Hyperlipoproteinämie(a) und KHK, die randomisiert einer Untersuchungs- oder Kontrollgruppe zugeordnet wurden. Die Effekte einer einmaligen Lipidfiltration, bezogen auf die Parameter des Lipidstoffwechsels und der Hämorrheologie, wurden laborchemisch vor und direkt nach der Lipidfiltration sowie nach 24 h und 96 h dokumentiert. Ferner erfolgte in einem 24- bzw. 96-stündigen Intervall nach der Lipidfiltration mittels MR-First Pass- Perfusionsmessung die Beurteilung der myokardialen Durchblutung. Alle Messungen wurden unter Ruhe- sowie Adenosinstress durchgeführt. Dabei erfolgte eine separate Auswertung der Perfusion für das subendokardiale und subepikardiale Myokard. Die im Rahmen der Lipidfiltration erzielten Veränderungen der Lipidwerte und rheologischen Parameter zeigten eine hohe Korrelation mit den in anderen Studien erhobenen Daten. Ferner wurde eine tendenzielle Verbesserung der linksventrikulären Funktion beobachtet. Bei der Messung der endo- und epikardialen Perfusionsparameter zeigten sich die Effekte der Lipidfiltration unter Ruhe bzw. Stress jeweils in derjenigen Myokardschicht verstärkt, die einen physiologischen Perfusionsvorteil hat. Als Maß für die relative vasodilatatorische Kapazität des Myokards wurden die differenziellen Veränderungen in Subendo- und Subepikard unter Ruhe bzw. Adenosinstress zudem in einem integrativen Parameter, der sog. EER-Stress/EER- Ruhe zusammengefasst. Bereits durch eine einmalige Lipidfiltration kam es nach 24 Stunden zu einer relativen Zunahme der endokardialen Perfusion in Ruhe sowie einer Zunahme der epikardialen Perfusion unter Stress, was sich in einer signifikanten Abnahme der EER-Stress/EER-Ruhe zeigte. Die vorgelegte Studie lieferte erstmalig Hinweise darauf, dass es bei Patienten mit Hyperlipoproteinämie(a) und KHK durch die Lipidapherese zu einer Verbesserung der mikrovaskulären Funktion kommt., Elevated lipoprotein(a) (Lp(a)) is an emerging, independent risk factor for atherosclerotic disease. Patients frequently present with premature and rapidly progressing coronary artery disease. Lp(a) impairs coronary endothelial function and appears to be a predictor of adverse outcome. Unfortunately, conservative therapy remains unsatisfactory, but significant reduction of Lp(a) plasma concentration can be achieved using lipid-apheresis. This intensive treatment strategy is not covered by standard health insurance in Germany. The additional costs would have to be justified by improvements in measurable end points. Cardiac magnetic resonance imaging (CMR) is emerging as a state of the art tool to monitor subtle changes in microvascular perfusion. The purpose of this prospective, controlled and randomized study was to provide evidence that a single lipid-apheresis attenuates myocardial microvascular dysfunction in coronary artery disease patients with strongly elevated lipoprotein(a). A total of n = 25 patients were included and randomized into a treatment-group or a control-group. On day 1 all patients underwent baseline fasting blood sampling immediately before baseline CMR. After CMR the treatment-group underwent lipid-apheresis on the same day. At 24 hours both groups underwent repeat blood sampling and CMR with identical parameters. At 96 hours blood-samples were drawn in the treatment-group and this group underwent a final CMR exam. The transmyocardial perfusion gradient (i.e. endo-epi-ratio, EER) was determined and a comprehensive parameter of resting and adenosinstress perfusion was derived (EER stress/rest). While hematocrite remained unchanged, apheresis reduced lipoproteins and rheological parameters significantly. Left ventricular ejection fraction transiently improved after lipid-apheresis, emphasizing the close relation between microvascular function, myocardial perfusion and contraction. Lipid-apheresis also had subtle, opposing effects on subendo- and subepicardial perfusion: adenosin-mediated vasodilation now caused the expected benefit of subepicardial perfusion whereas the relative subendokardial perfusion advantage was reinforced at rest. Lipid-apheresis significantly reduced EER stress/rest. Although the exact physiological mechanisms remain unresolved, the observed treatment-related effects may be interpreted as functional improvement and as a “trend towards normalizsation” of myocardial microvascular function. Cardiac magnetic resonance imaging has high sensitivity to detect subtle treatment-related changes in regional myocardial perfusion in patients with elevated lipoprotein(a) and coronary artery disease undergoing lipid-apheresis.

Published
2008
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11. Cohort Profile: The Berlin Aging Study II (BASE-II)†

Author

Bertram, Lars, primary, Böckenhoff, Anke, additional, Demuth, Ilja, additional, Düzel, Sandra, additional, Eckardt, Rahel, additional, Li, Shu-Chen, additional, Lindenberger, Ulman, additional, Pawelec, Graham, additional, Siedler, Thomas, additional, Wagner, Gert G, additional, and Steinhagen-Thiessen, Elisabeth, additional

Published
2013
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13. Patient Empowerment Improved Perioperative Quality of Care in Cancer Patients Aged ≥ 65 Years – A Randomized Controlled Trial.

Author

Schmidt, Maren, Eckardt, Rahel, Scholtz, Kathrin, Neuner, Bruno, von Dossow-Hanfstingl, Vera, Sehouli, Jalid, Stief, Christian G., Wernecke, Klaus-Dieter, Spies, Claudia D., and null, null

Subjects
*CANCER patients, *SELF-efficacy, *PERIOPERATIVE care, *MEDICAL quality control, *RANDOMIZED controlled trials, *HEALTH outcome assessment
Abstract

Purpose: This randomized controlled, clinical prospective interventional trial was aimed at exploring the effect of patient empowerment on short- and long-term outcomes after major oncologic surgery in elderly cancer patients. Methods: This trial was performed from February 2011 to January 2014 at two tertiary medical centers in Germany. The study included patients aged 65 years and older undergoing elective surgery for gastro-intestinal, genitourinary, and thoracic cancer. The patients were randomly assigned to the intervention group, i.e. patient empowerment through information booklet and diary keeping, or to the control group, which received standard care. Randomization was done by block randomization in blocks of four in order of enrollment. The primary outcome were 1,postoperative length of hospital stay (LOS) and 2. long-term global health-related quality of life (HRQoL) one year postoperatively. HRQoL was assessed using the EORTC QLQ C30 questionnaire. Secondary outcomes encompassed postoperative stress and complications. Further objectives were the identification of predictors of LOS, and HRQoL at 12 months. Results: Overall 652 patients were included. The mean age was 72 ± 4.9 years, and the majority of patients were male (68.6%, n = 447). The ^median of postoperative length of stay was 9 days (IQR 7–14 day). There were no significant differences between the intervention and the control groups in postoperative LOS (p = 0.99) or global HRQoL after one year (women: p = 0.54, men: p = 0.94). While overall complications and major complications occurred in 74% and 24% of the cases, respectively, frequency and severity of complications did not differ significantly between the groups. Patients in the intervention group reported significantly less postoperative pain (p = 0.03) than the control group. Independent predictors for LOS were identified as severity of surgery, length of anesthesia, major postoperative complications, nutritional state, and pre-operative physical functional capacity measured by the Timed Up and Go-test by multiple robust regressions. Conclusion: Patient empowerment through information booklet and diary keeping did not shorten the postoperative LOS in elderly onco-surgical patients, but improved quality of care regarding postoperative pain. Postoperative length of stay is influenced by pre-operative nutritional state, pre-operative functional impairment, severity of surgery, and length of anesthesia. Trial Registration: Clinicaltrials.gov. Identifier [ABSTRACT FROM AUTHOR]

Published
2015
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14. Cohort Profile: The Berlin Aging Study II (BASE-II)†.

Author

Bertram, Lars, Böckenhoff, Anke, Demuth, Ilja, Düzel, Sandra, Eckardt, Rahel, Li, Shu-Chen, Lindenberger, Ulman, Pawelec, Graham, Siedler, Thomas, Wagner, Gert G, and Steinhagen-Thiessen, Elisabeth

Subjects
QUALITY of life, IMMUNOLOGY, PSYCHOLOGY, INTERNAL medicine, ECONOMICS, DEVELOPED countries
Abstract

Similar to other industrialized countries, Germany's population is ageing. Whereas some people enjoy good physical and cognitive health into old age, others suffer from a multitude of age-related disorders and impairments which reduce life expectancy and affect quality of life. To identify and characterize the factors associated with ‘healthy’ vs. ‘unhealthy’ ageing, we have launched the Berlin Aging Study II (BASE-II), a multidisciplinary and multi-institutional project that ascertains a large number of ageing-related variables from a wide range of different functional domains. Phenotypic assessments include factors related to geriatrics and internal medicine, immunology, genetics, psychology, sociology and economics. Baseline recruitment of the BASE-II cohort was recently completed and has led to the sampling of 1600 older adults (age range 60–80 years), as well as 600 younger adults (20–35 years) serving as the basic population for in-depth analyses. BASE-II data are linked to the German Socio-Economic Panel Study (SOEP), a long-running panel survey representative of the German population, to estimate sample selectivity. A major goal of BASE-II is to facilitate collaboration with other research groups by freely sharing relevant phenotypic and genotypic data with qualified outside investigators. [ABSTRACT FROM PUBLISHER]

Published
2014
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15. Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) - short version.

Author

Baron R, Binder A, Biniek R, Braune S, Buerkle H, Dall P, Demirakca S, Eckardt R, Eggers V, Eichler I, Fietze I, Freys S, Fründ A, Garten L, Gohrbandt B, Harth I, Hartl W, Heppner HJ, Horter J, Huth R, Janssens U, Jungk C, Kaeuper KM, Kessler P, Kleinschmidt S, Kochanek M, Kumpf M, Meiser A, Mueller A, Orth M, Putensen C, Roth B, Schaefer M, Schaefers R, Schellongowski P, Schindler M, Schmitt R, Scholz J, Schroeder S, Schwarzmann G, Spies C, Stingele R, Tonner P, Trieschmann U, Tryba M, Wappler F, Waydhas C, Weiss B, and Weisshaar G

Subjects
Anxiety diagnosis, Anxiety drug therapy, Consensus, Delirium diagnosis, Delirium therapy, Evidence-Based Medicine, Humans, Hypnotics and Sedatives therapeutic use, Sleep, Stress, Psychological diagnosis, Stress, Psychological drug therapy, Analgesia standards, Conscious Sedation standards, Critical Care standards, Deep Sedation standards, Delirium drug therapy
Abstract

In 2010, under the guidance of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine) and DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine), twelve German medical societies published the "Evidence- and Consensus-based Guidelines on the Management of Analgesia, Sedation and Delirium in Intensive Care". Since then, several new studies and publications have considerably increased the body of evidence, including the new recommendations from the American College of Critical Care Medicine (ACCM) in conjunction with Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) from 2013. For this update, a major restructuring and extension of the guidelines were needed in order to cover new aspects of treatment, such as sleep and anxiety management. The literature was systematically searched and evaluated using the criteria of the Oxford Center of Evidence Based Medicine. The body of evidence used to formulate these recommendations was reviewed and approved by representatives of 17 national societies. Three grades of recommendation were used as follows: Grade "A" (strong recommendation), Grade "B" (recommendation) and Grade "0" (open recommendation). The result is a comprehensive, interdisciplinary, evidence and consensus-based set of level 3 guidelines. This publication was designed for all ICU professionals, and takes into account all critically ill patient populations. It represents a guide to symptom-oriented prevention, diagnosis, and treatment of delirium, anxiety, stress, and protocol-based analgesia, sedation, and sleep-management in intensive care medicine.

Published
2015
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