30 results on '"Niels, Hagenbuch"'
Search Results
2. Ocrelizumab-treated patients with relapsing multiple sclerosis show volume loss rates similar to healthy aging
- Author
-
Shannon Kolind, Laura Gaetano, Haz-Edine Assemlal, Corrado Bernasconi, Ulrike Bonati, Colm Elliott, Niels Hagenbuch, Stefano Magon, Douglas L Arnold, and Anthony Traboulsee
- Subjects
Neurology ,Neurology (clinical) - Abstract
Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by two major and interconnected hallmarks: inflammation and progressive neurodegeneration. Objective: The aim of this work was to compare neurodegenerative processes, in the form of global and regional brain volume loss rates, in healthy controls (HCs) and in patients with relapsing MS (RMS) treated with ocrelizumab, which suppresses acute inflammation. Methods: Whole brain, white matter, cortical gray matter, thalamic, and cerebellar volume loss rates were assessed in 44 HCs that were part of a substudy in the OPERA II randomized controlled trial (NCT01412333) and 59 patients with RMS enrolled in the same substudy as well as age- and sex-matched patients in OPERA I (NCT01247324) and II. Volume loss rates were computed using random coefficients models over a period of 2 years. Results: Ocrelizumab-treated patients showed global and regional brain volume loss rates that were approaching that of HCs. Conclusion: These findings are consistent with an important role of inflammation on overall tissue loss and the role of ocrelizumab in reducing this phenomenon.
- Published
- 2023
3. NRS-2002 components, nutritional score and severity of disease score, and their association with hospital length of stay and mortality
- Author
-
Luca Sahli, Niels Hagenbuch, Peter E. Ballmer, Maya Rühlin, and Reinhard Imoberdorf
- Subjects
malnutrition ,Malnutrition Screening ,NRS-2002 ,Length of Hospital Stay ,Hospital Mortality ,Linear Models ,Medicine - Abstract
BACKGROUND Malnutrition is a substantial issue in hospitals, leading to prolonged length of hospital stay, increased perioperative morbidity and increased mortality. There are several validated screening tools for malnutrition, one of which is the Nutritional Risk Screening 2002 (NRS). It screens patients based on recent weight loss, reduction of recent food intake, body mass index (BMI), severity of disease and age. Higher NRS scores have been shown to be negatively associated with patients’ outcomes such as increased morbidity and mortality. OBJECTIVES The aim of the study was to evaluate how the two NRS components Nutritional Score (NS) and Severity of Disease Score (SDS) are associated with patients’ length of hospital stay and mortality. METHODS All patients admitted to the medical department of a large community hospital in Switzerland were screened for malnutrition using the nutrition screening NRS during the years 2014 to 2017. Data on patients’ NRS, primary diagnosis, number of secondary diagnoses, mortality, length of stay (LOS), discharge, sex and age were collected. The association between the NRS components and LOS/mortality was estimated using a linear mixed-effects regression model and a logistic regression model, respectively, with adjustment for confounders (age, sex, comorbidity, diagnosis group, mode of discharge and year of hospitalisation). RESULTS The evaluation of the outcomes of 21,855 hospitalisations demonstrated that the NS was associated with an increment in the LOS of 5.5–12.3% per score point, depending on the diagnosis group. An increase in the SDS by one point was associated with an increase in the LOS of 2.2–11.3%. The odds for all-cause in-hospital mortality were increased by 44.1% (95% confidence interval [CI] 33.7–55.2%) per point in the NS, and by 73% (95% CI 57.5–90.1%) per point in the SDS. CONCLUSIONS Increases in both components of the NRS are associated with longer LOS. The NS has a slightly stronger impact on LOS compared to the SDS and its effect is dependent on the patient’s diagnosis group. Increases in the SDS are linked to a higher mortality than increases in the NS.
- Published
- 2021
- Full Text
- View/download PDF
4. Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss?
- Author
-
Irena Pjanic, Roland Müller, Markus Laimer, Niels Hagenbuch, Kurt Laederach, and Zeno Stanga
- Subjects
Obesity ,Behavioral therapy ,Multiprofessional intervention ,Life style behavioral change ,Weight loss ,Psychiatry ,RC435-571 - Abstract
Abstract Background According to the current evidence, behavior modifications are an effective part of a non-surgical multiprofessional obesity treatment program (MOTP). The purpose of the present study was to report changes in weight as well in psychological variables during a one year MOTP. We aimed to identify the associations of emotional state and patients’ emotion regulation skills with weight change. Methods Prospective interventional study. Data of participants attending the one year obesity treatment in either a group or individual structured MOTP were analyzed. Weight, BMI (Body Mass Index) and measures on psychosomatic variables, emotion regulation skills, affective state, shame and guilt were collected at baseline, after three months and after one year. Mixed-effects models were used for the statistical analysis of BMI. Results We included 238 patients at baseline (t1), 234 after three months (t2) and 179 after one year (t3). A drop in BMI measurements of at least 5% was observed in 20.6% of participants at t2 and 41.4% of participants at t3. After three months, participants showed significant improvements in the following psychosomatic variables: somatisation (p
- Published
- 2017
- Full Text
- View/download PDF
5. Safety and efficacy of balloon angioplasty in symptomatic intracranial stenosis: A systematic review and meta-analysis
- Author
-
Anton Valavanis, Niels Hagenbuch, Keisuke Kadooka, Zsolt Kulcsar, Vania Anagnostakou, University of Zurich, and Kadooka, Keisuke
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,610 Medicine & health ,Balloon ,Brain Ischemia ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Restenosis ,10043 Clinic for Neuroradiology ,Angioplasty ,Outcome Assessment, Health Care ,medicine ,Humans ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,Cumulative incidence ,Stroke ,3614 Radiological and Ultrasound Technology ,Radiological and Ultrasound Technology ,business.industry ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,Intracranial Arteriosclerosis ,medicine.disease ,Surgery ,Stenosis ,Treatment Outcome ,2728 Neurology (clinical) ,medicine.anatomical_structure ,Meta-analysis ,Neurology (clinical) ,business ,Angioplasty, Balloon ,030217 neurology & neurosurgery ,Artery - Abstract
Background and purpose Endovascular treatment is offered for symptomatic intracranial stenosis (ICS) when medical therapy fails. The purpose of this meta-analysis is to evaluate the risks and effectiveness of balloon angioplasty (BA) alone. Materials and methods Systematic review and meta-analysis of all available articles on BA for symptomatic ICS was conducted. Data was analyzed separately for > 70% (Group 1) and > 50% (Group 2) stenosis. The results of the Group 1 were compared with those of SAMMPRIS study to the extent possible. Results A total of 25 studies comprising 674 patients were included. The cumulative incidence of periprocedural (within 30 days) stroke and death were 16.3% (Group 1), 7.6% (Group 2) and 11.5% (all studies). Incidence rates of ischemic stroke in the qualifying artery territory during follow-up (per 100 patient-years) were 2.0, 2.4 and 2.3, any stroke and death during follow-up were 4.4, 7.4 and 6.9, restenosis rates were 4.9, 11.5 and 8.9 respectively. While comparison of cumulative incidences of periprocedural ischemic stroke between Group 1 (13.0%) and the medical arm from SAMMPRIS study(4.4%) showed a significant difference (P = 0.008), there was no significant difference between the Group 1 and the stenting arm from SAMMPRIS study(10.7%) in the same variable. Conclusion Balloon angioplasty for stenosis of more than 70% is likely to have similar outcome comparable to the stenting arm in the SAMMPRIS study, however it presents lower rates of late ischemic events and restenosis. These data may help deciding on the endovascular method of choice in case of medical therapy failure.
- Published
- 2020
6. Key Factors in Decision Making for ECLS: A Binational Factorial Survey
- Author
-
Peter Steiger, Philipp K. Buehler, Tanja Krones, Niels Hagenbuch, Ana Rosca, Daniel Drewniak, Giovanna Brandi, Liane Schenk, Sabine Stamm-Balderjahn, and University of Zurich
- Subjects
endocrine system ,medicine.medical_specialty ,610 Medicine & health ,030204 cardiovascular system & hematology ,extracorporeal life support ,decision making ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,Germany ,Surveys and Questionnaires ,medicine ,Humans ,Intensive care medicine ,Health policy ,Retrospective Studies ,business.industry ,Neurological status ,Health Policy ,Factorial survey ,3. Good health ,factorial survey ,Treatment Outcome ,Key factors ,030228 respiratory system ,age ,neurological status ,Life support ,10222 Institute of Biomedical Ethics and History of Medicine ,10023 Institute of Intensive Care Medicine ,business - Abstract
BackgroundExtracorporeal life support (ECLS) provides support to patients with cardiopulmonary failure refractory to conventional therapy. While ECLS is potentially life-saving, it is associated with severe complications; decision making to initiate ECLS must, therefore, carefully consider which patients ECLS potentially benefits despite its consequences.ObjectiveTo answer 2 questions: First, which medically relevant patient factors influence decisions to initiate ECLS? Second, what are factors relevant to decisions to withdraw a running ECLS treatment?MethodsWe conducted a factorial survey among 420 physicians from 111 hospitals in Switzerland and Germany. The study included 2 scenarios: 1 explored willingness to initiate ECLS, and 1 explored willingness to withdraw a running ECLS treatment. Each participant responded to 5 different vignettes for each scenario. Vignettes were analyzed using mixed-effects regression models with random intercepts.ResultsFactors in the vignettes such as patients’ age, treatment costs, therapeutic goal, comorbidities, and neurological outcome significantly influenced the decision to initiate ECLS. When it came to the decision to withdraw ECLS, patients’ age, days on ECLS, criteria for discontinuation, condition of the patient, comorbidities, and neurological outcome were significant factors. In both scenarios, patients’ age and neurological outcome were the most influential factors.ConclusionsThis study provided insights into physicians’ decision making processes about ECLS initiation and withdrawal. Patients’ age and neurological status were the strongest factors influencing decisions regarding initiation of ECLS as well as for ECLS withdrawal. The findings may contribute to a more refined understanding of complex decision making for ECLS.
- Published
- 2022
- Full Text
- View/download PDF
7. Erratum to: Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss?
- Author
-
Irena Pjanic, Roland Müller, Markus Laimer, Niels Hagenbuch, Kurt Laederach, and Zeno Stanga
- Subjects
Psychiatry ,RC435-571 - Published
- 2017
- Full Text
- View/download PDF
8. Physical activity and screen time in children who survived cancer: A report from the Swiss Childhood Cancer Survivor Study
- Author
-
Maria Otth, Christina Schindera, Niels Hagenbuch, Tamara Diesch, Claudia E. Kuehni, Nicolas von der Weid, and Annette Weiss
- Subjects
Gerontology ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Childhood cancer ,Physical activity ,Age at diagnosis ,Childhood Cancer Survivor Study ,Motor Activity ,Body Mass Index ,Screen Time ,03 medical and health sciences ,Screen time ,0302 clinical medicine ,Cancer Survivors ,Interquartile range ,Neoplasms ,Surveys and Questionnaires ,Humans ,Medicine ,Child ,610 Medicine & health ,Exercise ,business.industry ,Infant ,Cancer ,Hematology ,medicine.disease ,Oncology ,020 Library & information sciences ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,Sedentary Behavior ,business ,human activities ,Clinical risk factor ,Switzerland ,360 Social problems & social services ,Neurological problems ,Follow-Up Studies ,Sports ,030215 immunology - Abstract
BackgroundPhysical activity (PA) can reduce the risk of chronic adverse health conditions in childhood cancer survivors. We examined physical activity and sedentary screen time behavior in a nationwide study in Switzerland.ProceduresThe Swiss Childhood Cancer Survivor Study sent questionnaires to parents of all Swiss resident ≥5 year-survivors diagnosed 1995–2010. We assessed physical activity including compulsory school sport, recreational sport, commuting to school, and time spent with screen media in those aged 5–15 years, and compared results to international recommendations.ResultsWe included 766 survivors with a median age at diagnosis of 2.8 (interquartile range 1.4–5.0) years and a median age at study of 12.5 (10.0–14.3) years. Median PA time was 7.3 (4.8–10.0) hours/week and median screen time 1.4 (0.8–2.0) hours/day. Compulsory school sport hours and walking or cycling to school contributed significantly to total PA. 55% of survivors met PA and 68% screen time recommendations. PA was lower for children living in regions of Switzerland speaking French or Italian compared to German, and for those who had a relapse or musculoskeletal/neurological conditions. Screen time was higher in males, and children with lower parental education and a migration background.ConclusionsPA and sedentary screen watching were associated with social factors and PA also with clinical risk factors. Structural preventions that afford active commuting to school and sufficient school sport are essential, as is counselling vulnerable survivor groups such as those with musculoskeletal and neurological problems, and those who have had a relapse.
- Published
- 2019
9. NRS-2002 components, nutritional score and severity of disease score, and their association with hospital length of stay and mortality
- Author
-
Reinhard Imoberdorf, Peter E. Ballmer, Niels Hagenbuch, Luca Sahli, and Maya Rühlin
- Subjects
medicine.medical_specialty ,business.industry ,Malnutrition ,Confounding ,Nutritional Status ,General Medicine ,Perioperative ,Length of Stay ,medicine.disease ,Logistic regression ,Severity of Illness Index ,Comorbidity ,Hospitals ,Confidence interval ,Community hospital ,Nutrition Assessment ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,business ,Body mass index - Abstract
BACKGROUND Malnutrition is a substantial issue in hospitals, leading to prolonged length of hospital stay, increased perioperative morbidity and increased mortality. There are several validated screening tools for malnutrition, one of which is the Nutritional Risk Screening 2002 (NRS). It screens patients based on recent weight loss, reduction of recent food intake, body mass index (BMI), severity of disease and age. Higher NRS scores have been shown to be negatively associated with patients’ outcomes such as increased morbidity and mortality. OBJECTIVES The aim of the study was to evaluate how the two NRS components Nutritional Score (NS) and Severity of Disease Score (SDS) are associated with patients’ length of hospital stay and mortality. METHODS All patients admitted to the medical department of a large community hospital in Switzerland were screened for malnutrition using the nutrition screening NRS during the years 2014 to 2017. Data on patients’ NRS, primary diagnosis, number of secondary diagnoses, mortality, length of stay (LOS), discharge, sex and age were collected. The association between the NRS components and LOS/mortality was estimated using a linear mixed-effects regression model and a logistic regression model, respectively, with adjustment for confounders (age, sex, comorbidity, diagnosis group, mode of discharge and year of hospitalisation). RESULTS The evaluation of the outcomes of 21,855 hospitalisations demonstrated that the NS was associated with an increment in the LOS of 5.5–12.3% per score point, depending on the diagnosis group. An increase in the SDS by one point was associated with an increase in the LOS of 2.2–11.3%. The odds for all-cause in-hospital mortality were increased by 44.1% (95% confidence interval [CI] 33.7–55.2%) per point in the NS, and by 73% (95% CI 57.5–90.1%) per point in the SDS. CONCLUSIONS Increases in both components of the NRS are associated with longer LOS. The NS has a slightly stronger impact on LOS compared to the SDS and its effect is dependent on the patient’s diagnosis group. Increases in the SDS are linked to a higher mortality than increases in the NS.
- Published
- 2021
10. Evaluation of a multiprofessional, nonsurgical obesity treatment program: which parameters indicated life style changes and weight loss?
- Author
-
Roland Müller, Kurt Laederach, Markus Laimer, Niels Hagenbuch, Zeno Stanga, and Irena Pjanic
- Subjects
medicine.medical_specialty ,Weight loss ,Multiprofessional intervention ,lcsh:RC435-571 ,media_common.quotation_subject ,Shame ,030209 endocrinology & metabolism ,610 Medicine & health ,Body awareness ,Behavioral therapy ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,360 Social problems & social services ,lcsh:Psychiatry ,medicine ,030212 general & internal medicine ,Obesity ,Psychiatry ,Depression (differential diagnoses) ,media_common ,Nutrition and Dietetics ,business.industry ,Weight change ,medicine.disease ,Disgust ,Life style behavioral change ,Psychiatry and Mental health ,Eating disorders ,medicine.symptom ,Erratum ,business ,Body mass index ,Research Article ,Clinical psychology - Abstract
BACKGROUND According to the current evidence, behavior modifications are an effective part of a non-surgical multiprofessional obesity treatment program (MOTP). The purpose of the present study was to report changes in weight as well in psychological variables during a one year MOTP. We aimed to identify the associations of emotional state and patients' emotion regulation skills with weight change. METHODS Prospective interventional study. Data of participants attending the one year obesity treatment in either a group or individual structured MOTP were analyzed. Weight, BMI (Body Mass Index) and measures on psychosomatic variables, emotion regulation skills, affective state, shame and guilt were collected at baseline, after three months and after one year. Mixed-effects models were used for the statistical analysis of BMI. RESULTS We included 238 patients at baseline (t1), 234 after three months (t2) and 179 after one year (t3). A drop in BMI measurements of at least 5% was observed in 20.6% of participants at t2 and 41.4% of participants at t3. After three months, participants showed significant improvements in the following psychosomatic variables: somatisation (p
- Published
- 2017
11. Breastfeeding in Women Having Experienced Childhood Sexual Abuse
- Author
-
Emina Block, Gisela Görres, Brigitte Leeners, Constanze Elfgen, Niels Hagenbuch, University of Zurich, and Leeners, Brigitte
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Breastfeeding ,610 Medicine & health ,Mastitis ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Germany ,Surveys and Questionnaires ,030225 pediatrics ,Prevalence ,medicine ,Humans ,030212 general & internal medicine ,Child ,Self report ,Psychiatry ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,2729 Obstetrics and Gynecology ,Child Abuse, Sexual ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,Middle Aged ,10175 Clinic for Reproductive Endocrinology ,medicine.disease ,Mother-Child Relations ,Breast Feeding ,Sexual abuse ,Female ,Self Report ,business ,Breast feeding - Abstract
Background: Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child. Research aim: As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA. Methods: Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children’s age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data. Results: Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding. Conclusion: In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother–child relationship.
- Published
- 2017
12. Transcatheter Atrial Septal Defect Closure in Children with and without Fluoroscopy: A Comparison
- Author
-
Oliver Kretschmar, Martin Christmann, Daniel Quandt, Oliver Niesse, Walter Knirsch, S. Ackermann, Niels Hagenbuch, University of Zurich, and Quandt, D
- Subjects
Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Article Subject ,Septal Occluder Device ,medicine.medical_treatment ,610 Medicine & health ,030204 cardiovascular system & hematology ,Single Center ,2705 Cardiology and Cardiovascular Medicine ,Heart Septal Defects, Atrial ,Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Fluoroscopy ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Child ,Cardiac catheterization ,Retrospective Studies ,Heart septal defect ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Atrial septal defect closure ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,medicine.disease ,Surgery ,Outcome and Process Assessment, Health Care ,Surgery, Computer-Assisted ,Radiology Nuclear Medicine and imaging ,lcsh:RC666-701 ,Child, Preschool ,Feasibility Studies ,Observational study ,Female ,business ,Cardiology and Cardiovascular Medicine ,Echocardiography, Transesophageal ,Switzerland ,Research Article - Abstract
Objective. The aim of this study was to compare feasibility, effectiveness, safety, and outcome of atrial septal defect (ASD) device closure in children with and without fluoroscopy guidance. Methods and Results. Children undergoing transcatheter ASD closure between 2002 and 2016 were included into this single center, retrospective study. Patients were analysed in two groups [1: intraprocedural fluoroscopy ± transoesophageal echocardiography (TOE) guidance; 2: TOE guidance alone]. Three-hundred-ninety-seven children were included, 238 (97 male) in group 1 and 159 (56 male) in group 2. Two-hundred-twenty-nine of 238 (96%) patients underwent successful fluoroscopy guided ASD closures versus 154/159 (97%) successful procedures with TOE guidance alone. Median weight (IQR) at intervention was 20kg (16.0-35.0) in group 1 versus 19.3kg (16.0-31.2) in group 2. Mean (SD) preinterventional ASD diameter was 12.4mm (4.4) in group 1 versus 12.2mm (3.9) in group 2. There was no significant difference in number of defects or characteristics of ASD rims. Median procedure time was shorter in group 2 [60min (47-86) versus 34min (28-44)]. Device-size-to-defect-ratio was similar in both groups [group 1: 1.07 versus group 2: 1.09]. There were less technical intraprocedural events in group 2 [10 (6.3%) versus 47 (20%)]. Intraprocedural complications were less frequent in group 2 [1 (0.6%) versus 8 (3.3%)]. Conclusion. Transcatheter ASD device closure with TOE guidance alone (i.e., without fluoroscopy) is as effective and safe as ASD closure with fluoroscopy guidance. As fluoroscopy remains an important adjunct to transoesophageal echocardiography, especially in complex defects and complications, procedures are always performed in a fully equipped cardiac catheterization laboratory.
- Published
- 2019
- Full Text
- View/download PDF
13. The Spinal Transcriptome after Cortical Stroke: In Search of Molecular Factors Regulating Spontaneous Recovery in the Spinal Cord
- Author
-
Vladimir B.C. de Souza, Mark D. Robinson, Martin E. Schwab, Martina A. Maibach, Julia Kaiser, Niels Hagenbuch, Iris Salpeter, University of Zurich, and Kaiser, Julia
- Subjects
0301 basic medicine ,Male ,Plasticity ,Recovery ,Regeneration ,Spinal cord ,Stroke ,Transcriptome ,Neurite ,Development/Plasticity/Repair ,Pyramidal Tracts ,Biology ,Grey matter ,03 medical and health sciences ,Mice ,0302 clinical medicine ,medicine ,Animals ,RNA, Messenger ,Gray Matter ,Research Articles ,Cerebral Cortex ,Inflammation ,Phagocytes ,Microglia ,General Neuroscience ,Motor Cortex ,Computational Biology ,2800 General Neuroscience ,Recovery of Function ,Macrophage Activation ,medicine.disease ,10124 Institute of Molecular Life Sciences ,Nerve Regeneration ,Mice, Inbred C57BL ,Anterograde tracing ,030104 developmental biology ,medicine.anatomical_structure ,Gene Expression Regulation ,Corticospinal tract ,570 Life sciences ,biology ,Female ,Neuroscience ,030217 neurology & neurosurgery ,Motor cortex - Abstract
In response to cortical stroke and unilateral corticospinal tract degeneration, compensatory sprouting of spared corticospinal fibers is associated with recovery of skilled movement in rodents. To date, little is known about the molecular mechanisms orchestrating this spontaneous rewiring. In this study, we provide insights into the molecular changes in the spinal cord tissue after large ischemic cortical injury in adult female mice, with a focus on factors that might influence the reinnervation process by contralesional corticospinal neurons. We mapped the area of cervical gray matter reinnervation by sprouting contralesional corticospinal axons after unilateral photothrombotic stroke of the motor cortex in mice using anterograde tracing. The mRNA profile of this reinnervation area was analyzed using whole-genome sequencing to identify differentially expressed genes at selected time points during the recovery process. Bioinformatic analysis revealed two phases of processes: early after stroke (4–7 d post-injury), the spinal transcriptome is characterized by inflammatory processes, including phagocytic processes as well as complement cascade activation. Microglia are specifically activated in the denervated corticospinal projection fields in this early phase. In a later phase (28–42 d post-injury), biological processes include tissue repair pathways with upregulated genes related to neurite outgrowth. Thus, the stroke-denervated spinal gray matter, in particular its intermediate laminae, represents a growth-promoting environment for sprouting corticospinal fibers originating from the contralesional motor cortex. This dataset provides a solid starting point for future studies addressing key elements of the post-stroke recovery process, with the goal to improve neuroregenerative treatment options for stroke patients., The Journal of Neuroscience, 39 (24), ISSN:0270-6474, ISSN:1529-2401
- Published
- 2019
- Full Text
- View/download PDF
14. Cerebral Microembolization During Aortic Valve Replacement Using Minimally Invasive or Conventional Extracorporeal Circulation: A Randomized Trial
- Author
-
Monika Pia Stucki, Reto Basciani, Thierry Carrel, Gabor Erdoes, Balthasar Eberle, David Reineke, Felix Kröninger, Niels Hagenbuch, Hansjörg Jenni, and Erich Gygax
- Subjects
medicine.medical_specialty ,Oxygenators ,Biomedical Engineering ,Medicine (miscellaneous) ,Bioengineering ,030204 cardiovascular system & hematology ,law.invention ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Aortic valve replacement ,law ,Internal medicine ,medicine ,Oxygenator ,business.industry ,Extracorporeal circulation ,General Medicine ,medicine.disease ,Transcranial Doppler ,030228 respiratory system ,Anesthesia ,Cardiology ,Arterial line ,business ,Perfusion - Abstract
To compare intraoperative cerebral microembolic load between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) during isolated surgical aortic valve replacement (SAVR), we conducted a randomized trial in patients undergoing primary elective SAVR at a tertiary referral hospital. The primary outcome was the procedural phase-related rate of high-intensity transient signals (HITS) on transcranial Doppler ultrasound. HITS rate was used as a surrogate of cerebral microembolism in pre-defined procedural phases in SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with integrated arterial filter. Forty-eight patients were randomized in a 1:1 ratio to MiECC or CECC. Due to intraprocedural Doppler signal loss (n = 3), 45 patients were included in final analysis. MiECC perfusion regimen showed a significantly increased HITS rate compared to CECC (by a factor of 1.75; 95% confidence interval, 1.19-2.56). This was due to different HITS rates in procedural phases from aortic cross-clamping until declamping [phase 4] (P = 0.01), and from aortic declamping until stop of extracorporeal perfusion [phase 5] (P = 0.05). Post hoc analysis revealed that MiECC-F generated a higher HITS rate than CECC+F (P = 0.005), CECC-F (P = 0.05) in phase 4, and CECC-F (P = 0.03) in phase 5, respectively. In open-heart surgery, MiECC is not superior to CECC with regard to gaseous cerebral microembolism. When using MiECC for SAVR, the use of oxygenators with integrated arterial line filter appears highly advisable. Only with this precaution, MiECC confers a cerebral microembolic load comparable to CECC during this type of open heart surgery.
- Published
- 2016
15. Safety and immunogenicity of tetanus/diphtheria vaccination in patients with rheumatic diseases-a prospective multi-centre cohort study
- Author
-
Bettina Bannert, Michael John Nissen, Silja Bühler, Claire-Anne Siegrist, Ulrich A. Walker, Carolin Brümmerhoff, Kerstin Kling, Christian Herzog, Adrian Ciurea, Veronika K. Jaeger, Niels Hagenbuch, Diego Kyburz, Rüdiger Müller, Oliver Distler, Cem Gabay, Peter M. Villiger, Christoph Hatz, Paul Hasler, Juliane Franz, Sabine Adler, University of Zurich, and Bühler, Silja
- Subjects
Male ,Diphtheria-Tetanus Vaccine ,2745 Rheumatology ,Booster dose ,0302 clinical medicine ,Immunogenicity, Vaccine ,2736 Pharmacology (medical) ,Pharmacology (medical) ,030212 general & internal medicine ,Prospective Studies ,ddc:616 ,Aged, 80 and over ,Tetanus ,Immunogenicity ,Vaccination ,10051 Rheumatology Clinic and Institute of Physical Medicine ,Diphtheria ,Middle Aged ,Antibodies, Bacterial ,3. Good health ,Tetanus vaccine ,Female ,Safety ,Vasculitis ,Immunosuppressive Agents ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Immunization, Secondary ,Tetanus vaccination ,610 Medicine & health ,Diphtheria vaccination ,complex mixtures ,03 medical and health sciences ,Young Adult ,Rheumatology ,Internal medicine ,Clostridium tetani ,Rheumatic Diseases ,medicine ,Humans ,Aged ,030203 arthritis & rheumatology ,business.industry ,Corynebacterium diphtheriae ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,medicine.disease ,Rheumatic disease ,business ,Immunosuppression - Abstract
Objectives We aimed to assess the safety and immunogenicity of a diphtheria/tetanus vaccine booster dose in three different patient groups with rheumatic diseases on a variety of immunosuppressive/immunomodulatory medications compared with healthy controls (HCs). Methods We conducted a multi-centre prospective cohort study in Switzerland. We enrolled patients with RA, axial SpA/PsA, vasculitis (Behçet’s disease, ANCA-associated vasculitis) and HCs. Diphtheria/tetanus vaccination was administered according to the Swiss vaccination recommendations. Blood samples were drawn before vaccination, and 1 month and 3 months afterwards. Antibody concentrations against vaccine antigens were measured by ELISA. Immunogenicity was compared between patient and medication groups. A mixed model was applied for multivariate analysis. Missing data were dealt with using multiple imputation. Results Between January 2014 and December 2015, we enrolled 284 patients with rheumatic diseases (131 RA, 114 SpA/PsA, 39 vasculitis) and 253 HCs. Of the patients, 89% were on immunosuppressive/immunomodulatory medication. Three months post-vaccination 100% of HCs vs 98% of patients were protected against tetanus and 84% vs 73% against diphtheria. HCs and SpA/PsA patients had significantly higher responses than RA and vasculitis patients. Assessing underlying diseases and medications in a multivariate model, rituximab was the only factor negatively influencing tetanus immunogenicity, whereas only MTX treatment had a negative influence on diphtheria antibody responses. No vaccine-related serious adverse events were recorded. Conclusion Diphtheria/tetanus booster vaccination was safe. Tetanus vaccination was immunogenic; the diphtheria component was less immunogenic. Vaccine responses were blunted by rituximab and MTX. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, Identifier: NCT01947465.
- Published
- 2018
16. Outer Retinal Dysfunction in the Absence of Structural Abnormalities in Multiple Sclerosis
- Author
-
Praveena Manogaran, Michael Hediger, Christina Gerth-Kahlert, James V M Hanson, Klara Landau, Sven Schippling, Niels Hagenbuch, University of Zurich, and Hanson, James V M
- Subjects
Male ,Retinal Ganglion Cells ,genetic structures ,2804 Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,0302 clinical medicine ,Prospective Studies ,medicine.diagnostic_test ,Middle Aged ,2731 Ophthalmology ,Ganglion ,Electrophysiology ,medicine.anatomical_structure ,Inner nuclear layer ,Female ,Erg ,Tomography, Optical Coherence ,10018 Ophthalmology Clinic ,Adult ,medicine.medical_specialty ,Multiple Sclerosis ,Optic Neuritis ,Adolescent ,610 Medicine & health ,Multiple sclerosis ,Optic neuritis ,Optical coherence tomography ,Retina ,2809 Sensory Systems ,03 medical and health sciences ,Young Adult ,Retinal Diseases ,Ophthalmology ,medicine ,Electroretinography ,Humans ,Aged ,business.industry ,Retinal ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,medicine.disease ,eye diseases ,Axons ,10040 Clinic for Neurology ,Cross-Sectional Studies ,chemistry ,030221 ophthalmology & optometry ,sense organs ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Purpose: Recent evidence suggests structural changes distal to the inner retina in multiple sclerosis (MS) patients. The functional correlates of these proposed structural abnormalities remain unclear. We investigated outer retinal function and structure in MS patients, and quantified to what extent outer retinal structure influenced function in these patients. Methods: Outer retinal function was assessed using the full-field and multifocal electroretinogram (ERG/MF-ERG), whereas retinal structure was assessed using spectral-domain optical coherence tomography (OCT). Results were compared with preexisting normative data. The relationships between electrophysiology parameters and the OCT values corresponding to the proposed cellular origins of the ERG and MF-ERG were analyzed. Results: Most electrophysiological responses were delayed in MS patients, independently of optic neuritis (ON). Inner retinal thickness and volumes were reduced, and inner nuclear layer volume marginally increased, in eyes with previous ON; all other OCT parameters were normal. OCT results correlated with ERG amplitudes, but not with ERG peak times or any MF-ERG parameters. Conclusions: We recorded outer retinal dysfunction without detectable abnormalities of the corresponding retinal layers in MS patients, not ascribable to retrograde degeneration following ON. The findings complement a growing body of literature reporting primary retinal abnormalities distal to the ganglion cell–inner plexiform layer complex in MS patients, with our data suggesting that this may be a more widespread phenomenon than previously thought. ERG may be of more utility in detecting retinal dysfunction in MS patients than MF-ERG. Analysis of peak times, rather than response amplitudes, is recommended., Investigative Ophthalmology & Visual Science, 59 (1), ISSN:0146-0404
- Published
- 2018
17. 3D printing of anatomical models for surgeons: an investigation on repeatability
- Author
-
Didier D. Malis, Niels Hagenbuch, Carina Wiederer, and Jean H.D. Fasel
- Subjects
Reproducibility ,3d printed ,Preoperative planning ,business.industry ,Additive manufacturing ,3D printing ,Imaging study ,Repeatability ,030230 surgery ,Quantitative accuracy ,Industrial and Manufacturing Engineering ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Modeling and Simulation ,Anatomical models ,business ,ddc:612 ,Production chain ,Mathematics ,Biomedical engineering - Abstract
As part of the trend towards personalised medicine, surgeons are increasingly using 3D printed replicas for preoperative planning. This raises the question of how reliable these models are. This paper examines the repeatability of manufacturing human mandibles. Five polyamide replicas were produced using selective laser sintering and digitised using structured light scanning. Quantitative comparisons were made using Mimics Software. The differences were analysed graphically, using histograms and kernel density estimates. The mean differences ranged between + 0.0274 (SD 0.0671) mm and − 0.0284 (SD 0.0629) mm. The median of absolute differences was 0.0308 mm, i.e. 50% of absolute differences were smaller than 31 $$\upmu \hbox {m}$$ . For the 22,811,168 differences measured, all were between + 1.9836 and − 2.0526 mm. The proportion of absolute differences below 0.10 mm was between 82.09 and 98.84%, and between 94.43 and 99.90% when using a threshold of 0.20 mm. 99.95% of the absolute differences were below 1.00 mm. In conclusion: 3D printed models may not be identical, even when based on the same imaging study and patient; on the other hand, identical replicas can be obtained with a constant production chain; we recommend that four distinguishing criteria should be used in future investigations: qualitative and quantitative accuracy, repeatability and reproducibility.
- Published
- 2018
18. Pericardial effusion unrelated to surgery is a predictor of mortality in heart transplant patients
- Author
-
Georg M. Fröhlich, Frank Ruschitzka, Simon F. Stämpfli, Stephan Bernhart, Felix C. Tanner, Alessandra Vecchiati, Andreas J. Flammer, Tardu Özkartal, Leonhard Held, Niels Hagenbuch, University of Zurich, and Tanner, Felix C
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Renal function ,Hemodynamics ,610 Medicine & health ,Pericardial effusion ,Pericardial Effusion ,2705 Cardiology and Cardiovascular Medicine ,Internal medicine ,medicine ,Humans ,Clinical significance ,Retrospective Studies ,Heart Failure ,Heart transplantation ,business.industry ,Retrospective cohort study ,General Medicine ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,Middle Aged ,medicine.disease ,Transplant Recipients ,Surgery ,Transplantation ,Echocardiography ,Heart failure ,Cardiology ,10209 Clinic for Cardiology ,Heart Transplantation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Switzerland ,Follow-Up Studies ,Forecasting - Abstract
Background: Hemodynamically irrelevant pericardial effusion (PeEf) is a predictor of adverse outcome in heart failure patients. The clinical relevance of a PeEf unrelated to surgery in heart transplant patients remains unknown. This study assesses the prognostic value of PeEf occurring later than 1 year after transplantation. Methods: All patients undergoing heart transplantation in Zurich between 1989 and 2012 were screened. Cox proportional hazard models were used to analyze mortality (primary) and hospitalization (secondary endpoint). PeEf time points were compared to baseline for rejection, immunosuppressants, tumors, inflammation, heart failure, kidney function, hemodynamic, and echocardiographic parameters. Results: Of 152 patients (mean age 48.3 ± 11.9), 25 developed PeEf. Median follow-up period was 11.9 (IQR 5.8–17) years. The number of deaths was 6 in the PeEf group and 46 in the non-PeEf group. The occurrence of PeEf was associated with a 2.5-fold increased risk of death (HR 2.49, 95% CI 1.02–6.13, p = 0.046) and hospitalization (HR 2.53, 95% CI 1.57–4.1, p = 0.0002). Conclusions: This study reveals that the finding of hemodynamically irrelevant PeEf in heart transplant patients is a predictor of adverse outcome, suggesting that a careful clinical assessment is warranted in heart transplant patients exhibiting small PeEf.
- Published
- 2018
- Full Text
- View/download PDF
19. High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis
- Author
-
Thomas M. Kessler, Niels Hagenbuch, Michael Linnebank, Benjamin V. Ineichen, Marc P. Schneider, Martin Hlavica, University of Zurich, and Kessler, Thomas M
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multiple Sclerosis ,Urinary system ,030232 urology & nephrology ,Urology ,610 Medicine & health ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Medicine ,Humans ,Urinary Bladder, Neurogenic ,Prospective cohort study ,Urinary Tract ,Upper urinary tract ,Aged ,Expanded Disability Status Scale ,10242 Brain Research Institute ,business.industry ,Multiple sclerosis ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,10040 Clinic for Neurology ,Urodynamics ,Treatment Outcome ,2728 Neurology (clinical) ,Neurology ,Overactive bladder ,2808 Neurology ,Female ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background: Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. Objective: We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. Methods: A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Results: Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06–1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%–87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. Conclusion: High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.
- Published
- 2018
20. Prognostic power of NT-proBNP in left ventricular non-compaction cardiomyopathy
- Author
-
Beat A. Kaufmann, Leonhard Held, Simon F. Stämpfli, Niels Hagenbuch, Rolf Jenni, Christiane Gruner, Matthias Greutmann, Markus Niemann, Felix C. Tanner, Barbara E. Stähli, and Ladina Erhart
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cardiomyopathy ,030204 cardiovascular system & hematology ,Left Ventricular Non-Compaction Cardiomyopathy ,Ventricular Function, Left ,Cohort Studies ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Adverse effect ,Retrospective Studies ,Heart transplantation ,Ejection fraction ,business.industry ,Proportional hazards model ,Stroke Volume ,Middle Aged ,medicine.disease ,Prognosis ,Peptide Fragments ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,Cardiomyopathies ,Biomarkers ,Follow-Up Studies - Abstract
Background The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. This study was designed to determine the prognostic value of NT-proBNP, left ventricular ejection fraction (LVEF), NYHA class, and exercise capacity in LVNC patients. Methods Cox regression analyses were performed for evaluating the prognostic value of NT-proBNP, LVEF, NYHA class, and exercise capacity on the occurrence of death or heart transplantation. 153 patients were included. Results During 1013 person-years (longest follow-up 18.5years) 23 patients (15%) died or underwent heart transplantation. We observed a significant relationship of NT-proBNP (adjusted HR 2.44, 95% CI 1.45–4.09, for every NT-proBNP doubling, p =0.0007) and LVEF (adjusted HR for age 60years: 2.68, 95% CI 1.62–4.41, p =0.0001) with the risk of death or heart transplantation. Combined covariate analysis indicated a strong influence of NT-proBNP (adjusted 2.89, 95% CI 1.33–6.26, p =0.007), whereas LVEF was no longer significant (adjusted HR 0.82, 95% CI 0.42–1.67, p =0.66) demonstrating a favorable prognostic power of NT-proBNP over LVEF. An increase in NYHA class was associated with a worse outcome, and exercise capacity revealed a trend in the same direction. For all the abovementioned analyses, similar results were obtained when assessing the values at first presentation. Conclusion This study provides evidence that an increase in NT-proBNP is a strong predictor of outcome in patients with LVNC. The prognostic power of NT-proBNP is at least as good as that of LVEF, indicating that routine NT-proBNP measurement may improve risk assessment in LVNC.
- Published
- 2016
21. Feasibility of reusing time-matched controls in an overlapping cohort
- Author
-
Jonas Bergh, Agus Salim, Linda S. Lindström, Niels Hagenbuch, Marie Reilly, Bénédicte Delcoigne, Maria E. C. Schelin, and Kamila Czene
- Subjects
Statistics and Probability ,Adult ,Data Analysis ,Epidemiology ,Breast Neoplasms ,Kaplan-Meier Estimate ,computer.software_genre ,01 natural sciences ,Cohort Studies ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,Humans ,030212 general & internal medicine ,0101 mathematics ,Sampling bias ,Aged ,Proportional Hazards Models ,Proportional hazards model ,Sampling (statistics) ,Middle Aged ,Missing data ,Weighting ,Case-Control Studies ,Cohort ,Nested case-control study ,Feasibility Studies ,Female ,Data mining ,computer ,Cohort study - Abstract
The methods developed for secondary analysis of nested case-control data have been illustrated only in simplified settings in a common cohort and have not found their way into biostatistical practice. This paper demonstrates the feasibility of reusing prior nested case-control data in a realistic setting where a new outcome is available in an overlapping cohort where no new controls were gathered and where all data have been anonymised. Using basic information about the background cohort and sampling criteria, the new cases and prior data are “aligned” to identify the common underlying study base. With this study base, a Kaplan–Meier table of the prior outcome extracts the risk sets required to calculate the weights to assign to the controls to remove the sampling bias. A weighted Cox regression, implemented in standard statistical software, provides unbiased hazard ratios. Using the method to compare cases of contralateral breast cancer to available controls from a prior study of metastases, we identified a multifocal tumor as a risk factor that has not been reported previously. We examine the sensitivity of the method to an imperfect weighting scheme and discuss its merits and pitfalls to provide guidance for its use in medical research studies.
- Published
- 2016
22. Cerebral Microembolization During Aortic Valve Replacement Using Minimally Invasive or Conventional Extracorporeal Circulation: A Randomized Trial
- Author
-
Reto, Basciani, Felix, Kröninger, Erich, Gygax, Hansjörg, Jenni, David, Reineke, Monika, Stucki, Niels, Hagenbuch, Thierry, Carrel, Balthasar, Eberle, and Gabor, Erdoes
- Subjects
Heart Valve Prosthesis Implantation ,Male ,Perfusion ,Extracorporeal Circulation ,Intracranial Embolism ,Ultrasonography, Doppler, Transcranial ,Aortic Valve ,Heart Valve Prosthesis ,Humans ,Female ,Aortic Valve Stenosis ,Middle Aged ,Aged - Abstract
To compare intraoperative cerebral microembolic load between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) during isolated surgical aortic valve replacement (SAVR), we conducted a randomized trial in patients undergoing primary elective SAVR at a tertiary referral hospital. The primary outcome was the procedural phase-related rate of high-intensity transient signals (HITS) on transcranial Doppler ultrasound. HITS rate was used as a surrogate of cerebral microembolism in pre-defined procedural phases in SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with integrated arterial filter. Forty-eight patients were randomized in a 1:1 ratio to MiECC or CECC. Due to intraprocedural Doppler signal loss (n = 3), 45 patients were included in final analysis. MiECC perfusion regimen showed a significantly increased HITS rate compared to CECC (by a factor of 1.75; 95% confidence interval, 1.19-2.56). This was due to different HITS rates in procedural phases from aortic cross-clamping until declamping [phase 4] (P = 0.01), and from aortic declamping until stop of extracorporeal perfusion [phase 5] (P = 0.05). Post hoc analysis revealed that MiECC-F generated a higher HITS rate than CECC+F (P = 0.005), CECC-F (P = 0.05) in phase 4, and CECC-F (P = 0.03) in phase 5, respectively. In open-heart surgery, MiECC is not superior to CECC with regard to gaseous cerebral microembolism. When using MiECC for SAVR, the use of oxygenators with integrated arterial line filter appears highly advisable. Only with this precaution, MiECC confers a cerebral microembolic load comparable to CECC during this type of open heart surgery.
- Published
- 2016
23. Posttraumatic growth in cancer patients and partners-effects of role, gender and the dyad on couples' posttraumatic growth experience
- Author
-
Margaret I. Carley, Josef Jenewein, Niels Hagenbuch, Diana Zwahlen, and Stefan Büchi
- Subjects
medicine.medical_specialty ,Gender identity ,Psychometrics ,Posttraumatic growth ,business.industry ,Cancer ,Experimental and Cognitive Psychology ,medicine.disease ,Psychiatry and Mental health ,Oncology ,Neoplasms diagnosis ,mental disorders ,Stress disorders ,medicine ,Young adult ,Psychiatry ,business ,psychological phenomena and processes ,Dyad ,Clinical psychology - Abstract
Little is known about factors influencing positive effects in couples facing a cancer diagnosis.
- Published
- 2009
24. High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis
- Author
-
Michael Linnebank, Thomas M. Kessler, Marc P. Schneider, Niels Hagenbuch, and Benjamin V. Ineichen
- Subjects
0301 basic medicine ,medicine.medical_specialty ,business.industry ,Urology ,Multiple sclerosis ,medicine.disease ,Gastroenterology ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Internal medicine ,medicine ,In patient ,business ,030217 neurology & neurosurgery ,Upper urinary tract - Published
- 2017
25. Effect of phenobarbital on the expression of bile salt and organic anion transporters of rat liver
- Author
-
Lukas Landmann, Valentino Cattori, Karin Fattinger, Bruno Stieger, Gerd A. Kullak-Ublick, Peter J. Meier, Niels Hagenbuch, Christoph Reichel, University of Zurich, and Kullak-Ublick, G A
- Subjects
Male ,Digoxin ,Organic anion transporter 1 ,Gene Expression ,Organic Anion Transporters, Sodium-Independent ,Sulfobromophthalein ,Rats, Sprague-Dawley ,0302 clinical medicine ,ABCB11 ,ATP Binding Cassette Transporter, Subfamily B, Member 11 ,0303 health sciences ,Symporters ,biology ,Multidrug resistance-associated protein 2 ,Multidrug Resistance-Associated Protein 2 ,Organic anion-transporting polypeptide ,medicine.anatomical_structure ,Liver ,Phenobarbital ,030220 oncology & carcinogenesis ,Hepatocyte ,Multidrug Resistance-Associated Proteins ,medicine.medical_specialty ,Biological Transport, Active ,Organic Anion Transporters, Sodium-Dependent ,610 Medicine & health ,In Vitro Techniques ,Bile Acids and Salts ,Solute Carrier Organic Anion Transporter Family Member 1B3 ,03 medical and health sciences ,Organic Anion Transport Protein 1 ,Cholestasis ,Internal medicine ,medicine ,Animals ,RNA, Messenger ,030304 developmental biology ,SLC10A1 ,Hepatology ,Membrane Transport Proteins ,medicine.disease ,Bile Salt Export Pump ,Rats ,Kinetics ,Endocrinology ,10199 Clinic for Clinical Pharmacology and Toxicology ,Hepatocytes ,biology.protein ,ATP-Binding Cassette Transporters ,2721 Hepatology ,Carrier Proteins - Abstract
Background/Aims : The hepatic clearance of drugs and cholephilic organic anions is stimulated by phenobarbital (PB). Our aim was to analyze the effects of PB on the expression of hepatocellular bile salt and organic anion transporters. Methods : Male Sprague–Dawley rats were treated intraperitoneally with PB (80 mg/kg/d) or saline for 5 days. Transporter expression was quantified by northern and western blot analysis and initial uptake rates of bromosulphophthalein (BSP) and digoxin were measured in isolated hepatocytes. Results : Compared to control rats, PB treatment increased expression of the organic anion transporting polypeptide 2 (Oatp2; Slc21a5 ) more than 2-fold on the RNA (P Slc21a1 ), Oatp4 ( Slc21a6 ) and the Na + -taurocholate cotransporting polypeptide (Ntcp; Slc10a1 ) was unaltered. At the canalicular pole, expression of the bile salt export pump (Bsep; ABCB11 ) and of the multidrug resistance proteins 2 (Mrp2; ABCC2 ) and 6 (Mrp6; ABCC6 ) was not significantly changed. Whereas hepatocellular BSP uptake was unaffected by PB, digoxin uptake was stimulated 4-fold. Conclusions : The induction of digoxin uptake by PB correlates with Oatp2 expression. In contrast, the lack of increase of Oatp1 and Oatp4 expression is in accordance with unchanged BSP uptake. These data challenge the previously held view that PB induces hepatocellular BSP uptake systems.
- Published
- 2001
26. Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer
- Author
-
Niels Hagenbuch, Diana Zwahlen, Margaret I. Carley, Stefan Büchi, Josef Jenewein, University of Zurich, and Zwahlen, D
- Subjects
Adult ,Male ,Psychometrics ,Cross-sectional study ,education ,information science ,610 Medicine & health ,Experimental and Cognitive Psychology ,Social support ,2738 Psychiatry and Mental Health ,Young Adult ,Sex Factors ,Neoplasms ,Surveys and Questionnaires ,Adaptation, Psychological ,medicine ,Distress Thermometer ,Humans ,Young adult ,Spouses ,Aged ,Aged, 80 and over ,Family Characteristics ,3205 Experimental and Cognitive Psychology ,Mental Disorders ,Cancer ,Reproducibility of Results ,Social Support ,Middle Aged ,medicine.disease ,Distress ,Psychiatry and Mental health ,10057 Klinik für Konsiliarpsychiatrie und Psychosomatik ,Cross-Sectional Studies ,Oncology ,Socioeconomic Factors ,2730 Oncology ,Female ,Psychology ,human activities ,Psychosocial ,Stress, Psychological ,Dyad ,Clinical psychology - Abstract
Objective: Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. Method: Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. Results: Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). Conclusion: A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley ; Sons, Ltd.
- Published
- 2011
- Full Text
- View/download PDF
27. Posttraumatic growth in cancer patients and partners--effects of role, gender and the dyad on couples' posttraumatic growth experience
- Author
-
Diana, Zwahlen, Niels, Hagenbuch, Margaret I, Carley, Josef, Jenewein, and Stefan, Buchi
- Subjects
Adult ,Aged, 80 and over ,Male ,Personality Inventory ,Psychometrics ,Gender Identity ,Middle Aged ,Health Surveys ,Stress Disorders, Post-Traumatic ,Young Adult ,Neoplasms ,Adaptation, Psychological ,Humans ,Female ,Spouses ,Aged - Abstract
Little is known about factors influencing positive effects in couples facing a cancer diagnosis.A heterogeneous sample of 224 couples from a multi-site study (four oncology units) completed questionnaire surveys including the Posttraumatic Growth Inventory (PTGI) as a measure of positive psychological effects.The data demonstrated that all three investigated factors--gender, role (patient vs partner) and the dyad (belonging to any of the 224 couples)--significantly contributed to variation in PTGI total scores and subscales. Variability between couples (factor dyad) appeared stronger than variability between patient and partner participants (factor role) and between male and female participants (factor gender). Role and gender analysis showed that patients demonstrated higher levels of posttraumatic growth than partners; and female participants scored higher on PTGI than males. Male patient-female partner pairs show greater association in their experience of posttraumatic growth than female patient-male partner pairs. Correlations also suggested that, regardless of the gender and role composition, patients and partners may experience parallel growth.Our findings indicate that positive psychological experiences may be shared by partners affected by cancer in similar ways as have been shown for negative psychological effects. Intra-couple similarities or processes may have a more important function in experiencing benefits than factors like gender or being the patient or the partner. These results underline the importance of a family approach to understanding negative and positive psychological effects of cancer.
- Published
- 2009
28. Identification of organic anion transporting polypeptide 4 (Oatp4) as a major full-length isoform of the liver-specific transporter-1 (rlst-1) in rat liver
- Author
-
Niels Hagenbuch, Kaspar E. Winterhalter, Valentino Cattori, Bruno Stieger, Peter J. Meier, Riem Ha, Bruno Hagenbuch, University of Zurich, and Meier, P J
- Subjects
Steroid conjugate ,1303 Biochemistry ,Organic anion transporter 1 ,medicine.medical_treatment ,030226 pharmacology & pharmacy ,Biochemistry ,Sulfobromophthalein ,Substrate Specificity ,1307 Cell Biology ,Xenopus laevis ,0302 clinical medicine ,1315 Structural Biology ,Structural Biology ,Protein Isoforms ,Cloning, Molecular ,Peptide sequence ,chemistry.chemical_classification ,0303 health sciences ,biology ,Leukotriene C4 ,Amino acid ,Organic anion-transporting polypeptide ,Liver ,Organic anion ,Gene isoform ,Anions ,Anion Transport Proteins ,Molecular Sequence Data ,Biophysics ,Liver transport ,610 Medicine & health ,Bile salt ,Steroid ,03 medical and health sciences ,1311 Genetics ,Genetics ,medicine ,1312 Molecular Biology ,Animals ,Amino Acid Sequence ,RNA, Messenger ,Molecular Biology ,030304 developmental biology ,Sequence Homology, Amino Acid ,Transporter ,Biological Transport ,Cell Biology ,Rats ,Thyroid hormone ,Alternative Splicing ,Kinetics ,chemistry ,10199 Clinic for Clinical Pharmacology and Toxicology ,biology.protein ,Oocytes ,Carrier Proteins ,1304 Biophysics - Abstract
A novel organic anion transporting polypeptide (Oatp)41 was isolated from rat liver that is 35 amino acids longer than the reported rat liver specific organic anion transporter (rlst)-1 and exhibits a 64% amino acid sequence identity with the human OATP-C (LST-1/OATP2; gene symbol SLC21A6). When expressed in Xenopus laevis oocytes, Oatp4 (Slc21a10) mediated polyspecific uptake of a variety of organic anions including taurocholate (Km∼27 μM), bromosulfophthalein (Km∼1.1 μM) and steroid conjugates. Based on nuclease protection analysis Oatp4 appears to be the predominant transcript in rat liver indicating that rlst-1 plays a minor role in overall hepatic organic anion uptake.1Sequence deposition: The EMBL/GenBank accession number of the Oatp4 sequence is AJ271682.
- Published
- 2000
29. Identification and characterization of rat Oatp4, a multispecificorganic anion transporting polypeptide that is closely related torlst-1
- Author
-
Valentino Cattori, K.E. Winterhalter, Peter J. Meier, Niels Hagenbuch, Bruno Hagenbuch, and Bruno Stieger
- Subjects
Hepatology ,Biochemistry ,Chemistry ,Identification (biology) ,Characterization (materials science) - Published
- 2000
30. Use of the elevated plus-maze test with opaque or transparent walls in the detection of mouse strain differences and the anxiolytic effects of diazepam.
- Author
-
Niels Hagenbuch
- Published
- 2006
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.