Humane Papillomvirus-Infektion in Kopf- und Halskarzinomen: die Rolle der Antileukoproteinase „Secretory Leukocyte Protease Inhibitor“ (SLPI)

Es ist in der vorliegenden Promotionsarbeit untersucht worden, ob ein Zusammenhang zwischen dem HPV-Infektionsstatus und der SLPI-Expression in Kopf- und Halskarzinomen besteht; eine mögliche Verbindung zur Metastasierung in die Halslymphknoten wurde analysiert. Es wurde zusätzlich Mukosa von Patienten mit nicht malignen Erkrankungen aus dem Kopf-Hals-Bereich auf den SLPI-Expressionsgrad untersucht und diese Ergebnisse mit dem Tabakkonsum der Patienten korreliert

Clinical Characteristics of Inpatients with Childhood vs. Adolescent Anorexia Nervosa

We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children

Seasonal variation of BMI at admission in German adolescents with anorexia nervosa

Objective Recent preliminary studies indicated a seasonal association of BMI at admission to inpatient treatment for anorexia nervosa (AN), indicating lower BMI in the cold season for restrictive AN. An impaired thermoregulation was proposed as the causal factor, based on findings in animal models of AN. However, findings regarding seasonality of BMI and physical activity levels in the general population indicate lower BMI and higher physical activity in summer than in winter. Therefore, we aimed to thoroughly replicate the findings regarding seasonality of BMI at admission in patients with AN in this study. Method AN subtype, age- and gender-standardized BMI scores (BMI-SDS) at admission, mean daily sunshine duration and ambient temperature at the residency of 304 adolescent inpatients with AN of the multi-center German AN registry were analyzed. Results A main effect of DSM-5 AN subtype was found (F(2,298) = 6.630, p = .002), indicating differences in BMI-SDS at admission between restrictive, binge/purge and subclinical AN. No main effect of season on BMI-SDS at admission was found (F(1,298) = 4.723, p = .025), but an interaction effect of DSM-5 subtype and season was obtained (F(2,298) = 6.625, p = .001). Post-hoc group analyses revealed a lower BMI-SDS in the warm season for restrictive AN with a non-significant small effect size (t(203.16) = 2.140, p = .033; Hedges′g = 0.28). Small correlations of mean ambient temperature (r = −.16) and daily sunshine duration (r = −.22) with BMI-SDS in restrictive AN were found. However, the data were widely scattered. Conclusions Our findings are contrary to previous studies and question the thermoregulatory hypothesis, indicating that seasonality in AN is more complex and might be subject to other biological or psychological factors, for example physical activity or body dissatisfaction. Our results indicate only a small clinical relevance of seasonal associations of BMI-SDS merely at admission. Longitudinal studies investigating within-subject seasonal changes might be more promising to assess seasonality in AN and of higher clinical relevance

Premorbid body weight predicts weight loss in both anorexia nervosa and atypical anorexia nervosa: Further support for a single underlying disorder.

OBJECTIVE For adolescents, DSM-5 differentiates anorexia nervosa (AN) and atypical AN with the 5th BMI-centile-for-age. We hypothesized that the diagnostic weight cut-off yields (i) lower weight loss in atypical AN and (ii) discrepant premorbid BMI distributions between the two disorders. Prior studies demonstrate that premorbid BMI predicts admission BMI and weight loss in patients with AN. We explore these relationships in atypical AN. METHOD Based on admission BMI-centile < or ≥5th, participants included 411 female adolescent inpatients with AN and 49 with atypical AN from our registry study. Regression analysis and t-tests statistically addressed our hypotheses and exploratory correlation analyses compared interrelationships between weight loss, admission BMI, and premorbid BMI in both disorders. RESULTS Weight loss in atypical AN was 5.6 kg lower than in AN upon adjustment for admission age, admission height, premorbid weight and duration of illness. Premorbid BMI-standard deviation scores differed by almost one between both disorders. Premorbid BMI and weight loss were strongly correlated in both AN and atypical AN. DISCUSSION Whereas the weight cut-off induces discrepancies in premorbid weight and adjusted weight loss, AN and atypical AN overall share strong weight-specific interrelationships that merit etiological consideration. Epidemiological and genetic associations between AN and low body weight may reflect a skewed premorbid BMI distribution. In combination with prior findings for similar psychological and medical characteristics in AN and atypical AN, our findings support a homogenous illness conceptualization. We propose that diagnostic subcategorization based on premorbid BMI, rather than admission BMI, may improve clinical validity. PUBLIC SIGNIFICANCE Because body weights of patients with AN must drop below the 5th BMI-centile per DSM-5, they will inherently require greater weight loss than their counterparts with atypical AN of the same sex, age, height and premorbid weight. Indeed, patients with atypical AN had a 5.6 kg lower weight loss after controlling for these variables. In comparison to the reference population, we found a lower and higher mean premorbid weight in patients with AN and atypical AN, respectively. Considering previous psychological and medical comparisons showing little differences between AN and atypical AN, we view a single disorder as the most parsimonious explanation. Etiological models need to particularly account for the strong relationship between weight loss and premorbid body weight

Short-term policy considerations to respond to Russia-Ukraine crisis disruptions in fertilizer availability and affordability

As discussed in an earlier post, fertilizer prices have increased drastically, up 230% between May 2020 and May 2022. Now — driven upward by supply disruptions stemming from the Russia-Ukraine conflict — they are nearing the peak reached in August 2008 during the last major food price crisis. Spiking fertilizer prices are likely to have major impacts on agriculture and food production — and thus, food security — around the world, as farmers struggle to pay for a key input and face potential supply disruptions, and governments look for ways to cushion the economic blow.Non-PRIFPRI4; Food Security PortalCP

High fertilizer prices contribute to rising global food security concerns

Like people, plants need a multitude of nutrients to thrive. These are categorized into micronutrients, such as zinc and iron; secondary macronutrients, such as calcium and magnesium; and three primary macronutrients: nitrogen (N), phosphorus (P), and potassium (K). Mineral fertilizers provide higher and more plant-accessible nutrients, while organic minerals importantly also provide carbon, which contributes to healthy soils. While efforts to reduce nutrient losses to the environment must be continued and stepped up, it bears emphasizing that fertilizers play a crucial role in agricultural productivity. World market prices for both food and fertilizer (here we focus only on N, P, and K) increased significantly over the past year and a half and have climbed to even higher levels following Russia’s invasion of Ukraine in February, hitting their highest levels yet in March (see Figure 1, +125% from January 2021 to January 2022, +17% from January 2022 to March 2022). While there is an immediate concern about the impact of high food prices on food security, especially in low and middle-income countries, fertilizer price spikes and concerns about availability cast a shadow on future harvests, and thus risk keeping food prices high for a longer period. In this blog post — which draws on data from the new IFPRI fertilizer dashboard; IFASTAT, compiled by the International Fertilizer Association (IFA); and FAOSTAT — we discuss the underlying drivers of current high pric es, explain why the global fertilizer market is particularly susceptible to shocks, and examine which countries are most vulnerable to fertilizer market disruptions. A subsequent post will explore short- and medium-term solutions to address the serious affordability and availability concerns.Non-PRIFPRI4; Food Security PortalCPA; Markets, Trade, and Institutions (MTI); Food and Nutrition Polic

The Russia-Ukraine war after a year: Impacts on fertilizer production, prices, and trade flows

Russia’s 2022 invasion of Ukraine triggered global disruptions in markets for key food crops and fertilizers, threatening food security worldwide. With the war now entering its second year, high international food prices have moderated, though domestic price levels remain high in many low- and middle-income countries. Here, we turn to global fertilizer markets, examining how they weathered the past year, and the likely impacts going forward for agricultural production and food security.Non-PRIFPRI4; Food Security PortalMarkets, Trade, and Institutions (MTI); Food and Nutrition Policy; CP

First Sociodemographic, Pretreatment and Clinical Data from a German Web-Based Registry for Child and Adolescent Anorexia Nervosa

Objective: The first web-based registry for childhood and adolescent anorexia nervosa (AN) in Germany was established to systematically collect demographic and clinical data. These data as well as information on how young individuals with AN can find access to healthcare services are presented. Method: Patients ́ data from child and adolescent psychiatry departments of 12 university hospitals and two major nonuniversity hospitals in Germany were collected between January 2015 and December 2016. All patients met the ICD-10 diagnostic criteria for (atypical) AN. Sociodemographic data, type and amount of healthcare utilization before admission, and clinical data at admission and discharge were compiled. Results: 258 patients with a mean age of 14.7 years and a mean BMI at admission of 15.3 kg/m2 were included. The parents and patients had a higher educational level than the general German population. More than 80 % of the patients reported having uti- lized healthcare before hospitalization. The mean duration of outpatient treatment before hospitalization was 7 months. Conclusions: There seem to be major barriers to specialist treatment for young patients with AN in Germany, which should be analyzed in future studies