Weiterentwicklung eines Test-Systems zur physiologischen Charakterisierung von fakultativ anaeroben (fermentativen) Aktinomyzeten

Die hier vorgelegte Arbeit beschäftigte sich mit der Weiterentwicklung eines für die Aktinomyzetendiagnostik einsetzbaren Testverfahrens. In Eigenarbeit wurde ein System entwickelt, welches auf miniaturisierter Verfahrensweise, ähnlich dem Minitek®-System, eine Aktinomyzetendiagnostik bis auf Speziesebene erlaubt. Das Testsystem verfügt über 46 Nachweisreaktionen, welche als flüssige Reagenzien für den Test zur Verfügung stehen. Zu diesen Reaktionen zählen im Einzelnen die Säureproduktion aus 39 Kohlenhydraten, Nitrat- und Nitritreduktion, Harnstoff- Arginin- und Äskulinverstoffwechslung, Indol- und Katalasenachweis. 87 verschiedene Teststämme aus der Stammsammlung des Instituts für Medizinische Mikrobiologie und Immunologie der Universität Bonn kamen bei der Testprüfung zum Einsatz. Sie bildeten in ihrer Gesamtheit eine speziesübergreifende, repräsentative Auswahl der verschiedensten Aktinomyzeten. Durch Clusteranayse wurden die Ergebnisse ausgewertet und die gewonnenen Daten in Form von Dendrogrammen bildlich dargestellt. Die Unterschiede zwischen den Dendrogrammen mit - beziehungsweise ohne - Berücksichtigung morphologischer Merkmale belegten die Wichtigkeit dieser einfach zu gewinnenden Daten. Auch unter Koeffizientenwechsel konnte gezeigt werden, dass es möglich ist, bis auf Speziesebene zu differenzieren. Die Reliabilität, durch Wiederholung zufällig ausgesuchter Teststämme errechnet, wies einen Testfehler von 3,0% auf. Die Validität der Ergebnisse wurde durch Vergleich mit bestehenden Referenzwerten bestimmt und eine falsch-positiv Quote von 2,54% bestimmt

Perceived outcomes of spiritual healing: results from a prospective case series

BACKGROUND: The aims of this pilot study were to observe perceived outcomes of spiritual healing in Germany. PATIENTS AND METHODS: In this prospective case study, we performed qualitative interviews with clients and healers about perceived outcomes of spiritual healing treatments. A directed qualitative content analysis was used. In addition, we applied questionnaires (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, intensity of complaints on visual analogue scale) at baseline and after week 1, month 2 and month 6 which were analysed descriptively. RESULTS: Seven healers and 7 clients participated, 42 interviews were analysed. In the interviews, the clients described positive body sensations, greater relaxation and well-being as short-term effects of healing treatments. Perceived longer-term effects were related to making significant life changes, creating new meanings, activating resources and improving social relationships. Patients in pain described a reduction of pain intensity. In the questionnaires, the clients reported improvements in quality of life and self-efficacy, to a smaller extent improvements of intensity of complaints and sense of coherence. CONCLUSION: The results from this pilot study could be useful to choose outcomes of future prospective studies with a larger sample: qualitative assessments combined with global and broad quantitative outcomes such as quality of life, self-efficacy and intensity of complaints could be applied

Wahrgenommene Effekte spirituellen Heilens: Ergebnisse einer prospektiven Fallserie

Background: The aims of this pilot study were to observe perceived outcomes of spiritual healing in Germany. Patients and Methods: In this prospective case study, we performed qualitative interviews with clients and healers about perceived outcomes of spiritual healing treatments. A directed qualitative content analysis was used. In addition, we applied questionnaires (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, intensity of complaints on visual analogue scale) at baseline and after week 1, month 2 and month 6 which were analysed descriptively. Results: Seven healers and 7 clients participated, 42 interviews were analysed. In the interviews, the clients described positive body sensations, greater relaxation and well-being as short-term effects of healing treatments. Perceived longer-term effects were related to making significant life changes, creating new meanings, activating resources and improving social relationships. Patients in pain described a reduction of pain intensity. In the questionnaires, the clients reported improvements in quality of life and self-efficacy, to a smaller extent improvements of intensity of complaints and sense of coherence. Conclusion: The results from this pilot study could be useful to choose outcomes of future prospective studies with a larger sample: qualitative assessments combined with global and broad quantitative outcomes such as quality of life, self-efficacy and intensity of complaints could be applied.Hintergrund: Ziel dieser Pilotstudie war es, subjektiv wahrgenommene Effekte des spirituellen Heilens quali­tativ und quantitativ zu erfassen. Patienten und Metho­den: In dieser prospektiven Pilotstudie wurden über 6 Monate qualitative Interviews mit Klienten und Heilern über wahrgenommene Effekte spiritueller Heilbehandlungen geführt und auf Basis einer qualitativen Inhaltsanalyse ausgewertet. Ergebnisse wurden zusätzlich mit Fragebögen (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, Beschwerdeintensität auf visueller Analogskala) zu Studienbeginn und nach der Woche 1, Monat 2 und Monat 6 erfasst. Ergebnisse: Sieben Heiler und 7 Klienten nahmen an dieser Studie teil, 42 ­Interviews wurden analysiert. Klienten beschrieben als kurzfristige Effekte der Heilbehandlungen positive Körperempfindungen, mehr Entspannung und Wohlbefinden. Die längerfristig wahrgenommenen Effekte standen im Zusammenhang mit signifikanten Veränderungen des Lebens, neuen Deutungen, Ressourcenaktivierung und der Verbesserung sozialer Beziehungen durch die Klien­ten. Klienten mit Schmerzen beschrieben eine Verringe­rung der Schmerzintensität. In den Fragebögen zeigten sich Verbesserungen der Lebensqualität und der Selbstwirksamkeit, zu einem geringeren Ausmaß Verbesserungen der Beschwerdeintensität und des Kohärenzgefühls. Schlussfolgerung: Die Ergebnisse dieser Pilotstudie könnten nützlich sein, um Endpunkte für künftige pros­pektive Studien mit einem größeren Stichprobenumfang zu wählen: qualitative Analysen in Kombination mit Fragebögen, die globale und umfassende Aspekte wie Lebensqualität, Selbstwirksamkeit und Intensität der ­Beschwerden erfassen, sind unserer Ansicht nach am besten geeignet

The Therapeutic Process in Spiritual Healing: Qualitative Results of a Prospective Case Series

Introduction: The aim of this study was to explore the therapeutic process between contemporary spiritual healers and their clients in Germany. Methods: This prospective observational case study was supported by questionnaires and semi-structured interviews with clients and healers from the first encounter through a period of 6 months. The qualitative analysis is based on a directed content analysis with focus in this article on the results relating to the therapeutic process. Results: Seven healers and seven clients were included, and 22 interviews with healers and 20 interviews with clients were conducted. The first treatment session was perceived as laying a foundation for the therapeutic process and the relationship, which was seen as crucial for healing to take place. Healers perceived the therapeutic process as highly individualized and multi-layered, with the perceived effects of spiritual healing sessions layered upon each other. The capacities to connect and to trust were seen as key elements of the healing process. Trust and connection operate multidimensionally: to oneself, to others, and to a transcendent or spiritual source. Clients’ spiritual attitudes were regarded as fundamental resources. Conclusion: The therapeutic process between spiritual healers and their clients was understood as a dynamic and individual activity, building up on a trustful relationship from the first encounter

Experiences and Perceived Effects of Rosary Praying: A Qualitative Study

The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion

Heart failure after pressure overload in autosomal-dominant desminopathies: Lessons from heterozygous DES-p.R349P knock-in mice

Background Mutations in the human desmin gene (DES) cause autosomal-dominant and -recessive cardiomyopathies, leading to heart failure, arrhythmias, and AV blocks. We analyzed the effects of vascular pressure overload in a patient-mimicking p.R349P desmin knock-in mouse model that harbors the orthologue of the frequent human DES missense mutation p. R350P. Methods and results Transverse aortic constriction (TAC) was performed on heterozygous (HET) DES-p.R349P mice and wild-type (WT) littermates. Echocardiography demonstrated reduced left ventricular ejection fraction in HET-TAC (WT-sham: 69.5 ± 2.9%, HET-sham: 64.5 ± 4.7%, WTTAC: 63.5 ± 4.9%, HET-TAC: 55.7 ± 5.4%; p<0.01). Cardiac output was significantly reduced in HET-TAC (WT sham: 13088 ± 2385 μl/min, HET sham: 10391 ± 1349μl/min, WT-TAC: 8097 ± 1903μl/min, HET-TAC: 5793 ± 2517μl/min; p<0.01). Incidence and duration of AV blocks as well as the probability to induce ventricular tachycardias was highest in HET-TAC. We observed reduced mtDNA copy numbers in HET-TAC (WT-sham: 12546 ± 406, HET-sham: 13526 ± 781, WT-TAC: 11155 ± 3315, HET-TAC: 8649 ± 1582; p = 0.025), but no mtDNA deletions. The activity of respiratory chain complexes I and IV showed the greatest reductions in HET-TAC. Conclusion Pressure overload in HET mice aggravated the clinical phenotype of cardiomyopathy and resulted in mitochondrial dysfunction. Preventive avoidance of pressure overload/arterial hypertension in desminopathy patients might represent a crucial therapeutic measure

Experimental research Deficiency of cyclase-associated protein 2 promotes arrhythmias associated with connexin43 maldistribution and fibrosis

A b s t r a c t Introduction: Cyclase-associated protein 2 (CAP2) plays a major role in regulating the actin cytoskeleton. Since inactivation of CAP2 in a mouse model by a gene trap approach (Cap2 gt/gt ) results in cardiomyopathy and increased mortality, we hypothesized that CAP2 has a major impact on arrhythmias and electrophysiological parameters. Material and methods: We performed long-term-ECG recordings in transgenic CAP2 deficient mice (C57BL/6) to detect spontaneous arrhythmias. In vivo electrophysiological studies by right heart catheterization and ex vivo epicardial mapping were used to analyze electrophysiological parameters, the inducibility of arrhythmias, and conduction velocities. Expression and distribution of cardiac connexins and the amount of cardiac fibrosis were evaluated. Results: Spontaneous ventricular arrhythmias could be detected in Cap2 gt/gt during the long-term-ECG recording. Cap2 gt/gt showed marked conduction delays at atrial and ventricular levels, including a reduced heart rate (421.0 ±40.6 bpm vs. 450.8 ±27.9 bpm; p &lt; 0.01), and prolongations of PQ (46.3 ±4.1 ms vs. 38.6 ±6.5 ms; p &lt; 0.01), QRS (16.2 ±2.6 ms vs. 12.6 ±1.4 ms; p &lt; 0.01), and QTc interval (55.8 ±6.0 ms vs. 45.2 ±3.3 ms; p = 0.02) in comparison to wild type mice. The PQ prolongation was due to an infra-Hisian conduction delay (HV: 9.7 ±2.1 ms vs. 6.5 ±3.1 ms; p = 0.02). The inducibility of ventricular tachycardias during the electrophysiological studies was significantly elevated in the mutant mice (inducible animals: 88% vs. 33%; p = 0.04). Cap2 gt/gt showed more abnormal distribution of connexin43 compared to WT (23.0 ±4.7% vs. 2.9 ±0.8%; p &lt; 0.01). Myocardial fibrosis was elevated in Cap2 gt/gt hearts (9.1 ±6.7% vs. 5.5 ±3.3%; p &lt; 0.01). Conclusions: Loss of CAP2 results in marked electrophysiological disturbances including impaired sinus node function, conduction delays, and susceptibility to malignant arrhythmias. Structural changes in Cap2 gt/gt are associated with alterations in myocardial connexins and fibrosis

Biographical similarities between spiritual healers and their clients in Germany – a qualitative study

Spiritual healers in contemporary Germany comprise a heterogeneous and growing group, yet little data exists about them. Therefore, one aim of this study was to learn about which biographical aspects and events were important to the process of becoming a healer and which biographical aspects drove clients to consult a healer. The study was based on semi-structured interviews combined with participant observations. All data were recorded digitally, transcribed, entered into the software program MAXQDA and analysed subjected to Content Analysis. In total, 15 healers (nine male, six female) and 16 clients (13 female, three male) were included. According to the healers, a talent for healing can be inborn, inherited or developed through life experiences. Most of the healers experienced a crisis, which prompted their transformation to healers (the wounded healer type). A smaller group became healers mainly out of interest without going through crisis and by focusing on the spiritual attitude itself (the healer by interest type). The basis of healing is seen as a connection to a transcendent reality, which enables an open, loving and empathetic attitude. The experience of crises and illnesses and the importance of spirituality are major biographical similarities between healers and clients. Near-death experiences as an extreme form of crisis were reported from a few healers and clients. The connections between healing talents and crises, including a deepened exploration of near-death experiences and questions regarding inclining towards spirituality could be of interest in further studies

Total beta-adrenoceptor knockout slows conduction and reduces inducible arrhythmias in the mouse heart.

INTRODUCTION: Beta-adrenoceptors (β-AR) play an important role in the neurohumoral regulation of cardiac function. Three β-AR subtypes (β(1), β(2), β(3)) have been described so far. Total deficiency of these adrenoceptors (TKO) results in cardiac hypotrophy and negative inotropy. TKO represents a unique mouse model mimicking total unselective medical β-blocker therapy in men. Electrophysiological characteristics of TKO have not yet been investigated in an animal model. METHODS: In vivo electrophysiological studies using right heart catheterisation were performed in 10 TKO mice and 10 129SV wild type control mice (WT) at the age of 15 weeks. Standard surface ECG, intracardiac and electrophysiological parameters, and arrhythmia inducibility were analyzed. RESULTS: The surface ECG of TKO mice revealed a reduced heart rate (359.2±20.9 bpm vs. 461.1±33.3 bpm; p<0.001), prolonged P wave (17.5±3.0 ms vs. 15.1±1.2 ms; p = 0.019) and PQ time (40.8±2.4 ms vs. 37.3±3.0 ms; p = 0.013) compared to WT. Intracardiac ECG showed a significantly prolonged infra-Hisian conductance (HV-interval: 12.9±1.4 ms vs. 6.8±1.0 ms; p<0.001). Functional testing showed prolonged atrial and ventricular refractory periods in TKO (40.5±15.5 ms vs. 21.3±5.8 ms; p = 0.004; and 41.0±9.7 ms vs. 28.3±6.6 ms; p = 0.004, respectively). In TKO both the probability of induction of atrial fibrillation (12% vs. 24%; p<0.001) and of ventricular tachycardias (0% vs. 26%; p<0.001) were significantly reduced. CONCLUSION: TKO results in significant prolongations of cardiac conduction times and refractory periods. This was accompanied by a highly significant reduction of atrial and ventricular arrhythmias. Our finding confirms the importance of β-AR in arrhythmogenesis and the potential role of unspecific beta-receptor-blockade as therapeutic target