Patienten-kontrollierte Epiduralanalgesie versus intravenöse Analgesie zur Schmerztherapie nach Sectio caesarea:prospektiv-randomisierte klinische Studie

Zwei Verfahren zur Schmerztherapie nach geplanter Sectio caesarea wurden hinsichtlich Analgesiequalität, Nebenwirkungen und Patientinnenzufriedenheit verglichen. Alle Patientinnen erhielten zur Sectio eine Spinalanästhesie mit Bupivacain. 25 Patientinnen erhielten postoperativ eine kontinuierliche intravenöse Novaminsulfoninfusion und bei Bedarf Piritramid intramuskulär (SPA-Gruppe). Die anderen 25 Patientinnen erhielten postoperativ eine kontinuierliche patienten-kontrollierte Epiduralanalgesie mit Bupivacain und Sufentanil und bei Bedarf Boli der Mischung (CSE-Gruppe). Die Schmerzquantität in Ruhe und beim Husten war signifikant niedriger in der CSE-Gruppe. Die Schmerzerleichterung nach Bolusgabe war signifikant besser als nach Gabe von Piritamid. Mobilitäts- und Sensibilitätseinschränkungen kamen signifikant häufiger in der CSE-Gruppe vor. Andere Nebenwirkungen waren selten. 88% der Patientinnen aus der CSE-Gruppe und 76% aus der SPA-Gruppe waren "sehr zufrieden" mit der Analgesie

The UV-A and visible solar irradiance spectrum: inter-comparison of absolutely calibrated, spectrally medium resolution solar irradiance spectra from balloon- and satellite-borne measurements

International audienceWithin the framework of the ENVISAT/-SCIAMACHY satellite validation, solar irradiance spectra are absolutely measured at moderate resolution in the UV/visible spectral range (in the UV from 316.7–418 nm and the visible from 400–652 nm at a full width half maximum resolution of 0.55 nm and 1.48 nm, respectively) from aboard the azimuth-controlled LPMA/DOAS balloon gondola at around 32 km balloon float altitude. After accounting for the atmospheric extinction due to Rayleigh scattering and gaseous absorption (O3, and NO2), the measured solar spectra are compared with previous observations. Our solar irradiance is +1.6% larger than the re-calibrated Kurucz et al. (1984) solar spectrum (Fontenla et al., 1999, called MODTRAN 3.5) in the visible spectral range (435–650 nm), +1.5% larger in the (370–415 nm) wavelength interval, but -4% smaller in the UV spectral range (316.7–370 nm), when the Kurucz spectrum is convolved to the spectral resolution of our instrument. The same comparison with the SOLSPEC solar spectrum (Thuillier et al., 1997, 1998a, b) confirms the somewhat larger solar irradiance (+1.7%) measured by the balloon instrument from 435–500 nm, but not from 500–650 nm, where the SOLSPEC is -1.3% lower than MODTRAN 3.5. Comparison of the SCIAMACHY solar spectrum from channels 1 to 4 (– re-calibrated by the University of Bremen –) with MODTRAN 3.5 indicates an agreement of +0.2% in the visible spectral range (435–585 nm). With this calibration, the SCIAMACHY solar spectrum is congruent with the balloon observations (-1%) in the 316.7–370 nm wavelength range, but both are up to -5%/-3% smaller than MODTRAN 3.5 and SOLSPEC, respectively. In agreement with findings of Skupin et al. (2002) our study emphasizes that the present ESA SCIAMACHY level 1 calibration is systematically +15% larger in the considered wavelength intervals when compared to all available other solar irradiance measurements

Machine Learning to Detect Alzheimer's Disease from Circulating Non-coding RNAs

Blood-borne small non-coding (sncRNAs) are among the prominent candidates for blood-based diagnostic tests. Often, high-throughput approaches are applied to discover biomarker signatures. These have to be validated in larger cohorts and evaluated by adequate statistical learning approaches. Previously, we published high-throughput sequencing based microRNA (miRNA) signatures in Alzheimer’s disease (AD) patients in the United States (US) and Germany. Here, we determined abundance levels of 21 known circulating miRNAs in 465 individuals encompassing AD patients and controls by RT-qPCR. We computed models to assess the relation between miRNA expression and phenotypes, gender, age, or disease severity (Mini-Mental State Examination; MMSE). Of the 21 miRNAs, expression levels of 20 miRNAs were consistently de-regulated in the US and German cohorts. 18 miRNAs were significantly correlated with neurodegeneration (Benjamini-Hochberg adjusted P < 0.05) with highest significance for miR-532-5p (Benjamini-Hochberg adjusted P = 4.8 × 10−30). Machine learning models reached an area under the curve (AUC) value of 87.6% in differentiating AD patients from controls. Further, ten miRNAs were significantly correlated with MMSE, in particular miR-26a/26b-5p (adjusted P = 0.0002). Interestingly, the miRNAs with lower abundance in AD were enriched in monocytes and T-helper cells, while those up-regulated in AD were enriched in serum, exosomes, cytotoxic t-cells, and B-cells. Our study represents the next important step in translational research for a miRNA-based AD test