A CYPome-wide study reveals new potential players in the pathogenesis of Parkinson's disease

Genetic and environmental factors lead to the manifestation of Parkinson's disease (PD) but related mechanisms are only rudimentarily understood. Cytochromes P450 (P450s) are involved in the biotransformation of toxic compounds and in many physiological processes and thus predestinated to be involved in PD. However, so far only SNPs (single nucleotide polymorphisms) in CYP2D6 and CYP2E1 have been associated with the susceptibility of PD. Our aim was to evaluate the role of all 57 human P450s and their redox partners for the etiology and pathophysiology of PD and to identify novel potential players which may lead to the identification of new biomarkers and to a causative treatment of PD. The PPMI (Parkinson's Progression Markers Initiative) database was used to extract the gene sequences of all 57 P450s and their three redox partners to analyze the association of SNPs with the occurrence of PD. Applying statistical analyses of the data, corresponding odds ratios (OR) and confidence intervals (CI) were calculated. We identified SNPs significantly over-represented in patients with a genetic predisposition for PD (GPD patients) or in idiopathic PD (IPD patients) compared to HC (healthy controls). Xenobiotic-metabolizing P450s show a significant accumulation of SNPs in PD patients compared with HC supporting the role of toxic compounds in the pathogenesis of PD. Moreover, SNPs with high OR values (>5) in P450s catalyzing the degradation of cholesterol (CYP46A1, CY7B1, CYP39A1) indicate a prominent role of cholesterol metabolism in the brain for PD risk. Finally, P450s participating in the metabolism of eicosanoids show a strong over-representation of SNPs in PD patients underlining the effect of inflammation on the pathogenesis of PD. Also, the redox partners of P450 show SNPs with OR > 5 in PD patients. Taken together, we demonstrate that SNPs in 26 out of 57 P450s are at least 5-fold over-represented in PD patients suggesting these P450s as new potential players in the pathogenesis of PD. For the first time exceptionally high OR values (up to 12.9) were found. This will lead to deeper insight into the origin and development of PD and may be applied to develop novel strategies for a causative treatment of this disease.The work was supported by a research grant from the “Dr. Rolf M. Schwiete Stiftung” Mannheim/Germany

Influence of pretreatments on microtensile bond strength to eroded dentin using a universal adhesive in self-etch mode

Purpose To evaluate the influence of pretreatments on microtensile bond strength (μTBS) to eroded dentin when using a universal adhesive in self-etch mode. Materials and methods Forty-eight human molars were randomly assigned to six groups (G1–G6, n = 8) and ground down until dentin exposure. G2–G6 were eroded with citric acid (pH 2.6) for 10 × 2 min (within 12 h) on 5 consecutive days. G1 and G2 served as uneroded and eroded controls and were not pretreated. G3 and G4 were pretreated for 60 s with NaOCl (10% and 5%, respectively). G5 was airborne-particle abraded using Al2O3 for 15 s, and G6 was roughened with a diamond bur. The universal adhesive Scotchbond Universal was applied in self-etch mode. After composite build-up, μTBS was determined. Results Control group G1 (uneroded) showed higher μTBS than G2 (eroded). The μTBS (mean MPa ±SD) of G5 (airborne-particle abrasion; 11.6 ± 4.6) and G6 (bur-roughening; 11.0 ± 3.3) did not differ significantly from the μTBS of G1 (12.4 ± 4.2). Significantly higher μTBS compared to all other groups was observed in G3 (NaOCl 10%; 17.6 ± 7.6). Pretreatment with NaOCl 5% (G4) achieved significantly lower μTBS (3.5 ± 2.6) than the other groups, except for G2 (8.8 ± 2.0). Conclusions Pretreatment with 10% NaOCl, diamond bur roughening or airborne-particle abrasion can increase bond strength of the tested adhesive to eroded dentine. Pre-treatment with 5% NaOCl is not recommended

Chapter 14 – Orientation for Professional Users of Health Apps

Versorger werden sich in Zukunft aus verschiedenen Gründen verstärkt mit Gesundheits-Apps auseinandersetzen müssen. Für die Nutzung und Bewertung von Apps werden offizielle Orientierungshilfen benötigt. Apps, die ursprünglich nicht mit Fokus auf die Gesundheit entwickelt wurden, erlangen mit dem Einsatz durch klinisches Fachpersonal eine Erweiterung für den Gesundheitsbereich. Da diese nicht primär für eine Anwendung im medizinischen Umfeld gedacht waren, unterlagen sie bei der Entwicklung auch nicht den einschlägigen Regularien und Anforderungen. Insbesondere hier muss daher von Seiten der professionellen Anwender überprüft werden, ob sie den Anforderungen genügen und für einen professionellen Einsatz geeignet sind. Erste Vorschläge konkreter Empfehlungen für Versorger selber und für die Weitergabe an Patientinnen und Patienten sind aufgestellt worden, sollten aber durch ein separates Verfahren weiter konsolidiert und veröffentlicht werden.For various reasons, health care personnel will increasingly be confronted with health apps. There is a strong need for official guidelines on how to use and rate these apps. If used by healthcare professionals, even apps that were not developed with a health related focus in mind may extend into this area. Since from their inception, these apps were never meant to be used in medical or health related setting, their development usually does not take the appropriate regulations and requirements into account. Therefore, professional users need to convince themselves that the apps conform to the necessary requirements and are suited for professional use. In this context, first concrete proposals are given within this chapter and these include recommendations for healthcare professionals themselves, but also aspects that should be covered when providing patients with information about apps. However, these proposals should be consolidated and published in an additional process

Use and importance of different information sources among patients with rare diseases and their relatives over time: a qualitative study

Background: Finding reliable information on one of more than 7000 rare diseases is a major challenge for those affected. Since rare diseases are defined only by the prevalence criterion, a multitude of heterogeneous diseases are included. Common to all, however, are difficulties regarding information access. Even though various quantitative studies have analyzed the use of different information sources for specific rare diseases, little is known about the use of information sources for different rare diseases, how users rate these information sources based on their experiences, and how the use and importance of these information sources change over time. Methods: Fifty-five patients with a variety of rare diseases and 13 close relatives participated in qualitative interviews. For these interviews, a semi-structured guideline was developed, piloted, and revised. Data analysis involved a qualitative content analysis developed by Philipp Mayring. Results: The participants considered internet as the most important and widespread information source, especially for early information. Although patients have difficulty dealing with information obtained online, they consider online searching a quick and practical option to gather information. During the course of the disease, personal contact partners, especially self-help associations and specialized doctors, become more important. This is also because information provided online is sometimes insufficiently detailed to answer their information needs, which can be complemented by information from doctors and self-help. Conclusions: People rarely use just one type of source, but rather refer to different sources and informants. The source used depends on the type of information sought as well as other person-related factors such as preexisting knowledge and the disease stage. To improve people’s information searching and connect them with medical specialists in rare diseases, a central information portal on rare diseases might be a suitable access point to provide free and quality assured information for patients, caregivers, and physicians. This would allow not only patients but also doctors to find quality assured information on symptoms and therapies as well as patient associations and specialized doctors

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

BACKGROUND: The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. OBJECTIVE: The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. METHODS: First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. RESULTS: We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. CONCLUSIONS: The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

BACKGROUND: The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. OBJECTIVE: The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. METHODS: First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. RESULTS: We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. CONCLUSIONS: The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality

Empedocle e la bonifica di Selinunte: un breve riesame

Alcune considerazioni intorno a un passo di Diogene Laerzio, secondo il quale il filosofo Empedocle avrebbe attuato un'operazione di bonifica a Selinunte, e sulla possibilit\ue0 di trovare riscontri in proposito

Eine kompakte immersierte Fläche konstanter mittlerer Krümmung in R3^{3} mit Geschlecht 30 und Ikosaedersymmetrie und die konjugierte Plateaumethode

In dieser Dissertation studieren wir die konjugierte Plateaumethode anhand der numerisch bestimmten Fläche mit Geschlecht 30 von Karsten Große-Brauckmann und Konrad Polthier aus dem Jahre 1996. Wir geben eine explizite Parametrisierung aller zugehörigen konjugierten Polygonzüge $\Gamma$ in S 3 an. Im Hinblick auf Barrieren konstruieren wir "optimal" an $\Gamma$ angepasste H-konvexe Rotationsflächen und berechnen, dass sich Schnitte von Cliffordvolltori nicht auf extremale Gebiete in S$^{2}$ × S$^{2}$ zurückspielen lassen. Die Eindeutigkeitsfrage der Plateaulösung betreffend zeigen wir, für in $\Gamma$ eingespannte Flächen, schwache Konvexität des Flächenfunktionals bei Variation mittels umskalierter Killingfelder. Ließe sich diese Aussage auf divergenzfreie Vektorfelder verallgemeinern, so könnte man mit Magnetfeldern zu einem in $\Gamma$ fließenden Strom arbeiten. Zur Beschreibung dieser Magnetfelder stellen wir explizite Formeln für den Greenschen Kern für 1-Formen auf S$^{n}$ bereit

Social Media -- sicherer Austausch zwischen Krankenhaus und Patient (Serie: Zukunft Mobility im Gesundheitswesen)

Albrecht U-V, Hartz T. Social Media -- sicherer Austausch zwischen Krankenhaus und Patient (Serie: Zukunft Mobility im Gesundheitswesen). Krankenhaus-IT Journal. 2014;(4):96-97

Social Media in der ärztlichen Praxis: Chancen, Risiken, Trends

Hartz T, Fangerau H, Albrecht U-V. Social Media in der ärztlichen Praxis: Chancen, Risiken, Trends. Deutsches Ärzteblatt. 2014;111(17 Suppl. PRAXIS):[6]