Pelvic organ prolapse and collagen-associated disorders

Contains fulltext : 109010.pdf (publisher's version ) (Open Access)INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) and other disorders, such as varicose veins and joint hypermobility, have been associated with changes in collagen strength and metabolism. We hypothesized that these various disorders were more prevalent in both POP patients and their family members. METHODS: In this study, the prevalence of various collagen-associated disorders, including POP, was compared between POP patients (n = 110) and control patients (n = 100) and their first and second degree family members. RESULTS: POP patients reported a higher prevalence of varicose veins, joint hypermobility and rectal prolapse and were more likely to have family members with POP as compared to the control group (p < 0.01). In contrast, the family members of the POP group did not report a higher prevalence of collagen-associated disorders compared to the family members of the control group (p = 0.82). CONCLUSIONS: POP and other collagen-associated disorders may have a common aetiology, originating at the molecular level of the collagens.1 maart 201

Cost Effectiveness of Implantable Cardioverter Defibrillator Therapy versus Drug Therapy for Patients at High Risk of Sudden Cardiac Death

The implantable cardioverter defibrillator (ICD) is a therapy for patients at risk of sudden cardiac death due to ventricular tachycardia (VT) or ventricular fibrillation (VF). But the apparent high cost of ICD therapy relative to antiarrhythmic drugs such as amiodarone has raised questions about the cost effectiveness of ICD therapy versus drug therapy. To inform this debate we reviewed the literature on ICD cost effectiveness. An electronic and manual search was conducted for articles published since 1980 reporting original data on the cost effectiveness of ICD versus drug therapy for patients at risk of VT/VF. Data on costs and life-years gained were abstracted and studies were grouped into those that used decision-analysis models and those that were trial-based analyses. Cost-effectiveness ratios were inflated to 2001 US dollars. Nine studies were included in the review; five studies were modelling studies and four were part of randomised trials of ICD therapy. Studies varied in time horizon, but all except one indicated that ICD therapy was more costly than drug therapy. Early decision models assumed larger survival benefits than those observed in subsequent trials and therefore had attractive incremental cost-effectiveness ratios in the range of $US27 000 to$US60 000 per life-year gained. Trial-based studies, with the exception of one small trial, indicated cost per life-year gained in the range $US44 000 to$US144 000. Stratified analysis shows clearly that patients with a greater risk of mortality due to structural heart disease (e.g. left ventricular ejection fractionAntiarrhythmics, Cost analysis, Heart arrest, Implantable cardioverter defibrillators, Pharmacoeconomics, Ventricular fibrillation, Ventricular tachycardia

Stuttgart Region - Sustainable Industrialization in Stuttgart Metropolitan Region

The Stuttgart region is a very prosperous area. The economical backbone of the region is the production of industrial goods. The globalization is a trigger for changing economical dependencies. Industrial processes are changing because of the new challenges. Digitalization is a current topic which has huge influence on economical procedures. A main topic in this context is the German initiative “Industry 4.0”. New ways of thinking have a great impact on the way manufacturing is done and the digitalization opens up new possibilities. Current discussions on sustainability are influencing the economic thinking heavily. The importance of sustainable development with respect to environment and climate becomes more and more obvious to everybody. The climate conference in Paris was finished with a consensus of all present parties. Every important economic nation has a common sense on climate targets nowadays. Reasons for that are manifold, e.g. limited resources and huge amount of emissions. Nevertheless, society will only accept limitations, without a reduction of living quality. Based on that, it is necessary to implement a new procedures in existing structures. Additionally, it is required to implement changes without reducing economic potentials. The approach of symbiosis can support these developments. However, technology is a required extension to reach the target of sustainability. In this chapter, different views are discussed to facilitate long-term development. The first view is a holistic view. The idea of creating a symbiosis between enterprises in an industrial estate is easy to realize. On one hand the enterprise manager are able to shape the collaborations, and on the other hand the local administration is able to support the approach with small efforts. Besides the sustainable development of industrial estates the companies need a strategy for their own development. A development path towards urban manufacturing is helping the management of companies to create a strategy. A concrete step-by-step approach is the base. Additional technological drivers are analyzed in their capability of supporting sustainability

Widespread non-central nervous system organ pathology in fragile X premutation carriers with fragile X-associated tremor/ataxia syndrome and CGG knock-in mice

Item does not contain fulltextFragile X-associated tremor/ataxia syndrome (FXTAS) is an adult-onset neurodegenerative disorder generally presenting with intention tremor and gait ataxia, but with a growing list of co-morbid medical conditions including hypothyroidism, hypertension, peripheral neuropathy, and cognitive decline. The pathological hallmark of FXTAS is the presence of intranuclear inclusions in both neurons and astroglia. However, it is unknown to what extent such inclusions are present outside the central nervous system (CNS). To address this issue, we surveyed non-CNS organs in ten human cases with FXTAS and in a CGG repeat knock-in (CGG KI) mouse model known to possess neuronal and astroglial inclusions. We find inclusions in multiple tissues from FXTAS cases and CGG KI mice, including pancreas, thyroid, adrenal gland, gastrointestinal, pituitary gland, pineal gland, heart, and mitral valve, as well as throughout the associated autonomic ganglia. Inclusions were observed in the testes, epididymis, and kidney of FXTAS cases, but were not observed in mice. These observations demonstrate extensive involvement of the peripheral nervous system and systemic organs. The finding of intranuclear inclusions in non-CNS somatic organ systems, throughout the PNS, and in the enteric nervous system of both FXTAS cases as well as CGG KI mice suggests that these tissues may serve as potential sites to evaluate early intervention strategies or be used as diagnostic factors