Die frühe Frühgeburt (23 – 31 SSW): Regionale Kohortenanalyse 2005 bis 2008

FRAGESTELLUNG: Identifikation von Risikofaktoren zur Frühgeburtlichkeit, Analyse des neonatalen Outcome. METHODE: Auswertung von 183 frühgeborenen Einlingsgeburten (23 – 31 SSW) der UFK Rostock (2005 – 2008); Einteilung in extrem frühe FG (23 – 26 SSW), sehr frühe Frühgeburt (27 – 29 SSW) und frühe Frühgeburt (30 – 31 SSW); Vergleichskollektiv: 189 termingeborene Einlingsgeburten (39 vollendete SSW) aus dem Jahr 2005. RISIKEN: Z.n. Frühgeburt, Z.n. Sectio, Erstgebärende, hypertensive Schwangerschaftserkrankung, vorzeitige Plazentaablösung, AIS, VBS, Nikotin, geringe Gewichtszunahme, vorzeitige Wehen

Safety, tolerability, and impact on allergic inflammation of autologous E.coli autovaccine in the treatment of house dust mite asthma - a prospective open clinical trial

Background: Asthma is increasing worldwide and results from a complex immunological interaction between genetic susceptibility and environmental factors. Autovaccination with E. coli induces a strong TH-1 immune response, thus offering an option for the treatment of allergic diseases. Methods: Prospective open trial on safety, tolerability, and impact on allergic inflammation of an autologous E.coli autovaccine in intermittent or mild persistent house dust mite asthma. Determination of exhaled nitric monoxide (eNO) before and after bronchial mite challenge initially and after nine months of autovaccination. Results: Median eNO increase after autovaccination was significantly smaller (from 27.3 to 33.8 ppb; p=0.334) compared to initial values (from 32.6 to 42.2 ppb; p=0.046) (p=0.034). In nine subjects and a total of 306 injections, we observed 101 episodes of local erythema (33.3%; median of maximal diameter 2.5 cm), 95 episodes of local swelling (31.1%; median of maximal diameter 3 cm), and 27 episodes of local pain (8.8%). Four subjects reported itching at the injection site with a total of 30 episodes (9.8%). We observed no serious adverse events. All organ functions (inclusive electrocardiogramm) and laboratory testing of the blood (clinical chemistry, hematology) and the urine (screening test, B-microglobuline) were within normal limits. Vital signs undulated within the physiological variability. Conclusion: The administration of autologous autovacine for the treatment of house dust mite asthma resulted in a reduction of the eNO increase upon bronchial mite challenge. In nine subjects and 306 injections, only a few mild local reactions and no systemic severe adverse events were observed. EudraCT Nr. 2005-005534-12 ClinicalTrials.gov ID NCT0067720

Central neuropeptide Y receptors are involved in 3(rd )ventricular ghrelin induced alteration of colonic transit time in conscious fed rats

BACKGROUND: Feeding related peptides have been shown to be additionally involved in the central autonomic control of gastrointestinal functions. Recent studies have shown that ghrelin, a stomach-derived orexigenic peptide, is involved in the autonomic regulation of GI function besides feeding behavior. Pharmacological evidence indicates that ghrelin effects on food intake are mediated by neuropeptide Y in the central nervous system. METHODS: In the present study we examine the role of ghrelin in the central autonomic control of GI motility using intracerobroventricular and IP microinjections in a freely moving conscious rat model. Further the hypothesis that a functional relationship between NPY and ghrelin within the CNS exists was addressed. RESULTS: ICV injections of ghrelin (0.03 nmol, 0.3 nmol and 3.0 nmol/5 μl and saline controls) decreased the colonic transit time up to 43%. IP injections of ghrelin (0.3 nmol – 3.0 nmol kg(-1 )BW and saline controls) decreased colonic transit time dose related. Central administration of the NPY(1 )receptor antagonist, BIBP-3226, prior to centrally or peripherally administration of ghrelin antagonized the ghrelin induced stimulation of colonic transit. On the contrary ICV-pretreatment with the NPY(2 )receptor antagonist, BIIE-0246, failed to modulate the ghrelin induced stimulation of colonic motility. CONCLUSION: The results suggest that ghrelin acts in the central nervous system to modulate gastrointestinal motor function utilizing NPY(1 )receptor dependent mechanisms

Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury::An explorative analysis of data from a randomized controlled trial

Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury. Design: Longitudinal analyses. Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function. Methods: Measurements were performed 4 weeks after the start of rehabilitation, 9 and 17 weeks after the first measurement, and one year after discharge from inpatient rehabilitation. Peak cough flow was measured with a spirometer. Maximum inspiratory and expiratory pressures (MIP and MEP), expressed in cmH(2)O, were measured at the mouth. Results: Both MIP and MEP were significantly positively associated with peak cough flow. After correction for confounders and time 10 cmH(2)O higher MIP was associated with a 0.32 Us higher peak cough flow, and a 10 cmH(2)O higher MEP was associated with a 0.15 l/s higher peak cough flow. The association between MIP and peak cough flow was mainly based on within-subject variance. The association between MIP and peak cough flow was stronger than between MEP and peak cough flow. Conclusion: Improvement in respiratory muscle strength is associated with improvement in cough capacity in persons with recent spinal cord injury who have impaired pulmonary function

Systematic review of measurement properties of questionnaires measuring somatization in primary care patients

Objective The aim of this review is to critically appraise the evidence on measurement properties of self-report questionnaires measuring somatization in adult primary care patients and to provide recommendations about which questionnaires are most useful for this purpose. Methods We assessed the methodological quality of included studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. To draw overall conclusions about the quality of the questionnaires, we conducted an evidence synthesis using predefined criteria for judging the measurement properties. Results We found 24 articles on 9 questionnaires. Studies on the Patient Health Questionnaire-15 (PHQ-15) and the Four-Dimensional Symptom Questionnaire (4DSQ) somatization subscale prevailed and covered the broadest range of measurement properties. These questionnaires had the best internal consistency, test-retest reliability, structural validity, and construct validity. The PHQ-15 also had good criterion validity, whereas the 4DSQ somatization subscale was validated in several languages. The Bodily Distress Syndrome (BDS) checklist had good internal consistency and structural validity. Some evidence was found for good construct validity and criterion validity of the Physical Symptom Checklist (PSC-51) and good construct validity of the Symptom Check-List (SCL-90-R) somatization subscale. However, these three questionnaires were only studied in a small number of primary care studies. Conclusion Based on our findings, we recommend the use of either the PHQ-15 or 4DSQ somatization subscale for somatization in primary care. Other questionnaires, such as the BDS checklist, PSC-51 and the SCL-90-R somatization subscale show promising results but have not been studied extensively in primary care. © 2017 Elsevier Inc

The German National Pandemic Cohort Network (NAPKON): rationale, study design and baseline characteristics

Schons M, Pilgram L, Reese J-P, et al. The German National Pandemic Cohort Network (NAPKON): rationale, study design and baseline characteristics. European Journal of Epidemiology . 2022.The German government initiated the Network University Medicine (NUM) in early 2020 to improve national research activities on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. To this end, 36 German Academic Medical Centers started to collaborate on 13 projects, with the largest being the National Pandemic Cohort Network (NAPKON). The NAPKON's goal is creating the most comprehensive Coronavirus Disease 2019 (COVID-19) cohort in Germany. Within NAPKON, adult and pediatric patients are observed in three complementary cohort platforms (Cross-Sectoral, High-Resolution and Population-Based) from the initial infection until up to three years of follow-up. Study procedures comprise comprehensive clinical and imaging diagnostics, quality-of-life assessment, patient-reported outcomes and biosampling. The three cohort platforms build on four infrastructure core units (Interaction, Biosampling, Epidemiology, and Integration) and collaborations with NUM projects. Key components of the data capture, regulatory, and data privacy are based on the German Centre for Cardiovascular Research. By April 01, 2022, 34 university and 40 non-university hospitals have enrolled 5298 patients with local data quality reviews performed on 4727 (89%). 47% were female, the median age was 52 (IQR 36-62-) and 50 pediatric cases were included. 44% of patients were hospitalized, 15% admitted to an intensive care unit, and 12% of patients deceased while enrolled. 8845 visits with biosampling in 4349 patients were conducted by April 03, 2022. In this overview article, we summarize NAPKON's design, relevant milestones including first study population characteristics, and outline the potential of NAPKON for German and international research activities.Trial registration https://clinicaltrials.gov/ct2/show/NCT04768998 . https://clinicaltrials.gov/ct2/show/NCT04747366 . https://clinicaltrials.gov/ct2/show/NCT04679584. © 2022. The Author(s)

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Eine prospektive Studie zur Effektivität von Kollagenen und Alginaten in der komplementären Adipositastherapie

Übergewicht und Adipositas stellen eine immer größer werdende Herausforderung für die heutigen Gesellschaften dar. Dabei ist nicht nur die Bedrohung der individuellen Gesundheit durch Folge- und Begleiterkrankungen, sondern auch die daraus resultierenden wirtschaftlichen Auswirkungen zu sehen. Neben den etablierten Therapieverfahren hat sich ein regelrechter Schlankheitsmittelmarkt entwickelt. Diätmittel stellen den schnellen und mühelosen Gewichtsverlust in Aussicht, wobei diese Versprechen in den meisten Fällen nicht durch wissenschaftliche Studien belegt werden können, so auch die Medizinprodukte Matricur® und CM3-Alginat® der Hersteller Dr. Suwelack Skin & Health Care AG und A + G Lifescience GmbH, die seit 1999 rezeptfrei in Apotheken erhältlich sind. In der vorliegenden Arbeit wurde eine erste Pilotstudie zu diesen Sättigungskomprimaten geplant und durchgeführt, um einen möglichen Effekt in der Sättigungswahrnehmung zu dokumentieren und den möglichen Wirkmechanismus zu entschlüsseln. Untersucht wurden 20 gesunde Probanden an jeweils drei Versuchstagen, wobei der erste Tag als Kontrolltag diente. An den beiden anderen Tagen wurden jeweils drei Sättigungskomprimate vor der Testmahlzeit eingenommen. Gemessen wurden das Sättigungsgefühl mittels einer visuellen Analogskala und die Magenentleerungskinetik mittels eines 13C-Oktanonsäure-Atemtests. Dabei wurden als Parameter die Halbwertszeit (HWZ), die lag-Periode und der Magenentleerungskoeffizient (GEC) bestimmt. Ein möglicher Wirkmechanismus über die „gut-brain“-Achse wurde durch die Messung von den Peptiden glukagon-like peptide (GLP-1) und Cholezystokinin (CCK) im Serum untersucht. In der Studie konnte nachgewiesen werden, dass sich durch Einnahme der Komprimate die Sättigung nach Ingestion der Testmahlzeit steigern lässt. Dieser Effekt stellte sich von der 45. bis zur 210. Versuchminute ein. Eine vom Hersteller beschriebene Vorsättigung und eine höhere Sättigung während der Nahrungsaufnahme zeigten sich hingegen nicht. Zudem ließ sich eine signifikante Verlangsamung der Magenentleerungskinetik feststellen. Die Halbwertszeit der Magenentleerung verlängerte sich signifikant von 123 ± 4,98 min am Kontrolltag auf 152 ± 5,10 min nach Einnahme von Matricur® bzw. auf 155 ± 6,46 min nach CM3-Alginat®. Der gastric emptying coefficient (GEC) und die lag-Periode hingegen veränderten sich nicht signifikant. Auch bei der Untersuchung der Peptide GLP-1 und CCK stellten sich keine signifikanten Unterschiede zum Kontrolltag ein. Als Wirkmechanismus der Komprimate wird ein Kombinationseffekt aus einem rein mechanischen Prinzip der Magendehnung und einer Einflussnahme der Komprimate im Sinne von löslichen Ballaststoffen angenommen. Für einen Wirkmechanismus im Sinne der „gut-brain“-Achse geben die vorliegenden Daten keinen Hinweis. Ob Matricur® und CM3-Alginat® in der Adipositastherapie einen positiven Beitrag leisten, bleibt fraglich. Anwendungsstudien auf Basis der erhobenen Daten müssten klären, ob sich durch die Komprimate eine Reduktion der Nahrungsaufnahme einstellt und Betroffene langfristig an Gewicht abnehmen