9 research outputs found

    Mucositis after Reduced Intensity Conditioning and Allogeneic Stem Cell Transplantation

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    Background: Therapyrelated mucositis is associated with considerable morbidity. This complication following allogeneic stem cell therapy (alloSCT) is less severe after reduced intense conditioning (RIC); however, even here it may be serious. Methods: 52 patients (male: n = 35 (67%), female: n = 17 (33%)) at a median age of 62 years (35–73 years) underwent alloSCT after RIC. Conditioning was either total body irradiation (TBI)2Gy/±fludarabine (n = 33, 63.5%) or chemotherapy based. Graftversushost disease (GvHD) prophylaxis was carried out with cyclosporine A ± mycophenolate mofetil (MMF). 45 patients (87%) received shortcourse methotrexate (MTX). Mucositis was graded according to the Bearman and the World Health Organisation (WHO) scale. A variety of parameters were correlated with mucositis. Results: The Bearman and WHO scales showed excellent correlation. Mucositis was significantly more severe after chemotherapybased conditioning compared to conditioning with TBI2Gy/±fludarabine (p < 0.002) as well as in cases with an increase in creatinine levels above the upper normal value (UNV) on day +1 after SCT (p < 0.05). Furthermore, the severity correlated with time to engraftment of leucocytes (correlation coefficient (cc) = 0.26, p < 0.02) and thrombocytes (cc = 0.38, p < 0.001). Conclusions: The conditioning regimen and increased creatinine levels at day +1 were identified as factors predicting the severity of mucositis after RICSCT. Creatinine levels on day +1 after SCT may help identify patients at risk for severe mucositis in the further course of transplantation

    Risks to pollinators and pollination from invasive alien species

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    Invasive alien species modify pollinator biodiversity and the services they provide that underpin ecosystem function and human well-being. Building on the Intergovernmental Science-Policy Platform for Biodiversity and Ecosystem Services (IPBES) global assessment of pollinators and pollination, we synthesize current understanding of invasive alien impacts on pollinators and pollination. Invasive alien species create risks and opportunities for pollinator nutrition, re-organize species interactions to affect native pollination and community stability, and spread and select for virulent diseases. Risks are complex but substantial, and depend greatly on the ecological function and evolutionary history of both the invader and the recipient ecosystem. We highlight evolutionary implications for pollination from invasive alien species, and identify future research directions, key messages and options for decision-making

    Der hyperdense Sinus im nativen kraniellen Computertomogramm – ein reliabler Marker fĂŒr den Nachweis einer Sinusvenenthrombose?

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    Die Sinusvenenthrombose (SVT) ist eine seltene, aber potentiell lebensbedrohliche Erkrankung, welche aufgrund der variablen und oft sehr unspezifischen klinischen Manifestationen schwierig zu diagnostizieren ist, jedoch einer frĂŒhzeitigen und adĂ€quaten Therapie zur Verbesserung des klinischen Outcomes bedarf. Das Ziel der vorliegenden Arbeit war daher, zu prĂŒfen, ob bereits aus der ersten routinemĂ€ĂŸig durchgefĂŒhrten Diagnostik, dem nativen cCT, mit Hilfe eines zu ermittelnden Schwellenwertes verlĂ€ssliche Prognosen bezĂŒglich des Vorliegens einer SVT getroffen werden können. Hierzu wurden in einem aus 225 Patienten bestehenden retrospektiven Kollektiv an vorher definierten Standardstellen Dichtewerte im Bereich der Sinus von Patienten mit und ohne nachgewiesener SVT gemessen. Daneben wurden zur Normalisierung der Dichtewerte zusĂ€tzlich VerhĂ€ltnisse zum HĂ€matokrit und zum HĂ€moglobinwert gebildet. Anschließend wurden mögliche Schwellenwerte ermittelt, welche dann an einem prospektiven Patientenkollektiv ĂŒberprĂŒft wurden. Es zeigte sich, dass das Messen im Bereich von definierten Standardstellen keinen Erfolg verspricht, ebenso verhielt es sich mit der zusĂ€tzlichen Messung von Dichtewerten im Bereich hyperdenser Sinus. Zudem konnten die in der Literatur beschriebenen Schwellenwerte prospektiv nicht bestĂ€tigt werden. Diese Ergebnisse weisen deutlich auf die Notwendigkeit einer weiterfĂŒhrenden GefĂ€ĂŸdiagnostik hin. Hierbei bietet sich insbesondere die CTV aufgrund der schnellen VerfĂŒgbarkeit direkt im Anschluss an das routinemĂ€ĂŸig zuerst durchgefĂŒhrte native cCT im Sinne einer „one-stop-examination“ an.The sinus venous thrombosis (SVT) is a rare, but potentially life-threatening disease, which is due to the variable and often very unspecific clinical manifestations difficult to diagnose. However, an early and adequate therapy is needed to improve the clinical outcome. The aim of this study was to investigate the possibility of generating reliable prognoses in regards to the diagnosis of SVT utilizing the first routine diagnostic modality, the non-contrast cranial computed tomography (cCT). Primarily, to identify possible thresholds. For this purpose 225 patients were selected and used as a retrospective group. Standardized regions-of-interest (ROIs) were defined and placed inside of the venous sinuses in patients with and without the diagnosis of SVT. In addition, hematocrit and hemoglobin were used to calculate ratios and thereby to normalize the measured density values. Subsequently possible thresholds were established and a prospective group was used to validate these thresholds. It could be shown that measuring density values in standardized ROIs is not effective, same with using additional measurements of density values in the region of hyperdense sinuses. Furthermore, the thresholds described in other studies could not be verified in the prospective group. These results emphasize the necessity of further diagnostics of the venous system. For this purpose the CT-venography seems to be especially useful because of its immediate availability after the first routinely executed cCT in the sense of a “one-stop-examination”

    Large-scale targeted sequencing identifies risk genes for neurodevelopmental disorders

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    Most genes associated with neurodevelopmental disorders (NDDs) were identified with an excess of de novo mutations (DNMs) but the significance in case–control mutation burden analysis is unestablished. Here, we sequence 63 genes in 16,294 NDD cases and an additional 62 genes in 6,211 NDD cases. By combining these with published data, we assess a total of 125 genes in over 16,000 NDD cases and compare the mutation burden to nonpsychiatric controls from ExAC. We identify 48 genes (25 newly reported) showing significant burden of ultra-rare (MAF < 0.01%) gene-disruptive mutations (FDR 5%), six of which reach family-wise error rate (FWER) significance (p < 1.25E−06). Among these 125 targeted genes, we also reevaluate DNM excess in 17,426 NDD trios with 6,499 new autism trios. We identify 90 genes enriched for DNMs (FDR 5%; e.g., GABRG2 and UIMC1); of which, 61 reach FWER significance (p < 3.64E−07; e.g., CASZ1). In addition to doubling the number of patients for many NDD risk genes, we present phenotype–genotype correlations for seven risk genes (CTCF, HNRNPU, KCNQ3, ZBTB18, TCF12, SPEN, and LEO1) based on this large-scale targeted sequencing effort

    Viral infections

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    Paramyxoviruses: Mumps

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