@article{ZhaoYuHuetal.2015,
  author    = {Zhao, De-Wei and Yu, Mang and Hu, Kai and Wang, Wei and Yang, Lei and Wang, Ben-Jie and Gao, Xiao-Hong and Guo, Yong-Ming and Xu, Yong-Qing and Wei, Yu-Shan and Tian, Si-Miao and Yang, Fan and Wang, Nan and Huang, Shi-Bo and Xie, Hui and Wei, Xiao-Wei and Jiang, Hai-Shen and Zang, Yu-Qiang and Ai, Jun and Chen, Yuan-Liang and Lei, Guang-Hua and Li, Yu-Jin and Tian, Geng and Li, Zong-Sheng and Cao, Yong and Ma, Li},
  title     = {Prevalence of Nontraumatic Osteonecrosis of the Femoral Head and its Associated Risk Factors in the Chinese Population: Results from a Nationally Representative Survey},
  series = {Chinese Medical Journal},
  volume    = {128},
  journal   = {Chinese Medical Journal},
  number    = {21},
  doi       = {10.4103/0366-6999.168017},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-138482},
  pages     = {2843-2850},
  year      = {2015},
  abstract  = {Background: Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population. Methods: A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH. Results: NONFH was diagnosed in 218 subjects (0.725\%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02\% vs. 0.51\%, \(\chi^2\) = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85\% vs. 0.61\%, \(\chi^2\) = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH. Conclusions: Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.},
  language  = {en}
}
@article{WagnerAshbyKurtzetal.2015,
  author    = {Wagner, Martin and Ashby, Damien R. and Kurtz, Caroline and Alam, Ahsan and Busbridge, Mark and Raff, Ulrike and Zimmermann, Josef and Heuschmann, Peter U. and Wanner, Christoph and Schramm, Lothar},
  title     = {Hepcidin-25 in diabetic chronic kidney disease is predictive for mortality and progression to end stage renal disease},
  series = {PLoS One},
  volume    = {10},
  journal   = {PLoS One},
  number    = {4},
  doi       = {10.1371/journal.pone.0123072},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125514},
  pages     = {e0123072},
  year      = {2015},
  abstract  = {Background Anemia is common and is associated with impaired clinical outcomes in diabetic chronic kidney disease (CKD). It may be explained by reduced erythropoietin (EPO) synthesis, but recent data suggest that EPO-resistance and diminished iron availability due to inflammation contribute significantly. In this cohort study, we evaluated the impact of hepcidin-25—the key hormone of iron-metabolism—on clinical outcomes in diabetic patients with CKD along with endogenous EPO levels. Methods 249 diabetic patients with CKD of any stage, excluding end-stage renal disease (ESRD), were enrolled (2003-2005), if they were not on EPO-stimulating agent and iron therapy. Hepcidin-25 levels were measured by radioimmunoassay. The association of hepcidin-25 at baseline with clinical variables was investigated using linear regression models. All-cause mortality and a composite endpoint of CKD progression (ESRD or doubling of serum creatinine) were analyzed by Cox proportional hazards models. Results Patients (age 67 yrs, 53\% male, GFR 51 ml/min, hemoglobin 131 g/L, EPO 13.5 U/L, hepcidin-25 62.0 ng/ml) were followed for a median time of 4.2 yrs. Forty-nine patients died (19.7\%) and forty (16.1\%) patients reached the composite endpoint. Elevated hepcidin levels were independently associated with higher ferritin-levels, lower EPO-levels and impaired kidney function (all p<0.05). Hepcidin was related to mortality, along with its interaction with EPO, older age, greater proteinuria and elevated CRP (all p<0.05). Hepcidin was also predictive for progression of CKD, aside from baseline GFR, proteinuria, low albumin- and hemoglobin-levels and a history of CVD (all p<0.05). Conclusions We found hepcidin-25 to be associated with EPO and impaired kidney function in diabetic CKD. Elevated hepcidin-25 and EPO-levels were independent predictors of mortality, while hepcidin-25 was also predictive for progression of CKD. Both hepcidin-25 and EPO may represent important prognostic factors of clinical outcome and have the potential to further define "high risk" populations in CKD.},
  language  = {en}
}
@article{ToepferCorovicFetteetal.2015,
  author    = {Toepfer, Martin and Corovic, Hamo and Fette, Georg and Kl{\"u}gl, Peter and St{\"o}rk, Stefan and Puppe, Frank},
  title     = {Fine-grained information extraction from German transthoracic echocardiography reports},
  series = {BMC Medical Informatics and Decision Making},
  volume    = {15},
  journal   = {BMC Medical Informatics and Decision Making},
  number    = {91},
  doi       = {doi:10.1186/s12911-015-0215-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125509},
  year      = {2015},
  abstract  = {Background Information extraction techniques that get structured representations out of unstructured data make a large amount of clinically relevant information about patients accessible for semantic applications. These methods typically rely on standardized terminologies that guide this process. Many languages and clinical domains, however, lack appropriate resources and tools, as well as evaluations of their applications, especially if detailed conceptualizations of the domain are required. For instance, German transthoracic echocardiography reports have not been targeted sufficiently before, despite of their importance for clinical trials. This work therefore aimed at development and evaluation of an information extraction component with a fine-grained terminology that enables to recognize almost all relevant information stated in German transthoracic echocardiography reports at the University Hospital of W{\"u}rzburg. Methods A domain expert validated and iteratively refined an automatically inferred base terminology. The terminology was used by an ontology-driven information extraction system that outputs attribute value pairs. The final component has been mapped to the central elements of a standardized terminology, and it has been evaluated according to documents with different layouts. Results The final system achieved state-of-the-art precision (micro average.996) and recall (micro average.961) on 100 test documents that represent more than 90 \% of all reports. In particular, principal aspects as defined in a standardized external terminology were recognized with f 1=.989 (micro average) and f 1=.963 (macro average). As a result of keyword matching and restraint concept extraction, the system obtained high precision also on unstructured or exceptionally short documents, and documents with uncommon layout. Conclusions The developed terminology and the proposed information extraction system allow to extract fine-grained information from German semi-structured transthoracic echocardiography reports with very high precision and high recall on the majority of documents at the University Hospital of W{\"u}rzburg. Extracted results populate a clinical data warehouse which supports clinical research.},
  language  = {en}
}
@phdthesis{Stoevesand2015,
  author    = {St{\"o}vesand, Torsten},
  title     = {Rekrutierungsstrategien in deutschen Nierenzentren am Beispiel der EQUAL-Pilotstudie ["EQUAL-Studie - eine Europ{\"a}ische QUALit{\"a}tsstudie zur Therapie bei fortgeschrittener chronischer Nierensuffizienz"]},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119069},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {FAZIT: Die EQUAL-Studie stellt eine europ{\"a}ische Initiative zur Beantwortung wichtiger Fragen rund um die Betreuung {\"a}lterer Patienten mit fortschreitender chronischen Niereninsuffizienz dar. Die Pilotstudie konnte in Deutschland erfolgreich durchgef{\"u}hrt werden. Es konnten insgesamt 30 Patienten eingeschlossen werden. Hierbei wurden geeignete Rekrutierungsarten und Rekrutierungsstrategien identifiziert. Die Hauptstudie konnte mit Modifikationen im Design und Organisation aktuell erfolgreich in Deutschland und Europa durchgef{\"u}hrt werden.},
  subject      = {Rekrutierungsstrategien},
  language  = {de}
}
@article{SherifInceManiucetal.2015,
  author    = {Sherif, Mohammad A. and Ince, H{\"u}seyin and Maniuc, Octavian and Reiter, Therese and Voelker, Wolfram and Ertl, Georg and {\"O}ner, Alper},
  title     = {Two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation},
  series = {BMC Cardiovascular Disorders},
  volume    = {15},
  journal   = {BMC Cardiovascular Disorders},
  number    = {181},
  doi       = {10.1186/s12872-015-0181-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-136002},
  year      = {2015},
  abstract  = {Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we examined the accuracy of a novel method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus. Methods: We evaluated the theoretical impact of the measurement of the annulus diameter and area using the circumcircle of a triangle method on the decision to perform the procedure and choice of the prosthesis size. Results: Sixty-three consecutive patients were scheduled for TAVI. Mean age was 82 +/- 4 years, and 25 patients (55.6 \%) were female. Mean aortic annulus diameter was 20.3 +/- 2.2 mm assessed by TEE on the mid-esophageal long-axis view and 23.9 +/- 2.3 mm using CT (p < 0.001). There was a tendency for the TEE derived areas using the new method to be higher (p < 0.001). The TEE measurements were on average 42.33 mm(2) higher than the CT measurements without an evidence of a systematic over-or under-sizing (p = 1.00). Agreement between TEE and CT chosen valve sizes was good overall (kappa = 0.67 and weighted kappa = 0.71). For patients who turned out to have no AR, the two methods agreed in 84.6 \% of patients. Conclusions: CT remanis the gold standard in sizing of the aortic valve annulus. Nevertheless, sizing of the aortic valve annulus using TEE derived area may be helpful. The impact of integration of this method in the algorithm of aortic annulus sizing on the outcome of patients undergoing TAVI should be examined in future studies.},
  language  = {en}
}
@article{SherifHeroldVoelkeretal.2015,
  author    = {Sherif, Mohammad A. and Herold, Joerg and Voelker, Wolfram and Maniuc, Octavian and Ertl, Georg and Praast, Christian and Braun-Dullaeus, Ruediger Christian},
  title     = {Feasibility of a new method using two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation; a case-control study},
  series = {BMC Cardiovascular Disorders},
  volume    = {15},
  journal   = {BMC Cardiovascular Disorders},
  number    = {78},
  doi       = {10.1186/s12872-015-0072-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148328},
  year      = {2015},
  abstract  = {Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we validated a new method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus prior to TAVI. Methods: We analysed 124 patients who underwent successful TAVI using a self-expandable prosthesis, divided equally into two groups; in the study group we used the cross sectional short axis 2D-TEE for measurement of the aortic annulus and in the control group we used the long axis 2D-TEE. Results: Both groups were comparable regarding the clinical parameters. On the other hand, patients in the study group had less left ventricular ejection fraction (38.9 \% versus 45.6 \%, p = 0.01). The aortic valve annulus was, although not statistically significant, smaller in the study group (21.58 versus 23.28 mm, p = 0.25). Post procedural quantification of the aortic regurgitation revealed that only one patient in both groups had severe aortic regurgitation (AR), in this patient the valve was implanted deep. The incidence of significant AR was higher in the control group (29.0 \% versus 12.9 \%, p = 0.027). Conclusions: Sizing of the aortic valve annulus using cross-sectional 2D-TEE offers a safe and plausible method for patients undergoing TAVI using the self-expandable prosthesis and is significantly superior to using long axis 2D-TEE.},
  language  = {en}
}
@article{SeyfriedvonRahdenMirasetal.2015,
  author    = {Seyfried, Florian and von Rahden, Burkhard H. and Miras, Alexander D. and Gasser, Martin and Maeder, Uwe and Kunzmann, Volker and Germer, Christoph-Thomas and Pelz, J{\"o}rg O. W. and Kerscher, Alexander G.},
  title     = {Incidence, time course and independent risk factors for metachronous peritoneal carcinomatosis of gastric origin - a longitudinal experience from a prospectively collected database of 1108 patients},
  series = {BMC Cancer},
  volume    = {15},
  journal   = {BMC Cancer},
  number    = {73},
  doi       = {10.1186/s12885-015-1081-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125014},
  year      = {2015},
  abstract  = {Background Comprehensive evidence on the incidence, time course and independent risk factors of metachronous peritoneal carcinomatosis (metaPC) in gastric cancer patients treated with curative intent in the context of available systemic combination chemotherapies is lacking. Methods Data from a prospectively collected single-institutional Center Cancer Registry with 1108 consecutive patients with gastric adenocarcinoma (GC), clinical, histological and survival data were analyzed for independent risk factors and prognosis with focus on the development of metaPC. Findings were then stratified to the time periods of treatment with surgery alone, 5-Fluorouracil-only and contemporary combined systemic perioperative chemotherapy strategies, respectively. Results Despite R0 D2 gastrectomy (n = 560), 49.6\% (±5.4\%) of the patients were diagnosed with tumour recurrence and 15.5\% (±1.8\%) developed metaPC after a median time of 17.7 (15.1-20.3) months after surgery resulting in a tumour related mortality of 100\% with a median survival of 3.0 months (2.1 - 4.0). Independent risk factors for the development of metaPC were serosa positive T-category, nodal positive-status, signet cell and undifferentiated gradings (G3/G4). Contemporary systemic combination chemotherapy did not improve the incidence and prognosis of metaPC (p = 0.54). Conclusions Despite significant improvements in the overall survival for the complete cohort with gastric cancer over time, those patients with metaPC did not experience the same benefits. The lack of change in the incidence, and persistent poor prognosis of metaPC after curative surgery expose the need for further prevention and/or improved treatment options for this devastating condition.},
  language  = {en}
}
@article{SchneiderSchneiderKrieteretal.2015,
  author    = {Schneider, Andreas and Schneider, Markus P. and Krieter, Detlef H. and Genser, Bernd and Scharnagl, Hubert and Stojakovic, Tatjana and Wanner, Christoph and Drechsler, Christiane},
  title     = {Effect of high-flux dialysis on circulating FGF-23 levels in end-stage renal disease patients: results from a randomized trial},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {5},
  doi       = {10.1371/journal.pone.0128079},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148559},
  pages     = {e0128079},
  year      = {2015},
  abstract  = {Background In patients undergoing maintenance hemodialysis (HD), increased levels of circulating fibroblast growth factor-23 (FGF-23) are independently associated with cardiovascular events and mortality. Interventional strategies aiming to reduce levels of FGF-23 in HD patients are of particular interest. The purpose of the current study was to compare the impact of high-flux versus low-flux HD on circulating FGF-23 levels. Methods We conducted a post-hoc analysis of the MINOXIS study, including 127 dialysis patients randomized to low-flux (n = 62) and high-flux (n = 65) HD for 52 weeks. Patients with valid measures for FGF-23 investigated baseline and after 52 weeks were included. Results Compared to baseline, a significant increase in FGF-23 levels after one year of low-flux HD was observed (Delta plasma FGF-23: +4026 RU/ml; p < 0.001). In contrast, FGF-23 levels remained stable in the high flux group (Delta plasma FGF-23: +373 RU/ml, p = 0.70). The adjusted difference of the absolute change in FGF-23 levels between the two treatment groups was statistically significant (p < 0.01). Conclusions Over a period of 12 months, high-flux HD was associated with stable FGF-23 levels, whereas the low-flux HD group showed an increase of FGF-23. However, the implications of the different FGF 23 time-trends in patients on high flux dialysis, as compared to the control group, remain to be explored in specifically designed clinical trials.},
  language  = {en}
}
@article{SchickBaarBrunoetal.2015,
  author    = {Schick, Martin Alexander and Baar, Wolfgang and Bruno, Raphael Romano and Wollborn, Jakob and Held, Christopher and Schneider, Reinhard and Flemming, Sven and Schlegel, Nicolas and Roewer, Norbert and Neuhaus, Winfried and Wunder, Christian},
  title     = {Balanced hydroxyethylstarch (HES 130/0.4) impairs kidney function in-vivo without inflammation},
  series = {PLoS One},
  volume    = {10},
  journal   = {PLoS One},
  number    = {9},
  doi       = {10.1371/journal.pone.0137247},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126068},
  pages     = {e0137247},
  year      = {2015},
  abstract  = {Volume therapy is a standard procedure in daily perioperative care, and there is an ongoing discussion about the benefits of colloid resuscitation with hydroxyethylstarch (HES). In sepsis HES should be avoided due to a higher risk for acute kidney injury (AKI). Results of the usage of HES in patients without sepsis are controversial. Therefore we conducted an animal study to evaluate the impact of 6\% HES 130/0.4 on kidney integrity with sepsis or under healthy conditions Sepsis was induced by standardized Colon Ascendens Stent Peritonitis (sCASP). sCASP-group as well as control group (C) remained untreated for 24 h. After 18 h sCASP+HES group (sCASP+VOL) and control+HES (C+VOL) received 50 ml/KG balanced 6\% HES (VOL) 130/0.4 over 6h. After 24h kidney function was measured via Inulin- and PAH-Clearance in re-anesthetized rats, and serum urea, creatinine (crea), cystatin C and Neutrophil gelatinase-associated lipocalin (NGAL) as well as histopathology were analysed. In vitro human proximal tubule cells (PTC) were cultured +/- lipopolysaccharid (LPS) and with 0.1-4.0\% VOL. Cell viability was measured with XTT-, cell toxicity with LDH-test. sCASP induced severe septic AKI demonstrated divergent results regarding renal function by clearance or creatinine measure focusing on VOL. Soleley HES (C+VOL) deteriorated renal function without sCASP. Histopathology revealed significantly derangements in all HES groups compared to control. In vitro LPS did not worsen the HES induced reduction of cell viability in PTC cells. For the first time, we demonstrated, that application of 50 ml/KG 6\% HES 130/0.4 over 6 hours induced AKI without inflammation in vivo. Severity of sCASP induced septic AKI might be no longer susceptible to the way of volume expansion},
  language  = {en}
}
@phdthesis{Reuter2015,
  author    = {Reuter, Miriam},
  title     = {Der Einfluss des Multityrosinkinaseinhibitors Sunitinib auf die Proliferation und Steroidbiosynthese von Nebennierenkarzinomzellen in vitro},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-129537},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Tyrosinkinaseinhibitoren nehmen in der modernen Onkologie einen wachsenden Stellenwert ein. Sunitinib wirkt als Multityrosinkinaseinhibitor einerseits antiangiogenetisch, andererseits auch direkt antiproliferativ auf Tumorzellen. Im Tierversuch sind unter Sunitinib adrenotoxische Wirkungen beschrieben. F{\"u}r das Nebennierenkarzinom, eine sehr seltene Tumorerkrankung mit schlechter Prognose, werden dringend neue Therapieoptionen ben{\"o}tigt. In dieser Arbeit wurde der Effekt von Sunitinib auf die Proliferation von Nebennierenkarzinomzellen in vitro und auf deren Steroidbiosynthese untersucht. Es konnte gezeigt werden, dass Sunitinib dosisabh{\"a}ngig auf die beiden Nebennierenkarzinomzelllinien NCI-h295(R) und SW-13 antiproliferativ wirkt (SW-13: unter 0,1 µM Sunitinib 96 ± 7 \%; 1 µM 90 ± 9 \%*; 5 µM 62 ± 6 \%*, Kontrollen 100 ± 9 \%, ab 1 µM p<0,05). Steroidanalysen in den Zellkultur{\"u}berst{\"a}nden von NCI-h295-Zellen mittels Isotopenverd{\"u}nnungs-/Gaschromatographie-Massenspektrometrie belegen eine Abnahme der Cortisolsekretion (1 μM 90,1 ± 1,5 \%*, 5 μM 57,2 ± 0,3 \%*, Kontrollen 100 ± 2,4 \%), w{\"a}hrend bestimmte Vorl{\"a}uferhormone akkumulieren. Der beobachtete Anstieg der Quotienten von 17-OH-Pregnenolon zu 17-OH-Progesteron und DHEA zu Androstendion belegt eine partielle Hemmung der Steroidsynthese auf Ebene der 3ß-Hydroxysteroiddehydrogenase (HSD3B2). Nachdem eine direkte Hemmung des Enzyms HSD3B2 mittels Hefe-Mikrosomen-Assay ausgeschlossen werden konnte, best{\"a}tigte sich auf RNA- mittels Real-Time-PCR und Proteinebene mittels Western Blot eine dosisabh{\"a}ngige Hemmung der Transkription und Translation des Enzyms (mRNA: 1 μM 47 ± 7 \%*; 5 μM 33 ± 7 \%*; 10 μM 27 ± 6 \%*; Protein: 1 μM 82 ± 8 \%; 5 μM 63 ± 8 \%*; 10 μM 55 ± 9 \%*). Auch f{\"u}r CYP11B1 zeigte sich eine dosisabh{\"a}ngige Transkriptionshemmung durch Sunitinib, andere Enzyme wie CYP11A1 dagegen werden nicht beeinflusst. Wenn sich diese in vitro Effekte bei Patienten unter Sunitinib-Therapie best{\"a}tigen sollten, k{\"o}nnte es bei einzelnen Patienten zu einer klinisch relevanten Nebenniereninsuffizienz kommen. Eine eindeutige Wirksamkeit von Sunitinib als Therapieoption beim Nebennierenkarzinom konnte im Rahmen der SIRAC-Studie nicht best{\"a}tigt werden. Hier ist jedoch anzumerken, dass wahrscheinlich eine gravierende Medikamenteninteraktion mit Mitotane zu einer Reduktion des Effekts von Sunitinib beigetragen hat.},
  subject      = {Nebennierenrindenkarzinom},
  language  = {de}
}
@article{PreisingSchneiderBucheretal.2015,
  author    = {Preising, Christina and Schneider, Reinhard and Bucher, Michael and Gekle, Michael and Sauvant, Christoph},
  title     = {Regulation of expression of renal organic anion transporters OAT1 and OAT3 in a model of ischemia/reperfusion injury},
  series = {Cellular Physiology and Biochemistry},
  volume    = {37},
  journal   = {Cellular Physiology and Biochemistry},
  number    = {1},
  doi       = {10.1159/000430328},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144504},
  year      = {2015},
  abstract  = {Background: Recently, we gained evidence that impairment of rOat1 and rOat3 expression induced by ischemic acute kidney injury (AKI) is mediated by COX metabolites and this suppression might be critically involved in renal damage. Methods: (i) Basolateral organic anion uptake into proximal tubular cells after model ischemia and reperfusion (I/R) was investigated by fluorescein uptake. The putative promoter sequences from hOAT1 (SLC22A6) and hOAT3 (SCL22A8) were cloned into a reporter plasmid, transfected into HEK cells and (ii) transcriptional activity was determined after model ischemia and reperfusion as a SEAP reporter gen assay. Inhibitors or antagonists were applied with the beginning of reperfusion. Results: By using inhibitors of PKA (H89) and PLC (U73122), antagonists of E prostanoid receptor type 2 (AH6809) and type 4 (L161,982), we gained evidence that I/R induced down regulation of organic anion transport is mediated by COX1 metabolites via E prostanoid receptor type 4. The latter signaling was confirmed by application of butaprost (EP2 agonist) or TCS2510 (EP4 agonist) to control cells. In brief, the latter signaling was verified for the transcriptional activity in the reporter gen assay established. Therein, selective inhibitors for COX1 (SC58125) and COX2 (SC560) were also applied. Conclusion: Our data show (a) that COX1 metabolites are involved in the regulation of renal organic anion transport(ers) after I/R via the EP4 receptor and (b) that this is due to transcriptional regulation of the respective transporters. As the promoter sequences cloned were of human origin and expressed in a human renal epithelial cell line we (c) hypothesize that the regulatory mechanisms described after I/R is meaningful for humans as well.},
  language  = {en}
}
@article{PippiasStelDiezetal.2015,
  author    = {Pippias, Maria and Stel, Vianda S. and Diez, Jos{\´e} Maria Abad and Afentakis, Nikolaos and Herrero-Calvo, Jose Antonio and Arias, Manuel and Tomilina, Natalia and Caama{\~n}o, Encarnaci{\´o}n Bouzas and Buturovic-Ponikvar, Jadranka and Čala, Svjetlana and Caskey, Fergus J. and de la Nuez, Pablo Castro and Cernevskis, Harijs and Collart, Frederic and de la Torre, Ram{\´o}n Alonso and de los {\´A}ngeles Garc{\´i}a Bazaga, Maria and De Meester, Johan and D{\´i}az, Joan Manuel and Djukanovic, Ljubica and Alamar, Manuel Ferrer and Finne, Patrik and Garneata, Liliana and Golan, Eliezer and Gonz{\´a}lez Fern{\´a}ndez, Raquel and Guti{\´e}rrez Avila, Gonzalo and Heaf, James and Hoitsma, Andries and Kantaria, Nino and Kolesnyk, Mykola and Kramar, Reinhard and Kramer, Anneke and Lassalle, Mathilde and Leivestad, Torbj{\o}rn and Lopot, Frantisek and Mac{\´a}rio, Fernando and Magaz, Angela and Mart{\´i}n-Escobar, Eduardo and Metcalfe, Wendy and Noordzij, Marlies and Palsson, Runolfur and Pechter, {\"U}lle and Pr{\"u}tz, Karl G. and Ratkovic, Marina and Resić, Halima and Rutkowski, Boleslaw and de Pablos, Carmen Santiuste and Spustov{\´a}, Viera and S{\"u}leymanlar, G{\"u}ltekin and Van Stralen, Karlijn and Thereska, Nestor and Wanner, Christoph and Jager, Kitty J.},
  title     = {Renal replacement therapy in Europe: a summary of the 2012 ERA-EDTA Registry Annual Report},
  series = {Clinical Kidney Journal},
  volume    = {8},
  journal   = {Clinical Kidney Journal},
  number    = {3},
  doi       = {10.1093/ckj/sfv014},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150054},
  pages     = {248-261},
  year      = {2015},
  abstract  = {Background This article summarizes the 2012 European Renal Association—European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). Methods Data provided by 45 national or regional renal registries in 30 countries in Europe and bordering the Mediterranean Sea were used. Individual patient level data were received from 31 renal registries, whereas 14 renal registries contributed data in an aggregated form. The incidence, prevalence and survival probabilities of patients with end-stage renal disease (ESRD) receiving renal replacement therapy (RRT) and renal transplantation rates for 2012 are presented. Results In 2012, the overall unadjusted incidence rate of patients with ESRD receiving RRT was 109.6 per million population (pmp) (n = 69 035), ranging from 219.9 pmp in Portugal to 24.2 pmp in Montenegro. The proportion of incident patients ≥75 years varied from 15 to 44\% between countries. The overall unadjusted prevalence on 31 December 2012 was 716.7 pmp (n = 451 270), ranging from 1670.2 pmp in Portugal to 146.7 pmp in the Ukraine. The proportion of prevalent patients ≥75 years varied from 11 to 32\% between countries. The overall renal transplantation rate in 2012 was 28.3 pmp (n = 15 673), with the highest rate seen in the Spanish region of Catalonia. The proportion of patients ≥65 years receiving a transplant ranged from 0 to 35\%. Five-year adjusted survival for all RRT patients was 59.7\% (95\% confidence interval, CI: 59.3-60.0) which fell to 39.3\% (95\% CI: 38.7-39.9) in patients 65-74 years and 21.3\% (95\% CI: 20.8-21.9) in patients ≥75 years.},
  language  = {en}
}
@article{PaschkeLinckeMuelleretal.2015,
  author    = {Paschke, Ralf and Lincke, Thomas and M{\"u}ller, Stefan P. and Kreissl, Michael C. and Dralle, Henning and Fassnacht, Martin},
  title     = {The Treatment of Well-Differentiated Thyroid Carcinoma},
  series = {Deutsches {\"A}rzteblatt International},
  volume    = {112},
  journal   = {Deutsches {\"A}rzteblatt International},
  doi       = {10.3238/arztebl.2015.0452},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151636},
  pages     = {452 -- 458},
  year      = {2015},
  abstract  = {Background: Recent decades have seen a rise in the incidence of well-differentiated (mainly papillary) thyroid carcinoma around the world. In Germany, the age-adjusted incidence of well-differentiated thyroid carcinoma in 2010 was 3.5 per 100 000 men and 8.7 per 100 000 women per year. Method: This review is based on randomized, controlled trials and multicenter trials on the treatment of well-differentiated thyroid carcinoma that were retrieved by a selective literature search, as well as on three updated guidelines issued in the past two years. Results: The recommended extent of surgical resection depends on whether the tumor is classified as low-risk or high-risk, so that papillary microcar cinomas, which carry a highly favorable prognosis, will not be overtreated. More than 90\% of localized, well-differentiated thyroid carcinomas can be cured with a combination of surgery and radioactive iodine therapy. Radio active iodine therapy is also effective in the treatment of well-differentiated thyroid carcinomas with distant metastases, yielding a 10-year survival rate of 90\%, as long as there is good iodine uptake and the tumor goes into remission after treatment; otherwise, the 10-year survival rate is only 10\%. In the past two years, better treatment options have become available for radioactive-iodine-resistant thyroid carcinoma. Phase 3 studies of two different tyrosine kinase inhibitors have shown that either one can markedly prolong progression-free survival, but not overall survival. Their more common clinically significant side effects are hand-foot syndrome, hypertension, diarrhea, proteinuria, and weight loss. Conclusion: Slow tumor growth, good resectability, and susceptibility to radioactive iodine therapy lend a favorable prognosis to most cases of well-differentiated thyroid carcinoma. The treatment should be risk-adjusted and interdisciplinary, in accordance with the current treatment guidelines. Even metastatic thyroid carcinoma has a favorable prognosis as long as there is good iodine uptake. The newly available medical treatment options for radioactive-iodine-resistant disease need to be further studied.},
  language  = {en}
}
@article{MostovayaGrootemanBasileetal.2015,
  author    = {Mostovaya, Ira M. and Grooteman, Muriel P.C. and Basile, Carlo and Davenport, Andrew and de Roij van Zuijdewijn, Camiel L.M. and Wanner, Christoph and Nub{\´e}, Menso J. and Blankestijn, Peter J.},
  title     = {High convection volume in online post-dilution haemodiafiltration: relevance, safety and costs},
  series = {Clinical Kidney Journal},
  volume    = {8},
  journal   = {Clinical Kidney Journal},
  number    = {4},
  doi       = {10.1093/ckj/sfv040},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149814},
  pages     = {368-373},
  year      = {2015},
  abstract  = {Increasing evidence suggests that treatment with online post-dilution haemodiafiltration (HDF) improves clinical outcome in patients with end-stage kidney disease, if compared with haemodialysis (HD). Although the primary analyses of three large randomized controlled trials (RCTs) showed inconclusive results, post hoc analyses of these and previous observational studies comparing online post-dilution HDF with HD showed that the risk of overall and cardiovascular mortality is lowest in patients who are treated with high-volume HDF. As such, the magnitude of the convection volume seems crucial and can be considered as the 'dose' of HDF. In this narrative review, the relevance of high convection volume in online post-dilution HDF is discussed. In addition, we briefly touch upon some safety and cost issues.},
  language  = {en}
}
@article{MontesCobosLiFischeretal.2015,
  author    = {Montes-Cobos, Elena and Li, Xiao and Fischer, Henrike J. and Sasse, Andr{\´e} and K{\"u}gler, Sebastian and Didi{\´e}, Michael and Toischer, Karl and Fassnacht, Martin and Dressel, Ralf and Reichardt, Holger M.},
  title     = {Inducible Knock-Down of the Mineralocorticoid Receptor in Mice Disturbs Regulation of the Renin-Angiotensin-Aldosterone System and Attenuates Heart Failure Induced by Pressure Overload},
  series = {PLoS One},
  volume    = {10},
  journal   = {PLoS One},
  number    = {11},
  doi       = {10.1371/journal.pone.0143954},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-137575},
  pages     = {e0143954},
  year      = {2015},
  abstract  = {Mineralocorticoid receptor (MR) inactivation in mice results in early postnatal lethality. Therefore we generated mice in which MR expression can be silenced during adulthood by administration of doxycycline (Dox). Using a lentiviral approach, we obtained two lines of transgenic mice harboring a construct that allows for regulatable MR inactivation by RNAi and concomitant expression of eGFP. MR mRNA levels in heart and kidney of inducible MR knock-down mice were unaltered in the absence of Dox, confirming the tightness of the system. In contrast, two weeks after Dox administration MR expression was significantly diminished in a variety of tissues. In the kidney, this resulted in lower mRNA levels of selected target genes, which was accompanied by strongly increased serum aldosterone and plasma renin levels as well as by elevated sodium excretion. In the healthy heart, gene expression and the amount of collagen were unchanged despite MR levels being significantly reduced. After transverse aortic constriction, however, cardiac hypertrophy and progressive heart failure were attenuated by MR silencing, fibrosis was unaffected and mRNA levels of a subset of genes reduced. Taken together, we believe that this mouse model is a useful tool to investigate the role of the MR in pathophysiological processes.},
  language  = {en}
}
@article{LiuHuPelzeretal.2015,
  author    = {Liu, Dan and Hu, Kai and Pelzer, Heinz-Theo and St{\"o}rk, Stefan and Weidemann, Frank},
  title     = {Journey of a patient with chronic thromboembolic pulmonary hypertension},
  series = {European Journal of Medical Research},
  volume    = {20},
  journal   = {European Journal of Medical Research},
  number    = {20},
  doi       = {10.1186/s40001-015-0112-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125009},
  year      = {2015},
  abstract  = {Right ventricle (RV) dysfunction is a key outcome determinant and a leading cause of death for patients with chronic thromboembolic pulmonary hypertension (CTEPH). In this report, we followed the 5-year clinical journey of a patient with CTEPH. The tricuspid pressure gradient was significantly increased in the early phase of CTEPH and "normalized" at the late phase of this patient's clinical journey, but this "normalized" gradient is not a positive treatment response but rather an ominous sign of advancing right heart failure owing to an exhaustion of RV contractile function. Thus, appropriate interpretation of the tricuspid pressure gradient change is of importance for assessing RV dysfunction and treatment outcome during follow-up in patients with CTEPH. Besides systolic pulmonary artery pressure (SPAP), other RV functional parameters such as tricuspid annular plane systolic excursion, RV fractional area change, and RV longitudinal strain, together with clinical markers, may provide additional guidance regarding functional improvement or progression in patients with CTEPH.},
  language  = {en}
}
@phdthesis{Link2015,
  author    = {Link, Daniela},
  title     = {Die Untersuchung von Asymmetrischem und Symmetrischem Dimethylarginin, Homoarginin und C-reaktivem Protein als kardiovaskul{\"a}re Biomarker mit besonderer Ber{\"u}cksichtigung des Schlaganfalls bei terminal niereninsuffizienten Patienten mit Diabetes mellitus Typ 2 an der H{\"a}modialyse},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-123603},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {In dieser post-hoc Analyse der 4D Studie wurde evaluiert, in welchem Maße endotheliale Dysfunktion und Inflammation f{\"u}r die deutlich erh{\"o}hte kardiovaskul{\"a}re Morbidit{\"a}t und Mortalit{\"a}t terminal niereninsuffizienter Patienten verantwortlich sind. Das untersuchte Patientenkollektiv bestand aus 1255 H{\"a}modialyse-Patienten mit Diabetes mellitus Typ 2, die multizentrisch, randomisiert und kontrolliert mit 20 mg Atorvastatin pro Tag oder Placebo behandelt wurden. Nutzen und Risiken dieser Therapie in Hinblick auf den prim{\"a}ren Endpunkt bestehend aus kardialem Tod, Myokardinfarkt und Schlaganfall wurden {\"u}ber einen medianen follow-up Zeitraum von vier Jahren evaluiert. Bei diesem Kollektiv wurden die Biomarker ADMA, SDMA, H-Arginin und SCRP gemessen und mit Hilfe eines multivariaten Cox-Regressionsmodells hinsichtlich ihres pr{\"a}diktiven Wertes in Bezug auf Schlaganfall und kardiovaskul{\"a}re Ereignisse untersucht. SCRP wurde zus{\"a}tzlich in Relation zu dem traditionellen kardiovaskul{\"a}ren Biomarker LDL-Cholesterin analysiert und der Einfluss von Atorvastatin auf die untersuchten Marker erforscht. Im Folgenden werden die wichtigsten Ergebnisse zusammengefasst. Patienten der zweiten Quartile (ADMA >0,77 bis ≤0,86 µmol L-1) hatten ein um 66\% h{\"o}heres Risiko einen Myokardinfarkt (HR 1.66, 95\% KI 1.12-2.46) und ein um 36\% h{\"o}heres Risiko den kombinierten kardiovaskul{\"a}ren Endpunkt zu erreichen (HR 1.36, 95\% KI 1.05-1.77) als Patienten der ersten Quartile (ADMA ≤0,77 µmol L-1). SDMA war mit einer erh{\"o}hten Inzidenz von Schlaganf{\"a}llen verbunden. Das Risiko einen Schlaganfall zu erleiden war f{\"u}r Patienten aus Quartile 3 (SDMA >2,45 bis ≤2,96 µmol L-1) um 125\% (HR 2.25, 95\% KI 1.24-4.11) und f{\"u}r Patienten aus Quartile 4 (SDMA >2,96 µmol L-1) um 90\% (HR 1.89, 95\% KI 1.02-3.53) h{\"o}her als f{\"u}r Patienten aus Quartile 1. In Abh{\"a}ngigkeit des H-Arginin-Wertes sank das Risiko des pl{\"o}tzlichen Herztodes und der Gesamtmortalit{\"a}t: Patienten in Quartile 4 (>1,4 µmol L-1) hatten ein um 51\% niedrigeres Risiko an pl{\"o}tzlichem Herztod zu versterben als Patienten in Quartile 1 (≤0,87 µmol L-1) (HR 0.49, 95\% KI 0.29-0.85). Das Risiko der Gesamtmortalit{\"a}t war in Quartile 3 (>1,1 bis ≤1,4 µmol L-1) (HR 0.78, 95\% KI 0.62-0.99) und 4 (HR 0.65, 95\% KI 0.50-0.84) im Vergleich zu Quartile 1 am niedrigsten. Sensitives CRP als Baseline-Parameter wurde als Pr{\"a}diktor f{\"u}r den kombinierten kardiovaskul{\"a}ren Endpunkt (HR 1.10, 95\% KI 1.01-1.18) und die Gesamtmortalit{\"a}t (HR 1.25, 95\% KI 1.17-1.33) identifiziert. Ebenso war der Mittelwert zweier Messungen mit einem erh{\"o}hten kardiovaskul{\"a}ren Risiko assoziiert: Das Risiko einen Schlaganfall (HR 1.20, 95\% KI 1.01-1.42) oder den pl{\"o}tzlichen Herztod (HR 1.20, 95\% KI 1.05-1.37) zu erleiden stieg um 20\% pro Einheit Anstieg in logarithmisch-transformiertem CRP, das den kombinierten kardiovaskul{\"a}ren Endpunkt zu erreichen um 10\% (HR 1.10, 95\% KI 1.02-1.20) und die Gesamtmortalit{\"a}t um 30\% (HR 1.30, 95\% KI 1.21-1.39). Patienten, deren SCRP-Wert initial unterhalb des Medians von 5 mg L-1 lag und im Verlauf um mehr als 100\% anstieg, hatten ein um mehr als 4fach erh{\"o}htes Risiko einen Schlaganfall zu erleiden (HR 4.07, 95\% KI 1.20-13.78) und ein um mehr als 60\% erh{\"o}htes Risiko zu versterben (HR 1.63, 95\% KI 1.08-2.45) als Patienten, deren SCRP im Verlauf um 47,3\% fiel. LDL in Kombination mit SCRP zeigte sich hier nicht pr{\"a}diktiv f{\"u}r kardiovaskul{\"a}re Ereignisse. Die Atorvastatin-Behandlung beeinflusste außer dem LDL-Cholesterin keinen der untersuchten Parameter. In der Subgruppe der Patienten mit den h{\"o}chsten CRP-Werten fand sich eine erh{\"o}hte Schlaganfallinzidenz unter denen, die mit Atorvastatin behandelt wurden. Insgesamt stellen hohes SDMA und SCRP als Verlaufsparameter im Gegensatz zu ADMA und H-Arginin unabh{\"a}ngige Pr{\"a}diktoren f{\"u}r das Auftreten von Schlaganf{\"a}llen bei H{\"a}modialyse-Patienten mit Diabetes mellitus Typ 2 dar.},
  subject      = {Schlaganfall},
  language  = {de}
}
@phdthesis{Koerbl2015,
  author    = {K{\"o}rbl, Daniela},
  title     = {Thalidomid als Therapieoption beim fortgeschrittenen Nebennierenkarzinom},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119661},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Thalidomid als Therapieoption beim fortgeschrittenen Nebennierenkarzinom: Eine retrospektive Studie Das adrenokortikale Karzinom (ACC) ist ein seltener Tumor mit einer schlechten Prognose. Im fortgeschrittenen Stadium gelten Mitotane und zytotoxische Chemotherapien als Standardtherapie, mit denen allerdings nur kurzzeitig eine Tumorkontrolle erreicht werden kann. Daher machte Thalidomid Hoffnung auf eine m{\"o}gliche ´Rettungs´-Therapie. Im Rahmen dieser retrospektiven Studie sollte der Nutzen und die Tolerabilit{\"a}t von Thalidomid beim fortgeschrittenen Nebennierenkarzinom untersucht werden. Insgesamt konnten 15 Patienten aus dem deutschen Nebennnierenkarzinomregister herausgefiltert werden, die den Einschlusskriterien entsprachen und Thalidomid als off-label erhalten haben. Als Endpunkt wurden das progressionsfreie {\"U}berleben, ausgewertet geblinded gem{\"a}ß RECIST 1.1., und das Gesamt{\"u}berleben festgelegt. Alle 15 Patienten (7 M{\"a}nner; medianes Alter 48,9 (Range 34,4 - 69,0) Jahre) waren bereits mit bis zu sechs systemischen Therapien vorbehandelt. Thalidomid wurde in einer Dosierung gem{\"a}ß Vertr{\"a}glichkeit verabreicht (mediane Startdosis 100 mg/d) und das Restaging erfolgte alle 12 Wochen, das Erste im Median nach 10,9 Wochen. Das progressionfreie {\"U}berleben lag im Median bei 11,1 Wochen (Range 4,4 - 34,4 Wochen), das Gesamt{\"u}berleben lag im Median bei 34,4 Wochen (Range 5,1 - 111,1 Wochen). W{\"a}hrend der erste Patient, der eine Krankheitsstabilisierung erfahren hat, die Behandlung aufgrund von Epistaxis und Diarrhoe Grad I nach 22,3 Wochen abbrach, zeigte der zweite Patient nach 34,4 Wochen weiterhin eine Krankheitsstabilisierung, obwohl er unter den vorangegangenen vier zytotoxischen Therapien progredient war. Unter Thalidomid wurden nur geringgradige bis m{\"a}ßige Nebenwirkungen beobachtet (haupts{\"a}chlich Fatigue und gastrointestinale Nebenwirkungen). Schlussfolgerung: Thalidomid ist ein gut vertr{\"a}gliches Medikament, das nur bei einer Minderheit zahlreich vortherapierter Patienten zu einer Krankheitsstabilisierung f{\"u}hrte.},
  subject      = {Thalidomid},
  language  = {de}
}
@phdthesis{Kutzer2015,
  author    = {Kutzer, Pia Elfriede Seyra},
  title     = {Langzeitergebnisse einer steroidfreien Immunsuppression ein Jahr nach Nierentransplantation},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-141586},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Die Transplantation nimmt, mehr noch als die verschiedenen Dialyseverfahren, den h{\"o}chsten Stellenwert in der Therapie eines terminalen Nierenversagens ein. Eine Transplantation erfordert jedoch auch immer eine suffiziente Immunsuppression, ohne die die Funktionalit{\"a}t des Transplantats nicht gew{\"a}hrleistet werden kann. Kortikosteroide werden dabei immer noch sehr h{\"a}ufig nach Nierentransplantation eingesetzt. Jedoch bringt diese Medikation auch Risiken mit sich. In der vorliegenden retrospektiven Analyse wurden die Daten von insgesamt 809 Patienten ausgewertet. Die Patienten wurden in zwei Gruppen aufgeteilt, wobei zwischen steroidfrei und nicht-steroidfrei in Jahr zwei nach Transplantation unterschieden wurde. Untersucht wurde, ob es Unterschiede im Patienten- und Transplantat{\"u}berleben, bei akuten Abstoßungen oder bei steroidtypischen Nebenwirkungen gibt. Wir konnten ein tendenziell besseres Patienten{\"u}berleben in der steroidfreien Gruppe feststellen, vor allem zu sehen an der Zehn-Jahres-{\"U}berlebensrate (86,0\% vs. 79,8\%). Bez{\"u}glich des Transplantat{\"u}berlebens zeigte sich ein statistisch signifikanter Unterschied zugunsten der steroidfreien Patienten (nach f{\"u}nf Jahren 92,2\% vs. 79,7\%). Ein Transplantatverlust war in der steroidfreien Kohorte seltener zu beobachten (23,1\% vs. 33,8\%). Bei den in Jahr zwei steroidfreien Patienten ereigneten sich weniger akute Abstoßungsereignisse, sowohl bioptisch gesicherte als auch nur klinisch verd{\"a}chtige Episoden. Steroidtypische Nebenwirkungen, zum Beispiel ein Posttransplantationsdiabetes sowie kardiovaskul{\"a}re Ereignisse wurden tendenziell h{\"a}ufiger in der Kohorte mit fortgesetzter Steroideinnahme diagnostiziert. Im Auftreten von Malignomen gab es keinen Unterschied zwischen den beiden Gruppen. Zu beachten ist die M{\"o}glichkeit eines Selektionsbias bei der retrospektiven Auswertung. Somit ergeben sich in unserer Analyse f{\"u}r eine verk{\"u}rzte Einnahme von Steroiden nach Transplantation greifbare Vorteile f{\"u}r das Patienten- und Transplantat{\"u}berleben. Die Steroidtherapie sollte jedoch mindestens bis sechs Monate nach Transplantation beibehalten werden. Nach diesem Zeitraum erscheint das Absetzen der Steroide sicherer zu sein, da akute Abstoßungsepisoden seltener auftreten. Sowohl Patienten- und Transplantat{\"u}berleben werden durch das Absetzen der Steroidtherapie g{\"u}nstig beeinflusst. Ein fr{\"u}heres Absetzen, wie es in anderen Studien durchgef{\"u}hrt wurde, f{\"u}hrte h{\"a}ufiger zu h{\"o}heren Raten an akuten Rejektionen. Kortikosteroide waren und bleiben somit ein unverzichtbarer Teil der initialen immunsuppressiven Therapie nach Nierentransplantation.},
  subject      = {Nierentransplantation},
  language  = {de}
}
@article{KraemerBijnensStoerketal.2015,
  author    = {Kr{\"a}mer, Johannes and Bijnens, Bart and St{\"o}rk, Stefan and Ritter, Christian O. and Liu, Dan and Ertl, Georg and Wanner, Christoph and Weidemann, Frank},
  title     = {Left ventricular geometry and blood pressure as predictors of adverse progression of Fabry cardiomyopathy},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {11},
  doi       = {10.1371/journal.pone.0140627},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145131},
  pages     = {e0140627},
  year      = {2015},
  abstract  = {Background In spite of several research studies help to describe the heart in Fabry disease (FD), the cardiomyopathy is not entirely understood. In addition, the impact of blood pressure and alterations in geometry have not been systematically evaluated. Methods In 74 FD patients (mean age 36±12 years; 45 females) the extent of myocardial fibrosis and its progression were quantified using cardiac magnetic-resonance-imaging with late enhancement technique (LE). Results were compared to standard echocardiography complemented by 2D-speckle-tracking, 3D-sphericity-index (SI) and standardized blood pressure measurement. At baseline, no patient received enzyme replacement therapy (ERT). After 51±24 months, a follow-up examination was performed. Results Systolic blood pressure (SBP) was higher in patients with vs. without LE: 123±17 mmHg vs. 115±13 mmHg; P = 0.04. A positive correlation was found between SI and the amount of LE-positive myocardium (r = 0.51; P<0.001) indicating an association of higher SI in more advanced stages of the cardiomyopathy. SI at baseline was positively associated with the increase of LE-positive myocardium during follow-up. The highest SBP (125±19 mmHg) and also the highest SI (0.32±0.05) was found in the subgroup with a rapidly increasing LE (ie, ≥0.2\% per year; n = 16; P = 0.04). Multivariate logistic regression analysis including SI, SBP, EF, left ventricular volumes, wall thickness and NT-proBNP adjusted for age and sex showed SI as the most powerful parameter to detect rapid progression of LE (AUC = 0.785; P<0.05). Conclusions LV geometry as assessed by the sphericity index is altered in relation to the stage of the Fabry cardiomyopathy. Although patients with FD are not hypertensive, the SBP has a clear impact on the progression of the cardiomyopathy.},
  language  = {en}
}
@article{KraftDrechslerSchuhmannetal.2015,
  author    = {Kraft, Peter and Drechsler, Christiane and Schuhmann, Michael K. and Gunreben, Ignaz and Kleinschnitz, Christoph},
  title     = {Characterization of Peripheral Immune Cell Subsets in Patients with Acute and Chronic Cerebrovascular Disease: A Case-Control Study},
  series = {International Journal of Molecular Science},
  volume    = {16},
  journal   = {International Journal of Molecular Science},
  number    = {10},
  doi       = {10.3390/ijms161025433},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126319},
  pages     = {25433-25449},
  year      = {2015},
  abstract  = {Immune cells (IC) play a crucial role in murine stroke pathophysiology. However, data are limited on the role of these cells in ischemic stroke in humans. We therefore aimed to characterize and compare peripheral IC subsets in patients with acute ischemic stroke/transient ischemic attack (AIS/TIA), chronic cerebrovascular disease (CCD) and healthy volunteers (HV). We conducted a case-control study of patients with AIS/TIA (n = 116) or CCD (n = 117), and HV (n = 104) who were enrolled at the University Hospital W{\"u}rzburg from 2010 to 2013. We determined the expression and quantity of IC subsets in the three study groups and performed correlation analyses with demographic and clinical parameters. The quantity of several IC subsets differed between the AIS/TIA, CCD, and HV groups. Several clinical and demographic variables independently predicted the quantity of IC subsets in patients with AIS/TIA. No significant changes in the quantity of IC subsets occurred within the first three days after AIS/TIA. Overall, these findings strengthen the evidence for a pathophysiologic role of IC in human ischemic stroke and the potential use of IC-based biomarkers for the prediction of stroke risk. A comprehensive description of IC kinetics is crucial to enable the design of targeted treatment strategies.},
  language  = {en}
}
@phdthesis{KoljajaBatzner2015,
  author    = {Koljaja-Batzner, Angelika},
  title     = {Der Zusammenhang zwischen endogenen Erythropoietin-Spiegeln und Mortalit{\"a}t bei niereninsuffizienten Patienten mit Typ 2-Diabetes},
  issn      = {1555-905X},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115535},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Wir haben 215 Typ 2-Diabetiker mit begleitender chronischer Nierenerkrankung, die noch keine Dialysebehandlung erhalten hatten, {\"u}ber maximal 7 Jahre nachverfolgt. Dabei konnten von allen Studienteilnehmern Follow-up-Daten erhoben werden. Ziel dieser Untersuchung war es, einen Zusammenhang zwischen erh{\"o}hten endogenen EPO-Spiegeln im Blut und einer erh{\"o}hten Mortalit{\"a}t zu eruieren. Diesen Zusammenhang konnten wir sowohl in der univariaten Analyse als auch nach Korrektur f{\"u}r etablierte Risikofaktoren wie Alter, vorangegangene kardiovaskul{\"a}re Ereignisse, erh{\"o}hte CRP-Spiegel und niedrige Albumin-Blutwerte zeigen. Somit ist ein erh{\"o}hter endogener EPO-Spiegel ein unabh{\"a}ngiger Risikofaktor f{\"u}r die Mortalit{\"a}t. Unsere Untersuchungen zeigen sogar, dass eine einzelne Messung des EPO-Spiegels einen h{\"o}heren pr{\"a}diktiven Wert bez{\"u}glich des Risikos zu versterben besitzt als eine einzelne CRP-Messung.},
  subject      = {Erythropoietin},
  language  = {de}
}
@phdthesis{Kling2015,
  author    = {Kling, Bernadette Anna},
  title     = {Untersuchung der neurokognitiven Funktion und klinischen Symptomatik von Patienten mit einer milden und moderaten Hyponatri{\"a}mie im intra-individuellen Vergleich},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115807},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Ziel: In dieser Arbeit wurden die Auswirkung der milden und moderaten Hyponatri{\"a}mie (125-133 mmol/l) auf das Befinden der betroffenen Patienten im Hinblick auf neurokognitive Funktion und klinische Symptomatik untersucht. In mehreren Studien wurde {\"u}ber eine erh{\"o}hte Sturzneigung sowie eine Minderung der Konzentrationsf{\"a}higkeit bei einem nur leicht erniedrigten Serumnatriumspiegel berichtet. Methoden: Die Testungen fanden im Longitudinalvergleich mit jeweils den gleichen Patienten vor und nach Anhebung des Serumnatriumspiegels statt, sodass bis auf das Serumnatrium keine Beeinflussung gegeben war. Die Patienten waren im Durchschnitt 61 Jahre alt und besaßen einen durchschnittlichen Serumnatriumwert von 128,7 mmol/l; die {\"A}tiologie der Hyponatri{\"a}mie war heterogen (normovol{\"a}mische und hypervol{\"a}mische Hyponatri{\"a}mie). Um die Aufmerksamkeitsdefizite aufzudecken, fanden Testungen der Patienten (n=16) mit vier verschiedenen Untertests der TAP, einem Standardprogramm der Psychologie, statt: „Alertness" mit „phasischer Alertness", „Daueraufmerksamkeit", „Geteilte Aufmerksamkeit" und „Go/Nogo". Um die Konzentrationsf{\"a}higkeit gegen eine St{\"o}rung wie Stress beurteilen zu k{\"o}nnen, wurde die „Wiener Form A", ein Subtyp des Wiener Testsystems verwendet, ein ebenfalls in der Psychologie genutzter Test (n=12). Verwendet wurde außerdem ein selbst designter Fragebogen (n=18), der auf die in der Literatur berichteten Symptome einer leichten Hyponatri{\"a}mie zugeschnitten war. Ein und dieselben Patienten wurden jeweils vor und nach Anhebung des Serumnatriumwertes getestet. Ergebnisse: Es zeigte sich, dass bei verschiedenen klinischen Symptomen wie Kr{\"a}mpfen (p= 0,018) und Gangunsicherheit (p= 0,092) signifikante Verbesserungen gefunden wurden. Auch bei dem unspezifischeren Symptom M{\"u}digkeit (p= 0,04) konnte eine Tendenz zur Besserung nach Anhebung des Serumnatriumspiegels verzeichnet werden. In den Aufmerksamkeitstests war - im Gegensatz zu einer Vorstudie, in der ebenfalls die TAP zur Beurteilung der neurokognitiven Funktion herangezogen worden war - weder die „Alertness", also die Reaktionsgeschwindigkeit, noch die Reaktions-Selektionsleistung beim Test „Go/Nogo" signifikant alteriert. Auch die „Daueraufmerksamkeit" und „Geteilte Aufmerksamkeit" wurden nicht signifikant beeinflusst. Ebenso wenig wie die verschiedenen Aufmerksamkeitfunktionen beeinflusst werden, ist die Reaktionsf{\"a}higkeit unter Stress wesentlich herabgesetzt. Denn der Stressreiz im Test „Wiener Form A" f{\"u}hrte bei den Patienten in Hyponatri{\"a}mie zu keinem signifikant schlechteren Ergebnis als der gleiche Test mit denselben Patienten bei angehobenem Serumnatriumwert. Zusammefassung: Zusammenfassend kann aus der vorliegenden Studie gefolgert werden, dass eine milde und moderate Hyponatri{\"a}mie keine Auswirkungen auf die neurokognitive Funktion hat und insofern die Sturzneigung bei {\"a}lteren Patienten wohl nicht beeinflusst. Bei bestimmten klinischen Symptomen konnte eine teilweise signifikante Verbesserung verzeichnet werden, jedoch gibt es zu viele m{\"o}gliche Einflussfaktoren, als dass man eine endg{\"u}ltige Aussage treffen k{\"o}nnte. Die Ergebnisse aus Vorstudien m{\"u}ssen in Frage gestellt werden. Um den tats{\"a}chlichen Einfluss einer milden und moderaten Hyponatri{\"a}mie auf die Aufmerksamkeitsfunktion zu kl{\"a}ren sowie die Beeintr{\"a}chtigung bei bestimmten klinischen Symptomen beweisen zu k{\"o}nnen, bedarf es weiterer Studien in randomisiertem Doppelblinddesign mit h{\"o}herer Patientenzahl.},
  subject      = {Hyponatri{\"a}mie},
  language  = {de}
}
@article{IyengarSedorFreedmanetal.2015,
  author    = {Iyengar, Sudha K. and Sedor, John R. and Freedman, Barry I. and Kao, W. H. Linda and Kretzler, Matthias and Keller, Benjamin J. and Abboud, Hanna E. and Adler, Sharon G. and Best, Lyle G. and Bowden, Donald W. and Burlock, Allison and Chen, Yii-Der Ida and Cole, Shelley A. and Comeau, Mary E. and Curtis, Jeffrey M. and Divers, Jasmin and Drechsler, Christiane and Duggirala, Ravi and Elston, Robert C. and Guo, Xiuqing and Huang, Huateng and Hoffmann, Michael Marcus and Howard, Barbara V. and Ipp, Eli and Kimmel, Paul L. and Klag, Michael J. and Knowler, William C. and Kohn, Orly F. and Leak, Tennille S. and Leehey, David J. and Li, Man and Malhotra, Alka and M{\"a}rz, Winfried and Nair, Viji and Nelson, Robert G. and Nicholas, Susanne B. and O'Brien, Stephen J. and Pahl, Madeleine V. and Parekh, Rulan S. and Pezzolesi, Marcus G. and Rasooly, Rebekah S. and Rotimi, Charles N. and Rotter, Jerome I. and Schelling, Jeffrey R. and Seldin, Michael F. and Shah, Vallabh O. and Smiles, Adam M. and Smith, Michael W. and Taylor, Kent D. and Thameem, Farook and Thornley-Brown, Denyse P. and Truitt, Barbara J. and Wanner, Christoph and Weil, E. Jennifer and Winkler, Cheryl A. and Zager, Philip G. and Igo, Jr, Robert P. and Hanson, Robert L. and Langefeld, Carl D.},
  title     = {Genome-wide association and trans-ethnic meta-analysis for advanced diabetic kidney disease: Family Investigation of Nephropathy and Diabetes (FIND)},
  series = {PLoS Genetics},
  volume    = {11},
  journal   = {PLoS Genetics},
  number    = {8},
  doi       = {10.1371/journal.pgen.1005352},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-180545},
  pages     = {e1005352},
  year      = {2015},
  abstract  = {Diabetic kidney disease (DKD) is the most common etiology of chronic kidney disease (CKD) in the industrialized world and accounts for much of the excess mortality in patients with diabetes mellitus. Approximately 45\% of U.S. patients with incident end-stage kidney disease (ESKD) have DKD. Independent of glycemic control, DKD aggregates in families and has higher incidence rates in African, Mexican, and American Indian ancestral groups relative to European populations. The Family Investigation of Nephropathy and Diabetes (FIND) performed a genome-wide association study (GWAS) contrasting 6,197 unrelated individuals with advanced DKD with healthy and diabetic individuals lacking nephropathy of European American, African American, Mexican American, or American Indian ancestry. A large-scale replication and trans-ethnic meta-analysis included 7,539 additional European American, African American and American Indian DKD cases and non-nephropathy controls. Within ethnic group meta-analysis of discovery GWAS and replication set results identified genome-wide significant evidence for association between DKD and rs12523822 on chromosome 6q25.2 in American Indians (P = 5.74x10\(^{-9}\)). The strongest signal of association in the trans-ethnic meta-analysis was with a SNP in strong linkage disequilibrium with rs12523822 (rs955333; P = 1.31x10\(^{-8}\)), with directionally consistent results across ethnic groups. These 6q25.2 SNPs are located between the SCAF8 and CNKSR3 genes, a region with DKD relevant changes in gene expression and an eQTL with IPCEF1, a gene co-translated with CNKSR3. Several other SNPs demonstrated suggestive evidence of association with DKD, within and across populations. These data identify a novel DKD susceptibility locus with consistent directions of effect across diverse ancestral groups and provide insight into the genetic architecture of DKD.},
  language  = {en}
}
@article{HofmannVoellerNagelsetal.2015,
  author    = {Hofmann, Reiner and V{\"o}ller, Heinz and Nagels, Klaus and Bindl, Dominik and Vettorazzi, Eik and Dittmar, Ronny and Wohlgemuth, Walter and Neumann, Till and St{\"o}rk, Stefan and Bruder, Oliver and Wegscheider, Karl and Nagel, Eckhard and Fleck, Eckart},
  title     = {First outline and baseline data of a randomized, controlled multicenter trial to evaluate the health economic impact of home telemonitoring in chronic heart failure - CardioBBEAT},
  series = {Trials},
  volume    = {16},
  journal   = {Trials},
  number    = {343},
  doi       = {10.1186/s13063-015-0886-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151429},
  year      = {2015},
  abstract  = {Background: Evidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Methods: Between January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva\(^{®}\)). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups' difference in total cost and in the combined clinical endpoint "days alive and not in hospital nor inpatient care per potential days in study" within the follow-up of 12 months. Results: A total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III-IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances. Conclusions: CardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic decision-making with regard to home telemonitoring solutions as an option for health care. Overall, it contributes to developing advanced health economic evaluation instruments to be deployed within the specific context of the German Health Care System.},
  language  = {en}
}
@article{HefnerCsefFrantzetal.2015,
  author    = {Hefner, Jochen and Csef, Herbert and Frantz, Stefan and Glatter, Nina and Warrings, Bodo},
  title     = {Recurrent Tako-Tsubo cardiomyopathy (TTC) in a pre-menopausal woman: late sequelae of a traumatic event?},
  series = {BMC Cardiovascular Disorders},
  volume    = {15},
  journal   = {BMC Cardiovascular Disorders},
  number    = {3},
  doi       = {10.1186/1471-2261-15-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124949},
  year      = {2015},
  abstract  = {Background "Tako-Tsubo cardiomyopathy" (TTC) is a syndrome characterized by left ventricular (LV) wall motion abnormalities, usually without coronary artery disease, mimicking the diagnosis of acute coronary syndrome. It most often affects post-menopausal women and TTC tends to run a benign course with very low rates of recurrence, complications or mortality. The condition is also called "stress-induced cardiomyopathy" because acute physical or emotional stress appears to be frequently related to its onset. The pathogenic role of premorbid or comorbid psychiatric illnesses has been discussed controversially. For the first time, we present a case of fourfold recurrent TTC with severe complications in a pre-menopausal woman. Furthermore, a long history of flaring posttraumatic stress symptoms anteceded the first event. Case presentation A 43-year old, pre-menopausal Caucasian woman was hospitalized with symptoms of acute coronary syndrome. Clinical examination revealed hypokinetic wall motion in the apical ventricular region with no signs of coronary artery disease and diagnosis of TTC was established. She experienced recurrence three times within the following ten months, which led to thrombembolism and myocardial scarring among others. The circumstances of chronic distress were striking. 16 years ago she miscarried after having removed a myoma according to her doctor's suggestion. Since then, she has suffered from symptoms of posttraumatic distress which peaked annually at the day of abortion. Chronic distress became even more pronounced after the premature birth of a daughter some years later. The first event of TTC occurred after a family dispute about parenting. Conclusion This is the first case report of fourfold TTC in a pre-menopausal woman. From somatic perspectives, the course of the disease with recurrences and complications underlines the fact that TTC is not entirely benign. Furthermore, it is the first case report of long lasting symptoms of traumatic stress anteceding TTC. Close connections between adrenergic signaling and late onset of clinical stress symptoms are well known in the psychopathology of traumatization. Although larger clinical trials are needed to elucidate possible interactions of premorbid psychiatric illnesses and TTC, cardiologists should be vigilant especially in cases of recurrent TTC.},
  language  = {en}
}
@phdthesis{Haring2015,
  author    = {Haring, Bernhard},
  title     = {Natriumkonsum, Bluthochdruck und Kognitive Beeintr{\"a}chtigung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-123223},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Natrium ist mit verschiedenen physiologischen Prozessen verbunden und spielt insbesondere in der Blutdruckregulation sowie in der Entstehung eines essentiellen Hypertonus eine bedeutende Rolle. Die t{\"a}glich konsumierte Natriummenge der Gegenwart {\"u}bersteigt den physiologisch notwendigen Natriumbedarf sowie den von den Fachgesellschaften empfohlenen Referenzwerten bedeutend. Exzessiver Natriumkonsum bei gleichzeitigem Vorliegen eines Bluthochdrucks erh{\"o}ht das kardiovaskul{\"a}re Risiko betr{\"a}chtlich. Eine Konsumbeschr{\"a}nkung in Verbindung mit ad{\"a}quatem Blutdruckmanagment wird von zahlreichen Fachgesellschaften empfohlen. Zum Zeitpunkt der Untersuchung ist weitestgehend ungekl{\"a}rt, ob Bluthochdruck im Alter sowie ein exzessiver Natriumkonsum mit oder ohne begleitendem Hypertonus die kognitive Funktionsf{\"a}higkeit beeintr{\"a}chtigt. Anhand der Daten der Women's Health Initiative Memory Study, konnte vorliegende Arbeit einen eindeutigen Zusammenhang zwischen dem Vorliegen eines Bluthochdrucks und dem Auftreten milder kognitiver Beeintr{\"a}chtigung bei postmenopausalen Frauen ≥ 60 Jahre zeigen. Gleichzeitig weist vorliegende Untersuchung auf einen m{\"o}glichen Zusammenhang zwischen erh{\"o}htem Natriumkonsum und sp{\"a}tere kognitive Funktionsf{\"a}higkeit bei hypertensiven Frauen hin. W{\"a}hrend eine natriumarme Ern{\"a}hrung das Risiko f{\"u}r kognitiven Abbau bei hypertensiven Individuen nicht erh{\"o}hte, wurde eine Assoziation zwischen natriumreicher Ern{\"a}hrung und einem gesteigerten Risiko f{\"u}r kognitive Verschlechterung beobachtet. Allerdings waren diese Ergebnisse nicht signifikant und bed{\"u}rfen weiterer {\"U}berpr{\"u}fung. Auswirkungen einer natriumreichen Ern{\"a}hrung auf die kognitive Funktionsf{\"a}higkeit bei normotensiven Frauen wurden nicht gefunden. Die Resultate dieser Untersuchung unterstreichen den {\"u}ber die kardiovaskul{\"a}re Pr{\"a}vention hinaus reichenden Stellenwert einer ad{\"a}quaten Blutdruckregulation im Allgemeinen sowie einer Natriumrestriktion bei hypertensiven Individuen im Besonderen zum Erhalt kognitiver Funktionsf{\"a}higkeit.},
  subject      = {Hypertonie},
  language  = {de}
}
@article{GuederBrennerStoerketal.2015,
  author    = {G{\"u}der, G{\"u}lmisal and Brenner, Susanne and St{\"o}rk, Stefan and Held, Matthias and Broekhuizen, Berna D. L. and Lammers, Jan-Willem J. and Hoes, Arno W. and Rutten, Frans H.},
  title     = {Diagnostic and prognostic utility of mid-expiratory flow rate in older community-dwelling persons with respiratory symptoms, but without chronic obstructive pulmonary disease},
  series = {BMC Pulmonary Medicine},
  volume    = {15},
  journal   = {BMC Pulmonary Medicine},
  number    = {83},
  doi       = {10.1186/s12890-015-0081-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125547},
  year      = {2015},
  abstract  = {Background The maximal expiratory flow at 50 \% of the forced vital capacity (MEF50) is the flow where half of forced vital capacity (FVC) remains to be exhaled. A reduced MEF50 has been suggested as a surrogate marker of small airways disease. The diagnostic and prognostic utility of this easy to assess spirometric variable in persons with respiratory symptoms, but without COPD is unclear. Methods We used data from the UHFO-COPD cohort in which 405 community-dwelling persons aged 65 years or over, and a general practitioner's diagnosis of chronic obstructive pulmonary disease (COPD) underwent pulmonary function testing and echocardiography. In total 161 patients had no COPD according to the spirometric GOLD criteria. We considered MEF50 as reduced if < 60 \% of predicted. Results Of the 161 patients without COPD (mean age 72 ± 5.7 years; 35 \% male; follow-up 4.5 ± 1.1 years), 61 (37.9 \%) had a reduced MEF50. They were older, had more pack-years of smoking, more respiratory symptoms, and used more frequently inhaled medication than the remaining 100 subjects. A reduced MEF50 was nearly twice as often associated with newly detected heart failure (HF) at assessment (29.5 \% vs. 15.6 \%, p = 0.045). In age-and sex-adjusted Cox regression analysis, a reduced MEF50 was significantly associated with episodes of acute bronchitis (hazard ratio 2.54 95 \% confidence interval (1.26; 5.13) P = 0.009), and in trend with pneumonia (2.14 (0.98; 4.69) P = 0.06) and hospitalizations for pulmonary reasons (2.28 (0.93; 5.62) P = 0.07). Conclusions In older community-dwelling persons with pulmonary symptoms but without COPD, a reduced MEF50 may help to uncover unrecognized HF, and identify those at a higher risk for episodes of acute bronchitis, pneumonia and hospitalizations for pulmonary reasons. Echocardiography and close follow-up should be considered in these patients.},
  language  = {en}
}
@article{GassenmaierPetritschKunzetal.2015,
  author    = {Gassenmaier, Tobias and Petritsch, Bernhard and Kunz, Andreas S. and Gkaniatsas, Spyridon and Gaudron, Philipp D. and Weidemann, Frank and Nordbeck, Peter and Beer, Meinrad},
  title     = {Long term evolution of MRI characteristics in a case of atypical left lateral wall hypertrophic cardiomyopathy},
  series = {World Journal of Cardiology},
  volume    = {7},
  journal   = {World Journal of Cardiology},
  number    = {6},
  doi       = {10.4330/wjc.v7.i6.357},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124934},
  pages     = {357-360},
  year      = {2015},
  abstract  = {We are reporting a long-time magnetic resonance imaging (MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance (CMR) imaging can be a valuable tool for assessment of detailed information on size, localization, and tissue characteristics of hypertrophied myocardium. However, there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently, our group reported a case of left lateral wall HCM as a rare variant of the more common forms, such as septal HCM, or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago, we are able to provide the thrilling experience of an ultra-long MRI follow-up presentation in this rare case of left lateral wall hypertrophy. Furthermore, this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.},
  language  = {en}
}
@phdthesis{Diehlmann2015,
  author    = {Diehlmann, Felix},
  title     = {Erregerdiagnostik und antibiotische Therapie bei antibiotisch nicht vorbehandelten Sepsis-Patienten im Rahmen der IMPACT Sepsis Studie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121039},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {EINLEITUNG: Die fr{\"u}hzeitige Erregeridentifikation bei Sepsis-Patienten ist essentiell zur Therapieoptimierung und Senkung der Letalit{\"a}t. Molekularbiologische Detektionsmethoden mit direktem Nachweis bakterieller oder fungaler DNA aus Vollblut stellen einen vielversprechenden Ansatz dar, mit k{\"u}rzerer Zeitdauer bis zum Resultat und potentiell erh{\"o}hter Sensitivit{\"a}t. Beim Vergleich dieser PCR-basierten, kulturunabh{\"a}ngigen Verfahren mit der konventionellen Blutkultur muss streng zwischen antibiotisch vorbehandelten und antibiotisch nicht vorbehandelten Patienten unterschieden werden. METHODIK: Bei Patienten, die sich von Mai 2010 bis Dezember 2011 mit V.a. Sepsis im Zentrum f{\"u}r Innere Medizin einer Universit{\"a}tsklinik vorstellten, wurden im Rahmen der IMPACT Sepsis Studie zus{\"a}tzlich zum routinem{\"a}ßigen Vorgehen 2 x 5 ml EDTA Blut f{\"u}r die VYOO®-PCR entnommen. In der vorliegenden Arbeit wurden die Erregernachweise der PCR mit den Ergebnissen der Blutkultur f{\"u}r alle antibiotisch nicht vorbehandelten Patienten hinsichtlich Detektionsrate, Time to Result und Plausibilit{\"a}t verglichen. Außerdem wurde die antibiotische Therapie dieser Patienten analysiert und potentielle Therapieoptimierungen durch die PCR-Ergebnisse evaluiert. ERGEBNISSE: 126 der 200 in die IMPACT Sepsis Studie eingeschlossenen Patienten waren nicht antibiotisch vorbehandelt. Ihr Durchschnittsalter betrug 66,0 ± 16,4 (MW ± SD) Jahre, der Anteil m{\"a}nnlicher Patienten 60\% und der Anteil immunsupprimierter Patienten 33\%. Die durchschnittliche Krankenhaus-Liegedauer lag bei 11,9 ± 10,5 (MW ± SD) Tagen, der Anteil der Patienten mit schwerer Sepsis oder septischem Schock bei 47\% und die Letalit{\"a}tsrate bei 9,7\%. Die durchschnittliche Latenzzeit bis zur ersten Antibiotika-Gabe betrug 4,13 ± 6,75 (MW ± SD) h bei einem Median von 2,16 h. Insgesamt wurden 26 Erreger identifiziert. In 6 F{\"a}llen wurde der Erreger von beiden Methoden identifiziert, in 15 nur von der Blutkultur und in 5 nur von der PCR. Die Detektionsraten betrugen 8,7\% f{\"u}r die PCR und 16,7\% f{\"u}r die Blutkultur (Fisher-Yates-Test; p=0,087; korrigiertes p=1). Die Zeitdauer bis zum Erregerresultat war bei der PCR signifikant k{\"u}rzer (8,0h bzw. 40,0h; korrigiertes p<0,001). Die PCR versagte vor allem beim Nachweis von Streptokokken, w{\"a}hrend die Blutkultur mehrere, teilweise gramnegative Problemkeime nicht erfasste. Bei mindestens 4\% aller Patienten, 9\% der Patienten mit schweren Verlaufsformen und 45\% der Patienten mit positivem PCR-Resultat h{\"a}tte eine Ber{\"u}cksichtigung des PCR-Ergebnisses h{\"o}chstwahrscheinlich zu einer Therapieoptimierung beigetragen. SCHLUSSFOLGERUNG: Die beiden untersuchten Verfahren zur Erregerdiagnostik unterschieden sich hinsichtlich der Detektionsrate nicht signifikant, eine diagnostische {\"U}berlegenheit der VYOO®-PCR gegen{\"u}ber der Blutkultur konnte also nicht festgestellt werden. Als komplement{\"a}res Verfahren zus{\"a}tzlich zur Blutkultur bei ausgew{\"a}hlten Patientengruppen eingesetzt, kann durch die PCR eine Verbesserung des therapeutischen Managements von Sepsis-Patienten erzielt werden.},
  subject      = {Sepsis},
  language  = {de}
}
@article{ChapdelainedeRoijvanZuijdewijnMostovayaetal.2015,
  author    = {Chapdelaine, Isabelle and de Roij van Zuijdewijn, Camiel L.M. and Mostovaya, Ira M. and L{\´e}vesque, Ren{\´e}e and Davenport, Andrew and Blankestijn, Peter J. and Wanner, Christoph and Nub{\´e}, Menso J. and Grooteman, Muriel P.C.},
  title     = {Optimization of the convection volume in online post-dilution haemodiafiltration: practical and technical issues},
  series = {Clinical Kidney Journal},
  volume    = {8},
  journal   = {Clinical Kidney Journal},
  number    = {2},
  doi       = {10.1093/ckj/sfv003},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150020},
  pages     = {191-198},
  year      = {2015},
  abstract  = {In post-dilution online haemodiafiltration (ol-HDF), a relationship has been demonstrated between the magnitude of the convection volume and survival. However, to achieve high convection volumes (>22 L per session) detailed notion of its determining factors is highly desirable. This manuscript summarizes practical problems and pitfalls that were encountered during the quest for high convection volumes. Specifically, it addresses issues such as type of vascular access, needles, blood flow rate, recirculation, filtration fraction, anticoagulation and dialysers. Finally, five of the main HDF systems in Europe are briefly described as far as HDF prescription and optimization of the convection volume is concerned.},
  language  = {en}
}
@phdthesis{BrillgebSchubert2015,
  author    = {Brill [geb. Schubert], Sabine},
  title     = {Blutzuckerverlauf, hormonelle Gegenregulation und kognitive Leistungsf{\"a}higkeit unter definierter k{\"o}rperlicher Belastung bei Patienten mit Morbus Addison und Diabetes mellitus Typ 1 CANDI - Studie: Counterregulatory Hormone Production in Adrenal Insufficiency and Diabetes Type I},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142646},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2015},
  abstract  = {Spiroergometrische Dauerbelastung von Probanden mit Morbus Addison, Diabetes mellitus Typ 1, Polyglandul{\"a}rem Autoimmunsyndrom Typ 2 (erkrankt sowohl an Mb. Addison als auch an Diabetes mellitus Typ1) und gesunden Kontrollen. Blutzuckerverlauf, hormonelle Gegenregulation und kognitive Leistungsf{\"a}higkeit vor und nach Belastung wurden gemessen. W{\"a}hrend einer spiroergometrischen Dauerbelastung von 23 Minuten zeigte sich bei keinem der 10 Probanden mit ausschließlich Morbus Addison eine Neigung zur Hypoglyk{\"a}mie trotz fehlender Einnahme der mitt{\"a}glichen Glukokortikoiddosis. Die Blutzucker blieben bei s{\"a}mtlichen Probanden stabil und es zeigte sich sogar ein leichter Anstieg in der der Ergometrie anschließenden Nachbeobachtungsphase, eventuell als Hinweis auf eine m{\"o}gliche Entwicklung einer Inulin-Resistenz. Auf die erwartungsgem{\"a}ße Mindersekretion von Adrenalin zeigte sich eine ame ehesten kompensatorisch leicht h{\"o}here Sekretion von Noradrenalin als bei den nebennierengesunden Gruppen. Die {\"u}brige Sekretion gegenregulatorischer Hormone entsprach den Vergleichsgruppen. Die geleistete Arbeit am Fahrradergometer war bei den Probandengruppen mit Morbus Addison und APS 2 nahezu identisch, die Morbus Addison - Probanden traten sogar minimal weniger Ergometerwiderstand {\"u}ber die 15 Minuten Dauerbelastung. Dennoch zeigten die Probanden mit ausschließlich M. Addison einen ad{\"a}quaten Anstieg der gegenregulatorischen Hormone ohne starke Schwankungen der Plasmaglukose, wohingegen es bei den Probanden mit APS 2, zu einem deutlichen Abfall der Plasmaglukose kam trotz deutlich niedrigerer Insulinkonzentrationen im Vergleich zur Probandengruppe mit ausschließlich Diabetes mellitus Typ 1. Die unzureichende Sekretion von Adrenalin, sowie der geringste Konzentrationsanstieg von Noradrenalin und dieser Untersuchung auch Wachstumshormon aller Probandengruppen verhinderte einen ad{\"a}quaten Wiederanstieg des Blutzuckers. Die Probanden mit Nebennierenrindeninsuffizienz verzeichneten teils signifikant schlechtere Ergebnisse bei einem Konzentrations- und einem Kurzzeitged{\"a}chtnistest im direkten Anschluss an die Ergometrie im Vergleich mit den anderen Probandengruppen. Es gab keine relevanten Unterschiede der Testergebnisse in Ruhe. Die nebenniereninsuffizienten Probanden verbesserten sich jedoch signifikant weniger nach der Ergometrie bzw. zeigten nach dem Dauertest teils sogar schlechtere Leistungen. Die Probandengruppen mit Diabetes mellitus Typ 1 und die Kontrollgruppe zeigten eine erwartungsgem{\"a}ße Verbesserung ihrer Leistung als Reaktion auf die vorherige k{\"o}rperliche Aktivit{\"a}t. Die Unterschiede in der kognitiven Performance sind am ehesten mit der unzureichenden Adrenalinsekretion und einem fehlenden akuten Cortisolanstieg der nebenniereninsuffizienten Probanden zu erkl{\"a}ren. Die Probanden mit Nebennierenrindeninsuffizienz wurden mit signifikant niedrigeren Widerst{\"a}nden am Fahrradergometer belastet als die nebennierengesunden Probanden. Ein m{\"o}glicher Erkl{\"a}rungsansatz hierf{\"u}r k{\"o}nnte eine gewisse cortisonbedingte Myopathie sein. Dies verdeutlicht nochmals die Notwendigkeit der Optimierung der Glukokortikoidsubstitutionstherapie. Neue Substitutionsregime sollten m{\"o}glichst die physiologische circadiane Sekretionsrhythmik besser imitieren und im Optimalfall die Tagesdosis an Hydrocortison reduzieren, um glukokortikoidbedingte Nebenwirkungen wie Myopathie und Insulin-Resistenz zu reduzieren. Die Probanden mit polyglandul{\"a}rem Autoimmunsyndrom Typ 2, welche sowohl an Morbus Addison als auch an Diabetes mellitus Typ 1 leiden, m{\"u}ssen im Rahmen von Patientenschulungen besonders auf das Risiko von Hypoglyk{\"a}mien bei vermehrter k{\"o}rperlicher Aktivit{\"a}t hingewiesen werden. Patienten mit Insulinpumpe sollten das Ausschalten w{\"a}hrenddessen erw{\"a}gen und dar{\"u}ber hinaus besondere Aufmerksamkeit auf die Einnahme einer zus{\"a}tzlichen Kohlenhydrateinheit f{\"u}r den Sport walten lassen. Eine zus{\"a}tzliche Einnahme des Glukokortikoids ist in diesem Zusammenhang nicht sinnvoll. [31] Ein vor dem Sport beispielsweise inhalativ appliziertes Epinephrinpr{\"a}parat w{\"a}re eine m{\"o}gliche Strategie zur Verbesserung des Plasmaglukose-Outcomes nach sportlicher Bet{\"a}tigung auf moderatem bzw. hohem Anstrengungslevel bei Patienten mit Morbus Addison und Diabetes mellitus Typ 1 und sollte Gegenstand weiterf{\"u}hrender Studien sein.},
  language  = {de}
}
@article{BeckTitzeHuebneretal.2015,
  author    = {Beck, Hanna and Titze, Stephanie I. and H{\"u}bner, Silvia and Busch, Martin and Schlieper, Georg and Schultheiss, Ulla T. and Wanner, Christoph and Kronenberg, Florian and Krane, Vera and Eckardt, Kai-Uwe and K{\"o}ttgen, Anna},
  title     = {Heart Failure in a Cohort of Patients with Chronic Kidney Disease: The GCKD Study},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {4},
  doi       = {10.1371/journal.pone.0122552},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-143315},
  pages     = {e0122552},
  year      = {2015},
  abstract  = {Background and Aims Chronic kidney disease (CKD) is a risk factor for development and progression of heart failure (HF). CKD and HF share common risk factors, but few data exist on the prevalence, signs and symptoms as well as correlates of HF in populations with CKD of moderate severity. We therefore aimed to examine the prevalence and correlates of HF in the German Chronic Kidney Disease (GCKD) study, a large observational prospective study. Methods and Results We analyzed data from 5,015 GCKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73m\(^{2}\) or with an eGFR >= 60 and overt proteinuria (>500 mg/d). We evaluated a definition of HF based on the Gothenburg score, a clinical HF score used in epidemiological studies (Gothenburg HF), and self-reported HF. Factors associated with HF were identified using multivariable adjusted logistic regression. The prevalence of Gothenburg HF was 43\% (ranging from 24\% in those with eGFR >90 to 59\% in those with eGFR<30 ml/min/1.73m2). The corresponding estimate for self-reported HF was 18\% (range 5\%-24\%). Lower eGFR was significantly and independently associated with the Gothenburg definition of HF (p-trend <0.001). Additional significantly associated correlates included older age, female gender, higher BMI, hypertension, diabetes mellitus, valvular heart disease, anemia, sleep apnea, and lower educational status. Conclusions The burden of self-reported and Gothenburg HF among patients with CKD is high. The proportion of patients who meet the criteria for Gothenburg HF in a European cohort of patients with moderate CKD is more than twice as high as the prevalence of self-reported HF. However, because of the shared signs, symptoms and medications of HF and CKD, the Gothenburg score cannot be used to reliably define HF in CKD patients. Our results emphasize the need for early screening for HF in patients with CKD.},
  language  = {en}
}
@article{BaurSchedelbeckPulzeretal.2015,
  author    = {Baur, Johannes and Schedelbeck, Ulla and Pulzer, Alina and Bluemel, Christina and Wild, Vanessa and Fassnacht, Martin and Steger, U.},
  title     = {A case report of a solitary pancreatic metastasis of an adrenocortical carcinoma},
  series = {BMC Surgery},
  volume    = {15},
  journal   = {BMC Surgery},
  number    = {93},
  doi       = {10.1186/s12893-015-0076-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126130},
  year      = {2015},
  abstract  = {Background Solitary metastases to the pancreas are rare. Therefore the value of resection in curative intention remains unclear. In the literature there are several promising reports about resection of solitary metastasis to the pancreas mainly of renal origin. Case presentation Here we report for the first time on the surgical therapy of a 1.5 cm solitary pancreatic metastasis of an adrenocortical carcinoma. The metastasis occurred almost 6 years after resection of the primary tumor. A partial pancreatoduodenectomy was performed and postoperatively adjuvant mitotane treatment was initiated. During the follow-up of 3 years after surgery no evidence of tumor recurrence occurred. Conclusion Resection of pancreatic tumors should be considered, even if the mass is suspicious for metastatic disease including recurrence of adrenocortical cancer.},
  language  = {en}
}