TY - THES A1 - Geier, Christoph T1 - BERAphon® versus Echo-Screen TDA : Vergleich zweier Untersuchungsgeräte im universellen Neugeborenen-Hörscreening T1 - BERAphon® versus Echo-Screen TDA,comparison of two examination devices in universal newborn hearing screening N2 - Universelles Neugeborenen Hörscreening ist die beste Methode frühestmöglich Kinder mit angeborenen Hörstörungen zu identifizieren. Es wird in der vorliegenden Arbeit das BERAphon® mit dem Echo-Screen TDA verglichen. Beide Geräte nutzen für das universelle Neugeborenen-Hörscreening die Hirnstammaudiometrie. Bei 5 von 226 Untersuchungsgängen war mit dem BERAphon® kein Screening möglich, bei 10 von 226 Untersuchungsgängen war mit dem Echo-Screen TDA kein Screening möglich. Der Unterschied ist bei einer Irrtumswahrscheinlichkeit von alpha < 0,05 statistisch nicht signifikant. Die Anzahl der auffälligen Untersuchungen zur Nachuntersuchung war mit 12 von 213 Untersuchungen bei beiden Geräten gleich. Die Gesamtscreeningdauer bei 85 gemessenen Untersuchungen lag als Median mit dem BERAphon® bei 2 Minuten 40 Sekunden, mit dem Echo-Screen TDA bei 6 Minuten 18 Sekunden. Bei 68 Untersuchungen lieferte das BERAphon® schneller ein Ergebnis als der Echo-Schreen TDA. Bei 17 Untersuchungen lieferte der Echo-Screen TDA schneller ein Ergebnis als das BERAphon®. Der Unterschied ist bei einer Irrtumswahrscheinlichkeit von alpha < 0,05 statistisch signifikant. Wesentliche Unterschiede gibt es in der Bedienungsfreundlichkeit der Geräte und beim Untersuchungskomfort für die Neugeborenen vor, während und nach dem Screening. N2 - Universal newborn hearing screening is the best method for early identification of newborn children with kongenital hearing impaiment. This issue compares the BERAphon® to the Echo-Screen TDA, both using brainstem evoked response audiometry (BERA) for universal newborn hearing screening. In 5 out of 226 sreenings no result could be achieved with the BERAphon®, while in 10 out of 226 screenings no result could be achieved with the Echo-Screen TDA. The difference is not statistically significant (alpha < 0,05). The number of screenings to be looked after were 12 out of 213 in both devices. In 85 sreenings total screening time with the BERAphon® was 2 minutes 40 seconds and 6 minutes and 18 seconds with the Echo-Sreen TDA. In 68 out of 85 screenings the BERAphon® was first to deliver a result. In 17 out of 85 screenings the Echo-Screen TDA was first to deliver a result. This difference is statistically significant (alpha < 0,05). Substantially different were the easyness in using the devices und in comfort for the newborn child before, during and after the screening. KW - Screening KW - Hörprüfung KW - Universelles Neugeborenen Hörscreening KW - BERAphon® KW - Echo-Screen TDA KW - BERA KW - Hirnstammaudiometrie KW - universal newborn hearing screening KW - BERA KW - brainstem evoked response audiometry Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-25420 ER - TY - JOUR A1 - Dietrich, Christoph G. A1 - Götze, Oliver A1 - Geier, Andreas T1 - Molecular changes in hepatic metabolism and transport in cirrhosis and their functional importance JF - World Journal of Gastroenterology N2 - Liver cirrhosis is the common endpoint of many hepatic diseases and represents a relevant risk for liver failure and hepatocellular carcinoma. The progress of liver fibrosis and cirrhosis is accompanied by deteriorating liver function. This review summarizes the regulatory and functional changes in phase I and phase II metabolic enzymes as well as transport proteins and provides an overview regarding lipid and glucose metabolism in cirrhotic patients. Interestingly, phase I enzymes are generally downregulated transcriptionally, while phase II enzymes are mostly preserved transcriptionally but are reduced in their function. Transport proteins are regulated in a specific way that resembles the molecular changes observed in obstructive cholestasis. Lipid and glucose metabolism are characterized by insulin resistance and catabolism, leading to the disturbance of energy expenditure and wasting. Possible non-invasive tests, especially breath tests, for components of liver metabolism are discussed. The heterogeneity and complexity of changes in hepatic metabolism complicate the assessment of liver function in individual patients. Additionally, studies in humans are rare, and species differences preclude the transferability of data from rodents to humans. In clinical practice, some established global scores or criteria form the basis for the functional evaluation of patients with liver cirrhosis, but difficult treatment decisions such as selection for transplantation or resection require further research regarding the application of existing non-invasive tests and the development of more specific tests. KW - Liver cirrhosis KW - Drug metabolism KW - Transport KW - Breath tests KW - Lipid metabolism KW - Glucose metabolism Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-191136 VL - 22 IS - 1 ER - TY - JOUR A1 - Metzner, Valentin A1 - Herzog, Gloria A1 - Heckel, Tobias A1 - Bischler, Thorsten A1 - Hasinger, Julia A1 - Otto, Christoph A1 - Fassnacht, Martin A1 - Geier, Andreas A1 - Seyfried, Florian A1 - Dischinger, Ulrich T1 - Liraglutide + PYY\(_{3-36}\) combination therapy mimics effects of Roux-en-Y bypass on early NAFLD whilst lacking-behind in metabolic improvements JF - Journal of Clinical Medicine N2 - Background: Treatment options for NAFLD are still limited. Bariatric surgery, such as Roux-en-Y gastric bypass (RYGB), has been shown to improve metabolic and histologic markers of NAFLD. Glucagon-like-peptide-1 (GLP-1) analogues lead to improvements in phase 2 clinical trials. We directly compared the effects of RYGB with a treatment using liraglutide and/or peptide tyrosine tyrosine 3-36 (PYY\(_{3-36}\)) in a rat model for early NAFLD. Methods: Obese male Wistar rats (high-fat diet (HFD)-induced) were randomized into the following treatment groups: RYGB, sham-operation (sham), liraglutide (0.4 mg/kg/day), PYY\(_{3-36}\) (0.1 mg/kg/day), liraglutide+PYY\(_{3-36}\), and saline. After an observation period of 4 weeks, liver samples were histologically evaluated, ELISAs and RNA sequencing + RT-qPCRs were performed. Results: RYGB and liraglutide+PYY\(_{3-36}\) induced a similar body weight loss and, compared to sham/saline, marked histological improvements with significantly less steatosis. However, only RYGB induced significant metabolic improvements (e.g., adiponectin/leptin ratio 18.8 ± 11.8 vs. 2.4 ± 1.2 in liraglutide+PYY\(_{3-36}\)- or 1.4 ± 0.9 in sham-treated rats). Furthermore, RNA sequencing revealed a high number of differentially regulated genes in RYGB treated animals only. Conclusions: The combination therapy of liraglutide+PYY\(_{3-36}\) partly mimics the positive effects of RYGB on weight reduction and on hepatic steatosis, while its effects on metabolic function lack behind RYGB. KW - liraglutide KW - GLP-1 KW - peptide tyrosine tyrosine (PYY) KW - peptide tyrosine tyrosine 3-36 (PYY\(_{3-36}\)) KW - RYGB KW - gastric bypass KW - obesity KW - NASH KW - NAFLD Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255244 SN - 2077-0383 VL - 11 IS - 3 ER -