TY - JOUR A1 - Schoffer, Olaf A1 - Schülein, Stefanie A1 - Arand, Gerlinde A1 - Arnholdt, Hans A1 - Baaske, Dieter A1 - Bargou, Ralf C. A1 - Becker, Nikolaus A1 - Beckmann, Matthias W. A1 - Bodack, Yves A1 - Böhme, Beatrix A1 - Bozkurt, Tayfun A1 - Breitsprecher, Regine A1 - Buchali, Andre A1 - Burger, Elke A1 - Burger, Ulrike A1 - Dommisch, Klaus A1 - Elsner, Gudrun A1 - Fernschild, Karin A1 - Flintzer, Ulrike A1 - Funke, Uwe A1 - Gerken, Michael A1 - Göbel, Hubert A1 - Grobe, Norbert A1 - Gumpp, Vera A1 - Heinzerling, Lucie A1 - Kempfer, Lana Raffaela A1 - Kiani, Alexander A1 - Klinkhammer-Schalke, Monika A1 - Klöcking, Sabine A1 - Kreibich, Ute A1 - Knabner, Katrin A1 - Kuhn, Peter A1 - Lutze, Stine A1 - Mäder, Uwe A1 - Maisel, Tanja A1 - Maschke, Jan A1 - Middeke, Martin A1 - Neubauer, Andreas A1 - Niedostatek, Antje A1 - Opazo-Saez, Anabelle A1 - Peters, Christoph A1 - Schell, Beatrice A1 - Schenkirsch, Gerhard A1 - Schmalenberg, Harald A1 - Schmidt, Peter A1 - Schneider, Constanze A1 - Schubotz, Birgit A1 - Seide, Anika A1 - Strecker, Paul A1 - Taubenheim, Sabine A1 - Wackes, Matthias A1 - Weiß, Steffen A1 - Welke, Claudia A1 - Werner, Carmen A1 - Wittekind, Christian A1 - Wulff, Jörg A1 - Zettl, Heike A1 - Klug, Stefanie J. T1 - Tumour stage distribution and survival of malignant melanoma in Germany 2002-2011 JF - BMC Cancer N2 - Background Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients. Methods Pooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival. Results The number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97–0.97), sex (OR 1.18, 95% CI 1.11–1.25), date of diagnosis (OR 1.05, 95% CI 1.04–1.06), ‘diagnosis during screening’ (OR 3.24, 95% CI 2.50–4.19) and place of residence (OR 1.23, 95% CI 1.16–1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8–83.9%). Conclusions No distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008. " KW - Malignant melanoma KW - TNM staging KW - Survival analysis KW - Skin cancer screening KW - Stage distribution Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164544 VL - 16 IS - 936 ER - TY - JOUR A1 - Herrmann, Johannes A1 - Lotz, Christopher A1 - Karagiannidis, Christian A1 - Weber-Carstens, Steffen A1 - Kluge, Stefan A1 - Putensen, Christian A1 - Wehrfritz, Andreas A1 - Schmidt, Karsten A1 - Ellerkmann, Richard K. A1 - Oswald, Daniel A1 - Lotz, Gösta A1 - Zotzmann, Viviane A1 - Moerer, Onnen A1 - Kühn, Christian A1 - Kochanek, Matthias A1 - Muellenbach, Ralf A1 - Gaertner, Matthias A1 - Fichtner, Falk A1 - Brettner, Florian A1 - Findeisen, Michael A1 - Heim, Markus A1 - Lahmer, Tobias A1 - Rosenow, Felix A1 - Haake, Nils A1 - Lepper, Philipp M. A1 - Rosenberger, Peter A1 - Braune, Stephan A1 - Kohls, Mirjam A1 - Heuschmann, Peter A1 - Meybohm, Patrick T1 - Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation JF - Critical Care N2 - Background Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients. Methods 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival. Results Most patients were between 50 and 70 years of age. PaO\(_{2}\)/FiO\(_{2}\) ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events. Conclusions Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival. KW - Covid-19 KW - extracorporeal membrane oxygenation (ECMO) KW - intensive care unit Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-299686 VL - 26 IS - 1 ER - TY - JOUR A1 - Schaeffer, Evelin L. A1 - Kühn, Franziska A1 - Schmitt, Angelika A1 - Gattaz, Wagner F. A1 - Gruber, Oliver A1 - Schneider-Axmann, Thomas A1 - Falkai, Peter A1 - Schmitt, Andrea T1 - Increased cell proliferation in the rat anterior cingulate cortex following neonatal hypoxia: relevance to schizophrenia JF - Journal of Neural Transmission N2 - As a consequence of obstetric complications, neonatal hypoxia has been discussed as an environmental factor in the pathophysiology of schizophrenia. However, the biological consequences of hypoxia are unclear. The neurodevelopmental hypothesis of schizophrenia suggests that the onset of abnormal brain development and neuropathology occurs perinatally, whereas symptoms of the disease appear in early adulthood. In our animal model of chronic neonatal hypoxia, we have detected behavioral alterations resembling those known from schizophrenia. Disturbances in cell proliferation possibly contribute to the pathophysiology of this disease. In the present study, we used postnatal rats to investigate cell proliferation in several brain areas following neonatal hypoxia. Rats were repeatedly exposed to hypoxia (89 % N2, 11 % O2) from postnatal day (PD) 4–8. We then evaluated cell proliferation on PD 13 and 39, respectively. These investigations were performed in the anterior cingulate cortex (ACC), caudate-putamen (CPU), dentate gyrus, and subventricular zone. Rats exposed to hypoxia exhibited increased cell proliferation in the ACC at PD 13, normalizing at PD 39. In other brain regions, no alterations have been detected. Additionally, hypoxia-treated rats showed decreased CPU volume at PD 13. The results of the present study on the one hand support the assumption of chronic hypoxia influencing transient cell proliferation in the ACC, and on the other hand reveal normalization during ageing. KW - schizophrenia KW - cell proliferation KW - rat KW - anterior cingulate cortex KW - neonatal hypoxia Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-125890 VL - 120 IS - 1 ER - TY - JOUR A1 - Kuhn, Manuel A1 - Scharfenort, Robert A1 - Schümann, Dirk A1 - Schiele, Miriam A. A1 - Münsterkötter, Anna L. A1 - Deckert, Jürgen A1 - Domschke, Katharina A1 - Haaker, Jan A1 - Kalisch, Raffael A1 - Pauli, Paul A1 - Reif, Andreas A1 - Romanos, Marcel A1 - Zwanzger, Peter A1 - Lonsdorf, Tina B. T1 - Mismatch or allostatic load? Timing of life adversity differentially shapes gray matter volume and anxious temperament JF - Social Cognitive and Affective Neuroscience N2 - Traditionally, adversity was defined as the accumulation of environmental events (allostatic load). Recently however, a mismatch between the early and the later (adult) environment (mismatch) has been hypothesized to be critical for disease development, a hypothesis that has not yet been tested explicitly in humans. We explored the impact of timing of life adversity (childhood and past year) on anxiety and depression levels (N = 833) and brain morphology (N = 129). Both remote (childhood) and proximal (recent) adversities were differentially mirrored in morphometric changes in areas critically involved in emotional processing (i.e. amygdala/hippocampus, dorsal anterior cingulate cortex, respectively). The effect of adversity on affect acted in an additive way with no evidence for interactions (mismatch). Structural equation modeling demonstrated a direct effect of adversity on morphometric estimates and anxiety/depression without evidence of brain morphology functioning as a mediator. Our results highlight that adversity manifests as pronounced changes in brain morphometric and affective temperament even though these seem to represent distinct mechanistic pathways. A major goal of future studies should be to define critical time periods for the impact of adversity and strategies for intervening to prevent or reverse the effects of adverse childhood life experiences. KW - VBM KW - childhood maltreatment KW - adversity KW - stressful life events KW - mismatch KW - allostatic load Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-189645 VL - 11 IS - 4 ER -