TY - JOUR A1 - Quinkler, Marcus A1 - Beuschlein, Felix A1 - Hahner, Stefanie A1 - Meyer, Gesine A1 - Schöfl, Christof A1 - Stalla, Günter K. T1 - Adrenal Cortical Insufficiency-a Life Threatening Illness With Multiple Etiologies JF - Deutsches Ärzteblatt International N2 - Background: The clinical signs of adrenal cortical insufficiency (incidence, ca. 25 per million per year; prevalence, ca. 400 per million) are nonspecific, and misdiagnoses are therefore common. Glucocorticoid substitution therapy has been in use for 50 years but is not a wholly adequate treatment. Our understanding of this disease remains incomplete in many ways. Methods: We selectively searched the Medline database for publications on adrenal cortical insufficiency, with particular attention to studies from the year 2000 onward (search terms: "adrenal insufficiency" or "Addison's disease" or "hypopituitarism"). Results: Hydrocortisone substitution therapy is often given in doses of 10-25 mg/day, timed according to the circadian rhythm. Gastrointestinal and other, febrile infections account for 30-50% of life-threatening adrenocortical crises. Such crises affect 8 of 100 persons with adrenal cortical insufficiency per year and must be treated by the immediate administration of glucocorticoids and fluids. When persons with adrenal cortical insufficiency are acutely ill or are otherwise under unusual stress, they may need additional amounts of hydrocortisone, often in the range of 5-10 mg but occasionally as high as 200 mg. The sustained administration of excessive amounts of steroid can shorten patients' lives by several years. Inappropriate substitution therapy can cause other major medical conditions, such as metabolic syndrome and osteoporosis. Conclusion: Important measures for the prevention of adrenocortical crises include improved care by treating physicians, education of patients and their families, the provision of emergency identifying documents, and the prescription of glucocorticoid emergency kits. KW - short term KW - subjective health-status KW - modified-release hydrocortisone KW - glucocorticoid replacement regimens KW - Addisons disease KW - therapeutic management KW - hypopituitary patients KW - premature mortality KW - circadian therapy KW - adult patients Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-131662 VL - 110 ER - TY - THES A1 - Meyer, Stefanie T1 - Der „Discursus medicus et politicus“ von Tobias Geiger (1656). Edition und Kommentar T1 - The "Discursus medicus et politicus" by Tobias Geiger (1656). Edition and commentary N2 - Der „Discursus medicus et politicus“ von Tobias Geiger ist eine Handschrift aus dem Jahr 1656. Als eine Art Lebensbericht stellt das Werk ein Plädoyer für die Chirurgie als wichtigen Bestandteil der Medizin dar. Tobias Geiger skizziert nicht nur einen „rechten medicus“ in „tempore pacis, belli et pestis", sondern er beschäftigt sich zudem mit gesundheitspolitischen Themen, wie die Vereinigung von Chirurgie und Medizin in der Ausbildung, die Abschaffung sowohl von der Landfahrerei als auch von unqualifizierten Heilpersonen, die Prüfung des Heilpersonals sowie die Verbesserung der Spitäler. In der vorliegenden Dissertation wurde das Schriftstück zunächst editiert, die lateinischen Passagen übersetzt und kommentiert. Im Anschluss wurden die Inhalte für ein besseres Verständnis weiter aufgegliedert und in den historischen Kontext gestellt. N2 - "Discursus medicus et politicus" by Tobias Geiger is a manuscript from 1656. The work shows similarities to an autobiography and functions as a plea for surgery as an important part of medicine. Not only is Tobias Geiger sketching out a "right medicus" in "tempore pacis, belli et pestis", he is also covering health policy issues such as the unification of surgery and medicine in education, the abolition of vagrancy and other unqualified healers, the examination of medical staff, and the improvement of hospitals. In the present dissertation, the document was edited for the first time. The Latin passages were translated and commented on. For a better understanding, the content was divided and placed in a historical context. KW - Geiger, Tobias KW - Chirurgie in der Frühen Neuzeit KW - Plädoyer für die Chirurgie KW - Handschrift Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232856 ER - TY - JOUR A1 - Koster, Stefanie A1 - Gurumurthy, Rajendra Kumar A1 - Kumar, Naveen A1 - Prakash, Pon Ganish A1 - Dhanraj, Jayabhuvaneshwari A1 - Bayer, Sofia A1 - Berger, Hilmar A1 - Kurian, Shilpa Mary A1 - Drabkina, Marina A1 - Mollenkopf, Hans-Joachim A1 - Goosmann, Christian A1 - Brinkmann, Volker A1 - Nagel, Zachary A1 - Mangler, Mandy A1 - Meyer, Thomas F. A1 - Chumduri, Cindrilla T1 - Modelling Chlamydia and HPV co-infection in patient-derived ectocervix organoids reveals distinct cellular reprogramming JF - Nature Communications N2 - Coinfections with pathogenic microbes continually confront cervical mucosa, yet their implications in pathogenesis remain unclear. Lack of in-vitro models recapitulating cervical epithelium has been a bottleneck to study coinfections. Using patient-derived ectocervical organoids, we systematically modeled individual and coinfection dynamics of Human papillomavirus (HPV)16 E6E7 and Chlamydia, associated with carcinogenesis. The ectocervical stem cells were genetically manipulated to introduce E6E7 oncogenes to mimic HPV16 integration. Organoids from these stem cells develop the characteristics of precancerous lesions while retaining the self-renewal capacity and organize into mature stratified epithelium similar to healthy organoids. HPV16 E6E7 interferes with Chlamydia development and induces persistence. Unique transcriptional and post-translational responses induced by Chlamydia and HPV lead to distinct reprogramming of host cell processes. Strikingly, Chlamydia impedes HPV-induced mechanisms that maintain cellular and genome integrity, including mismatch repair in the stem cells. Together, our study employing organoids demonstrates the hazard of multiple infections and the unique cellular microenvironment they create, potentially contributing to neoplastic progression. KW - Chlamydia KW - HPV KW - cellular reprogramming Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301349 VL - 13 IS - 1 ER -