@article{SuratVogelWiegeringetal.2021,
  author    = {Surat, G{\"u}zin and Vogel, Ulrich and Wiegering, Armin and Germer, Christoph-Thomas and Lock, Johan Friso},
  title     = {Defining the scope of antimicrobial stewardship interventions on the prescription quality of antibiotics for surgical intra-abdominal infections},
  series = {Antibiotics},
  volume    = {10},
  journal   = {Antibiotics},
  number    = {1},
  issn      = {2079-6382},
  doi       = {10.3390/antibiotics10010073},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223034},
  year      = {2021},
  abstract  = {Background: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. The study was conducted in a tertiary hospital in Germany from January 1, 2016, to January 30, 2020, three years after putting a set of antimicrobial stewardship standards into effect. Results: 767 patients were analyzed (n = 495 in 2016 and 2017, the baseline period; n = 272 in 2018, the antimicrobial stewardship period). The total days of therapy per 100 patient days declined from 47.0 to 42.2 days (p = 0.035). The rate of patients receiving postoperative therapy decreased from 56.8\% to 45.2\% (p = 0.002), comparing both periods. There was a significant decline in the rate of inappropriate indications (17.4\% to 8.1 \%, p = 0.015) as well as a significant change from broad-spectrum to narrow-spectrum antibiotic use (28.8\% to 6.5\%, p ≤ 0.001) for postoperative therapy. The significant decline in antibiotic use did not affect either clinical outcomes or the rate of postoperative wound complications. Conclusions: Postoperative antibiotic use for intra-abdominal infections could be significantly reduced by antimicrobial stewardship interventions. The identification of inappropriate indications remains a key target for antimicrobial stewardship programs.},
  language  = {en}
}
@article{DietzKudsiGarciaUrenaetal.2021,
  author    = {Dietz, Ulrich A. and Kudsi, O. Yusef and Garcia-Ure{\~n}a, Miguel and Baur, Johannes and Ramser, Michaela and Maksimovic, Sladjana and Keller, Nicola and D{\"o}rfer, J{\"o}rg and Eisner, Lukas and Wiegering, Armin},
  title     = {Robotische Hernienchirurgie III: Robotische Inzisionalhernienversorgung mit „transversus abdominis release" (r-TAR). Videobeitrag und Ergebnisse einer Kohortenstudie},
  series = {Der Chirurg},
  volume    = {92},
  journal   = {Der Chirurg},
  number    = {10},
  doi       = {10.1007/s00104-021-01480-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265172},
  pages     = {936-947},
  year      = {2021},
  abstract  = {Das Prinzip der gezielten Trennung bzw. Schw{\"a}chung einzelner Komponenten der Bauchdecke zur Spannungsentlastung der Medianlinie bei großen abdominellen Rekonstruktionen ist seit {\"u}ber 30 Jahren als anteriore Komponentenseparation (aKS) bekannt und ein etabliertes Verfahren. Auf der Suche nach Alternativen mit geringerer Komplikationsrate wurde die posteriore Komponentenseparation (pKS) entwickelt; der „transversus abdominis release" (TAR) ist eine nervenschonende Modifikation der pKS. Mit den ergonomischen Ressourcen der Robotik (z. B. abgewinkelte Instrumente) kann der TAR minimal-invasiv durchgef{\"u}hrt werden (r-TAR): Bruchl{\"u}cken von bis zu 14 cm lassen sich verschließen und ein großes extraperitoneales Netz implantieren. In diesem Videobeitrag wird die Versorgung großer Inzisionalhernien in der r‑TAR-Technik pr{\"a}sentiert. Exemplarisch werden die Ergebnisse einer Kohortenstudie an 13 konsekutiven Patienten vorgestellt. Der Eingriff ist anspruchsvoll, die eigenen Ergebnisse sind - wie auch die Berichte aus der Literatur - ermutigend. Der r‑TAR entwickelt sich zur K{\"o}nigsdisziplin der Bauchdeckenrekonstruktion.},
  language  = {de}
}
@article{LauruschkatPageWhiteetal.2021,
  author    = {Lauruschkat, Chris D. and Page, Lukas and White, P. Lewis and Etter, Sonja and Davies, Helen E. and Duckers, Jamie and Ebel, Frank and Schnack, Elisabeth and Backx, Matthijs and Dragan, Mariola and Schlegel, Nicolas and Kniemeyer, Olaf and Brakhage, Axel A. and Einsele, Hermann and Loeffler, Juergen and Wurster, Sebastian},
  title     = {Development of a simple and robust whole blood assay with dual co-stimulation to quantify the release of T-cellular signature cytokines in response to Aspergillus fumigatus antigens},
  series = {Journal of Fungi},
  volume    = {7},
  journal   = {Journal of Fungi},
  number    = {6},
  issn      = {2309-608X},
  doi       = {10.3390/jof7060462},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241025},
  year      = {2021},
  abstract  = {Deeper understanding of mold-induced cytokine signatures could promote advances in the diagnosis and treatment of invasive mycoses and mold-associated hypersensitivity syndromes. Currently, most T-cellular immunoassays in medical mycology require the isolation of mononuclear cells and have limited robustness and practicability, hampering their broader applicability in clinical practice. Therefore, we developed a simple, cost-efficient whole blood (WB) assay with dual α-CD28 and α-CD49d co-stimulation to quantify cytokine secretion in response to Aspergillus fumigatus antigens. Dual co-stimulation strongly enhanced A. fumigatus-induced release of T-cellular signature cytokines detectable by enzyme-linked immunosorbent assay (ELISA) or a multiplex cytokine assay. Furthermore, T-cell-dependent activation and cytokine response of innate immune cells was captured by the assay. The protocol consistently showed little technical variation and high robustness to pre-analytic delays of up to 8 h. Stimulation with an A. fumigatus lysate elicited at least 7-fold greater median concentrations of key T-helper cell signature cytokines, including IL-17 and the type 2 T-helper cell cytokines IL-4 and IL-5 in WB samples from patients with Aspergillus-associated lung pathologies versus patients with non-mold-related lung diseases, suggesting high discriminatory power of the assay. These results position WB-ELISA with dual co-stimulation as a simple, accurate, and robust immunoassay for translational applications, encouraging further evaluation as a platform to monitor host immunity to opportunistic pathogens.},
  language  = {en}
}
@article{GerhardHartmannWiegeringBenoitetal.2021,
  author    = {Gerhard-Hartmann, Elena and Wiegering, Verena and Benoit, Clemens and Meyer, Thomas and Rosenwald, Andreas and Maurus, Katja and Ernestus, Karen},
  title     = {A large retroperitoneal lipoblastoma as an incidental finding: a case report},
  series = {BMC Pediatrics},
  volume    = {21},
  journal   = {BMC Pediatrics},
  doi       = {10.1186/s12887-021-02628-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260173},
  year      = {2021},
  abstract  = {Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.},
  language  = {en}
}
@article{KayisogluSchlegelBartfeld2021,
  author    = {Kayisoglu, {\"O}zge and Schlegel, Nicolas and Bartfeld, Sina},
  title     = {Gastrointestinal epithelial innate immunity-regionalization and organoids as new model},
  series = {Journal of Molecular Medicine},
  volume    = {99},
  journal   = {Journal of Molecular Medicine},
  number    = {4},
  doi       = {10.1007/s00109-021-02043-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265220},
  pages     = {517-530},
  year      = {2021},
  abstract  = {The human gastrointestinal tract is in constant contact with microbial stimuli. Its barriers have to ensure co-existence with the commensal bacteria, while enabling surveillance of intruding pathogens. At the centre of the interaction lies the epithelial layer, which marks the boundaries of the body. It is equipped with a multitude of different innate immune sensors, such as Toll-like receptors, to mount inflammatory responses to microbes. Dysfunction of this intricate system results in inflammation-associated pathologies, such as inflammatory bowel disease. However, the complexity of the cellular interactions, their molecular basis and their development remains poorly understood. In recent years, stem cell-derived organoids have gained increasing attention as promising models for both development and a broad range of pathologies, including infectious diseases. In addition, organoids enable the study of epithelial innate immunity in vitro. In this review, we focus on the gastrointestinal epithelial barrier and its regional organization to discuss innate immune sensing and development.},
  language  = {en}
}
@phdthesis{Kettler2019,
  author    = {Kettler, Julia},
  title     = {Der antiproliferative Effekt des epigenetischen BRD4- Inhibitors JQ1 auf den proliferativen Ph{\"a}notyp humaner kolorektaler Karzinomzellen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176418},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {Der niedermolekulare Inhibitor JQ1 bindet an der Bromodom{\"a}ne von BRD4, ein auf epigenetischer Ebene agierendes Protein. Der antiproliferative Effekt von JQ1 wurde bisher bei verschiedenen Tumorentit{\"a}ten vor allem des lymphatischen und blutbildenden Systems gezeigt. In dieser Arbeit wurde der antiproliferative Effekt von JQ1 an f{\"u}nf humanen kolorektalen Karzinomzelllinien im Vergleich zu nicht transformierten Kontrollzellen (Fibroblasten) in Normoxie, Hypoxie und in der Langzeitkultur nachgewiesen. Außerdem verringerte JQ1 die Expression von MYC auf Protein- und mRNA-Ebene und steigerte die Transkription des durch MYC negativ regulierten Zielegens p21. Diese Steigerung korrelierte mit einem Zellzyklusarrest in der G0/G1-Phase in vier von f{\"u}nf kolorektalen Karzinomzelllinien.},
  subject      = {MYC},
  language  = {de}
}
@phdthesis{Fuhr2022,
  author    = {Fuhr, Sebastian},
  title     = {Behandlungsoptionen Offene Abdomen Therapie - Entwicklung und Validierung eines multizentrischen Registers},
  doi       = {10.25972/OPUS-25708},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-257080},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die Offene Abdomen Therapie (OAT) stellt eine der gr{\"o}ßten Herausforderungen im Bereich der Chirurgie dar. Ziel war es ein offenes, kostenloses und internationales Register zu entwickeln, um eine Basis f{\"u}r zuk{\"u}nftige Therapien und den Weg zu einer evidenzbasierten Leitlinie zu legen. Es wurden 630 F{\"a}lle identifiziert welche mittels OAT behandelt wurden und im Rahmen einer gemischt retrospektiven als auch prospektiven Datenauswertung in das von uns entwickelte Register eingetragen. Schwerpunkte waren dabei einerseits die Praktikabilit{\"a}t des Registers zu testen als auch Einflussfaktoren f{\"u}r eine erfolgreiche OAT zu finden. Es konnte gezeigt werden, dass das Register in seiner Konzeption funktioniert und in der ersten Auswertungen Einflussfaktoren f{\"u}r eine erh{\"o}hte Faszienverschlussrate gefunden werden konnten. Der verbesserte Faszienverschluss am Ende der Therapie mit zeitgleich reduzierter Komplikationsrate ist m{\"o}glich. Aus diesem Grund besitzt die konsequente Nutzung des Registers von behandelnden Einrichtungen, die wo immer m{\"o}gliche l{\"u}ckenlose Dokumentation, sowie die multizentrische Auswertung der Daten einen hohen Stellenwert in Hinsicht auf Pr{\"a}vention, Therapie und Nachsorge der OAT.},
  subject      = {Chirurgie},
  language  = {de}
}
@phdthesis{Doerries2022,
  author    = {D{\"o}rries, Luise},
  title     = {Einfluss der pr{\"a}operativen Konditionierung mittels Magenballon vor bariatrischer Operation auf den Therapieerfolg bei extremer Adipositas - Eine retrospektive Vergleichsstudie},
  doi       = {10.25972/OPUS-27294},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-272945},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die Adipositaschirurgie ist die effektivste Methode in der Behandlung der Adipositas. Bei extrem adip{\"o}sen Patientin ist eine prim{\"a}re Operation oftmals riskant. Die Anlage eines Magenballons als erster Schritt von Mehrstufenkonzepten kann die Operabilit{\"a}t gew{\"a}hrleisten und die perioperative Sicherheit erh{\"o}hen. Durch den Magenballon wird ein signifikanter Gewichtsverlust erreicht. Der postoperative Gewichtsverlust f{\"a}llt allerdings schw{\"a}cher aus. Es ist wichtig, den Patienten realistische Therapieergebnisse zu vermitteln, um {\"u}berh{\"o}hte Erwartungen und Unzufriedenheit zu vermeiden. Die Sleevegastrektomie eignet sich besonders f{\"u}r extrem adip{\"o}se Patienten, da diese eine geringere Komplikationsrate aufweist und einfach in einen Roux-en-Y Bypass umzuwandeln ist.},
  subject      = {Sleeve-Resektion},
  language  = {de}
}
@article{ReimerLockFlemmingetal.2022,
  author    = {Reimer, Stanislaus and Lock, Johan F. and Flemming, Sven and Weich, Alexander and Widder, Anna and Plaßmeier, Lars and D{\"o}ring, Anna and Hering, Ilona and Hankir, Mohammed K. and Meining, Alexander and Germer, Christoph-Thomas and Groneberg, Kaja and Seyfried, Florian},
  title     = {Endoscopic management of large leakages after upper gastrointestinal surgery},
  series = {Frontiers in Surgery},
  volume    = {9},
  journal   = {Frontiers in Surgery},
  issn      = {2296-875X},
  doi       = {10.3389/fsurg.2022.885244},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-274044},
  year      = {2022},
  abstract  = {Background Endoscopic vacuum therapy (EVT) is an evidence-based option to treat anastomotic leakages of the upper gastrointestinal (GI) tract, but the technical challenges and clinical outcomes of patients with large defects remain poorly described. Methods All patients with leakages of the upper GI tract that were treated with endoscopic negative pressure therapy at our institution from 2012-2021 were analyzed. Patients with large defects (>30 mm) as an indicator of complex treatment were compared to patients with smaller defects (control group). Results Ninety-two patients with postoperative anastomotic or staplerline leakages were identified, of whom 20 (21.7\%) had large defects. Compared to the control group, these patients required prolonged therapy (42 vs. 14 days, p < 0.001) and hospital stay (63 vs. 26 days, p < 0.001) and developed significantly more septic complications (40 vs. 17.6\%, p = 0.027.) which often necessitated additional endoscopic and/or surgical/interventional treatments (45 vs. 17.4\%, p = 0.007.) Nevertheless, a resolution of leakages was achieved in 80\% of patients with large defects, which was similar compared to the control group (p = 0.42). Multiple leakages, especially on the opposite side, along with other local unfavorable conditions, such as foreign material mass, limited access to the defect or extensive necrosis occurred significantly more often in cases with large defects (p < 0.001). Conclusions Overall, our study confirms that EVT for leakages even from large defects of the upper GI tract is feasible in most cases but comes with significant technical challenges.},
  language  = {en}
}
@article{WidderKelmReibetanzetal.2022,
  author    = {Widder, Anna and Kelm, Matthias and Reibetanz, Joachim and Wiegering, Armin and Matthes, Niels and Germer, Christoph-Thomas and Seyfried, Florian and Flemming, Sven},
  title     = {Robotic-assisted versus laparoscopic left hemicolectomy — postoperative inflammation status, short-term outcome and cost effectiveness},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {17},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph191710606},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-286203},
  year      = {2022},
  abstract  = {Robotic-assisted colon surgery may contain advantages over the laparoscopic approach, but clear evidence is sparse. This study aimed to analyze postoperative inflammation status, short-term outcome and cost-effectiveness of robotic-assisted versus laparoscopic left hemicolectomy. All consecutive patients who received minimal-invasive left hemicolectomy at the Department of Surgery I at the University Hospital of Wuerzburg in 2021 were prospectively included. Importantly, no patient selection for either procedure was carried out. The robotic-assisted versus laparoscopic approaches were compared head to head for postoperative short-term outcomes as well as cost-effectiveness. A total of 61 patients were included, with 26 patients having received a robotic-assisted approach. Baseline characteristics did not differ among the groups. Patients receiving a robotic-assisted approach had a significantly decreased length of hospital stay as well as lower rates of complications in comparison to patients who received laparoscopic surgery (n = 35). In addition, C-reactive protein as a marker of systemic stress response was significantly reduced postoperatively in patients who were operated on in a robotic-assisted manner. Consequently, robotic-assisted surgery could be performed in a cost-effective manner. Thus, robotic-assisted left hemicolectomy represents a safe and cost-effective procedure and might improve patient outcomes in comparison to laparoscopic surgery.},
  language  = {en}
}