TY - JOUR A1 - Jarius, Sven A1 - Ruprecht, Klemens A1 - Kleiter, Ingo A1 - Borisow, Nadja A1 - Asgari, Nasrin A1 - Pitarokoili, Kalliopi A1 - Pache, Florence A1 - Stich, Oliver A1 - Beume, Lena-Alexandra A1 - Hümmert, Martin W. A1 - Ringelstein, Marius A1 - Trebst, Corinna A1 - Winkelmann, Alexander A1 - Schwarz, Alexander A1 - Buttmann, Mathias A1 - Zimmermann, Hanna A1 - Kuchling, Joseph A1 - Franciotta, Diego A1 - Capobianco, Marco A1 - Siebert, Eberhard A1 - Lukas, Carsten A1 - Korporal-Kuhnke, Mirjam A1 - Haas, Jürgen A1 - Fechner, Kai A1 - Brandt, Alexander U. A1 - Schanda, Kathrin A1 - Aktas, Orhan A1 - Paul, Friedemann A1 - Reindl, Markus A1 - Wildemann, Brigitte T1 - MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome JF - Journal of Neuroinflammation N2 - Background A subset of patients with neuromyelitis optica spectrum disorders (NMOSD) has been shown to be seropositive for myelin oligodendrocyte glycoprotein antibodies (MOG-IgG). Objective To describe the epidemiological, clinical, radiological, cerebrospinal fluid (CSF), and electrophysiological features of a large cohort of MOG-IgG-positive patients with optic neuritis (ON) and/or myelitis (n = 50) as well as attack and long-term treatment outcomes. Methods Retrospective multicenter study. Results The sex ratio was 1:2.8 (m:f). Median age at onset was 31 years (range 6-70). The disease followed a multiphasic course in 80% (median time-to-first-relapse 5 months; annualized relapse rate 0.92) and resulted in significant disability in 40% (mean follow-up 75 ± 46.5 months), with severe visual impairment or functional blindness (36%) and markedly impaired ambulation due to paresis or ataxia (25%) as the most common long-term sequelae. Functional blindness in one or both eyes was noted during at least one ON attack in around 70%. Perioptic enhancement was present in several patients. Besides acute tetra-/paraparesis, dysesthesia and pain were common in acute myelitis (70%). Longitudinally extensive spinal cord lesions were frequent, but short lesions occurred at least once in 44%. Fourty-one percent had a history of simultaneous ON and myelitis. Clinical or radiological involvement of the brain, brainstem, or cerebellum was present in 50%; extra-opticospinal symptoms included intractable nausea and vomiting and respiratory insufficiency (fatal in one). CSF pleocytosis (partly neutrophilic) was present in 70%, oligoclonal bands in only 13%, and blood-CSF-barrier dysfunction in 32%. Intravenous methylprednisolone (IVMP) and long-term immunosuppression were often effective; however, treatment failure leading to rapid accumulation of disability was noted in many patients as well as flare-ups after steroid withdrawal. Full recovery was achieved by plasma exchange in some cases, including after IVMP failure. Breakthrough attacks under azathioprine were linked to the drug-specific latency period and a lack of cotreatment with oral steroids. Methotrexate was effective in 5/6 patients. Interferon-beta was associated with ongoing or increasing disease activity. Rituximab and ofatumumab were effective in some patients. However, treatment with rituximab was followed by early relapses in several cases; end-of-dose relapses occurred 9-12 months after the first infusion. Coexisting autoimmunity was rare (9%). Wingerchuk’s 2006 and 2015 criteria for NMO(SD) and Barkhof and McDonald criteria for multiple sclerosis (MS) were met by 28%, 32%, 15%, 33%, respectively; MS had been suspected in 36%. Disease onset or relapses were preceded by infection, vaccination, or pregnancy/delivery in several cases. Conclusion Our findings from a predominantly Caucasian cohort strongly argue against the concept of MOG-IgG denoting a mild and usually monophasic variant of NMOSD. The predominantly relapsing and often severe disease course and the short median time to second attack support the use of prophylactic long-term treatments in patients with MOG-IgG-positive ON and/or myelitis. KW - Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) KW - Aquaporin-4 antibodies (AQP4-IgG, NMO-IgG) KW - Optic neuritis KW - Transverse myelitis KW - Longitudinally extensive transverse myelitis KW - Magnetic resonance imaging KW - Autoantibodies KW - Neuromyelitis optica spectrum disorders (NMOSD) KW - Cerebrospinal fluid KW - Oligoclonal bands KW - Electrophysiology KW - Evoked potentials KW - Treatment KW - Therapy KW - Methotrexate KW - Azathioprine KW - Rituximab KW - Ofatumumab KW - Interferon beta KW - Glatiramer acetate KW - Natalizumab KW - Outcome KW - Pregnancy KW - Infections KW - Vaccination KW - Multiple sclerosis KW - Barkhof criteria KW - McDonald criteria KW - Wingerchuk criteria 2006 and 2015 KW - IPND criteria KW - International consensus diagnostic criteria for neuromyelitis optica spectrum disorders Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-165570 VL - 13 IS - 280 ER - TY - THES A1 - Siebert, Alexander T1 - Mundgesundheit und Gebisszustand bei Patienten der Geriatrischen Rehabilitationsklinik der Arbeiterwohlfahrt e.V. (AWO) Würzburg - gibt es Zusammenhänge mit den medizinischen Grunderkrankungen? T1 - Oral health status of patients of the Geriatric Rehabilitation Hospital Würzburg - relation to systemic deseases N2 - Patienten der Geriatrischen Rehabilitationsklinik Würzburg wurden bezüglich ihrer zahnärtztlichen Versorgung, ihres Mundgesundheitszustandes, der zahnärztlichen Behandlungsbedürftigkeit und ihres Mundgygieneverhaltens befragt und untersucht. Die Datenauswertung zeigte, daß ungünstige Zahn-, Prothesen- und Hygieneverhältnisse die Effektivität der Rehabilitationsmaßnahmen negativ beeinflussen. N2 - Patients of the Geriatric Rehabilitation Hospital Würzburg have been examined in relation to their state of oral health, mouth hygiene behaviour and dental care as well as necessity of dental treatment. Data evaluation showed, that missing teeth, incorrect dentures and hygiene conditions have a lasting influence on the effectiveness of rehabilitation measures. KW - Mundgesundheit KW - allgemeine Erkrankungen KW - Rehabilitaion KW - oral health KW - systemic deseases KW - rehabilitaion Y1 - 2002 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-4733 ER - TY - JOUR A1 - López, Cristina A1 - Kleinheinz, Kortine A1 - Aukema, Sietse M. A1 - Rohde, Marius A1 - Bernhart, Stephan H. A1 - Hübschmann, Daniel A1 - Wagener, Rabea A1 - Toprak, Umut H. A1 - Raimondi, Francesco A1 - Kreuz, Markus A1 - Waszak, Sebastian M. A1 - Huang, Zhiqin A1 - Sieverling, Lina A1 - Paramasivam, Nagarajan A1 - Seufert, Julian A1 - Sungalee, Stephanie A1 - Russell, Robert B. A1 - Bausinger, Julia A1 - Kretzmer, Helene A1 - Ammerpohl, Ole A1 - Bergmann, Anke K. A1 - Binder, Hans A1 - Borkhardt, Arndt A1 - Brors, Benedikt A1 - Claviez, Alexander A1 - Doose, Gero A1 - Feuerbach, Lars A1 - Haake, Andrea A1 - Hansmann, Martin-Leo A1 - Hoell, Jessica A1 - Hummel, Michael A1 - Korbel, Jan O. A1 - Lawerenz, Chris A1 - Lenze, Dido A1 - Radlwimmer, Bernhard A1 - Richter, Julia A1 - Rosenstiel, Philip A1 - Rosenwald, Andreas A1 - Schilhabel, Markus B. A1 - Stein, Harald A1 - Stilgenbauer, Stephan A1 - Stadler, Peter F. A1 - Szczepanowski, Monika A1 - Weniger, Marc A. A1 - Zapatka, Marc A1 - Eils, Roland A1 - Lichter, Peter A1 - Loeffler, Markus A1 - Möller, Peter A1 - Trümper, Lorenz A1 - Klapper, Wolfram A1 - Hoffmann, Steve A1 - Küppers, Ralf A1 - Burkhardt, Birgit A1 - Schlesner, Matthias A1 - Siebert, Reiner T1 - Genomic and transcriptomic changes complement each other in the pathogenesis of sporadic Burkitt lymphoma JF - Nature Communications N2 - Burkitt lymphoma (BL) is the most common B-cell lymphoma in children. Within the International Cancer Genome Consortium (ICGC), we performed whole genome and transcriptome sequencing of 39 sporadic BL. Here, we unravel interaction of structural, mutational, and transcriptional changes, which contribute to MYC oncogene dysregulation together with the pathognomonic IG-MYC translocation. Moreover, by mapping IGH translocation breakpoints, we provide evidence that the precursor of at least a subset of BL is a B-cell poised to express IGHA. We describe the landscape of mutations, structural variants, and mutational processes, and identified a series of driver genes in the pathogenesis of BL, which can be targeted by various mechanisms, including IG-non MYC translocations, germline and somatic mutations, fusion transcripts, and alternative splicing. KW - cancer genomics KW - lymphocytes KW - lymphoid tissues KW - oncology Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237281 VL - 10 ER -