TY - JOUR A1 - Zdziarski, Jaroslaw A1 - Brzuszkiewicz, Elzbieta A1 - Wullt, Bjorn A1 - Liesegang, Heiko A1 - Biran, Dvora A1 - Voigt, Birgit A1 - Gronberg-Hernandez, Jenny A1 - Ragnarsdottir, Bryndis A1 - Hecker, Michael A1 - Ron, Eliora Z. A1 - Daniel, Rolf A1 - Gottschalk, Gerhard A1 - Hacker, Joerg A1 - Svanborg, Catharina A1 - Dobrindt, Ulrich T1 - Host Imprints on Bacterial Genomes-Rapid, Divergent Evolution in Individual Patients N2 - Bacteria lose or gain genetic material and through selection, new variants become fixed in the population. Here we provide the first, genome-wide example of a single bacterial strain’s evolution in different deliberately colonized patients and the surprising insight that hosts appear to personalize their microflora. By first obtaining the complete genome sequence of the prototype asymptomatic bacteriuria strain E. coli 83972 and then resequencing its descendants after therapeutic bladder colonization of different patients, we identified 34 mutations, which affected metabolic and virulence-related genes. Further transcriptome and proteome analysis proved that these genome changes altered bacterial gene expression resulting in unique adaptation patterns in each patient. Our results provide evidence that, in addition to stochastic events, adaptive bacterial evolution is driven by individual host environments. Ongoing loss of gene function supports the hypothesis that evolution towards commensalism rather than virulence is favored during asymptomatic bladder colonization. KW - Proteomanalyse KW - Bakterien Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-68594 ER - TY - JOUR A1 - Fraunholz, Martin A1 - Bernhardt, Jörg A1 - Schuldes, Jörg A1 - Daniel, Rolf A1 - Hecker, Michael A1 - Sinh, Bhanu T1 - Complete Genome Sequence of Staphylococcus aureus 6850, a Highly Cytotoxic and Clinically Virulent Methicillin-Sensitive Strain with Distant Relatedness to Prototype Strains JF - Genome Announcements N2 - Staphylococcus aureus is a frequent human commensal bacterium and pathogen. Here we report the complete genome sequence of strain 6850 (spa type t185; sequence type 50 [ST50]), a highly cytotoxic and clinically virulent methicillin-sensitive strain from a patient with complicated S. aureus bacteremia associated with osteomyelitis and septic arthritis. KW - gen Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-129294 VL - 1 IS - 5 ER - TY - JOUR A1 - Hill, Aileen A1 - Heyland, Daren K. A1 - Rossaint, Rolf A1 - Arora, Rakesh C. A1 - Engelman, Daniel T. A1 - Day, Andrew G. A1 - Stoppe, Christian T1 - Longitudinal outcomes in octogenarian critically ill patients with a focus on frailty and cardiac surgery JF - Journal of Clinical Medicine N2 - Cardiac surgery (CSX) can be lifesaving in elderly patients (age ≥ 80 years) but may still be associated with complications and functional decline. Frailty represents a determinant to outcomes in critically ill patients, but little is known about its influence on elderly CSX-patients. This is a secondary exploratory analysis of a multi-center, prospective observational cohort study of 610 elderly patients admitted to the ICU and followed for one year to document long-term outcomes. CSX-ICU-patients (n = 49) were compared to surgical ICU patients (n = 184) with regard to demographics, frailty, and outcomes. Of all surgical patients, 102 (43%) were considered vulnerable or frail. The subdistribution hazard ratio (SHR) of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.54 (95% confidence interval (CI), 0.34, 0.86, p = 0.007). The p-value for effect modification between surgery group (CSX vs. surgical ICU patients) and Clinical Frailty Scale (CFS) group was not significant (p = 0.37) suggesting that the observed difference in the CFS effect between the CSX and surgical ICU patients is consistent with random error. A further subgroup analysis shows that among surgical ICU patients, the SHR of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.49 (95% CI, 0.29, 0.83) while the corresponding SHR for CSX patients was 0.77 (0.32–1.88). In conclusion, preoperative frailty reduced the rate of discharge to home in both surgical and CSX patients, but a larger sample of CSX patients is needed to adequately address this question in this patient group. KW - population characteristics KW - demography KW - aged 80 and over KW - critical illness KW - cardiac surgery KW - critical care KW - frailty KW - prospective studies KW - nutrition therapy Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-220064 SN - 2077-0383 VL - 10 IS - 1 ER - TY - JOUR A1 - Stein, Roland Gregor A1 - Wollschläger, Daniel A1 - Kreienberg, Rolf A1 - Janni, Wolfgang A1 - Wischnewsky, Manfred A1 - Diessner, Joachim A1 - Stüber, Tanja A1 - Bartmann, Catharina A1 - Krockenberger, Mathias A1 - Wischhusen, Jörg A1 - Wöckel, Achim A1 - Blettner, Maria A1 - Schwentner, Lukas T1 - The impact of breast cancer biological subtyping on tumor size assessment by ultrasound and mammography - a retrospective multicenter cohort study of 6543 primary breast cancer patients JF - BMC Cancer N2 - Background Mammography and ultrasound are the gold standard imaging techniques for preoperative assessment and for monitoring the efficacy of neoadjuvant chemotherapy in breast cancer. Maximum accuracy in predicting pathological tumor size non-invasively is critical for individualized therapy and surgical planning. We therefore aimed to assess the accuracy of tumor size measurement by ultrasound and mammography in a multicentered health services research study. Methods We retrospectively analyzed data from 6543 patients with unifocal, unilateral primary breast cancer. The maximum tumor diameter was measured by ultrasound and/or mammographic imaging. All measurements were compared to final tumor diameter determined by postoperative histopathological examination. We compared the precision of each imaging method across different patient subgroups as well as the method-specific accuracy in each patient subgroup. Results Overall, the correlation with histology was 0.61 for mammography and 0.60 for ultrasound. Both correlations were higher in pT2 cancers than in pT1 and pT3. Ultrasound as well as mammography revealed a significantly higher correlation with histology in invasive ductal compared to lobular cancers (p < 0.01). For invasive lobular cancers, the mammography showed better correlation with histology than ultrasound (p = 0.01), whereas there was no such advantage for invasive ductal cancers. Ultrasound was significantly superior for HR negative cancers (p < 0.001). HER2/neu positive cancers were also more precisely assessed by ultrasound (p < 0.001). The size of HER2/neu negative cancers could be more accurately predicted by mammography (p < 0.001). Conclusion This multicentered health services research approach demonstrates that predicting tumor size by mammography and ultrasound provides accurate results. Biological tumor features do, however, affect the diagnostic precision. KW - histopathology KW - breast cancer KW - ultrasound KW - mammography KW - tumor size Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-161050 VL - 16 IS - 549 ER -