TY - JOUR A1 - Kotseva, Kornelia A1 - De Backer, Guy A1 - De Bacquer, Dirk A1 - Rydén, Lars A1 - Hoes, Arno A1 - Grobbee, Diederick A1 - Maggioni, Aldo A1 - Marques-Vidal, Pedro A1 - Jennings, Catriona A1 - Abreu, Ana A1 - Aguiar, Carlos A1 - Badariene, Jolita A1 - Bruthans, Jan A1 - Castro Conde, Almudena A1 - Cifkova, Renata A1 - Crowley, Jim A1 - Davletov, Kairat A1 - Deckers, Jaap A1 - De Smedt, Delphine A1 - De Sutter, Johan A1 - Dilic, Mirza A1 - Dolzhenko, Marina A1 - Dzerve, Vilnis A1 - Erglis, Andrejs A1 - Fras, Zlatko A1 - Gaita, Dan A1 - Gotcheva, Nina A1 - Heuschmann, Peter A1 - Hasan-Ali, Hosam A1 - Jankowski, Piotr A1 - Lalic, Nebojsa A1 - Lehto, Seppo A1 - Lovic, Dragan A1 - Mancas, Silvia A1 - Mellbin, Linda A1 - Milicic, Davor A1 - Mirrakhimov, Erkin A1 - Oganov, Rafael A1 - Pogosova, Nana A1 - Reiner, Zeljko A1 - Stöerk, Stefan A1 - Tokgözoğlu, Lâle A1 - Tsioufis, Costas A1 - Vulic, Dusko A1 - Wood, David T1 - Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry JF - European Journal of Preventive Cardiology N2 - Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events. KW - EUROASPIRE KW - lifestyle KW - cardiovascular risk factors KW - secondary prevention KW - guidelines Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-205526 SN - 2047-4873 SN - 2047-4881 N1 - This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. VL - 26 IS - 8 ER - TY - JOUR A1 - Dengler, Julius A1 - Maldaner, Nicolai A1 - Gläsker, Sven A1 - Endres, Matthias A1 - Wagner, Martin A1 - Malzahn, Uwe A1 - Heuschmann, Peter U. A1 - Vajkoczy, Peter T1 - Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis JF - Cerebrovascular Diseases N2 - Background: Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. Methods: Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all included GIA and for unruptured GIA by meta-analysis using a random effects model. Results: We included 54 studies containing 64 study populations with 1,269 GIA at a median follow-up time (FU-T) of 26.4 months (95% CI 10.8-42.0). PGO was 80.9% (77.4-84.4) in the analysis of all GIA compared to 81.2% (75.3-86.1) in the separate analysis of unruptured GIA. For each year added to patient age, PGO decreased by 0.8%, both for all GIA and unruptured GIA. For all GIA, surgical treatment resulted in a PGO of 80.3% (95% CI 76.0-84.6) compared to 84.2% (78.5-89.8, p = 0.27) after endovascular treatment. In unruptured GIA, PGO was 79.7% (95% CI 71.5-87.8) after surgical treatment and 84.9% (79.1-90.7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. Conclusions: We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA. KW - surgical aneurysm treatment KW - giant intracranial aneurysm KW - endovascular treatment Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-196792 SN - 1015-9770 SN - 1421-9786 N1 - This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. VL - 41 IS - 3-4 ER - TY - JOUR A1 - Schuler, Michael A1 - Murauer, Kathrin A1 - Stangl, Stephanie A1 - Grau, Anna A1 - Gabriel, Katharina A1 - Podger, Lauren A1 - Heuschmann, Peter U. A1 - Faller, Hermann T1 - Pre-post changes in main outcomes of medical rehabilitation in Germany: protocol of a systematic review and meta-analysis of individual participant and aggregated data JF - BMJ Open N2 - Introduction Multidisciplinary, complex rehabilitation interventions are an important part of the treatment of chronic diseases. However, little is known about the effectiveness of routine rehabilitation interventions within the German healthcare system. Due to the nature of the social insurance system in Germany, randomised controlled trials examining the effects of rehabilitation interventions are challenging to implement and scarcely accessible. Consequently, alternative pre-post designs can be employed to assess pre-post effects of medical rehabilitation programmes. We present a protocol of systematic review and meta-analysis methods to assess the pre-post effects of rehabilitation interventions in Germany. Methods and analysis The respective study will be conducted within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic literature review will be conducted to identify studies reporting the pre-post effects (start of intervention vs end of intervention or later) in German healthcare. Studies investigating the following disease groups will be included: orthopaedics, rheumatology, oncology, pulmonology, cardiology, endocrinology, gastroenterology and psychosomatics. The primary outcomes of interest are physical/mental quality of life, physical functioning and social participation for all disease groups as well as pain (orthopaedic and rheumatologic patients only), blood pressure (cardiac patients only), asthma control (patients with asthma only), dyspnoea (patients with chronic obstructive pulmonary disease only) and depression/anxiety (psychosomatic patients only). We will invite the principal investigators of the identified studies to provide additional individual patient data. We aim to perform the meta-analyses using individual patient data as well as aggregate data. We will examine the effects of both study-level and patient-level moderators by using a meta-regression method. Ethics and dissemination Only studies that have received institutional approval from an ethics committee and present anonymised individual patient data will be included in the meta-analysis. The results will be presented in a peer-reviewed publication and at research conferences. A declaration of no objection by the ethics committee of the University of Würzburg is available (number 20180411 01). KW - medical rehabilitation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201929 VL - 9 IS - 5 ER - TY - THES A1 - Pietrowski, Finn T1 - SymptomCheck - ein Programm zur Symptom-orientierten Ableitung eines Diagnosevorschlags T1 - SymptomCheck - a program for the symptom-oriented derivation of a proposal of diagnosis N2 - Das Thema dieser Dissertation lautet „SymptomCheck - ein Programm zur Symptom-orientierten Ableitung eines Diagnosevorschlags“. Der Rahmen dieser Dissertation umfasst die ausführliche, eigenständige Konzeption von SymptomCheck, dessen Untersuchung auf Benutzerfreundlichkeit und eine Überprüfung auf allgemeine Validität bezüglich der Verdachtsgenerierung. Hierbei wurde die Entwicklung der Wissensbasis mit dem dafür eigens konzipierten Bewertungsschema entwickelt. Desweiteren wurde eine alltagstaugliche Benutzeroberfläche generiert, die ein breites Personenspektrum adressiert. In einer Pilotstudie I wurde das Programm auf die oben erwähnten Aspekte hin untersucht und dessen Mängel überarbeitet. Die endgültige Version von SymptomCheck wurde sodann sowohl in einer Online-Evaluation wie auch einer weiteren klinischen Anwendung getestet (Pilotstudie II). Während bei der Online-Evaluation der Fokus auf der Untersuchung der Benutzungsqualität lag, wurde in der Pilotstudie II mit stationären Patienten vor allem die Präzision der Verdachtsgenerierung untersucht. Die vorliegende Arbeit ist demnach vermutlich die erste, die ein selbstentwickeltes Online-Programm im Rahmen einer Online-Evaluation an Probanden und im Rahmen einer klinischen Studie an echten Patienten testete. SymptomCheck ist somit der erste vielversprechende Schritt, ein für den Alltagsgebrauch entwickeltes, breit gefächertes Selbstdiagnoseprogramm klinisch zu validieren. N2 - The topic of this dissertation is "SymptomCheck - a program for the symptom-oriented derivation of a proposal of diagnosis". The scope of this dissertation includes the detailed, self-contained conception of SymptomCheck, its investigation on usability and a review for general validity regarding the generation of suspicion. The development of the knowledge base was developed with a specially designed evaluation scheme. Furthermore, an everyday user interface was generated that addresses a wide range of people. In a pilot study I, the program was examined for the above-mentioned aspects and its shortcomings revised. The final version of SymptomCheck was then tested in an online evaluation and in another clinical setting (Pilot Study II). While the focus of the online evaluation was on the analysis of the usability, the precision of the generation of suspicion was examined in particular with hospitalized patients in pilot study II. This dissertation is therefore probably the first to test a self-developed online program as part of an online evaluation on volunteers and as part of a clinical study on real patients. SymptomCheck is thus the first promising step to clinically validate a wide-ranging self-diagnostic program developed for everyday use. KW - Entscheidungsunterstützungssystem KW - Clinical decision support system KW - Verdachtsgenerierung Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188688 ER - TY - JOUR A1 - Hopp, Sarah A1 - Albert-Weissenberger, Christiane A1 - Mencl, Stine A1 - Bieber, Michael A1 - Schuhmann, Michael K. A1 - Stetter, Christian A1 - Nieswandt, Bernhard A1 - Schmidt, Peter M. A1 - Monoranu, Camelia-Maria A1 - Alafuzoff, Irina A1 - Marklund, Niklas A1 - Nolte, Marc W. A1 - Sirén, Anna-Leena A1 - Kleinschnitz, Christoph T1 - Targeting coagulation factor XII as a novel therapeutic option in brain trauma JF - Annals of Neurology N2 - Objective: Traumatic brain injury is a major global public health problem for which specific therapeutic interventions are lacking. There is, therefore, a pressing need to identify innovative pathomechanism-based effective therapies for this condition. Thrombus formation in the cerebral microcirculation has been proposed to contribute to secondary brain damage by causing pericontusional ischemia, but previous studies have failed to harness this finding for therapeutic use. The aim of this study was to obtain preclinical evidence supporting the hypothesis that targeting factor XII prevents thrombus formation and has a beneficial effect on outcome after traumatic brain injury. Methods: We investigated the impact of genetic deficiency of factor XII and acute inhibition of activated factor XII with a single bolus injection of recombinant human albumin-fused infestin-4 (rHA-Infestin-4) on trauma-induced microvascular thrombus formation and the subsequent outcome in 2 mouse models of traumatic brain injury. Results: Our study showed that both genetic deficiency of factor XII and an inhibition of activated factor XII in mice minimize trauma-induced microvascular thrombus formation and improve outcome, as reflected by better motor function, reduced brain lesion volume, and diminished neurodegeneration. Administration of human factor XII in factor XII-deficient mice fully restored injury-induced microvascular thrombus formation and brain damage. Interpretation: The robust protective effect of rHA-Infestin-4 points to a novel treatment option that can decrease ischemic injury after traumatic brain injury without increasing bleeding tendencies. KW - Molecular-weight heparin KW - Thrombus formation KW - Cerebral-ischemia KW - in-vivo KW - Intravascular coagulation KW - Hemodynamic depression KW - Head-injury KW - Rats KW - Model KW - Mice Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188800 VL - 79 IS - 6 ER - TY - JOUR A1 - Wagner, Martin A1 - Krämer, Johannes A1 - Blohm, Elisabeth A1 - Vergho, Dorothee A1 - Weidemann, Frank A1 - Breunig, Frank A1 - Wanner, Christoph T1 - Kidney function as an underestimated factor for reduced health related quality of life in patients with Fabry disease N2 - Background: Impairments of health related quality of life (HRQoL) are frequently observed in Fabry disease (FD) and are known to be related to neuropathic pain and cardiovascular events. This study aimed to explore the role of chronic kidney disease (CKD) in a large cohort of patients with FD. Methods: In 96 patients (53% female; age 40 ± 12 yrs) with genetically proven FD, HRQoL was assessed by the Medical Outcomes Study (SF-36) questionnaire. All patients were naïve to enzyme replacement therapy. Three categories for kidney dysfunction were chosen, eGFR ≥/<60 ml/min/1.73 m2 or need of renal replacement therapy (RRT). Minor (e.g. arrhythmia, angina pectoris, etc.) and major (e.g. myocardial infarction, coronary artery bypass, stroke or implantable cardioverter-defibrillator) vascular events as well as pain and pain therapy were considered in linear regression analyses with the dimensions of HRQoL. Results: Ten patients (10%) had impaired kidney function and a further nine were on RRT (9.4%). Kidney function and pain emerged as the main factors associated with lower scores on the SF 36, in particular on physical components (PCS beta-coefficients for CKD −6.2, for RRT −11.8, for pain −9.1, p < 0.05, respectively), while controlling for gender, vascular event and pain-therapy. Relationships were found for mental aspects of HRQoL. Age and history of vascular events were not related to HRQoL. Conclusion: Cardiovascular events and pain are important factors related to HRQoL, social functioning and depression. Our study highlights impaired chronic kidney disease, in particular after initiation of RRT, as a strong determinant of reduced HRQoL in FD. KW - Quality of life KW - SF-36 KW - Chronic kidney disease KW - Fabry disease Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-111159 UR - http://www.biomedcentral.com/1471-2369/15/188 ER - TY - THES A1 - Mages, Christine Maria Gabriele T1 - Effekt von Mitofusin 2 Defizienz auf die IP\(_3\)-induzierte mitochondriale Calciumregulation in Kardiomyozyten T1 - Effect of mitofusin 2 deficiency on the IP\(_3\)-induced mitochondrial calcium regulation in cardiomyocytes N2 - Das Herz ist physiologisch auf einen fein regulierten und ausgeglichenen bioenergetischen Energiehaushalt angewiesen, um auf akute Belastungssituationen adäquat reagieren zu können und oxidativen Stress zu vermeiden. Ca2+ reguliert zentral sowohl die zyklischen Kontraktions-/Relaxationsprozesse (ECC) als auch unmittelbar den mitochondrialen Metabolismus. Der ECC liegt in den Kardiomyozyten die Ca2+- Freisetzung durch die RyR2 zu Grunde; die IP3 Rezeptoren des sarkoplasmatischen Retikulums (SR) führen davon unabhängig zu einer Ca2+ Freisetzung aus dem SR. Diese IP3R vermittelten Signale werden in den räumlich nahe gelegenen Mitochondrien zum Teil über den mRyR1 in die mitochondriale Matrix aufgenommen und stimulieren dort langfristig die oxidative Phosphorylierung und den Erhalt der antioxidativen Kapazität. Die enge räumliche Nähe zwischen SR und Mitochondrien wird durch Strukturproteine wie Mitofusin 2 (Mfn2) ergänzt, die das SR mit der äußeren Mitochondrienmembran koppeln und so die Ca2+-Interaktion beeinflussen. Ziel der Arbeit war, den Effekt von Mfn2 Defizienz auf die IP3 induzierte mitochondriale Ca2+-Regulation in Kardiomyozyten zu evaluieren. Dazu erfolgten Fluoreszenzfärbungen an adulten isolierten Ventrikelkardiomyozyten kardiospezifischer Mfn2 Knock-Out (KO) Mäusen bzw. deren wildtypischen Geschwistertieren (WT). Erhobene Parameter umfassten das mitochondriale Ca2+, das mitochondriale Membranpotenzial, die mitochondriale Superoxidbildung und mitochondriale ATP-Gehalt. Die Ergebnisse bestätigten eine Signalachse, bei der die Stimulation von isolierten murinen Kardiomyozyten mit dem IP3 Agonisten ET-1 zu einer mitochondrialen Ca2+ Aufnahme führte, dem Erhalt des mitochondrialen Membranpotenzials diente und der ATP Gehalt stiegt. Bei induzierter kardiospezifischer Ablation von Mfn2 geht diese SR-mitochondriale Interaktion verloren, und es entstand ein energetisches Defizit sowie eine verminderte Superoxidbildung. Bei beta-adrenerger Stimulation mit Isoproterenol (ISO) resultierte in WT zwar eine mitochondriale Ca2+-Aufnahme, allerdings ein Abfall des ATP-Gehaltes. In den Mfn2 defizienten Kardiomyozyten zeigte sich eine Steigerung des ATP-Gehaltes auch auf beta-adrenerge Stimulation, die einen energetischen Kompensationsmechanismus in den Mfn2 KO Tieren vermuten lässt. Dies identifiziert Mfn2 als kritische Strukturkomponente für die basale bioenergetische Adaptation der durch IP3R-mRyR1 vermittelten Signalachse unter physiologischen Bedingungen. N2 - Under physiological conditions the heart needs a finely tuned bioenergetic adaptation system to adequately match sudden changes in the workload and to avoid oxidative stress. Ca2+ regulates the excitation-contraction-coupling (ECC) as well as the mitochondrial metabolism. The ECC is based on the release of Ca2+ via the RyR2 while the IP3 receptor (IP3R) releases Ca2+ independently from the sarcoplasmatic reticulum (SR). The signals from the latter are taken up by the surrounding mitochondria via the mRyR1 channel to stimulate both the basal oxidative phosphorylation and the antioxidative capacity. The close functional relationship between mitochondria and SR is affected by membrane-coupling proteins like mitofusin 2 (Mfn2) that may influence the Ca2+ transmission. This work aimed at evaluating the effect of Mfn2 deficiency on the IP3-induced mitochondrial calcium regulation in cardiomyocytes. Mitochondrial Ca2+ uptake, membrane potential, redox state and ATP generation were monitored in isolated ventricular cardiomyocytes of cardio-specific mitofusin 2 Knock-out (KO) mice and their wildtype littermates (WT) via fluorescent staining using laser scanning confocal microscopy. The results show that stimulation with the IP3 agonist ET-1 led to mitochondrial calcium uptake, ATP generation and maintained mitochondrial membrane potential. The cardio-specific loss of the tethering protein Mfn2 resulted in an energetic deficit and decreased levels of superoxide. Beta adrenergic receptor activation with isoproterenol (ISO) in WT resulted in a mitochondrial calcium uptake but decreased ATP content, while leading in Mfn2 KO cardiomyocyte to increased levels of ATP, pointing probably towards an energetic compensatory mechanism. Taken together these results propose Mfn2 as a critical structural component that affects under physiological conditions the privileged SR-mitochondrial metabolic feedback mechanism via IP3R and mRYR1 to maintain normal cardiac function and bioenergetics. KW - SR/Mitochondriales Feedback KW - Mitofusin2 KW - IP3-Signaling Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237966 ER - TY - THES A1 - Jordan, Franziska T1 - Systematische Bildanalyse des Röntgen-Thorax bei Patienten mit akuter Herzinsuffizienz. Ergebnisse des AHF-Registers Würzburg T1 - Systematic image analysis of chest x-ray in patients with acute heart failure. Results of the AHF-Register Würzburg N2 - Im Zuge der Erstdiagnostik einer Krankenhausaufnahme bei akuter Herzinsuffizienz ist die Röntgen-Thorax-Untersuchung fester Bestandteil. Ziel dieser Arbeit war es, ihren klinischen Stellenwert und die Aufnahmequalität systematisch zu untersuchen. In der AHF-Registerstudie wurden alle am Universitätsklinikum Würzburg vorstelligen Patienten mit akuter Herzinsuffizienz konsekutiv registriert und umfassend phänotypisiert. Die Röntgen-Thorax-Befunde wurden systematisch informationsextrahiert, auf Konsistenz überprüft, katalogisiert und klassifiziert. N2 - In the course of the initial diagnosis of acute heart failure is chest x-ray an integral part. The aim of this work was to systematically research the clinical value and the image quality. All patients, who presented to the Würzburg University Hospital with acute heart failure, were consecutively registered and extensively phenotyped. The chest x-ray findings were systematically extracted, checked for consistency, cataloged and classified. KW - AHF KW - acute heart failure KW - akute Herzinsuffizienz KW - Röntgen-Thorax KW - chest-x-ray Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-243324 ER - TY - THES A1 - Palzer, Johanna T1 - Erfassung und Evaluierung des palliativmedizinischen Bedarfs bei aufgrund von Herzinsuffizienz stationär aufgenommenen Patienten mittels IPOS T1 - Palliative care needs in patients hospitalized with heart failure explored with the IPOS N2 - In dieser explorativen prospektiven Beobachtungsstudie wurden 100 Patienten, die im Universitätsklinikum Würzburg aufgrund akut dekompensierter Herzinsuffizienz stationär aufgenommen wurden, mittels eines mehrteiligen Fragebogens im Zeitraum von März bis August 2018 befragt. Ziel der Studie war es den Palliativbedarf bei Herzinsuffizienzpatienten mithilfe des Palliativfragebogens IPOS zu erfassen, sowie die Informiertheit der Patienten selbst zum Thema Palliativmedizin zu eruieren. Ergebnisse: Mit der IPOS konnte bei 63,0 % der Patienten ein hoher/komplexer Palliativbedarf ermittelt werden. Die für die Patienten relevantesten Items waren dabei „Sorgen der Angehörigen“ (62,0 %), „Mundtrockenheit“ (44,0 %), „eingeschränkte Mobilität“ (43,0 %) und „Atemnot“ (40,0 %). Mittels explorativer Faktorenanalyse konnten von den 17 Items der IPOS 16 Items folgenden drei übergeordneten Faktoren zugeordnet werden: physische Symptome, emotionale Symptome und Ernährung. Damit konnte man eine Multidimensionalität der IPOS als Messinstrument zeigen. Im letzten Teil des Fragebogens gaben nur 32,0 % an sich unter dem Begriff Palliativmedizin etwas vorstellen zu können. Bei diesen 32,0 % der Patienten zeigte sich ein sehr heterogenes und mehrheitlich falschs Verständnis von Palliativmedizin. Zusammengefasst konnte diese Studie zeigen, dass Herzinsuffizienzpatienten eine sehr hohe Symptomlast aufweisen - welche neben den körperlichen Beeinträchtigungen auch die psychischen Probleme mit einschließt - , dass die IPOS ein adäquates Messinstrument zur Erfassung des palliativmedizinischen Bedarfs von Herzinsuffizienzpatienten darstellt und dass ein Mangel an Informiertheit bezüglich Palliativmedizin seitens der Patienten vorliegt. N2 - Survey of 100 heart failure patients during their hospitalization utilizing the IPOS (integrated palliative care outcome scale) and additional questions regarding knowledge about palliative care and the acceptance of the IPOS. 63,0 % of patients show increased and complex need of palliative care. The most relevant item of IPOS was „family anxiety (about the patient)“ (62,0 %), followed by „dry mouth“ (44,0 %), „poor mobility“ (43,0 %) and „dyspnea“ (40,0 %). Employing explorative factor analysis 16 of 17 items of IPOS could be linked to three superordinated factors: „physical symptoms“, „emotional symptoms“ and „nutrition“. Therefore a multidimensionality of the IPOS as a measurement tool could be shown. Only a minor fraction of patients were able to define the concept of palliative care. In summary this study confirms that the patients with heart failure have a large burden of symptoms – which includes physical aswell as mental symptoms – and shows a great acceptance of IPOS by the patients. KW - Palliativmedizin KW - Herzinsuffizienz KW - Integrated Palliative care outcome scale Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-248801 ER - TY - JOUR A1 - Shityakov, Sergey A1 - Hayashi, Kentaro A1 - Störk, Stefan A1 - Scheper, Verena A1 - Lenarz, Thomas A1 - Förster, Carola Y. T1 - The conspicuous link between ear, brain and heart − Could neurotrophin-treatment of age-related hearing loss help prevent Alzheimer's disease and associated amyloid cardiomyopathy? JF - Biomolecules N2 - Alzheimer's disease (AD), the most common cause of dementia in the elderly, is a neurodegenerative disorder associated with neurovascular dysfunction and cognitive decline. While the deposition of amyloid β peptide (Aβ) and the formation of neurofibrillary tangles (NFTs) are the pathological hallmarks of AD-affected brains, the majority of cases exhibits a combination of comorbidities that ultimately lead to multi-organ failure. Of particular interest, it can be demonstrated that Aβ pathology is present in the hearts of patients with AD, while the formation of NFT in the auditory system can be detected much earlier than the onset of symptoms. Progressive hearing impairment may beget social isolation and accelerate cognitive decline and increase the risk of developing dementia. The current review discusses the concept of a brain–ear–heart axis by which Aβ and NFT inhibition could be achieved through targeted supplementation of neurotrophic factors to the cochlea and the brain. Such amyloid inhibition might also indirectly affect amyloid accumulation in the heart, thus reducing the risk of developing AD-associated amyloid cardiomyopathy and cardiovascular disease. KW - Alzheimer's disease KW - amyloid cardiomyopathy KW - heart failure KW - age-related hearing loss KW - neurotrophins KW - blood–brain barrier KW - blood–labyrinth barrier KW - spiral ganglion neuron KW - BDNF KW - GDNF Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-241084 SN - 2218-273X VL - 11 IS - 6 ER -