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This article discusses a case series that investigated the correlation between molecular features and overall survival (OS) in cases suspected of having a diffuse low-grade glioma. The study found that the presence of a TERT promoter (TERTp) mutation, even without additional molecular features, indicated unfavorable clinical behavior. Cases with only TERTp mutations had better OS compared to those with TERTp mutations accompanied by EGFR amplification and/or +7/−10 alterations. The findings suggest that tumors with isolated TERTp mutations may be different from glioblastoma cases with additional genetic aberrations and may require further research to determine their clinical parameters and prognosis. [Extracted from the article]

Few older adults regain their pre-fracture mobility after a hip fracture. Intervention studies evaluating effects on gait typically use short clinical tests or in-lab parameters that are often limited to gait speed only. Measurements of mobility in daily life settings exist and should be considered to a greater extent than today. Less than half of hip fracture patients regain their pre-fracture mobility. Mobility recovery is closely linked to health status and quality of life, but there is no comprehensive overview of how gait has been evaluated in intervention studies on hip fracture patients. The purpose was to identify what gait parameters have been used in randomized controlled trials to assess intervention effects on older people's mobility recovery after hip fracture. This scoping review is a secondary paper that identified relevant peer-reviewed and grey literature from 11 databases. After abstract and full-text screening, 24 papers from the original review and 8 from an updated search and manual screening were included. Records were eligible if they included gait parameters in RCTs on hip fracture patients. We included 32 papers from 29 trials (2754 unique participants). Gait parameters were primary endpoint in six studies only. Gait was predominantly evaluated as short walking, with gait speed being most frequently studied. Only five studies reported gait parameters from wearable sensors. Evidence on mobility improvement after interventions in hip fracture patients is largely limited to gait speed as assessed in a controlled setting. The transition from traditional clinical and in-lab to out-of-lab gait assessment is needed to assess effects of interventions on mobility recovery after hip fracture at higher granularity in all aspects of patients' lives, so that optimal care pathways can be defined. [ABSTRACT FROM AUTHOR]

Background: COVID-19 can cause myocardial injury in a significant proportion of patients admitted to the hospital and seems to be associated with worse prognosis. The aim of this review was to study how often and to what extent COVID-19 causes myocardial injury and whether this is an important contributor to outcome with implications for management. Methods: A literature search was performed in Medline and Embase. Myocardial injury was defined as elevated cardiac troponin (cTn) levels with at least one value > 99th percentile of the upper reference limit. The primary outcome measure was mortality, whereas secondary outcome measures were intensive care unit (ICU) admission and length of hospital stay. Results: Four studies and one review were included. The presence of myocardial injury varied between 9.6 and 46.3%. Myocardial injury was associated with a higher mortality rate (risk ratio (RR) 5.54, 95% confidence interval (CI) 3.48–8.80) and more ICU admissions (RR 3.78, 95% CI 2.07–6.89). The results regarding length of hospital stay were inconclusive. Conclusion: Patients with myocardial injury might be classified as high-risk patients, with probably a higher mortality rate and a larger need for ICU admission. cTn levels can be used in risk stratification models and can indicate which patients potentially benefit from early medication administration. We recommend measuring cTn levels in all COVID-19 patients admitted to the hospital or who deteriorate during admission. [ABSTRACT FROM AUTHOR]

Background: Hospitalised COVID-19 patients with underlying cardiovascular disease (CVD) and cardiovascular risk factors appear to be at risk of poor outcome. It is unknown if these patients should be considered a vulnerable group in healthcare delivery and healthcare recommendations during the COVID-19 pandemic. Methods: A systematic literature search was performed to answer the following question: In which hospitalised patients with proven COVID-19 and with underlying CVD and cardiovascular risk factors should doctors be alert to a poor outcome? Relevant outcome measures were mortality and intensive care unit admission. Medline and Embase databases were searched using relevant search terms until 9 June 2020. After systematic analysis, 8 studies were included. Results: Based on the literature search, there was insufficient evidence that CVD and cardiovascular risk factors are significant predictors of mortality and poor outcome in hospitalised patients with COVID-19. Due to differences in methodology, the level of evidence of all studies was graded 'very low' according to the Grading Recommendations Assessment, Development and Evaluation methodology. It is expected that in the near future, two multinational and multicentre European registries (CAPACITY-COVID and LEOSS) will offer more insight into outcome in COVID-19 patients. Conclusion: This literature review demonstrated there was insufficient evidence to identify CVD and cardiovascular risk factors as important predictors of poor outcome in hospitalised COVID-19 patients. However, patients with CVD and cardiovascular risk factors remain vulnerable to infectious disease outbreaks. As such, governmental and public health COVID-19 recommendations for vulnerable groups apply to these patients. [ABSTRACT FROM AUTHOR]

Background: In patients hospitalised with COVID-19, an increased incidence of thromboembolic events, such as pulmonary embolism, deep vein thrombosis and stroke, has been reported. It is unknown whether anticoagulation can prevent these complications and improve outcome. Methods: A systematic literature search was performed to answer the question: What is the effect of (prophylactic and therapeutic dose) anticoagulation therapy in COVID-19 patients on cardiovascular and thromboembolic complications and clinical outcome? Relevant outcome measures were mortality (crucial), hospital admission, length of stay, thromboembolic complications (pulmonary embolism, stroke, transient ischaemic attack), need for mechanical ventilation, acute kidney injury and use of renal replacement therapy. Medline and Embase databases were searched with relevant search terms until 17 July 2020. After systematic analysis, eight studies were included. Analysis was stratified for the start of anticoagulation before or during hospital admission. Results: There was insufficient evidence that therapeutic anticoagulation could improve the outcome in patients hospitalised with COVID-19. None of the studies demonstrated improved mortality, except for one very small Italian study. Furthermore, none of the studies showed a positive effect of anticoagulation on other outcome measures in COVID-19, such as ICU admission, length of hospital stay, thromboembolic complications, need for mechanical ventilation, acute kidney failure or need for renal replacement therapy, except for two studies demonstrating an association between anticoagulation and a lower incidence of pulmonary embolism. However, the level of evidence of all studies varied from 'low' to 'very low', according to the GRADE methodology. Conclusion: Analysis of the literature showed that there was insufficient evidence to answer our objective on the effect of anticoagulation on outcome in COVID-19 patients, especially due to the low scientific quality of the described studies. Randomised controlled studies are needed to answer this question. [ABSTRACT FROM AUTHOR]

Our aim was to investigate the diagnostic yield of rapid T1-mapping for the differentiation of malignant and non-malignant effusions in an ex-vivo set up. T1-mapping was performed with a fast modified Look-Locker inversion-recovery (MOLLI) acquisition and a combined turbo spin-echo and inversion-recovery sequence (TMIX) as reference. A total of 13 titrated albumin-solutions as well as 48 samples (29 ascites/pleural effusions from patients with malignancy; 19 from patients without malignancy) were examined. Samples were classified as malignant-positive histology, malignant-negative histology and non-malignant negative histology. In phantom analysis both mapping techniques correlated with albumin-content (MOLLI: r = − 0.97, TMIX: r = − 0.98). MOLLI T1 relaxation times were shorter in malignancy-positive histology fluids (2237 ± 137 ms) than in malignancy-negative histology fluids (2423 ± 357 ms) as well as than in non-malignant-negative histology fluids (2651 ± 139 ms); post hoc test for all intergroup comparisons: < 0.05. ROC analysis for differentiation between malignant and non-malignant effusions (malignant positive histology vs. all other) showed an (AUC) of 0.89 (95% CI 0.77–0.96). T1 mapping allows for non-invasive differentiation of malignant and non-malignant effusions in an ex-vivo set up. [ABSTRACT FROM AUTHOR]

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A method and results are described for international interlaboratory comparisons of hydroacoustic measurement reference standards. The comparison was organized by the National Institute of Ocean Technology, India, with the participation of reference standards from Germany and Russia. Data are presented on the reference standard installations of the comparison participants and the measurement methods used, and the impact of water temperature on comparison results during calibration is discussed. [ABSTRACT FROM AUTHOR]

Background and Aims: Progressive fibrosis increases hepatic resistance and causes portal hypertension with complications. During progressive fibrosis remodeling and deposition of collagens and elastin occur. Elastin remodeling is crucially involved in fibrosis progression in animal models and human data. This study investigated the association of circulating elastin with the clinical outcome in cirrhotic patients with severe portal hypertension receiving transjugular intrahepatic porto-systemic shunt (TIPS).Methods: We analyzed portal and hepatic venous samples of 110 cirrhotic patients obtained at TIPS insertion and 2 weeks later. The circulating levels of elastin fragments (ELM) were determined using specific monoclonal ELISA. The relationship of ELM with clinical short-time follow-up and long-term outcome was investigated.Results: Circulating levels of ELM showed a gradient across the liver before TIPS with higher levels in the hepatic vein. Interestingly, the circulating ELM levels remained unchanged after TIPS. The circulating levels of ELM in portal and hepatic veins correlated with platelet counts and inversely with serum sodium. Hepatic venous levels of ELM were higher in CHILD C compared to CHILD A and B and were associated with the presence of ascites. Patients with high levels of ELM in the hepatic veins before TIPS showed poorer survival. In multivariate analysis ELM levels in the hepatic veins and MELD were independent predictors of mortality in these patients.Conclusion: This study demonstrated that circulating levels of ELM are not associated with hemodynamic changes, but might reflect fibrosis remodeling and predict survival in patients with severe portal hypertension receiving TIPS independently of MELD. [ABSTRACT FROM AUTHOR]

An aortopulmonary window (APW) is a communication between the ascending aorta and the pulmonary trunk in the presence of two separate semilunar valves. In order to increase our understanding about the surgical management of this rare lesion and its long-term results, we describe our experience over a 37-year period. Between 1968 and 2005, 18 patients were diagnosed with APW. Seventeen underwent surgical correction. Age at operation ranged from 22 days to 22 years (median, 0.20 years). Follow-up ranged from 2 weeks to 28.6 years (median, 11.0 years). Surgical closure was achieved using a single patch in 7 patients (41.2%) double patch in 4 (23.5%), primary closure in 3 (17.6%), clip in 2 (11.8%), and ligation in 1 (5.9%). Complex APW was present in 8 patients (44.4%). One patient was treated nonsurgically. There were no early or late deaths after surgery. Both primary closure and patch closure gave excellent long-term results. Sporadic postoperative complications were only associated with complex lesions. One patient who was treated conservatively died (of pulmonary hypertension) 21 years after diagnosis. Repair of APW is ideally performed in the first months of life, before irreversible PHT has developed. Various surgical repair techniques in this series of patients gave excellent short-term and long-term results, without significant hemodynamic sequelae. [ABSTRACT FROM AUTHOR]

Fusarium head blight (FHB) is a major disease of wheat in the warm and humid wheat growing areas of the world. FHB causes severe yield reduction, decreases grain quality and entails toxicological problems in food and feed. After date there is not much known about the molecular basis of the interaction between Fusarium spp. and cereals. To improve disease resistance in cereals, we want to establish a comprehensive collection of disease resistance-related barley genes including key elements involved in the defense response the genus Fusarium. To identify barley cultivars with differential responses (high and low susceptibility) to Fusarium, we comparatively investigated the interaction phenotypes of barley accessions to F. culmorum in roots and spikes. Beside a consistent, high reproducible variation in the reaction pattern of different genotypes, we found an overall consistency between the degree of susceptibility of root and spike tissue in the selected lines, suggesting that root tissue can be used for high throughput disease resistance screening. [ABSTRACT FROM AUTHOR]

Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lycopersicon pennellii shoots, cultured in vitro for more than a year (type I plants) produced few viable protoplasts in contrast to shoots cultured in vitro for less than five months (type II plants). Ethylene production of both plant types was compared. The low viability of plant type I protoplasts could be correlated with high ethylene production and an increased cell sap osmolality. The ethylene action inhibitor silver thiosulphate improved protoplast yield and viability, especially when using donor tissue, germinated and cultured on medium containing silver thiosulphate (type III plants). Moreover, the choice of cell wall degrading enzymes influenced protoplast viability, since ethylene release was significantly lower using Cellulase R 10 than Cellulysin. All improvements together resulted in an efficient protocol for the isolation and regeneration of Lycopersicon pennellii protoplasts. [ABSTRACT FROM AUTHOR]

We studied lymphocyte proliferation and subsets in ten atopic dermatitis (AD) patients and ten healthy controls. In addition, monocyte production of interleukin 1 (IL-1) was investigated. Mean numbers of total T cells, T-cells subsets, and B cells did not significantly differ between AD patients and controls even though the patients had slightly decreased amounts of suppressor T lymphocytes. Proliferative responses of AD patients to purified protein derivative of tuberculin (PPD), concanavalin A (ConA), or allogeneic cells did not significantly differ from those of healthy controls at optimal stimulant concentrations. In contrast, at suboptimal concentrations, AD patients showed a diminished response to all of these stimulants. Monocytes from AD patients elaborated clearly less IL-1 than those from healthy controls. [ABSTRACT FROM AUTHOR]

Following labeling of human keratinocytes in culture for 48 h with C-arachidonic acid (800,000 cpm), 86.8±0.5% (mean±SEM) of the radioactivity was incorporated into the cells. Two hours after exposure to UVB irradiation at doses up to 392 mJ/cm of erythemally effective (EE) UVB irradiation, only slight changes in the distribution of arachidonic acid could be detected. However, 24 h after irradiation the release of arachidonic acid into the culture medium was significantly increased. The distribution of arachidonic acid was also changed: there was a considerable loss in the amount of radioactivity associated with phosphatidylethanolamine. With doses up to 174 mJ/cm (EE) of UVB, the decrease in the labeling of phospholipids was accompanied by an increased arachidonic acid content in the nonphosphorus lipids, especially in the triacylglycerols. Following a high dose of UVB (392 mJ/cm, EE), a substantial release of label was detected, but the labeling of triacylglycerols was unaltered. The present study suggests that in human keratinocytes UVB irradiation induces the release of arachidonic acid from the cellular lipids and that the major source of the released arachidonic acid is phosphatidylethanolamine. [ABSTRACT FROM AUTHOR]

RQ, plasma insulin, blood glucose, lactate and pyruvate were measured in six fit, normal subjects during a series of exercise and rest experiments with and without sucrose ingestion. Subjects exercised on a bicycle ergometer for 50 min of every hour for 6 h at about 47% of the group's average maximal aerobic capacity. In the resting experiments, the subjects sat for 6 h in an armchair. A solution containing 100 g of sucrose was ingested at the beginning of the fourth hour during the sucrose experiments. Ingestion of sucrose caused a significant increase in RQ, plasma insulin, blood glucose, lactate and pyruvate in both exercise and rest experiments. Insulin, lactate and pyruvate concentrations rose higher during rest after sucrose ingestion than during exercise. The time courses of the changes in RQ, insulin, glucose, lactate and pyruvate after sucrose ingestion, suggest that glucose entering the cell during rest is immediately oxidized, while during work there is some delay in the oxidation of glucose. [ABSTRACT FROM AUTHOR]

Four well-trained male subjects worked for periods of 6 h on bicycle ergometers at work loads requiring about 47% of their maximal aerobic capacity. In one series of studies they received only water; in a second series they received 100 g of sucrose containing 100 μc U-C-labelled sucrose at the beginning of the fourth hour of work. In a third series of experiments, the same subjects received 100 g of non-labelled sucrose at the beginning of the fourth hour. During the experiment without U-C-labelled sucrose, blood samples were withdrawn and analysed for glucose, lactate and pyruvate content. Data from CO recovery in expired air showed a good correlation with the amount of carbohydrate oxidized during the sucrose experiment. Peak values for the respiratory exchange ratio showed the same time response as those observed for the CO in the expired air. It is concluded that the observed rise in RQ after sucrose ingestion, under the conditions studied, is of metabolic origin, resulting from a complete conversion of pyruvate to CO. [ABSTRACT FROM AUTHOR]

A method for the isolation of xanthomegnin, viomellein, rubrosulphin, viopurpurin, and brevianamide A from Penicillium viridicatum (DSM 2447) is described. After extraction, HPLC was performed with a preparative silicagel column, eluted with toluene / ethyl acetate / formic acid (27/9/1, v/v/v) and dichloromethane / acetic acid (9/1, v/v). The toxins were detected with a UV-monitor. It was possible to isolate them in an absolutely pure state. The described method is operationally simple and very efficient. [ABSTRACT FROM AUTHOR]

A letter to the editor regarding a new variant of Creutzfeldt-Jakob disease is presented.

There is no big difference between reocurrence of cholesteatoma in open or closed cavities. Following the way of smallest resistence the recurrent cholesteatoma causes a destruction of the thinned posterior bony canal wall or it perforates the soft tissue cover retroauricularly. Residual cholesteatoma mostly occur in the tympanic cavity behind an intact tympanic membrane. Formation of a small white pearl is seen very often. Serious complications as brain abscess etc. did not occur so far. For controlinspection or revision a second stage surgery after several months or about a year is to advice. For the socalled 'second look' the antrotympanoscopy was introduced. Using a trocar a small guide tube is brought through the concha into the closed cavity. In the same way a small ear speculum can be installed. The Ward-Bercy pharyngoscope with its optical system as well as the Zeiss microscope can be used for inspecting the closed cavity. Biopsy can be taken using a small forceps. Small suction tubes are available. [ABSTRACT FROM AUTHOR]

Epi-, meso-, and hypotympanotomy are the three most important characteristics of 'Posterior Tympanotomy'. In special regard to the difficulties which have been mentioned by some authors recently, the technical details of epitympanotomy are demonstrated. A new way for microsurgery of the Eustachian tube is shown. [ABSTRACT FROM AUTHOR]