RepoMed (Medizinische Hochschule Hannover)
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Better models, better treatment? a systematic review of current three dimensional (3D) in vitro models for implant-associated infections
Full text linkIntroduction Understanding the biology of implant-associated infections is essential in order to provide adequate detection, prevention and therapeutic strategies. Advanced 3D in vitro models offer valuable insights into the complex interactions between cells and bacteria in the presence of implant materials. This review aims to give a comprehensive overview of current 3D in vitro models that mimic implant-associated infections. Methods The structured literature search initially identified 258 publications, seven of which fitted the inclusion criteria. Results The included 3D models were established either to mimic the in vivo situation (organotypic model) or to investigate future implant materials. In three studies, organotypic models for dental implants were created and one study described an organotypic model containing immune cells. In the remaining three studies, biomaterials for constructing future orthopedic implants were developed and tested. All authors included specific cells and bacteria suitable for the respective implants. The dental implant models used fibroblasts and keratinocytes; the orthopedic implant models used stem cells and fibroblast-like cells; the model containing immune cells incorporated co-cultivation of fibroblasts and THP-1 derived macrophages. For bacterial challenge, most authors used Gram positive bacteria, but three studies employed Gram negative bacterial species. A wide variety of analytical methods of different complexity were applied after co-culture of cells and bacteria and between one and five different methods were used. Discussion All models could be employed to provide answers to specific scientific questions regarding implant-associated infections. Nonetheless, this review reveals the limitations of current 3D models for the investigation of implant-associated infections and highlights the opportunities for further development in this scientific field
Severe soft tissue injuries in multiple trauma patients-a challenge we can meet? A matched-pair analysis from the TraumaRegisterDGU®
Full text linkIntroduction Despite tremendous clinical efforts over the past few decades, the treatment of severely injured patients remains still challenging. Concomitant soft tissue injuries represent a particular challenge, as they can lead to complications at any time of trauma care, hold a high risk of infection and often require multiple surgical interventions and interdisciplinary collaboration. Methods This retrospective, multicentric study used the TraumaRegister DGU® to examine the effect of open fractures and severe soft tissue injuries on outcome of multiple trauma patients. Primary admitted multiple trauma patients at the age of 16 to 70 years, treated from 2010 to 2021, were included. A Matched pair analysis was performed for better comparability of trauma patients with and without open fractures and/or severe soft tissue injuries. Results After applying the matching criteria, 5,795 pairs were created and analyzed. The group with sustained soft tissue injuries/open fractures was found to have a higher ISS ([mean ± SD] 22.1 ± 10.4 vs. 20.6 ± 10.2, p < 0.001). Endotracheal tube insertion (27.7% vs. 30.4%, p = 0.003), catecholamine administration (6.0% vs. 8.4%, p < 0.001) and cardio-pulmonary resuscitation (1.6% vs. 2.1%, p = 0.027) were more frequent in the group with sustained soft tissue injury. Both groups were equally frequent admitted to the intensive care unit (ICU) and length of stay (LOS) at the ICU (median (quartiles) 3 (1-9) versus 3 (1-9)) did not differ significantly. However, total LOS at the hospital was longer for the group with sustained soft tissue injury (median (quartiles) 18 (11-29) versus 17 (10-27)). Sepsis occurred more often in patients with soft tissue injury (4.3% vs. 5.2%, p = 0.034). There was no significant difference in prevalence of multi organ failure, 24 h-mortality (2.1% vs. 2.5%, p = 0.151) and overall-mortality (3.6% vs. 3.9%, p = 0.329) between both groups. Conclusion Due to database analysis and revision of guidelines, the treatment of severely injured patients has steadily improved in recent years. Patients with severe soft tissue injuries/open fractures required more medical interventions and length of stay at the hospital was longer. In this study, we were able to show that although concomitant severe soft tissue injuries required more ICU interventions and led to a longer length of stay, 24-h and all-cause mortality were not significantly increased
Sleep quality, restless legs syndrome and daytime sleepiness in adults with 5q-spinal muscular atrophy
Full text linkBackgroundThis study aimed to investigate sleep quality, restless legs syndrome (RLS), and excessive daytime sleepiness in adults with spinal muscular atrophy (SMA) and their relationships with motor function, quality of life (QoL), fatigue, and depression.MethodsWe included 43 adults with SMA (31 non-ambulatory; 11 using non-invasive ventilation) and 43 age- and sex-matched healthy controls (HC). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). RLS was diagnosed using the International RLS Study Group diagnostic criteria. Revised Upper Limb Module (RULM), Hammersmith Functional Motor Scale Expanded (HFMSE) and respiratory function, as well as, 36-Item Short Form Health Survey (SF-36), Beck Depression Inventory (BDI) and Fatigue Severity Scale (FSS) were recorded.ResultsSMA patients had significantly worse scores in sleep efficiency domain of the PSQI (0.7 ± 1.0 vs. 0.3 ± 0.6, p = 0.04) as well as in global PSQI score compared to HC (5.5 ± 3.5 vs. 4.0 ± 2.6, p = 0.029). Patients classified as poor sleepers (PSQI > 5) had a higher body mass index (BMI), greater BDI, and ESS scores. No association between global PSQI score and HFMSE or RULM score was observed. Patients classified as poor sleepers had lower total SF-36 score in comparison to good sleepers (53.2 ± 15.4 vs. 69.6 ± 12.3, p < 0.001). RLS was present in five SMA patients (11.6%).ConclusionPoor sleep quality is common in adults with SMA. It contributes to a lower QoL and should be addressed as a part of the standard of care in adults with SMA
Saisonalität, Risikofaktoren und Therapiebedarf frühkindlicher RSV-Infektionen vor und nach Aufkommen von SARS-CoV-2
Full text linkEntwicklung der Biohybridlunge: auf dem Weg zur vollständigen Endothelialisierung eines zusammengebauten extrakorporalen Membranoxygenators
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Persistent immune reconstitution with virus- and minor histocompatibility antigen-reactive T cells as a predictor for persistent leukemia remission after allogeneic hematopoietic stem cell transplantation
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