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Targeting SARS-CoV-2 with Nanobodies and Antibodies: Neutralization and Escape Variants
No full textThe SARS-CoV-2 pandemic revealed significant limitations in existing preventive measures
against coronavirus infections. Before vaccines were approved, over 64 million infections and
1.6 million deaths were reported globally (World Health Organization, 2024), underscoring the
need for rapid therapeutic interventions.
We hypothesized that blocking the initial step of SARS-CoV-2 infection, i.e. the binding of the
viral Spike protein to the human Angiotensin-Converting Enzyme 2 (ACE2) receptor, could
neutralize infection. To disrupt this critical interaction, we made use of VHH antibodies (also
called “nanobodies”), which are variable domains of heavy-chain-only antibodies. Nanobodies
targeting the SARS-CoV-2 Spike protein are well suited for the viral neutralization due to their
specificity and high-affinity. We demonstrated that nanobodies could be produced rapidly
against multiple SARS-CoV-2 variants of concern, and that they were capable of potently
neutralizing both authentic virus variants and vesicular stomatitis virus (VSV)-based
pseudotyped viruses. Importantly, one representative nanobody exhibited potent neutralization
of SARS-CoV-2 even in an aerosolized form and its inhalation provided near-complete
protection to Syrian golden hamsters, either as a prophylactic treatment prior to infection or as
a therapeutic agent administered 24 hours after infection. In summary, these findings highlight
the potential of aerosolized nanobodies as a promising therapeutic or preventive strategy
against SARS-CoV-2.
While no nanobody-based therapeutic solutions for SARS-CoV-2 are currently clinically
available, therapeutic monoclonal antibodies also targeting the viral Spike protein have played
a critical role in mitigating disease severity, particularly in patients at high risk of hospitalization.
However, as the pandemic progressed, the emergence of SARS-CoV-2 variants with Spike
protein mutations posed significant challenges, most notably the reduced efficacy of vaccines
and therapeutic antibodies. To make the occurrence of such mutations more predictable, we
developed a method to efficiently identify antibody-resistant SARS-CoV-2 mutants by selecting
them from mutagenized virus pools. Mutations were induced using N4-hydroxycytidine (NHC),
the active compound of the antiviral drug molnupiravir, followed by virus passaging in the
presence of antibodies. This approach enabled the identification of specific Spike mutations
potentially associated with resistance. These mutations were subsequently validated through
VSV-pseudotype assays and immunofluorescence analyses. Some of them, such as F490S,
E484K, and K444R, were also detected in circulating variants, while others, e.g. D428G and
K462E, were novel. Crucially, all identified mutations retained the ability of the virus to bind
ACE2 and remain infectious, highlighting SARS-CoV-2’s remarkable adaptability to immune pressures.
Thus, in the second study, we developed a strategy for predicting the therapeutic
efficacy of antibodies against emerging SARS-CoV-2 variants.2025-05-2
In-vivo-Biofilmakkumulation auf Prothesenkunststoffen
No full textINTRODUCTION:
Denture base resins, such as heat- and cold-polymerized PMMA, as well as newer materials like CAD/CAM-PMMA and Polyamide-12, are widely used in removable dentures. Their long-term oral presence makes them susceptible to microbial biofilm formation, which can contribute to oral and systemic diseases. MATERIALS AND METHODS: Multi-material test specimens were fabricated using the four materials to be tested. The surfaces were polished and half of the specimen were artificially aged. Surface roughness was then measured. Two artificially aged and two non-aged specimens were mounted into an upper jaw splint, which was worn by 20 participants for 24 hours. After removal, biofilm accumulation on the specimens was analyzed using fluorescence staining and fluorescence microscopy. AIM: This in vivo study aimed to determine whether initial biofilm accumulation differs among various denture base materials and to evaluate the influence of variables such as age, gender, intraoral position, and artificial aging on biofilm accumulation. RESULTS: Artificial aging generally reduced surface roughness in all materials except for Polyamide-12, which became significantly rougher. Thus surface roughness had no significant impact on biofilm levels. Cold-polymerized PMMA was excluded from the final comparison, because of autofluorescence no measurement was possible. No significant differences in biofilm accumulation were observed among the remaining three materials. Neither gender nor artificial aging influenced biofilm formation. In contrast, patient age and intraoral positioning of the test specimens were significant factors: older individuals exhibited greater biofilm accumulation, and posterior locations showed significantly more biofilm than anterior ones. CONCLUSION: The results in this study suggest that the initial oral biofilm accumulation is not significantly affected by the type of denture base material used. Material selection should therefore be based on other clinical criteria, such as mechanical properties, biocompatibility, and ease of processing. Additionally, the study indicates that the development of new materials like CAD/CAM-PMMA or Polyamide-12 does not currently offer clinical advantages in terms of biofilm resistance.2025-07-1
Comparison of the articulation patterns of stuttering and nonstuttering subjects using real-time magnetic resonance imaging
No full textThe original neurogenic non-syndromic stuttering begins in early childhood and can persist into adulthood. Its characteristic symptoms are repetition of sounds and syllables, prolongation of sounds, blocking and a variety of accompanying symptoms. Its average prevalence is about 1%. Its average incidence is about 5%. Spontaneous remission is observed in about 75% of all children who stutter an girls recover more often than boys. Early identification increases the chances of successful therapy. Stuttering modification, fluency shaping and the Lidcombe program are considered to be effective therapy methods.
The present research investigated stuttering speech according to the hypotheses 1) that altered articulator movement sequences are likely during stuttering, 2) that these movement deviations are related to specific stuttering symptoms, and 3) that these conspicuous movement patterns are not found in fluent speaking control subjects. The snapshot-flash technique used by Jens Frahm and colleagues from Göttingen displayed the articulation of fluent speakers and stuttering speakers in real time and enabled the author to make a descriptive comparison of the two groups.
The adults who stuttered and the control subjects were critically examined according to predefined objective criteria. A total of nine stuttering adults were examined during stuttering speech. After excluding two subjects, the control group comprised 14 fluent speakers. None of the fluent speakers stuttered. The analysis focused on the pseudoword “gakscheitideuk”, which contained velar, alveolar and postalveolar sounds that enabled an analysis of internal articulators with a focus on the tongue and soft palate. The first step was to analyze the control subjects´ fluent speech in text form, which gave the author a basic understanding of the articulatory movements. Then the pseudoword was analyzed in 54 stuttered runs with the help of previously defined coding levels. This was followed by a tabular evaluation of the analysis, as well as the determination of the tremor frequency of certain articulation movements and the statistical analysis, using descriptive statistics and binary logistic regression analysis.
Within the stuttering speech of stuttering subjects, the stuttering symptoms repetition and silent block were evident. During their articulation, more stuttering adults showed only silent blocks or a combination of silent blocks and repetitions and only two stuttering adults showed only repetitions. In comparison, the articulators of stuttering adults clearly showed deviations from the normal speech flow of fluent speakers. The stuttering was characterized by movement patterns which were not found in the four randomly selected fluent speakers. These deviations could be divided into 3 main categories: (1) isometric movements, (2) tremor and (3) dystonia. All three forms of the classic movement disorder, namely hyperkinesis, hypokinesia and dystonia, were found. The tremor was characterized by repetitive movements of the tongue with an average frequency of 6.0 +/- 2.3 Hz. During the analysis, it became clear that several movement patterns can occur within one stuttering symptom. On the one hand, the individual movement patterns can be observed with different stuttering symptoms. There were hypokinetic movement segments that led to a standstill of the movement and to an interruption of speech. There was a higher chance of their occurrence if the articulated stuttering symptom was a silent block as opposed to a repetition. On the other hand, the odds ratio of being able to observe repetitive movements in a stuttering subject was higher if he articulated the stuttering symptom repetition. In addition, changes in the shape of the tip of the tongue were observed, which resembled dystonic movements and could be due to insufficient environmental inhibition, previously described in a study as reduced intracortical inhibition in stutterers.
As the research presented here shows, ultimately only an intensive examination of stuttering speech itself can lead to an understanding of the moments and progression of stuttering. One of the worlds largest data sets of stuttering speech in the form of real-time MRI video sequences as the basis of this research has given an unprecedented insight into the dynamic process of speech production in stutterers. The author´s research leads to results that are consistent with an even go far beyond previous findings on the impairment of speech motor initiation in stutterers. It can be clearly shown that stuttering speakers differ in their articulatory movements from those of fluent speakers. The present research thus expands our understanding of stuttering speech by shedding light on the neurogenetic component of stuttering and by making a substantial contribution to the classification of developmental stuttering as a movement disorder.2026-01-0
Investigation of Newborn Defecation Patterns in Relation to Extrinsic Factors (Cohort Study)
No full textDelayed meconium passage in preterm infants is common in very low birth weight infants, and there is evidence in the literature of a high risk of gastrointestinal complications, particularly in preterm infants of low gestational age. The aim of the present study was to investigate the influence of a number of extrinsic predictive factors on the defecation performance of newborns. For this purpose, we prospectively analyzed patient data collected over twelve months.
The results indicate that there is no significant difference between female and male newborns with regard to the timing of meconium excretion and transitional defecation. Furthermore, newborns who passed their first transitional stool earlier than average were significantly heavier and taller than those in the late-excreting group. No significant associations were found between head circumference and the timing of meconium or transitional defecation.
Further analysis of meconium data revealed that early meconium excreters had a significantly longer gestational duration compared to late-excreting newborns. This relationship was not significant concerning transitional defecation.
Apgar scores showed no significant differences between early and late meconium excreting newborns. Nevertheless, a significant difference emerged after five minutes for transitional defecation, suggesting that newborns with initially higher Apgar scores passed their first transitional defecation significantly later.
Early meconium excreting infants demonstrated significantly lower umbilical cord blood pH values postnatally. No significant correlations were found with body temperature or duration of birth. Interestingly, early excreting newborns of meconium and transitional defecation were significantly more likely to be born naturally, while late excreting infants were more often delivered via cesarean section at above-average rates. Parity and the timing of defecation showed a near-significant association (p = 0.077).
No significant relationships were identified between postpartum nutrition, maternal pregnancy behaviors involving intoxicants, or birth outcomes. However, mothers of infants with early meconium and transitional defecation gained significantly more weight during pregnancy compared to the late-excreting group. Additionally, mothers of early meconium excreting infants were statistically younger.
Finally, no significant correlations were observed between the timing of meconium and transitional defecation. Our findings suggest that specific predictive factors are associated with the timing of meconium or transitional defecation. Future large-scale, multicenter prospective studies are needed to validate these factors in combination with clinical symptoms to develop risk-stratification algorithms and enable early identification of at-risk patients.2025-03-1
Biomechanical analysis of different methods for anterior screw osteosynthesis in odontoid fractures Anderson and D'Alonzo type II
No full textThe data on the use of single- or double-screw techniques for anterior osteosynthesis of type II odontoid fractures is inconclusive and contradictory. Although the double-screw technique appears to offer more rotational stability, no biomechanical studies have shown clear advantages over the single-screw technique. The double-screw technique increases the duration of surgery and leads to greater stress on the cervical soft tissues. It appears however to lead to a higher fusion rate in some radiological studies. Previous biomechanical studies on single- and double-screw techniques have neglected physiological conditions and only examined osteosyntheses with direct loading tests on the odontoid. The aim of this study was to design a device that mimics the physiological conditions of the atlantoaxial joint in order to test the stability after single- and double-screw techniques, as well as using a larger-diameter screw for the osteosynthesis of artificially created type II odontoid fractures. A 3D-printed, motor-driven apparatus was developed for mounting on a Zwick testing machine, allowing a combination of all directions of movement. 18 intact C1-3 specimens were embedded to best simulate physiological conditions. They were stratified into three groups, receiving either one 4.0 mm screw (1S), two 4.0 mm screws (2S) or one 5.0 mm double-threaded headless compression screw (HCS) after artificially creating a type II fracture. Each specimen was tested in combined motion in all movement dimensions with an increasing preload from 1 to 40 N. Screw loosening was observed visually, by fatigue data, and by a camera tracking system. Analysis of the Zwick data and the camera data revealed a significantly higher stability after 2S osteosynthesis compared to 1S and HCS treatment (Zwick data: p = 0.021, camera data: p < 0.001), while visible screw loosening showed a superiority of the 2S only over HCS (p = 0.038). The developed apparatus allowed the dynamic study of the atlantoaxial joint with a high approximation to physiological conditions. The results suggest a superiority of the 2S over the 1S and HCS in biomechanical stability in the treatment of type II odontoid fractures.2025-12-1
Morphologische Normwerte von Augenmuskeln (M. levator palpebrae superioris und M. rectus superior) im Vergleich zu Extremitätenmuskeln (M. deltoideus und M. quadriceps femoris)
No full textThe function of the eye muscles enables them to perform fast and precise movements while also exhibiting a pronounced resistance to fatigue. Although the structure and function of eye muscles differ from the limb musculature, there are no distinct established and standardized histomorphological analysis criteria. Therefore, this work is focused on a practical approach in routine diagnostics to improve the general understanding by describing the unique characteristics of eye muscles and to address the lack of standardized values.
Particular attention was paid to histochemical stains commonly used in the primary diagnosis of muscle tissue: hematoxylin and eosin (HE), myoadenylate deaminase (MAD), Periodic acid–Schiff (PAS), Oil Red O (ORO), Elastica by van Gieson (EvG), nonspecific esterase (UE), nicotinamide adenine dinucleotide (NADH), menadione-linked alpha-glycerophosphatase (MAG), myofibrillar ATPase (ATPase), trichrome modified according to Gomori, acid phosphatase (AP), cytochrome c oxidase/succinate dehydrogenase (COX/SDH), supplemented by some more specific stains (LAMP-1, SERCA-1, Prohibitin).
Compared to peripheral musculature, the eye muscles show a pronounced variation in muscle fiber caliber and abundant connective tissue. In addition, varying degrees of elastic fibers were particularly evident in the superior rectus muscle. The trichrome stain modified according to Gomori exhibited intensive fuchsinophilic stained fibers in up to 90% of all fibers per field of view. While in limb muscles, those fibers are defined as so called pathologic ragged red fibers, due to their common appearance in eye muscles a classification as pathologic would be a misinterpretation. There were frequently larger fractions of small fibers in the eye muscles, implying an overestimation of per definition pathologically atrophic fibers. Additionally, the assessment of the angularity of fibers as well as the identification of pyknotic core clusters was more challenging than in peripheral muscle tissue. Thus, the usual diagnostic criteria of muscle fiber atrophy and hypertrophy including the respective etiological classification are probably not equally applicable to the assessment of eye muscle tissue. Muscle fiber type assessment was also more challenging because of limited reciprocity of different stains (NADH, ATPase stain) and a partly wider staining spectrum. Other findings appearing to distinct eye from peripheral muscles were fibers with a stronger reaction in the PAS stain, a subtly increased fat content in some fibers, a slightly higher overall proportion of confluent vacuoles were noted in the ORO stain, more frequent COX deficiencies in the context of aging, a stronger reactivity in the UE stain in some fibers of the superior rectus muscle as well as an increased signal in the acid phosphatase reaction in the superior rectus muscle.
All in all, due to the specific characteristics of the eye muscles classical assessment schemes and standard values obtained from the analysis of peripheral muscles are not uncritically applicable. Further studies on pathological eye muscle tissue are necessary to clearly differentiate normal from pathological findings.2025-03-0
Dementia-specific consultations in general hospitals - description and evaluation of an innovative project to improve the medical care of people with dementia
No full textHintergrund: Dementielle Erkrankungen sind vielgestaltig und zählen zu den häufigsten
psychiatrischen Leiden im Allgemeinkrankenhaus. Sie können mit einer Vielzahl von
Komplikationen wie bspw. Verhaltensauffälligkeiten oder Delir einhergehen. Der derzeitige
demografische Trend mit einer weiterhin steigenden Lebenserwartung führt prognostisch zu
einem Anstieg dementieller Erkrankungen, bei einem gleichzeitigen Rückgang von
Versorgungsstrukturen im ländlichen Raum. Hieraus ergibt sich eine Versorgungslücke bei
der Behandlung von Menschen mit Demenz insbesondere in Allgemeinkrankenhäusern
ohne eigene neurologische oder psychiatrische Expertise.
Methode: Das Projekt Demenz-Konsiliardienst für Krankenhäuser der Regelversorgung – ein
kombiniertes aufsuchendes und telemedizinisches Konzept der Klinik für Psychiatrie und
Psychotherapie der UMG sollte im Sinne eines Modellprojektes eruieren, ob ein
Konsiliardienst zur Versorgung von Menschen mit Demenz umsetzbar ist und inwiefern
fünf regionale Krankenhäuser im Raum Südniedersachsen davon profitieren können. Die
Weitergabe von demenzspezifischer Expertise erfolgte in erster Linie über die hier
ausgewerteten persönlichen oder telemedizinischen Konsiliarleistungen zu konkreten
psychiatrischen Fragestellungen. Im Anschluss an die Projektphase konnten die erhobenen
Daten gesammelt, digitalisiert und analysiert werden.
Ergebnisse: Insgesamt wurden zwischen dem 10.07.2020 und dem 14.03.21 65
Konsiliarleistungen zu 61 Patient*innen an fünf regionalen Krankenhäusern durchgeführt.
Knapp 95% der Konsilanfragen hatten einen konservativen (internistisch/geriatrisch) und
5% einen chirurgischen Hintergrund. Das durchschnittliche Alter der Patient*innen betrug
79,2 Jahre mit einem Häufigkeitsgipfel zwischen 80 bis 89 Jahren (45,0%), bei einem Anteil
von knapp zwei Dritteln weiblicher Patient*innen. Die häufigsten Fragestellungen waren zur
Abklärung einer Demenz (50,8%), gefolgt von Fragestellungen zu Deliren (24,6%),
Verhaltensstörungen bei Demenz (23,0%), therapeutischen bzw. medikamentösen
Herangehensweisen (21,3%) und Fragestellungen zu Depressionen (8,2%). Die Auswertung
des erhobenen MMST gemäß der S3-Leitlinie „Demenzen“ ergab bei drei Personen (7,5%)
ein unauffälliges Ergebnis, bei 37,5% den Hinweis auf eine leichtgradige Demenz, bei 42,5%
den Hinweis auf eine mittelschwere Demenz und bei einer Person (2,5%) den Hinweis auf
eine schwere Demenz. Von Polypharmazie bei einem Cut-Off-Wert von fünf oder mehr
parallel eingenommen Medikamenten waren mehr als drei Viertel aller Patient*innen (78,7%)
betroffen. Eine Diagnose aus dem Formenkreis der Demenzen wurde bei 52,5% der
Patient*innen festgestellt, ein Delir bei 13,1%, eine leichte kognitive Störung bei 4,9% und
eine Depression bei 14,8%. Empfehlungen wurden in erster Linie zur medikamentösen
Therapie ausgesprochen (54,1%) sowie zur ambulanten neurologischen oder psychiatrischen
Anbindung (27,9%) oder einer weiterführenden Diagnostik (26,6%).
Schlussfolgerungen: Das Projekt konnte erfolgreich umgesetzt und wissenschaftlich begleitet
werden, trotz struktureller Hindernisse durch die Coronapandemie. Die Ergebnisse zeigten,
dass die Implementierung eines demenzspezifischen Konsiliardienstes für regionale
Krankenhäuser realisierbar ist. Es zeigte sich, dass mithilfe von demenzspezifischer
Expertise und diagnostischen Mitteln (bspw. MMST) regionale Krankenhäuser beim
Erkennen und Umgang mit Demenzen und einhergehenden Komplikationen unterstützt
werden können. Zudem können die Empfehlungen eines Demenz-Konsiliardienstes für die
Behandelnden und Patient*innen Hilfestellungen bieten und potentiell Verlegungen in
(geronto)psychiatrische Kliniken reduzieren, wodurch auch weitere Komplikationen im
Rahmen von Verlegungen vermieden und die wohnortnahe Versorgung der Patient*innen
gefördert werden könnte.Background: Dementia disorders are polymorphic and among the most common psychiatric
disorders seen in general hospitals. They can be associated with a variety of complications
such as behavioral problems or delirium. The current demographic trend with a continued
increase in life expectancy of older patients is leading to an increase in dementia-related
illnesses, while at the same time the medical infrastructure is changing with a decrease in care
centers in rural areas, where proper psychiatric expertise is often missed.
Method: The project Dementia Consultation Service for Hospitals in Standard Care of the
Department of Psychiatry and Psychotherapy of the University Medical Center Göttingen
was designed to determine the extent to which five regional hospitals in the area of southern
Lower Saxony could benefit from a consultation service in dementia care over a period of
17 months. The transfer of dementia-specific expertise took primarily place through the in-
person or telemedicine consults evaluated here for specific psychiatric issues. Following the
project stage, the data was collected, digitized and analyzed.
Results: A total of 65 consultations on 61 patients were performed at five regional hospitals
between 07/10/2020 and 03/14/21. Nearly 95% of the consultation requests came from
internal medicine wards and 5% from surgical wards. The average age was 79.2 years with a
frequency peak between 80 to 89 years (45.0%) and a proportion of almost two thirds female
patients (63.9%) and 36.1% male patients. The most frequent questions came for clarification
of a possible dementia (50.8%), followed by delirium (24.6%), behavioral disorders (23,0%),
questions concerning the medication or therapy recommendation (21.3%) and questions
about depression (8.2%). The evaluation of the MMST according to the S3 guideline
"Dementia" showed an inconspicuous result in three persons (7.5%), in 37.5% an indication
of mild dementia, in 42.5% an indication of moderate dementia and in 2.5% an indication of
severe dementia. Polypharmacy at a cut-off value of five or more medications taken in
parallel affected 78.7% of the patients. A diagnosis relating dementia was found in 52.5% of
the patients, delirium in 13.1%, mild cognitive disorder in 4.9% and depression in 14.8%.
Concluding recommendations primarily for medication therapy (54.1%) as well as for
outpatient neuropsychiatric follow up (27.9%) or further diagnostics (26.6%).
Conclusions: The project was successfully completed and scientifically accompanied, despite
structural obstacles due to the corona pandemic. The results showed in connection with
current literature that for the implementation of a dementia-specific consultation service, a
good dementia diagnosis, e.g. with the help of the MMST, is necessary. It also showed that
the recognition and assessment of complications in dementia (such as delirium or
polypharmacy) play an important role for general hospitals, and recommendations for the
further course are central aids for both staff and patients. Overall, the evaluation of the
results showed the need for a permanently implemented consultation service for a
qualitatively better care of people with dementia in general hospitals.
The project was successfully implemented and scientifically accompanied, despite structural
obstacles due to the corona pandemic. The results showed that the implementation of a
dementia-specific consultation service for regional hospitals is feasible. It was shown that
with the help of dementia-specific expertise and diagnostic tools (e.g. MMST), regional
hospitals can be supported in recognizing and managing dementias and associated
complications. In addition, the recommendations of a dementia consultation service can be
of central assistance for the treating physicians and patients and potentially reduce transfers
to geriatric psychiatry, which could also avoid further complications in the context of
transfers and promote the care of patients close to their home.2025-02-2
Influence of frontal theta oscillation during conflicting Pavlovian bias
No full textPavlovian biases influence learning and decision-making by shaping action initiation and suppression but vary among individuals and are not always advantageous. The prefrontal cortex plays a key role in resolving conflicts between competing motivational systems, with midfrontal theta oscillations serving as a marker of prefrontal control. However, the exact mechanisms of this regulation remain unclear. This study used two experimental phases with continuous EEG recordings. In Phase 1, participants learned active and passive choices within probabilistic reward and punishment contexts, separating model-free (Pavlovian bias) and model-based (prefrontal control) systems. Phase 2 introduced a forced-choice task to evaluate Pavlovian biases in learned value.
Behavioral results showed the best performance in the Go-to-Win condition and the worst in the NoGo-to-Win condition, with poorer performance on Pavlovian conflicting cards. EEG analysis revealed increased theta power associated with Pavlovian conflict, independent of action and reinforcement demands, and a negative correlation between theta peak frequency and task accuracy. These findings highlight the role of theta oscillations in regulating Pavlovian biases and suggest theta power as a marker for prefrontal control in decision-making. This work provides a foundation for future studies on theta oscillations using non-invasive brain stimulation techniques.2025-02-2
Patient adherence in the outpatient follow-up of retinopathy of prematurity at a university eye clinic
No full textDie Frühgeborenenretinopathie (ROP) bedeutet für die betroffenen Kinder eine ernsthafte Gefahr der lebenslangen Sehbehinderung bis zur Erblindung, weshalb konsequente Screeninguntersuchungen unumgänglich sind. Während im stationären Bereich die Kontrollen vom medizinischen Personal organisiert und überwacht werden, birgt die ambulante Nachsorge das Risiko, dass Kontrollen nicht wahrgenommen werden. In dieser Arbeit haben wir die Patientenadhärenz beim ambulanten ROP-Screening an einer universitären Augenklinik untersucht.
Es handelt sich um eine monozentrische und zweiteilige Studie mit einem retrospektiven Arm und einer prospektiven Befragungsgruppe. Im retrospektiven Teil wurden patientenbezogene Daten aller Frühgeborenen anhand der Patientenakte erhoben, die ein ambulantes ROP-Screening zwischen April 2017 und Dezember 2020 durchliefen. Im prospektiven Studienarm wurden die Eltern im Rahmen der ambulanten ROP-Sprechstunde von März bis Dezember 2021 mit Hilfe eines Fragebogens interviewt. Primäres Ziel beider Arme war die Ermittlung der No-Show-Rate (fehlende Vorstellung). Der Fragebogen beinhaltete darüber hinaus eine Sozialanamnese und erfasste weitere Ursachen, die ein Fernbleiben erklären können.
In die retrospektive Auswertung wurden 188 Probanden eingeschlossen, an der prospektiven Befragung nahmen 30 Probanden teil. 175 der 188 Probanden (93%) erschienen zu allen Terminen. Von den restlichen 13 Probanden, die eine Erinnerung erhielten, kamen 8 zum ROP-Screening zurück. Insgesamt 3 von 188 Probanden sind ohne ersichtlichen Grund dem Screening ferngeblieben, was eine No-Show-Rate von 1,6% ergibt. In der prospektiven Befragungsgruppe gaben 5 der 30 Eltern (17%) an, einen Termin schon einmal nicht wahrgenommen zu haben. Alle erhielten einen Ersatztermin innerhalb einer Woche, der dann auch eingehalten wurde. Insgesamt 29 (97%) der Befragten hielten das Screening nach Entlassung für sinnvoll. Nur 50% der Eltern gaben an, gut über die Erkrankung und die möglichen Folgen aufgeklärt worden zu sein.
Sowohl in der retrospektiven, als auch in der prospektiven Studiengruppe fanden wir eine hohe Patientenadhärenz bei den Screeninguntersuchungen. Die hohe Termintreue scheint aber von anderen Faktoren, als der Patientenaufklärung, abzuhängen. Ein ROP-Aufklärungsbogen zum verbesserten Krankheitsverständnis der Eltern ist sinnvoll und wurde im Zuge dieser Arbeit erstellt.Retinopathy of prematurity (ROP) poses a serious risk of lifelong visual impairment or even blindness for affected children, which is why consistent screening examinations are essential. While in the inpatient setting, check-ups are organized and monitored by medical staff, outpatient follow-up care carries the risk that check-ups are not carried out. In this study, we investigated patient adherence to outpatient ROP screening at a university eye clinic.
This is a monocentric and two-part study with a retrospective arm and a prospective survey group. In the retrospective arm, patient-related data was collected from all preterm infants who underwent outpatient ROP screening between April 2017 and December 2020 using the patient file. In the prospective arm of the study, parents were interviewed during outpatient ROP consultations from March to December 2021 using a questionnaire. The primary aim of both arms was to determine the no-show rate. The questionnaire also included a social history and recorded other causes that could explain absenteeism.
188 subjects were included in the retrospective evaluation, 30 subjects took part in the prospective survey. 175 of the 188 subjects (93%) attended all appointments. Of the remaining 13 subjects who received a reminder, 8 returned for ROP screening. A total of 3 out of 188 subjects failed to attend the screening for no apparent reason, resulting in a no-show rate of 1.6%. In the prospective survey group, 5 of the 30 parents (17%) stated that they had already missed an appointment. All of them were given an alternative appointment within a week, which was then kept. A total of 29 (97%) of those surveyed considered the post-discharge screening to be useful. Only 50% of parents stated that they had been well informed about the disease and the possible consequences.
In both the retrospective and prospective study groups, we found a high level of patient adherence to the screening examinations. However, the high adherence to appointments seems to depend on factors other than patient education. A ROP information sheet to improve parents' understanding of the disease is useful and was developed in the course of this work.2025-04-0
Effect of the standardized Japanese Kampo Extract Juzen-taiho-to on the Tumor microenvironment in a Pancreatic cancer mouse model – a comparison to Gemcitabine
No full textPancreatic ductal adenocarcinoma (PDAC) is among the most aggressive gastrointestinal malignancies, characterized by poor prognosis and limited therapeutic success. Despite surgical resection being the sole curative approach, the high recurrence rate and late-stage diagnosis necessitate innovative therapeutic strategies. This study investigates the immunomodulatory effects of the standardized Japanese herbal medicine Juzentaihoto (JUZ) alone and in combination with gemcitabine, a standard chemotherapeutic agent, in an orthotopic pancreatic cancer mouse model and in vitro settings. The findings demonstrate that JUZ promotes M1 macrophage polarization, enhancing anti-tumor immune responses, while improving the efficacy of gemcitabine by mitigating its resistance. Additionally, JUZ significantly modulates the tumor microenvironment and cytokine expression, resulting in prolonged survival in treated groups. These results underline the potential of JUZ as an adjuvant therapy for PDAC, emphasizing the need for further molecular investigations and clinical trials to validate its application.2025-04-2