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Publikationen von unseren Experten bei MEDIAN

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Long Covid - Die neue Volkskrankheit

Erscheinung: 17. 3. 2022 / C.H.Beck

Dr. Jördis Frommhold, Chefärztin der Abteilung für Atemwegserkrankungen und Allergien der MEDIAN Klinik Heiligendamm, hat ein Buch herausgebracht, das ab dem 17.03.2022 erhältlich ist. Unter dem Titel „Long Covid – die neue Volkskrankheit: Wie man sie erkennt, warum sie so viele betrifft und was wirklich hilft“ beschreibt Dr. Frommhold auch für Laien verständlich wie Krankheitsbilder, –verläufe, gesellschaftliche sowie volkswirtschaftliche Folgen aussehen, welche Therapieansätze es gibt und wo Betroffene Hilfe finden können.Hier lesen Sie einen Auszug aus dem Klappentext: „Allein in Deutschland, Österreich und der Schweiz bewegt sich die Zahl derer, die langfristig an einer Beeinträchtigung leiden, auf eine halbe Million zu. Die Symptome von Long Covid sind vielfältig. So fühlen sich die Betroffenen beispielsweise krankhaft erschöpft (Fatigue), leiden an einer Verschlechterung ihres Zustands nach Belastung, an Lärm- und Lichtempfindlichkeit, haben Schmerzen, Schlafstörungen, Konzentrations- oder Gedächtnisprobleme, Kreislaufprobleme und grippeähnliche Symptome.“

Autoren: Frommhold Jördis

Effects of chess-based cognitive remediation training as therapy add-on in alcohol and tobacco use disorders: protocol of a randomised, controlled clinical fMRI trial

Erscheinung: 16. 8. 2022 / BMJ Open

BackgroundAlcohol and tobacco use disorders (AUD, TUD) are frequent, both worldwide and in the German population, and cognitive impairments are known to facilitate instances of relapse. Cognitive training has been proposed for enhancing cognitive functioning and possibly improving treatment outcome in mental disorders. However, these effects and underlying neurobiological mechanisms are not yet fully understood regarding AUD and TUD. Examining the effect of chess-based cognitive remediation training (CB-CRT) on neurobiological, neuropsychological and psychosocial aspects as well as treatment outcomes will provide insights into mechanisms underlying relapse and abstinence and might help to improve health behaviour in affected individuals if used as therapy add-on.Methods and analysisN=96 individuals with either AUD (N=48) or TUD (N=48) between 18 and 65 years of age will participate in a randomised, controlled clinical functional MRI (fMRI) trial. Two control groups will receive treatment as usual, that is, AUD treatment in a clinic, TUD outpatient treatment. Two therapy add-on groups will receive a 6-week CB-CRT as a therapy add-on. FMRI tasks, neurocognitive tests will be administered before and afterwards. All individuals will be followed up on monthly for 3months. Endpoints include alterations in neural activation and neuropsychological task performance, psychosocial functioning, and relapse or substance intake. Regarding fMRI analyses, a general linear model will be applied, and t-tests, full factorial models and regression analyses will be conducted on the second level. Behavioural and psychometric data will be analysed using t-tests, regression analyses, repeated measures and one-way analyses of variance.Ethics and disseminationThis study has been approved by the ethics committee of the medical faculty Mannheim of the University of Heidelberg (2017-647N-MA). The findings of this study will be presented at conferences and published in peer-reviewed journals.Trial registration The study was registered in the Clinical Trials Register (trial identifier: NCT04057534 at clinicaltrials.gov).

Autoren: Gerhardt Sarah, Lex Gereon, Holzammer Jennifer, Karl Damian, Wieland Alfred, Schmitt Roland, Recuero Ainoa Jiménez, Montero Juan Antonio , Weber Tillmann, Vollstädt-Klein Sabine

Entwöhnungsbehandlung (Sucht-Rehabilitation) der Alkoholabhängigkeit

Erscheinung: 16. 3. 2022 / PSYCH up2date

Die ambulante, tagesklinische und stationäre Alkoholentwöhnungsbehandlung (AEB) ermöglicht eine effektive Behandlung der Alkoholabhängigkeit mit hohen Abstinenzquoten. Nach bewilligtem Reha-Antrag können abstinente Rehabilitanden mit einem multimodalen, interdisziplinären, primär psychotherapeutischen Behandlungskonzept an den zugrunde liegenden Ursachen ihrer Abhängigkeitsentwicklung, ihrer Abstinenzmotivation und Rückfallprophylaxe arbeiten.

Autoren: Enke M., Wallenwein E. , Weber Tillmann

Predicting participation in and success of a concurrent smoking cessation program during inpatient treatment for alcohol dependence

Erscheinung: 2021 / Psychiatria Danubina

Background: Predicting participation in and success of smoking cessation programs in alcohol dependent patients has yielded heterogeneous results. Moreover, these findings have rarely been based on prospective studies from clinical routine settings. Identifying predictors in prospective studies could help to tailor interventions that increase participation and success rates of smoking cessation therapies for these patients at a high risk for alcohol- and smoking-related morbidities and mortalities.Subjects and methods: During inpatient alcohol dependence treatment, 99 nicotine dependent patients were recruited. 73 patients chose to participate in a voluntary smoking cessation program. Interviews and questionnaires were used at baseline and at discharge to assess a large set of variables covering smoking and alcohol related factors, general psychopathology, quality of life and personality traits. Multiple logistic regression models were calculated to predict participation in the smoking cessation program and smoking abstinence at follow-up three months after discharge.Results: Participation in the smoking cessation program was predicted by higher stage of change, higher confidence in abstaining from smoking and lower perceived stress. Successful smoking cessation at follow-up was predicted by higher expectations of negative physical feelings due to smoking and lower expectations of temptations to smoke at baseline, and by lower number of daily smoked cigarettes at discharge.Conclusion: Despite the small sample size, this prospective study gives a first indication of clinically relevant predictors of participation in and success of a smoking cessation program by exploring many previously reported predictors simultaneously. The findings and their implications for treatment allocation and optimization are discussed. 

Autoren: Frischknecht U., Pätz T., Reinhard I., Dinter C., Kiefer F., Weber Tillmann

Activation of the Glucocorticoid Receptor Rapidly Triggers Calcium-dependent Serotonin Release in vitro

Erscheinung: 2021 / CNS Neuroscience & Therapeutics

Aims: Glucocorticoids rapidly provoke serotonin (5-HT) release in vivo. We aimed to investigate molecular mechanisms of glucocorticoid receptor (GR)-triggered 5-HT release.Methods: Employing 1C11 cells to model 5-HT neurotransmission, immunofluorescence and Pearson's Correlation Coefficient were used to analyze colocalization of GR, 5-HT, vesicle membrane protein synaptotagmin 1 and vesicle dye FM4-64FX. FFN511 and FM4-64FX dyes as well as calcium imaging were used to visualize vesicular 5-HT release upon application of GR agonist dexamethasone, GR antagonist mifepristone and voltage-gated calcium channel (VGCC) inhibitors.Results: GR, 5-HT, synaptotagmin 1 and FM4-64FX showed overlapping staining patterns, with Pearson's Correlation Coefficient indicating colocalization. Similarly to potassium chloride, dexamethasone caused a release of FFN511 and uptake of FM4-64FX, indicating vesicular 5-HT release. Mifepristone, calcium depletion and inhibition of L-type VGCC significantly diminished dexamethasone-induced vesicular 5-HT release.Conclusions: In close proximity to 5-HT releasing sites, activated GR rapidly triggers L-type VGCC-dependent vesicular 5-HT release. These findings provide a better understanding of the interrelationship between glucocorticoids and 5-HT relea

Autoren: Paul N., Raymond J., Lumbreras S., Bartsch D., Weber Tillmann, Lau T

Serotonin deficiency induced after brain maturation rescues consequences of early life adversity

Erscheinung: 2021 / Scientific Reports

Brain serotonin (5-HT) system dysfunction is implicated in depressive disorders and acute depletion of 5-HT precursor tryptophan has frequently been used to model the influence of 5-HT deficiency on emotion regulation. Tamoxifen (TAM)-induced Cre/loxP-mediated inactivation of the tryptophan hydroxylase-2 gene (Tph2) was used to investigate the effects of provoked 5-HT deficiency in adult mice (Tph2 icKO) previously subjected to maternal separation (MS). The efficiency of Tph2 inactivation was validated by immunohistochemistry and HPLC. The impact of Tph2 icKO in interaction with MS stress (Tph2 icKO × MS) on physiological parameters, emotional behavior and expression of 5-HT system-related marker genes were assessed. Tph2 icKO mice displayed a significant reduction in 5-HT immunoreactive cells and 5-HT concentrations in the rostral raphe region within four weeks following TAM treatment. Tph2 icKO and MS differentially affected food and water intake, locomotor activity as well as panic-like escape behavior. Tph2 icKO prevented the adverse effects of MS stress and altered the expression of the genes previously linked to stress and emotionality. In conclusion, an experimental model was established to study the behavioral and neurobiological consequences of 5-HT deficiency in adulthood in interaction with early-life adversity potentially affecting brain development and the pathogenesis of depressive disorders.

Autoren: Aboagye B., Weber Tillmann, Merdian H. L., Bartsch D., Lesch K. P., Waider J.

Obesity – An Update on the Basic Pathophysiology and Review of Recent Therapeutic Advances

Erscheinung: 29. 9. 2021 / Biomolecules

Obesity represents a major public health problem with a prevalence increasing at an alarming rate worldwide. Continuous intensive efforts to elucidate the complex pathophysiology and improve clinical management have led to a better understanding of biomolecules like gut hormones, antagonists of orexigenic signals, stimulants of fat utilization, and/or inhibitors of fat absorption. In this article, we will review the pathophysiology and pharmacotherapy of obesity including intersection points to the new generation of antidiabetic drugs. We provide insight into the effectiveness of currently approved anti-obesity drugs and other therapeutic avenues that can be explored.  Keywords: obesity; diabetes mellitus; anti-obesity drugs; obesity metabolism; energy balance

Autoren: Gjermeni Erind, Kirstein Anna S., Kolbig Florentine, Kirchhof Michael, Bundalian Linnaeus, Katzmann Julius L., Laufs U., Blüher Matthias, Garten Antje, Le Duc Diana

Phenotype-tissue expression and exploration (PTEE) resource facilitates the choice of tissue for RNA-seq-based clinical genetics studies

Erscheinung: 2021 / BMC Genomics

Background: RNA-seq emerges as a valuable method for clinical genetics. The transcriptome is “dynamic” and tissue-specific, but typically the probed tissues to analyze (TA) are different from the tissue of interest (TI) based on pathophysiology.Results: We developed Phenotype-Tissue Expression and Exploration (PTEE), a tool to facilitate the decision about the most suitable TA for RNA-seq. We integrated phenotype-annotated genes, used 54 tissues from GTEx to perform correlation analyses and identify expressed genes and transcripts between TAs and TIs. We identified skeletal muscle as the most appropriate TA to inquire for cardiac arrhythmia genes and skin as a good proxy to study neurodevelopmental disorders. We also explored RNA-seq limitations and show that on-off switching of gene expression during ontogenesis or circadian rhythm can cause blind spots for RNA-seq-based analyses.Conclusions: PTEE aids the identification of tissues suitable for RNA-seq for a given pathology to increase the success rate of diagnosis and gene discovery. PTEE is freely available at bioinf.eva.mpg.de/PTEE

Autoren: Velluva Akhil, Radtke Maximilian, Horn Susanne, Popp Bernt, Platzer Konrad, Gjermeni Erind, Lin Chen-Ching, Lemke Johannes R. , Garten Antje, Schöneberg Torsten, Blüher Matthias, Abdou Jamra Rami, Le Duc Diana

Mammakarzinom: 4x AC + 12x Paclitaxel anstelle von 4x EC + 12x Paclitaxe

Erscheinung: 2020 / Journal Onkologie

Das Mammakarzinom ist die häufigste Form von Krebs bei Frauen und in Deutschland mit einem Anteil von 32% aller Krebsneuerkrankungen die wichtigste Krebserkrankung bei Frauen. Grundsätzlich ist das Mammakarzinom chemosensitiv und die Chemotherapie spielt als adjuvante, neoadjuvante und palliative Therapie eine besonders große Rolle, v.a. bei HER2-positivem und triplenegativem Mammakarzinom sowie bei erhöhter Expression von Ki67. 

Autoren: Kowefateia Muhammed

Einsatz des 6 Minuten Gehtest in der neurologischen Rehabilitation nach Schlaganfall: Reliabilität, Validität und Veränderungen im Verlauf

Erscheinung: 2020 / Neurologie und Rehabilitation

Autoren: Lamprecht J., Guse I., Gursch A., Sickert A., Sailer M.

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