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Introduction: The influence of our diet on mental health is of increasing importance in current research. Study results on the gut-brain axis suggest that the gut microbiome can influence mental processes via neuronal, hormonal and immune signaling pathways [1]. The gut microbiome is largely influenced by our diet. Some studies provide evidence that a "Western diet" rich in saturated fat and sugar may promote mental disorders [2]. There is evidence, that dietary behaviour in individuals with Attention Deficit Hyperactivity Disorder (ADHD) is characterized by an increased intake of sugar and saturated fat [3]. So far, it is unclear whether this dietary pattern contributes to ADHD symptoms such as impulsivity. The aim of this study is to investigate the influence of certain macronutrients such as fats and mono/disaccharides on impulsivity in individuals with ADHD. Using our APPetite-mobile-app [4] enabled us to study dietary behaviour and momentary impulsiveness in everyday life of our participants.
Methods: 43 participants with ADHD (mean age 36.0 ± 12.3 years, 21 females) and 186 healthy controls (mean age 28.5 ± 7.7 years, 133 females) without any psychiatric condition were included into the study. Food intake was recorded over a period of three days using the APPetite-mobile-app via a 6 step process: (1) Selection of meal type, (2) Entry of time of meal, (3) Selection of consumed foods and drinks, (4) Specification of consumed amounts, (5) Presentation of reminder for commonly forgotten foods, and (6) Indication of predominant reason for eating. In addition to entering consumed foods in the APPetite-mobile-app, subjects completed an online food log for the last 24 hours (myfood 24) at the beginning of the study. After the data collection period, a detailed analysis of the ingested nutrients was performed for each subject. Trait impulsivity was assessed using the UPPS-P, a self-assessment questionnaire. Momentary impulsiveness was assessed via the mHealth APP by means of the Momentary Impulsiveness scale (MIS). The MIS consists of 4 questions capturing different aspects of impulsivity. The participants were prompted to answer these questions at 8 semi-random times per day between 8 AM and 10 PM. The minimum time between 2 prompts was 1 hour. Thereby participants could not predict the exact time of the next prompt and the assessed situations are a better reflection of the participant’s real life.
Results: ANOVA revealed higher levels of both, trait and momentary impulsivity in individuals with ADHD compared to controls (p < 0,01). After preprocessing of data that was sampled via the mHealth APP is completed, a regression analysis with different macronutrients as predictors and impulsivity as dependent variable will be computed. To assess the association between momentary impulsiveness and dietary intake, generalized linear multilevel modelling will be used. Results of these analyses will be presented.
Background: The most frequent therapy of hydrocephalus is the implantation of ventriculoperitoneal shunts for diverting cerebrospinal fluid from the ventricles into the peritoneum. We compared two adjustable valves, the proGAV and proGAV 2.0, for complications which resulted in revision operations.
Methods: Four hundred patients who underwent primary shunt implantation between 2014 and 2020 were analyzed for overall revision rate, one-year revision rate, revision free survival and overall survival observing patient age group, gender, etiology of hydrocephalus, implantation site, prior diversion of cerebrospinal fluid and cause of revision.
Results: All data were available of all 400 patients (female/male 208/192). Overall, 99 patients underwent revision surgery after primary implantation. ProGAV valve was implanted in 283 patients, proGAV 2.0 in 117 patients. There was no significant difference between the two shunt valves concerning revision rate (p=0.8069), one-year revision rate (p=0.9077), revision free survival (p=0.6921) and overall survival (p=0.3232). Furthermore, regarding one-year revision rate, we observed no significant difference between the two shunt valves in pediatric patients (40.7% vs 27.6%; p=0.2247). Revision operation had to be performed more frequently in pediatric patients (46.6% vs 24.8%; p=0.0093) with a significant higher number of total revisions with proGAV than proGAV 2.0 (55.9% vs. 27.6%; p=0.0110) most likely due to longer follow up in the proGAV -group.
Conclusion: According to the target variables we analyzed, aside from lifetime revision rate in pediatric patients there is no significant difference between the two shunt valves. From our subjective point of view, implantation of the newer proGAV 2.0 valve is preferable due to higher adjustment comfort for both patients and physicians.
Background: During the COVID-19 pandemic, decreased volumes of acute stroke admissions were reported. We aimed to examine whether subarachnoid hemorrhage (SAH) volumes demonstrated similar declines in our department. Furthermore, the impact of pandemic on disease progression should be analyzed.
Methods: We conducted a retrospective study in neurosurgical department of university hospital Frankfurt including patients with the diagnosis of aneurysmal SAH during the first year of COVID-pandemic. One year cumulative volume for SAH hospitalization procedures were compared to the one-year period before (03/2020–02/2021 versus 03/2019–02/2020) and the last 5 pre-COVID-pandemic years (2015-2020). All relevant patient characteristics concerning family history, disease history, clinical condition at admission, active/past COVID-infection, treatment management, complications and outcome were analyzed.
Results: There was a decline in SAH hospitalizations, with 84 admissions in the year immediately before and 56 admissions during the pandemic, without reaching a significance. No significant difference in analyzed patient characteristics including clinical condition at onset, treatment, complications and outcome, between 56 SAH patients admitted during COVID pandemic and treated patients in the last 5 years in pre-COVID period were found. Using a multivariable analysis, we detected young age (p<0.05;OR4,2) and no existence of early hydrocephalus (p<0.05;OR0,13) as important factors for a favorable outcome (mRS≤0-2) after aSAH during the COVID-pandemic. A past COVID-infection was detected in young patients suffering from aSAH (Age< 50years, p<0.05;OR10,5) with increased rate of cerebral vasospasm after SAH onset (p<0.05;OR26). Nevertheless, past COVID-infection did not reach a significance as a high risk factor for unfavorable outcome.
Conclusion: There was a relative decrease in the volume of SAH during the COVID-19 pandemic. Despite of extremely different conditions of hospitalization, there was no impairing significant effect on treatment and outcome of admitted SAH patients. A past COVID-infection seemed not to be a relevant limiting factor concerning favorable outcome.