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The plaque reduction neutralization test (PRNT) is a preferred method for the detection of functional, SARS-CoV-2 specific neutralizing antibodies from serum samples. Alternatively, surrogate enzyme-linked immunosorbent assays (ELISAs) using ACE2 as the target structure for the detection of neutralization-competent antibodies have been developed. They are capable of high throughput, have a short turnaround time, and can be performed under standard laboratory safety conditions. However, there are very limited data on their clinical performance and how they compare to the PRNT. We evaluated three surrogate immunoassays (GenScript SARS-CoV-2 Surrogate Virus Neutralization Test Kit (GenScript Biotech, Piscataway Township, NJ, USA), the TECO® SARS-CoV-2 Neutralization Antibody Assay (TECOmedical AG, Sissach, Switzerland), and the Leinco COVID-19 ImmunoRank™ Neutralization MICRO-ELISA (Leinco Technologies, Fenton, MO, USA)) and one automated quantitative SARS-CoV-2 Spike protein-based IgG antibody assay (Abbott GmbH, Wiesbaden, Germany) by testing 78 clinical samples, including several follow-up samples of six BNT162b2 (BioNTech/Pfizer, Mainz, Germany/New York, NY, USA) vaccinated individuals. Using the PRNT as a reference method, the overall sensitivity of the examined assays ranged from 93.8 to 100% and specificity ranged from 73.9 to 91.3%. Weighted kappa demonstrated a substantial to almost perfect agreement. The findings of our study allow these assays to be considered when a PRNT is not available. However, the latter still should be the preferred choice. For optimal clinical performance, the cut-off value of the TECO assay should be individually adapted.
Background: To minimize the risk of disease transmission in cornea transplantation, donor screening for blood-derived viral infections is mandatory. Ideally, pre-mortem blood samples are used, but based on availability, cadaveric blood samples of cornea donors may also be used. However, serological and nucleic acid amplification tests (NATs) need to be validated for the use of cadaveric specimens.
Methods: Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV) 1/2, and Treponema pallidum (syphilis)-specific serological and/or NAT assays were validated on different platforms (Abbott Alinity i, Alinity m, Roche Cobas 6800, and Roche Cobas AmpliPrep/Cobas TaqMan (CAP/CTM)) using (un)spiked paired pre- and post-mortem cornea donor blood samples from the same individual (up to 23.83 h after death) of 28 individuals in accordance with the specifications of the German Federal Institute for Vaccines and Biomedicines (Paul-Ehrlich-Institut [PEI]). In addition, routinely HBV-, HCV- and HIV-PCR-negative tested post-mortem blood samples of 24 individuals were used to assess NAT specificity.
Results: For the majority of serological parameters on the Abbott Alinity i (HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, anti-HTLV 1/2, and anti-Treponema pallidum), ratios of generated test results of (un)spiked paired pre- and post-mortem blood samples differed ≤25%, with an agreement of qualitative pre- and post-mortem test results ranging from 91.2 to 100%. For NAT parameters (HBV, HCV, and HIV) on the Cobas 6800, Alinity m, and CAP/CTM, no significant deviation in virus concentrations (factor >5) of spiked pre- and post-mortem blood samples could be observed. Ct-values of corresponding internal controls did also not differ significantly (>1.5 Ct-values). In addition, no false-positive test results were generated when specificity was assessed.
Conclusion: Overall, fluctuations of test results for serological and NAT parameters in pre- and post-mortem blood samples examined in this study, were only limited and within the range of what is also observed when routinely testing fresh patient specimens. We conclude that all examined assays are eligible for the screening of blood samples taken up to about 24 h after the occurrence of death.
Testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by RT-PCR is a vital public health tool in the pandemic. Self-collected samples are increasingly used as an alternative to nasopharyngeal swabs. Several studies suggested that they are sufficiently sensitive to be a useful alternative. However, there are limited data directly comparing several different types of self-collected materials to determine which material is preferable. A total of 102 predominantly symptomatic adults with a confirmed SARS-CoV-2 infection self-collected native saliva, a tongue swab, a mid-turbinate nasal swab, saliva obtained by chewing a cotton pad and gargle lavage, within 48 h of initial diagnosis. Sample collection was unsupervised. Both native saliva and gargling with tap water had high diagnostic sensitivity of 92.8% and 89.1%, respectively. Nasal swabs had a sensitivity of 85.1%, which was not significantly inferior to saliva (p = 0.092), but 16.6% of participants reported they had difficult in self-collection of this sample. A tongue swab and saliva obtained by chewing a cotton pad had a significantly lower sensitivity of 74.2% and 70.2%, respectively. Diagnostic sensitivity was not related to the presence of clinical symptoms or to age. When comparing self-collected specimens from different material, saliva, gargle lavage or mid-turbinate nasal swabs may be considered for most symptomatic patients. However, complementary experiments are required to verify that differences in performance observed among the five sampling modes were not attributed to collection impairment.
Cytochrome c oxidases (CcOs), members of the heme-copper containing oxidase (HCO) superfamily, are the terminal enzymes of aerobic respiratory chains. The cbb3-type cytochrome c oxidases (cbb3-CcO) form the C-family and have only the central catalytic subunit in common with the A- and B-family HCOs. In Pseudomonas stutzeri, two cbb3 operons are organized in a tandem repeat. The atomic structure of the first cbb3 isoform (Cbb3-1) was determined at 3.2 Å resolution in 2010 (S. Buschmann, E. Warkentin, H. Xie, J. D. Langer, U. Ermler, and H. Michel, Science 329:327-330, 2010, http://dx.doi.org/10.1126/science.1187303). Unexpectedly, the electron density map of Cbb3-1 revealed the presence of an additional transmembrane helix (TMH) which could not be assigned to any known protein. We now identified this TMH as the previously uncharacterized protein PstZoBell_05036, using a customized matrix-assisted laser desorption ionization (MALDI)-tandem mass spectrometry setup. The amino acid sequence matches the electron density of the unassigned TMH. Consequently, the protein was renamed CcoM. In order to identify the function of this new subunit in the cbb3 complex, we generated and analyzed a CcoM knockout strain. The results of the biochemical and biophysical characterization indicate that CcoM may be involved in CcO complex assembly or stabilization. In addition, we found that CcoM plays a role in anaerobic respiration, as the ΔCcoM strain displayed altered growth rates under anaerobic denitrifying conditions.om Pseudomonas stutzeri, a bacterium closely related to the human pathogen Pseudomonas aeruginosa.
Das Angiotensin konvertierende Enzym (ACE) ist als eine der zentralen Komponenten des ReninAngiotensin-Systems entscheidend an der Regulation der vaskulären Funktion und Homöostase sowie an der Regulation des Flüssigkeits- und Elektrolythaushaltes beteiligt. Dabei katalysiert die Zinkmetallopeptidase ACE vor allem die Bildung des vasokonstriktorisch wirkenden Angiotensins II und die Degradation des vasodilatorisch wirkenden Bradykinins. Die Hemmung des ACE zur antihypertensiven Therapie ist klinisch weit verbreitet, wobei die zahlreichen protektiven Eigenschaften der eingesetzten, hochpotenten ACE-lnhibitoren nicht allein durch die Beeinflussung des Metabolismus der zwei beschriebenen vasoaktiven Peptide zu erklären sind. Vielmehr wird seit einiger Zeit angenommen, dass ACE beispielsweise durch eine Interaktion mit dem Bradykinin-B2-Rezeptor aktiv an der Regulation intrazellulärer Signaltransduktionsprozesse beteiligt ist. Da ACE als plasmamembranäres Ektoenzym in seiner kurzen cytoplasmatischen Sequenz fünf potentiell phosphorylierbare Serinreste besitzt, deren posttranslationale Modifikation durch Phosphorylierung möglicherweise intrazelluläre Signaltransduktionskaskaden beeinflussen könnte, wurde die potentielle Phosphorylierung von ACE sowie die Assoziation von ACE mit intrazellulären Proteinen analysiert. Mittels 32P-Markierung humaner Endothelzellen und ACE-überexprimierender Schweineaortenendothelzellen konnte erstmals die Phosphorylierung des ACE gezeigt werden, sowie unter Verwendung spezifischer Kinaseinhibitoren und anhand von in vitro Phosphorylierungsexperimenten die Proteinkinase CK2 als ACE-phosphorylierende Kinase identifiziert werden. Dies wurde zudem durch die Assoziation der CK2 sowohl mit ACE, als auch mit einem dem cytoplasmatischen Anteil von ACE entsprechenden Peptid bestätigt. Drei der intrazellulären Serinreste des ACE liegen innerhalb Konsensusse1uenzen bekannter Proteinkinasen, wobei nach Punktmutation der Serinreste Ser1253, Ser1263 oder Ser1270, entsprechend in Konsensussequenzmotiven für die PKC, PKA oder CK2 lokalisiert, der Ser1270-Rest als Hauptphosphorylierungsstelle des ACE identifiziert werden konnte. Die Reduktion der ACE-Phosphorylierung nach Mutation des Ser1270 zu Alanin sowie nach Hemmung der CK2 durch Einsatz des spezifischen lnhibitors 5,6-Dichloro-1-ß-D-ribofuranosylbenzimidazol (DRB) resultierte in einer verstärkten proteolytischen Spaltung des ACE, weiche extrazellulär in der juxtamembranär gelegenen "Stalk"-Region des Enzyms erfolgt, so dass vermehrt sekretiertes lösliches ACE in den Zellkulturüberständen der untersuchten Zellen zu finden war. Neben der CK2 fanden sich auch die schwere Kette nicht-muskulären Myosins (NMMHC), ß-Aktin, Annexin 2, die c-Jun NH2-terminalen Kinase (JNk) und die Proteinphosphatase PP1 assoziiert mit ACE oder einem dem intrazellulären Anteil von ACE entsprechenden Peptid. Da die an ACE gebundenen Proteine mehr oder minder in die Regulation intrazellulärer Signaltransduktionskakaden involviert sind, wurde überprüft, inwiefern die Aktivität oder Phosphorylierung dieser Proteine durch die Hemmung des ACE beeinflusst werden kann. Die Behandlung P-markierter Endothelzellen mit dem ACE-lnhibitor Ramiprilat resultierte deutlich nicht nur in einer transient gesteigerten Phosphorylierung des ACE selbst, sondern auch in einer verstärkten Phosphorylierung des ACE-gebundenen NMMHC. Dabei werden beide Proteine durch die ACE-assoziierte CK2 phosphoryliert, deren Aktivität deutlich nach Hemmung des ACE zunahm. Die Identität des ACE als aktives Signaltransduktionsmoleküi wurde zudem sehr überzeugend durch die Messung der JNK-Aktivität bestätigt, da die Stimulation mit Ramiprilat nur in Wildtyp-ACE exprimierenden Endothelzelien in einer Aktivierun dieser Kinase resultierte, wohingegen nach Mutation der ACE-Phosphorylierungsstelle (Ser1270) keine durch Ramiprilat gesteigerte JNK-Aktivität zu verzeichnen war. Ebenso führte neben der Hemmung des ACE die Stimulation mit dem ACE-Substrat Bradykinin zur lnitiation der beschriebenen Prozesse. Die durch ACE-lnhibitoren induzierte Signaltransduktion scheint auch an der Potenzierung und Reaktivierung der durch Bradykinin vermittelten Zellaktivierung beteiligt zu sein, da nur in ACE-exprimierenden Zellen die Hemmung der CK2 in einer verminderten Bradykinin-induzierten Endothelzellaktivierung resultierte und der ACE-lnhibitor diese Reduktion vollständig umkehrte. Die Entdeckung der posttranslationalen Modifikation des ACE durch Phosphorylierung zur Regulation der Sekretion des Enzyms sowie zur lnitiation intrazellulärer Signalkaskaden eröffnet eine neue molekulare Basis für das Verständnis und die Charakterisierung der zahlreichen protektiven Eigenschaften der ACE-lnhibitoren. Zudem liefert die Identifizierung des ACE als aktives Signaitransduktionsmolekül mit der Fähigkeit zum "Outside-In-Signaling" möglicherweise neue Ansatzpunkte für die Entwicklung antihypertensiver Therapien.
Thrombopoietin (Thpo) signals via its receptor Mpl and regulates megakaryopoiesis, hematopoietic stem cell (HSC) maintenance and post-transplant expansion. Mpl expression is tightly controlled and deregulation of Thpo/Mpl-signaling is linked to hematological disorders. Here, we constructed an intracellular-truncated, signaling-deficient Mpl protein which is presented on the cell surface (dnMpl). The transplantation of bone marrow cells retrovirally transduced to express dnMpl into wildtype mice induced thrombocytopenia, and a progressive loss of HSC. The aplastic BM allowed the engraftment of a second BM transplant without further conditioning. Functional analysis of the truncated Mpl in vitro and in vivo demonstrated no internalization after Thpo binding and the inhibition of Thpo/Mpl-signaling in wildtype cells due to dominant-negative (dn) effects by receptor competition with wildtype Mpl for Thpo binding. Intracellular inhibition of Mpl could be excluded as the major mechanism by the use of a constitutive-dimerized dnMpl. To further elucidate the molecular changes induced by Thpo/Mpl-inhibition on the HSC-enriched cell population in the BM, we performed gene expression analysis of Lin-Sca1+cKit+ (LSK) cells isolated from mice transplanted with dnMpl transduced BM cells. The gene expression profile supported the exhaustion of HSC due to increased cell cycle progression and identified new and known downstream effectors of Thpo/Mpl-signaling in HSC (namely TIE2, ESAM1 and EPCR detected on the HSC-enriched LSK cell population). We further compared gene expression profiles in LSK cells of dnMpl mice with human CD34+ cells of aplastic anemia patients and identified similar deregulations of important stemness genes in both cell populations. In summary, we established a novel way of Thpo/Mpl inhibition in the adult mouse and performed in depth analysis of the phenotype including gene expression profiling.
This work focuses on the investigation of K+, K- and ϕ-meson production in Ag(1.58 A GeV)+Ag collisions. The energetically cheapest channel for direct K+ production in binary NN-collisions NN→NΛK+ lies at exactly this energy. For the remaining K- and ϕ-mesons, an excess energy of 0.31 GeV and 0.34 GeV in the centre of mass system has to be provided by the system. This makes these particles an excellent probe for effects inside the medium.
K+ and K- mesons can be reconstructed directly as they possess a cτ of approximately 3.7 m. Using the approximately 3 billion recorded Ag(1.58 A GeV)+Ag 0-30% most central collision events, all reconstructed K+ and K- within the detector acceptance are investigated for their kinematic properties and their particle production rates compared to a selection of existing models.
As Bernhard Jussen correctly stresses in his introduction to this essay collection, we do not need to rediscover kingship. Kings and queens have always been favorite subjects for historians--at least, one might add, as far as medieval and early modern history are concerned. But even for the premodern period, kingship has rarely been studied in long-term perspective. This lacuna is all the more striking as kingship, existent in one form or another since ancient times, seems ideally suited to such a study. A history of kingship--prescinding from specific rulers--would bring to light the very characteristics of this form of rule. Moreover, as kingship was a highly visible and politically relevant phenomenon, and thus comparatively well represented in the sources, such an approach would also allow insights into general social, political, and cultural developments. Jussen's essay collection, in filling the gap, strives for both goals. It does so in a form that, at least in the German context, is innovative. The book combines the characteristics of a single-author volume and essay collection in the sense that each chapter follows clear rules and--with some exceptions--the same structure, though written by different authors. In addition, the strict chronological order, with each of the twenty-six chapters focusing on one particular date and source, and the respective headlines in the form of general questions (for example, "How to Depose a King"), point beyond the scope of the chapter and at the same time make the process of historical analysis visible to the reader. ...
Division of labor and task specialization explain the success of human and insect societies. Social insect colonies are characterized by division of labor, with workers specializing in brood care early and foraging later in life. Theory posits that this task switching requires shifts in responsiveness to task-related cues, yet experimental evidence is weak. Here, we show that a Vitellogenin (Vg) ortholog identified in an RNAseq study on the ant T. longispinosus is involved in this process: using phylogenetic analyses of Vg and Vg-like genes, we firstly show that this candidate gene does not cluster with the intensively studied honey bee Vg but falls into a separate Vg-like A cluster. Secondly, an experimental knockdown of Vg-like A in the fat body caused a reduction in brood care and an increase in nestmate care in young ant workers. Nestmate care is normally exhibited by older workers. We demonstrate experimentally that this task switch is at least partly based on Vg-like A–associated shifts in responsiveness from brood to worker cues. We thus reveal a novel mechanism leading to early behavioral maturation via changes in social cue responsiveness mediated by Vg-like A and associated pathways, which proximately play a role in regulating division of labor.
A checklist of the dung beetles (Coleoptera: Geotrupidae; Scarabaeidae: Aphodiinae and Scarabaeinae) of Oaxaca, Mexico, is presented for the first time. The checklist contains 252 taxa, 15 Geotrupidae, 77 Aphodiinae, and 160 Scarabaeinae. The state includes 58 genera and 15 tribes, where Onthophagus is the most species-rich genus with 49 taxa, followed by Ataenius with 22, Canthon with 17 and Phanaeus with 15 taxa. Valid names, as well as synonyms, are provided. First records, notes on presently recognized species, nomenclatural problems, and biodiversity comparisons are included. Phanaeus dionysius Kohlmann, Arriaga-Jiménez and Rös, 2018 (Coleoptera: Scarabaeidae: Scarabaeinae) is re-established as a valid species.
ZooBank registration. urn:lsid:zoobank.org:pub:3DE939E2-5A69-45EF-A7E5-ED427D978BE3
Brecht zufolge birgt die Frage nach den Verpflichtungen der Kunst eine unauflösbare Dialektik: Kunst und politischer Zweck sind einander nicht äußerlich, ihre Beziehung ist nicht durch Konflikt oder gegenseitigen Ausschluss gekennzeichnet, sondern vielmehr durch das Versprechen schöpferischer Reibung und gegenseitiger Bereicherung. Dies entspricht nicht der Art und Weise, in der die Literaturwissenschaft traditionell über die Beziehung der Literatur zur Sphäre der Politik nachgedacht hat. Sie hat vielmehr dazu geneigt, den Versuch, Kunst als politische Arbeit zu begreifen, als Kategorienfehler zubetrachten - als eine von außen herangetragene Zumutung, die beiden schadet: der Kunst und der Politik. [...] Wenn wir verschüttete literaturgeschichtliche Genealogien wiederherstellen, um der theoretischen Untersuchung alternative Wege aufzuzeigen, orientieren wir uns an neueren Bemühungen, ausgewählte Episoden politisierten Schreibens nicht als literaturgeschichtliche Anomalien zu betrachten, sondern als Schlüsselmomente in der Konfiguration der Beziehung zwischen Literatur und Politik - als einflussreiche Epizentren interventionistischer Kunst, von denen aus Debatten über Literaturpolitik und Praktiken engagierten Schreibens in neue und global ausgedehnte Kontexte ausstrahlen können. Die von uns vorgeschlagene Periodisierung verbindet experimentell drei Perioden intensiv politisierter und aktivistischer Kunst und Schriftstellerei: die Zwischenkriegszeit, die langen 1960er Jahre und die Gegenwart. Damit sollen alternative Traditionen sichtbar gemacht werden, die Raymond Williams zufolge oft an den Rändern des Jahrhunderts zurückgelassen wurden. Diese Periodisierung verzichtet auch bewusst darauf, eine einzige oder eindeutige Geschichte politisierter Literatur nachzuzeichnen.
Acute kidney injury is associated with mortality in COVID-19 patients. However, host cell changes underlying infection of renal cells with SARS-CoV-2 remain unknown and prevent understanding of the molecular mechanisms that may contribute to renal pathology. Here, we carried out quantitative translatome and whole-cell proteomics analyses of primary renal proximal and distal tubular epithelial cells derived from human donors infected with SARS-CoV-2 or MERS-CoV to disseminate virus and cell type–specific changes over time. Our findings revealed shared pathways modified upon infection with both viruses, as well as SARS-CoV-2-specific host cell modulation driving key changes in innate immune activation and cellular protein quality control. Notably, MERS-CoV infection–induced specific changes in mitochondrial biology that were not observed in response to SARS-CoV-2 infection. Furthermore, we identified extensive modulation in pathways associated with kidney failure that changed in a virus- and cell type–specific manner. In summary, we provide an overview of the effects of SARS-CoV-2 or MERS-CoV infection on primary renal epithelial cells revealing key pathways that may be essential for viral replication.
Beim Stichwort Inquisition fällt der Blick zumeist nach Spanien, Portugal oder Italien und nicht auf das Alte Reich, denn dort wurde die Inquisition im Gegensatz zum Süden Europas nie institutionalisiert. Die Frage, warum es im Alten Reich nicht zur Einführung von Tribunalen kam und in welchen anderen Formen die Inquisition dort agierte, stand im Herbst 2009 im Zentrum einer Tagung, deren Ergebnisse nun in einem Sammelband vorliegen. Die Aktivitäten der Inquisition werden nicht nur für den deutschen Sprachraum analysiert, sondern auch mit anderen Ländern in Bezug gesetzt und verglichen. Dies erscheint sinnvoll, da die Inquisition und ihre Rezeption im Alten Reich ohne den Einbezug ihres Wirkens in den romanischen Ländern nicht beurteilt werden kann. Trotz der internationalen Bezüge stammen alle Beiträge, bis auf eine Ausnahme, aus der Feder deutschsprachiger Autoren. Es fällt dann auch auf, dass die spanische Inquisition – abgesehen von den Tribunalen in den spanischen Niederlanden – im Gegensatz zur italienischen und portugiesischen nicht thematisiert wird. Auch in der Einführung wird so gut wie keine aktuelle spanische Literatur genannt. Hier zeigt sich, dass ihre Erforschung auf deutscher Seite bisher kaum betrieben noch rezipiert wurde. Auch die zentrale Frage, ob es Pläne zur Institutionalisierung einer Inquisition in einzelnen katholischen Territorien gab, ist nach wie vor ein Forschungsdesiderat. Auszuschließen ist diese Möglichkeit laut den Herausgebern nicht. Warum es nicht dazu kam, wird mit der Durchsetzung des landesherrlichen Kirchenregiments begründet sowie mit Vorbehalten der Fürsten, für die eine institutionalisierte Inquisition eine Beschränkung ihrer Herrschaftsrechte bedeutet hätte. ...
Background: Patients with epilepsy often require a specialized treatment, which may differ because of the responsibility of the federal states for healthcare policy in Germany.
Objective: State-specific differences in healthcare structures based on inpatient hospital cases of epilepsy patients between 2000 and 2020 in relation to specialized treatment offers.
Material and methods: The inpatient hospital cases of the German federal states were evaluated using the Friedman test and time series trend analysis. A state-specific inpatient undertreatment or overtreatment of inpatient hospital cases outside the registered state was analyzed by comparing residence-related and treatment site-related case numbers with a threshold of ±5%.
Results: After age adjustment, significantly more inpatient cases were found in the “new states” compared to the “old states” (p < 0.001); the highest number of cases nationwide was found in Saarland with 224.8 ± 11.5 cases per 100,000 inhabitants. The trend analysis showed an increase in cases until the end of 2016 with a trend reversal from 2017 and a further significant decrease in hospital cases in the COVID year 2020. A relative inpatient undertreatment was shown for Brandenburg, Lower Saxony, Rhineland-Palatinate, Saxony-Anhalt, Schleswig-Holstein and Thuringia. Additional, possibly compensatory, inpatient care was found for all city states (Hamburg, Bremen and Berlin) and Baden-Wuerttemberg. In federal states with a relative inpatient undertreatment and/or high inpatient hospital case numbers, there was often a lower availability of specialized epilepsy centers, specialized outpatient clinics and epilepsy outpatient clinics.
Conclusion: In Germany there are state-specific differences in the structure of care, with higher inpatient hospital care in the “new states” and Saarland. In addition, there were federal states with disproportionately higher treatment of patients not registered in this federal state. A potential influencing factor may be the availability of centers with specialized treatment for epilepsy patients.
Magnetic resonance-guided laser interstitial laser therapy (MRgLITT) and radiofrequency ablation (RFA) represent two minimally invasive methods for the treatment of drug-refractory mesial temporal lobe epilepsy (mTLE). We performed a systematic review and a meta-analysis to compare outcomes and complications between MRgLITT, RFA, and conventional surgical approaches to the temporal lobe (i.e., anterior temporal lobe resection [ATL] or selective amygdalohippocampectomy [sAHE]). Forty-three studies (13 MRgLITT, 6 RFA, and 24 surgery studies) involved 554, 123, 1504, and 1326 patients treated by MRgLITT, RFA, ATL, or sAHE, respectively. Engel Class I (Engel-I) outcomes were achieved after MRgLITT in 57% (315/554, range = 33.3%–67.4%), RFA in 44% (54/123, range = 0%–67.2%), ATL in 69% (1032/1504, range = 40%–92.9%), and sAHE in 66% (887/1326, range = 21.4%–93.3%). Meta-analysis revealed no significant difference in seizure outcome between MRgLITT and RFA (Q = 2.74, p = .098), whereas ATL and sAHE were both superior to MRgLITT (ATL: Q = 8.92, p = .002; sAHE: Q = 4.33, p = .037) and RFA (ATL: Q = 6.42, p = .0113; sAHE: Q = 5.04, p = .0247), with better outcome in patients at follow-up of 60 months or more. Mesial hippocampal sclerosis (mTLE + hippocampal sclerosis) was associated with significantly better outcome after MRgLITT (Engel-I outcome in 64%; Q = 8.55, p = .0035). The rate of major complications was 3.8% for MRgLITT, 3.7% for RFA, 10.9% for ATL, and 7.4% for sAHE; the differences did not show statistical significance. Neuropsychological deficits occurred after all procedures, with left-sided surgeries having a higher rate of verbal memory impairment. Lateral functions such as naming or object recognition may be more preserved in MRgLITT. Thermal therapies are effective techniques but show a significantly lower rate of Engel-I outcome in comparison to ATL and sAHE. Between MRgLITT and RFA there were no significant differences in Engel-I outcome, whereby the success of treatment seems to depend on the approach used (e.g., occipital approach). MRgLITT shows a similar rate of complications compared to RFA, whereas patients undergoing MRgLITT may experience fewer major complications compared to ATL or sAHE and might have a more beneficial neuropsychological outcome.
Background: Mechanical thrombectomy and systemic thrombolysis are important therapies for stroke patients. However, there is disagreement about the accompanying risk of acute symptomatic seizures.
Methods: A retrospective analysis of patients with an acute ischaemic stroke caused by large vessel occlusion was performed. The patients were divided into four groups based on whether they received either mechanical thrombectomy (MT) or systemic thrombolysis (ST; group 1: MT+/ST−; group 2: MT+/ST+; group 3: MT−/ST+; group 4: MT−/ST−). Propensity score matching was conducted for each group combination (1:3, 1:4, 2:3, 2:4, 1:2, 3:4) using the covariates “NIHSS at admission”, “mRS prior to event” and “age”. The primary endpoint was defined as the occurrence of acute symptomatic seizures.
Results: A total of 987 patients met the inclusion criteria, of whom 208, 264, 169 and 346 belonged to groups 1, 2, 3 and 4, respectively. Propensity score matched groups consisted of 160:160, 143:143, 156:156, 144:144, 204:204 and 165:165 patients for the comparisons 1:3, 1:4, 2:3, 2:4, 1:2 and 3:4, respectively. Based on chi-squared tests, there was no significant difference in the frequency of acute symptomatic seizures between the groups. Subgroups varied in their frequency of acute symptomatic seizures, ranging from 2.8 to 3.8%, 2.8–4.4%, 3.6–3.8% and 4.9–6.3% in groups 1, 2, 3 and 4, respectively.
Conclusion: There was no association between MT or ST and an increased risk of acute symptomatic seizures in patients with an acute ischaemic stroke caused by large vessel occlusion who were treated at a primary stroke centre.