TY - GEN A1 - Hocher, Berthold A1 - Yin, Lianghong T1 - Why Current PTH Assays Mislead Clinical Decision Making in Patients with Secondary Hyperparathyroidism T2 - Nephron N2 - Preclinical studies in cell culture systems as well as in whole animal chronic kidney disease (CKD) models showed that parathyroid hormone (PTH), oxidized at the 2 methionine residues (positions 8 and 18), caused a loss of function. This was so far not considered in the development of PTH assays used in current clinical practice. Patients with advanced CKD are subject to oxidative stress, and plasma proteins (including PTH) are targets for oxidants. In patients with CKD, a considerable but variable fraction (about 70 to 90%) of measured PTH appears to be oxidized. Oxidized PTH (oxPTH) does not interact with the PTH receptor resulting in loss of biological activity. Currently used intact PTH (iPTH) assays detect both oxidized and non-oxPTH (n-oxPTH). Clinical studies demonstrated that bioactive, n-oxPTH, but not iPTH nor oxPTH, is associated with mortality in CKD patients. KW - Serum intact-parathyroid hormone level KW - Dialysis patients KW - Mortality Y1 - 2017 U6 - https://doi.org/10.1159/000455289 SN - 1660-8151 SN - 2235-3186 SN - 0028-2766 VL - 136 IS - 2 SP - 137 EP - 142 PB - Karger CY - Basel ER - TY - JOUR A1 - Gross, Stephanie A1 - Claus, Philip A1 - Wohlsein, Peter A1 - Kesselring, Tina A1 - Lakemeyer, Jan A1 - Reckendorf, Anja A1 - Roller, Marco A1 - Tiedemann, Ralph A1 - Siebert, Ursula T1 - Indication of lethal interactions between a solitary bottlenose dolphin (Tursiops truncatus) and harbor porpoises (Phocoena phocoena) in the German Baltic Sea JF - BMC zoology N2 - Background Aggressive interactions between bottlenose dolphins (Tursiops truncatus) and harbor porpoises (Phocoena phocoena) have been reported in different parts of the world since the late 1990s. In the Baltic Sea, harbor porpoises are the only native cetacean species, while bottlenose dolphins may appear there temporarily. In the fall of 2016, a solitary male photo-identified bottlenose dolphin stayed in the German Baltic Sea of Schleswig-Holstein for 3 months. During that time, the necropsies of the stranded harbor porpoises revealed types of trauma of varying degrees in six animals, which is unusual in this area. The purpose of this study was to determine if the appearance of the bottlenose dolphin could be linked to the trauma of the harbor porpoise carcasses. Results Pathological findings in these animals included subcutaneous, thoracic and abdominal hemorrhages, multiple, mainly bilateral, rib fractures, and one instance of lung laceration. These findings correspond with the previously reported dolphin-caused injuries in other regions. Moreover, public sighting reports showed a spatial and temporal correlation between the appearance of the dolphin and the stranding of fatally injured harbor porpoises. Conclusion Despite the fact that no attack has been witnessed in German waters to date, our findings indicate the first record of lethal interactions between a bottlenose dolphin and harbor porpoises in the German Baltic Sea. Furthermore, to our knowledge, this is the first report of porpoise aggression by a socially isolated bottlenose dolphin. KW - Cetaceans KW - Interspecific aggression KW - Porpicide KW - Blunt trauma KW - Mortality KW - Stranding Y1 - 2020 U6 - https://doi.org/10.1186/s40850-020-00061-7 SN - 2056-3132 VL - 5 IS - 1 PB - BMC CY - London ER - TY - JOUR A1 - Eichler, Sarah A1 - Salzwedel, Annett A1 - Harnath, Axel A1 - Butter, Christian A1 - Wegscheider, Karl A1 - Chiorean, Mihai A1 - Völler, Heinz A1 - Reibis, Rona Katharina T1 - Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation JF - Clinical research in cardiology : official journal of the German Cardiac Society. N2 - The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. From 10/2013 to 07/2015, 344 patients (80.9 +/- 5.0 years, 44.5% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model. At discharge, 333 patients were alive (in-hospital mortality 3.2%; n = 11). During a follow-up of 381.0 +/- 41.9 days, 46 patients (13.8%) died. The non-survivors were older (82.3 +/- 5.0 vs. 80.6 +/- 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 +/- 1.3 vs. 2.1 +/- 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 +/- 13.6 vs. 54.6 +/- 10.6%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality. Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores. KW - TAVI KW - Frailty KW - Mortality KW - Malnutrition KW - Mobility Y1 - 2018 U6 - https://doi.org/10.1007/s00392-017-1183-1 SN - 1861-0684 SN - 1861-0692 VL - 107 IS - 4 SP - 304 EP - 311 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - van de Weijer, Steve A1 - Bijleveld, Catrien A1 - Huschek, Doreen T1 - Offending and mortality JF - Advances in life course research N2 - Background: Previous research has shown that offenders are at increased risk to die prematurely, but the etiology of this association is still unknown. Moreover, most previous studies use relatively short follow-up periods and do not take into account variation within the offender population with respect to frequency, timing and types of offenses. Method: Using conviction data for a number of families at high-risk of offending born on average in 1932, we study mortality in both offenders and non-offenders, from a similar socio-economic background, until 2007. We condition on life expectancy of the parents, age, gender, year of birth and marital status. We investigate associations between mortality and offending for different types of offenses: violent offenses, property offenses, weapons offenses, drugs offenses and driving under influence. Results: In general, offending sample members were not significantly more likely to have died than non offending sample members. Compared to the general population, however, both the offending and non offending sample members were at increased risk to die. Sample members who were convicted for driving under the influence of alcohol or weapons offenses were at increased risk to die prematurely compared to non-offending sample members. Conclusions: The relationship between offending in general and mortality is largely spurious. Limitations: The use of official conviction data might have influenced the results. (C) 2015 Elsevier Ltd. All rights reserved. KW - Mortality KW - Offending KW - Mechanisms KW - Survival KW - The Netherlands Y1 - 2016 U6 - https://doi.org/10.1016/j.alcr.2015.11.004 SN - 1569-4909 SN - 1879-6974 VL - 28 SP - 91 EP - 99 PB - Elsevier CY - Oxford ER - TY - JOUR A1 - Hofmann, Reiner A1 - Völler, Heinz A1 - Nagels, Klaus A1 - Bindl, Dominik A1 - Vettorazzi, Eik A1 - Dittmar, Ronny A1 - Wohlgemuth, Walter A1 - Neumann, Till A1 - Störk, Stefan A1 - Bruder, Oliver A1 - Wegscheider, Karl A1 - Nagel, Eckhard A1 - Fleck, Eckart T1 - First outline and baseline data of a randomized, controlled multicenter trial to evaluate the health economic impact of home telemonitoring in chronic heart failure - CardioBBEAT JF - Trials N2 - Background: Evidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Methods: Between January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva (R)). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups' difference in total cost and in the combined clinical endpoint "days alive and not in hospital nor inpatient care per potential days in study" within the follow-up of 12 months. Results: A total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III-IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances. Conclusions: CardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic decision-making with regard to home telemonitoring solutions as an option for health care. Overall, it contributes to developing advanced health economic evaluation instruments to be deployed within the specific context of the German Health Care System. KW - Home telemonitoring KW - Chronic heart failure (CHF) KW - Incremental Cost-Effectiveness Ratio (ICER) KW - Mortality KW - Telemedicine KW - Health economics Y1 - 2015 U6 - https://doi.org/10.1186/s13063-015-0886-8 SN - 1745-6215 VL - 16 PB - BioMed Central CY - London ER - TY - JOUR A1 - Rokutan, Hirofumi A1 - Suckow, Christian A1 - von Hähling, Stephan A1 - Strassburg, Sabine A1 - Bockmeyer, Barbara A1 - Döhner, Wolfram A1 - Waller, Christiane A1 - Bauersachs, Johann A1 - von Websky, Karoline A1 - Hocher, Berthold A1 - Anker, Stefan D. A1 - Springer, Jochen T1 - Furosemide induces mortality in a rat model of chronic heart failure JF - International journal of cardiology N2 - Objectives: In an experimental heart failure model, we tested the hypothesis that furosemide causes excess mortality. Background: Post-hoc analysis of large clinical heart failure trails revealed that furosemide treatment might be associated with worsening of morbidity and even mortality in heart failure patients. Methods and results: Myocardial infarction was induced in 7 +/- 1 week old male Wistar rats by ligation of the left coronary artery. In study 1, animals were randomly assigned to treatment with furosemide (10 mg/kg/d via drinking water, n = 33) or placebo (n = 33) starting 18 days after surgery. In study 2, animals received furosemide from day 18 and were then randomized to ongoing treatment with either furosemide only (n = 38) or furosemide plus ACE-inhibitor Ramipril (1 mg/kg/d, n = 38) starting on day 42. In study 1 survival rate in the furosemide group was lower than in the placebo group (hazard ratio {HR} 3.39, 95% confidence interval {CI} 1.14 to 10.09, p = 0.028). The furosemide group had a lower body weight (-6%, p = 0.028) at the end of the study and a higher sclerosis index of the glomeruli (+9%, p=0.026) than the placebo group. Wet lung weight, infarct size, and cardiac function were similar between the groups. In study 2, the furosemide group had a higher mortality rate than the furosemide + ramipril group (HR 4.55, 95% CI 2.0 to 10.0, p = 0.0003). Conclusion: In our rat model of heart failure furosemide, provided at a standard dose, was associated with increased mortality. This increased mortality could be prevented by additional administration of an ACE-inhibitor. KW - Angiotensin converting enzyme inhibitor KW - Furosemide KW - Heart failure KW - Loop diuretics KW - Mortality Y1 - 2012 U6 - https://doi.org/10.1016/j.ijcard.2011.03.005 SN - 0167-5273 VL - 160 IS - 1 SP - 20 EP - 25 PB - Elsevier CY - Clare ER -