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Glutamatergic mechanisms in early salience processing
(2025) Lockhofen, Denise Elfriede Liesa; Hübner, Nils; Debnath, Ranjan; Rumpf, Karl Philipp; Sander, Michael; Wolff, Matthias; Luxi, Daniel; Roller, Lukas; Mulert, Christoph
Introduction: Patients with schizophrenia frequently experience inadequate attribution of motivational salience, possibly related to impaired attentional processing and dysfunctional reward learning. According to the “glutamate hypothesis of schizophrenia”, glutamatergic dysregulations can contribute to the emergence of psychotic symptoms and cognitive deficits in patients with schizophrenia. Blocking the N-methyl-D-aspartate receptor (NMDAR) with NMDAR antagonists such as ketamine can lead to temporary schizophrenia-like symptoms in healthy volunteers, including cognitive and attentional impairments. Method: The present study investigated how the administration of a subclinical dose of ketamine compared to placebo affects the interaction of attention and reward. 27 healthy volunteers received either an intravenous infusion of ketamine or a placebo. Subsequently, an EEG was recorded while the subjects performed a visual attention task with salient, reward-related distractors. Results: The results demonstrate that ketamine primarily interfered with distractor processing, with little to no effect on target or reward processing. In addition, ketamine administration led to an increase in gamma band power compared to placebo and in salient distractor trials compared to target-only trials. Interestingly, these effects were related to the occurrence of negative symptoms. Discussion: Therefore, the present findings further emphasize the role of the glutamate system in the development of dysfunctional gamma band oscillations, early salience processing alterations and negative symptoms in patients with schizophrenia.
Culturally sensitive psychotherapy : technique or attitude?
(2025) Stingl, Markus; Hanewald, Bernd
Culturally sensitive psychotherapy is essential in increasingly diverse societies, where cultural, religious, and linguistic differences shape how distress is experienced and communicated. This article conceptualizes culturally sensitive psychotherapy not only as a set of techniques, but as a reflective professional attitude. Drawing on models of intercultural competence and clinical examples, the article explores how culture affects the expression of symptoms, help-seeking behavior, and therapeutic relationships, especially among migrants. Integrating the cultural contexts enhances diagnostic accuracy, therapeutic alliance, and treatment outcomes. The approach balances awareness of cultural influence with the risk of stereotyping, urging clinicians to adopt a self-reflective stance. Culturally sensitive psychotherapy thus fosters effective and respectful care across diverse populations.
Intracellular Eimeria bovis macromeront formation induces bystander cell accumulation and TNT formation
(2025) Fischer, Jobst; Sous, Lara; Velásquez, Zahady D.; Hermosilla, Carlos; Taubert, Anja
Introduction: Eimeria bovis first merogony is an intracellular process (~ 3 weeks) resulting in the formation of large macromeronts (≤ 400 μm) containing up to 140,000 merozoites I, each. The production of merozoites I poses critical metabolic stress on bovine endothelial host cells, leading to mitochondrial dysregulation and premature senescence. In this context, an accumulation of non-infected bystander cells (BCs) around E. bovis macromeront-carrying host cells (MCHCs), eventually supporting MCHCs, was observed. Methods: BC accumulation was quantified by 3D confocal microscopy. A meront-transfer-system was established to evaluate the supportive BC capacity of different cell types. Since healthy cells might support stressed cells by transferring cargo like mitochondria via TNTs, we studied if E. bovis infection affected cellular TNT formation. By utilizing the meront-transfer-system, recipient non-infected BCs were pre-treated with inhibitor of TNT formation (cytochalasin B) and the effect on E. bovis development was estimated in BC-MCHC-cocultures. To study the transfer of mitochondria via TNTs, non-infected and E. bovis-infected cells where stained with respective dyes and cargo transfer was illustrated. Results: In E. bovis-infected cell layers, an increase of BCs at all sides of MCHCs was stated, thereby correlating with meront sizes and maturation. When using different cell types as BCs, we showed that macromeront development was best supported by human endothelial cells, followed by human fibroblasts and bovine endothelial cells. Overall, TNT numbers were increased in E. bovis-infected cell layers. The relevance of TNTs for parasite development was underlined by selective BC cytochalasin B treatments, which blocked both TNT formation and merozoite I production. Given that TNT-based transfer may improve the energetic status of E. bovis-infected cells, we observed bidirectional mitochondrial transfer between non-infected and E. bovis-infected cells, thereby potentially helping to restore the energetic status of the infected host cell. Discussion: Bystander cell-based TNT-mediated mitochondria transfer may evidence a new mechanism of parasite-induced host cell modulation, aiding MCHCs to support parasite proliferation.
Short- and long-term outcomes after transcatheter or surgical aortic valve replacement in patients with chronic lung disease : an analysis from the German Aortic Valve Registry
(2025) Böning, Andreas; Balaban, Umniye; Herrmann, Eva; Beckmann, Andreas; Bekeredjian, Raffi; Bleiziffer, Sabine; Ensminger, Stephan; Frerker, Christian; Möllmann, Helge; Walther, Thomas; Bauer, Timm
Objectives: Data from the German Aortic Valve Registry (GARY) were analysed to determine whether there are differences between patients with and without chronic lung disease (CLD) undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) and whether TAVI or SAVR is more beneficial in patients with preexisting CLD. Methods: Follow-up data from GARY registry patients treated from 2014 to 2015 and from 2018 to 2019 were incorporated in the analysis. Demographic results for each of the 2 treatment modalities were evaluated, and patients with and without CLD were compared. In a second step, variables that would have influenced the treatment decision in CLD patients in direction of either SAVR or TAVI were accounted for in the adjusted analysis. This led to a subgroup of 1385 patients with CLD that was subjected to propensity score weighted analysis to compare outcomes of TAVI and SAVR. Results: After exclusion, 11 457 SAVR patients and 2378 TAVI patients were analysed. CLD patients were sicker than patients without CLD, although the observed 30-day mortality was lower than expected by 3 risk scores. Accordingly, long-term survival in CLD patients was lower in both treatment groups than in patients without CLD. Thirty-day mortality was similar in the 2 treatment groups (SAVR 2.3%, TAVI 3.8%, P = .964) in spite of a possible selection bias in favour of SAVR. During a 5-year follow-up, survival after TAVI (44.6%) was significantly lower than after SAVR (56.7%), P = .029. Conclusions: Patients with CLD undergoing SAVR or TAVI are generally at higher risk for complications or death after the procedure than patients without CLD. After 5 years, patient-reported outcomes were similar in TAVI and in SAVR patients.
Correlation between coronary artery disease severity detected by CT coronary angiography and grade of left ventricular diastolic dysfunction detected by echocardiography
(2025) El-Barbary, Ahmed; Elsayed, Mohamed Atef; Yousef Selim, Yousef Ahmed; Elkaffas, Sameh Mohamed Helmy; Sabit, Hussein; Arneth, Borros; Taghiyev, Zulfugar T.; Tantawy, Mahmoud Ahmed
Background: Coronary artery disease (CAD) and left-ventricular (LV) diastolic dysfunction are leading drivers of morbidity and mortality. Clarifying how anatomical CAD burden relates to diastolic impairment may refine diagnosis and risk stratification. Methods: We conducted a cross-sectional analytical study of 200 adults with intermediate pretest probability of CAD who underwent both coronary CT angiography (CCTA) and transthoracic echocardiography (TTE) within ≤1 year. Coronary burden was quantified by Segment Involvement Score (SIS). Diastolic function was graded by contemporary echocardiographic guidelines. Patients were classified as obstructive (≥50% LM or ≥70% in other major epicardial arteries) or non-obstructive CAD. Results: Obstructive CAD was present in 73/200 (36.5%). Diastolic dysfunction occurred in 161/200 (80.5%) and was markedly more prevalent/severe in obstructive vs. non-obstructive CAD (p < 0.001). SIS rose stepwise with higher diastolic dysfunction grades; SIS correlated strongly with diastolic grade (r = 0.809, p < 0.001). Compared with non-obstructive CAD, obstructive CAD showed worse diastolic indices (higher E/e′, larger LAVI, shorter DT and IVRT; all p < 0.001) and a shift toward Grades II–III. Obstructive CAD was also associated with higher total cholesterol, triglycerides, LDL, HbA1c, lower HDL (all p ≤ 0.002), and a greater prevalence of hypertension and diabetes. Discussion: Increasing coronary atherosclerotic burden—captured by SIS, parallels progressive impairment of LV relaxation and elevated filling pressures, supporting a pathophysiologic link between epicardial disease extent and diastolic dysfunction. Conclusions: In symptomatic intermediate-risk patients, greater CAD extent on CCTA is strongly associated with higher grades of LV diastolic dysfunction on echocardiography. Integrating anatomic (SIS) and functional (TTE) metrics may enhance risk assessment and guide management in CAD.