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JLUpub ist das institutionelle Repositorium der Justus-Liebig-Universität.
JLUpub bietet Mitgliedern und Angehörigen der Universität die Möglichkeit neben wissenschaftlichen Dokumenten auch Forschungsdaten elektronisch zu veröffentlichen und dauerhaft zugänglich zu machen. Alle Veröffentlichungen erhalten einen Digital Object Identifier (DOI) und werden über nationale und internationale Bibliothekskataloge sowie Suchmaschinen nachgewiesen und auffindbar.
Neue Veröffentlichungen:
Randomized Pilot Trial of Pre- and Postoperative Heart Failure Nurse-Supported Care in Heart Failure Patients Requiring Noncardiac Surgery - Feasibility and Results
(2024) Herrmann, Ester J.; Raghavan, Badrinarayanan; Tekeste, Meaza; Mantzsch, Kathleen; Meybohm, Patrick; Assmus, Birgit
Introduction: The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre-existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse-based pre- and postoperative specialized HF management in reducing postoperative HF-associated complications in patients with known HF undergoing noncardiac surgery.
Methods: This prospective, randomized pilot study included patients with established HF requiring intermediate- to high-risk noncardiac surgery. Patients received postoperatively either standard care (control group, CG) or nurse-supported HF management (intervention group, IG). The primary endpoint was a composite of HF-related postoperative complications at 30 days. Secondary endpoints included length on intensive care unit, length of hospital stay, death, hospitalization for HF, and quality of life assessment using the SF-12 questionnaire.
Results: The trial was halted prematurely for futility. A total of 34 patients (median age 70.5 [IQR 67–75] years; with 15 HfpEF, 9 HfmrEF,10 HfrEF), with an average NT-proBNP of 1.413 [463–2.832] pg/mL were included. The IG had a lower rate of postoperative primary events (25%; n = 4) compared with the CG (33%; n = 6). There were no differences in secondary endpoints between the groups. Quality-of-life scores improved slightly in both groups (δ 5.6 ± 0.9 [CG] and 3.1 ± 1.2 [IG]).
Conclusion: Nurse-based pre- and postoperative HF care appears to be feasible and may reduce HF-associated complications in patients undergoing noncardiac surgery. Larger clinical trials are needed to further evaluate the effectiveness of this approach in reducing postoperative complications in this high-risk patient population.
CTRP13-Mediated Effects on Endothelial Cell Function and Their Potential Role in Obesity
(2024) Aslam, Muhammad; Li, Ling; Nürnberger, Sina; Niemann, Bernd; Rohrbach, Susanne
Background: Obesity, a major component of cardiometabolic syndrome, contributes to the imbalance between pro- and anti-atherosclerotic factors via dysregulation of adipocytokine secretion. Among these adipocytokines, the C1q/TNF-related proteins (CTRPs) play a role in the modulation of atherosclerosis development and progression. Here, we investigated the vascular effects of CTRP13. Results: CTRP13 is not only expressed in adipose tissue but also in vessels/endothelial cells (ECs) of mice, rats, and humans. Obese individuals (mice, rats, and humans) showed higher vascular CTRP13 expression. Human Umbilical Vein Endothelial Cells (HUVECs), cultured in the presence of serum from obese mice, mimicked this obesity-associated effect on CTRP13 protein expression. Similarly, high glucose conditions and TNF-alpha, but not insulin, resulted in a strong increase in CTRP13 in these cells. Recombinant CTRP13 induced a reduction in EC proliferation via AMPK. In addition, CTRP13 reduced cell cycle progression and increased p53 phosphorylation and p21 protein expression, but reduced Rb phosphorylation, with the effects largely depending on alpha-2 AMPK as suggested by adenoviral overexpression of dominant-negative (DN) or wild-type (WT) alpha 1/alpha 2 AMPK.
Conclusion: The present study demonstrates that CTRP13 expression is induced in ECs under diabetic conditions and that CTRP13 possesses significant vaso-modulatory properties which may have an impact on vascular disease progression in patients.
Bisphosphonate-Related Osteonecrosis of the Jaw and Oral Microbiome: Clinical Risk Factors, Pathophysiology and Treatment Options
(2024) Jelin-Uhlig, Sapir; Weigel, Markus; Ott, Benjamin; Imirzalioglu, Can; Howaldt, Hans-Peter; Böttger, Sebastian; Hain, Torsten
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a serious health condition, impacting the lives of many patients worldwide. The condition challenges clinical care due to its complex etiology and limited therapeutic options. A thorough understanding of the pathophysiological and patient-related factors that promote disease development is essential. Recently, the oral microbiome has been implicated as a potential driver and modulating factor of BRONJ by several studies. Modern genomic sequencing methods have provided a wealth of data on the microbial composition of BRONJ lesions; however, the role of individual species in the process of disease development remains elusive. A comprehensive PubMed search was conducted to identify relevant studies on the microbiome of BRONJ patients using the terms “microbiome”, “osteonecrosis of the jaws”, and “bisphosphonates”. Studies focusing on symptoms, epidemiology, pathophysiology, risk factors, and treatment options were included. The principal risk factors for BRONJ are tooth extraction, surgical procedures, and the administration of high doses of bisphosphonates. Importantly, the oral microbiome plays a significant role in the progression of the disease. Several studies have identified alterations of microbial composition in BRONJ lesions. However, there is no consensus regarding bacterial species that are associated with BRONJ across studies. The bacterial genera typically found include Actinomyces, Fusobacterium, and Streptococcus. It is postulated that these microbes contribute to the pathogenesis of BRONJ by promoting inflammation and disrupting normal bone remodeling processes. Current therapeutic approaches are disease-stage-specific and the necessity for more effective treatment strategies remains. This review examines the potential causes of and therapeutic approaches to BRONJ, highlighting the link between microbial colonization and BRONJ development. Future research should seek to more thoroughly investigate the interactions between bisphosphonates, the oral microbiome, and the immune system in order to develop targeted therapies.
Post and Core Treatment to Refit Telescopic Crown-Retained Dentures after Abutment Tooth Fracture: An Evaluation of Therapy by Retrospective Survival Analysis
(2024) Vogler, Jonas Adrian Helmut; Abrahamian, William; Reich, Sarah Marie; Wöstmann, Bernd; Rehmann, Peter
Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra axial forces, abutment tooth fracture is a common cause of failure for TCDs; thus, PC treatment is often needed to refit the existing telescopic crown (TC). However, there are no clinical survival data on whether the PC treatment was used to refit the TC after abutment tooth fracture (PC2) or the PC was already fitted at the time of TCD treatment (PC1). A total of 246 patients with 399 PC treatments were retrospectively evaluated for follow-ups up to 17.33 years. The files were analysed for PC1 and PC2. Furthermore, the influence of the jaw, type of tooth, luting material, PC material, bone attachment, therapist and cause of failure was recorded. For statistical analysis, Kaplan–Meier and Cox regression analyses were conducted. PC2 showed highly significant lower survival probabilities than PC1 (p < 0.001). Moreover, the bone attachment and the age of the patient at the time of fitting the PC crown had an influence on the survival (p < 0.001). Therefore, PC2 should be carefully discussed with the patient and PC1 should be favoured in endodontically treated abutment teeth for TCDs.
Closing the nutrient-food loop: technology innovation and (de)politicization in European nutrient policy
(2024) Schwindenhammer, Sandra; Gonglach, Denise
This contribution examines the development of the European Union’s nutrient policy from 2000 to 2022. It focuses on the policy’s shift orienting toward expert knowledge and technological innovations in nutrient recovery and recycling, and explores the resulting (de)politicization of the policy area. Drawing on evolutionary policy change, agri-food (de)politicization, and agri-food technology innovation research, a three-phase development is identified through qualitative document and public feedback data analysis. The policy development started with a focus on environmental issues and nutrient scarcity in the 2000s (phase 1), expanded to nutrient recycling as a means to close the nutrient-food loop in the mid-2010s (phase 2), and began utilizing secondary nutrient sources for agri-food production and to ensure a stable supply of fertilizers in the 2020s (phase 3). The study shows that while expert knowledge and technological advancements have steered sectoral policies toward a circular agri-food system, they have also led to the EU’s nutrient policy adopting a technocratic approach, privileging specific expert insights and depoliticizing the policy area. The findings highlight the intricate relationship between technological innovation, policy evolution, and public engagement in shaping the European agri-food system.