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  1. Article: Routine Postoperative Antibiotic Prophylaxis Offers No Benefit after Hepatectomy-A Systematic Review and Meta-Analysis.

    Murtha-Lemekhova, Anastasia / Fuchs, Juri / Teroerde, Miriam / Chiriac, Ute / Klotz, Rosa / Hornuss, Daniel / Larmann, Jan / Weigand, Markus A / Hoffmann, Katrin

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 5

    Abstract: Background: Prophylactic antibiotics are frequently administered after major abdominal surgery including hepatectomies aiming to prevent infective complications. Yet, excessive use of antibiotics increases resistance in bacteria. The aim of this ... ...

    Abstract Background: Prophylactic antibiotics are frequently administered after major abdominal surgery including hepatectomies aiming to prevent infective complications. Yet, excessive use of antibiotics increases resistance in bacteria. The aim of this systematic review and meta-analysis is to assess the efficacy of prophylactic antibiotics after hepatectomy (postoperative antibiotic prophylaxis, POA).
    Method: This systematic review and meta-analysis were completed according to the current PRISMA guidelines. The protocol has been registered prior to data extraction (PROSPERO registration Nr: CRD42021288510). MEDLINE, Web of Science and CENTRAL were searched for clinical reports on POA in hepatectomy restrictions. A random-effects model was used for synthesis. Methodological quality was assessed with RoB2 and ROBINS-I. GRADE was used for the quality of evidence assessment.
    Results: Nine comparative studies comprising 2987 patients were identified: six randomized controlled trials (RCTs) and three retrospectives. POA did not lead to a reduction in postoperative infective complications or have an effect on liver-specific complications-post-hepatectomy liver failure and biliary leaks. POA over four or more days was associated with increased rates of deep surgical site infections compared to short-term administration for up to two days (OR 1.54; 95% CI [1.17;2.03];
    Conclusion: Routine POA cannot be recommended after hepatectomy since it does not reduce postoperative infection or liver-specific complications but contributes to resistance in bacteria. Studies into individualized risk-adapted antibiotic prophylaxis strategies are needed to further optimize perioperative treatment in liver surgery.
    Language English
    Publishing date 2022-05-12
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11050649
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Kidney Cancer Models for Pre-Clinical Drug Discovery: Challenges and Opportunities.

    Pohl, Laura / Friedhoff, Jana / Jurcic, Christina / Teroerde, Miriam / Schindler, Isabella / Strepi, Konstantina / Schneider, Felix / Kaczorowski, Adam / Hohenfellner, Markus / Duensing, Anette / Duensing, Stefan

    Frontiers in oncology

    2022  Volume 12, Page(s) 889686

    Abstract: Renal cell carcinoma (RCC) is among the most lethal urological malignancies once metastatic. The introduction of immune checkpoint inhibitors has revolutionized the therapeutic landscape of metastatic RCC, nevertheless, a significant proportion of ... ...

    Abstract Renal cell carcinoma (RCC) is among the most lethal urological malignancies once metastatic. The introduction of immune checkpoint inhibitors has revolutionized the therapeutic landscape of metastatic RCC, nevertheless, a significant proportion of patients will experience disease progression. Novel treatment options are therefore still needed and
    Language English
    Publishing date 2022-05-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.889686
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  3. Article ; Online: Study protocol of REpeat versus SIngle ShoT Antibiotic prophylaxis in major Abdominal Surgery (RESISTAAS I): a prospective observational study of antibiotic prophylaxis practice for patients undergoing major abdominal surgery.

    Murtha-Lemekhova, Anastasia / Fuchs, Juri / Teroerde, Miriam / Rau, Heike / Frey, Otto R / Hornuss, Daniel / Billeter, Adrian / Klotz, Rosa / Chiriac, Ute / Larmann, Jan / Weigand, Markus A / Probst, Pascal / Hoffmann, Katrin

    BMJ open

    2022  Volume 12, Issue 9, Page(s) e062088

    Abstract: Introduction: Surgical site infections (SSIs) are among the most common complications after abdominal surgery and develop in approximately 20% of patients. These patients suffer a 12% increase in mortality, underlying the need for strategies reducing ... ...

    Abstract Introduction: Surgical site infections (SSIs) are among the most common complications after abdominal surgery and develop in approximately 20% of patients. These patients suffer a 12% increase in mortality, underlying the need for strategies reducing SSI. Perioperative antibiotic prophylaxis is paramount for SSI prevention in major abdominal surgery. Yet, intraoperative redosing criteria are subjective and whether patients benefit from it remains unclear.
    Methods and analysis: The REpeat versus SIngle ShoT Antibiotic prophylaxis in major Abdominal Surgery (RESISTAAS I) study is a single-centre, prospective, observational study investigating redosing of antibiotic prophylaxis in 300 patients undergoing major abdominal surgery. Adult patients scheduled for major abdominal surgery will be included. Current practice of redosing regarding number and time period will be recorded. Postoperative SSIs, nosocomial infections, clinically relevant infection-associated bacteria, postoperative antibiotic treatment, in addition to other clinical, pharmacological and economical outcomes will be evaluated. Differences between groups will be analysed with analysis of covariance.
    Ethics and dissemination: RESISTAAS I will be conducted in accordance with the Declaration of Helsinki and internal, national and international standards of GCP. The Medical Ethics Review Board of Heidelberg University has approved the study prior to initiation (S-404/2021). The study has been registered on 7 February 2022 at German Clinical Trials Register, with identifier DRKS00027892. We plan to disseminate the results of the study in a peer-reviewed journal.
    Trial registration: German Clinical Trials Register (DRKS): DRKS00027892.
    MeSH term(s) Adult ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis/methods ; Humans ; Observational Studies as Topic ; Prospective Studies ; Surgical Wound Infection/microbiology ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-09-19
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-062088
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Is metabolic syndrome a risk factor in hepatectomy? A meta-analysis with subgroup analysis for histologically confirmed hepatic manifestations.

    Murtha-Lemekhova, Anastasia / Fuchs, Juri / Feiler, Svenja / Schulz, Erik / Teroerde, Miriam / Kalkum, Eva / Klotz, Rosa / Billeter, Adrian / Probst, Pascal / Hoffmann, Katrin

    BMC medicine

    2022  Volume 20, Issue 1, Page(s) 47

    Abstract: Background: Metabolic syndrome (MetS) is a risk factor in surgery. MetS can progress to metabolic (dysfunction)-associated fatty liver disease (MAFLD), a vast-growing etiology of primary liver tumors which are major indications for liver surgery. The ... ...

    Abstract Background: Metabolic syndrome (MetS) is a risk factor in surgery. MetS can progress to metabolic (dysfunction)-associated fatty liver disease (MAFLD), a vast-growing etiology of primary liver tumors which are major indications for liver surgery. The aim of this meta-analysis was to investigate the impact of MetS on complications and long-term outcomes after hepatectomy.
    Methods: The protocol for this meta-analysis was registered at PROSPERO prior to data extraction. MEDLINE, Web of Science, and Cochrane Library were searched for publications on liver resections and MetS. Comparative studies were included. Outcomes encompassed postoperative complications, mortality, and long-term oncologic status. Data were pooled as odds ratio (OR) with a random-effects model. Risk of bias was assessed using the Quality in Prognostic Studies tool (QUIPS), and the certainty of the evidence was evaluated with GRADE. Subgroup analyses for patients with histopathologically confirmed non-alcoholic fatty liver disease (NAFLD) versus controls were performed.
    Results: The meta-analyses included fifteen comparative studies. Patients with MetS suffered significantly more overall complications (OR 1.55; 95% CI [1.05; 2.29]; p=0.03), major complications (OR 1.97 95% CI [1.13; 3.43]; p=0.02; I
    Conclusion: Patients with MetS that undergo liver surgery suffer more complications, such as postoperative hemorrhage and infection but not liver-specific complications-PHLF and biliary leakage. Histologically confirmed NAFLD is associated with significantly higher PHLF rates, yet, survivals of these patients are similar to patients without the MetS. Further studies should focus on identifying the tipping point for increased risk in patients with MetS-associated liver disease, as well as reliable markers of MAFLD stages and early markers of PHLF.
    Trial registration: PROSPERO Nr: CRD42021253768.
    MeSH term(s) Hepatectomy/adverse effects ; Humans ; Metabolic Syndrome/complications ; Metabolic Syndrome/epidemiology ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/surgery ; Risk Factors
    Language English
    Publishing date 2022-01-28
    Publishing country England
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-022-02239-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Conference proceedings: Metabolic syndrome and hepatectomy - a meta-analysis with subgroup analysis for NAFLD

    Murtha-Lemekhova, Anastasia / Fuchs, Juri / Feiler, Svenja / Schulz, Erik / Teroerde, Miriam / Kalkum, Eva / Klotz, Rosa / Billeter, Adrian / Probst, Pascal / Hoffmann, Katrin

    Zeitschrift für Gastroenterologie

    2022  Volume 60, Issue 01

    Event/congress 38. Jahrestagung der Deutsche Arbeitsgemeinschaft zum Studium der Leber, Mannheim, 2022-01-28
    Language English
    Publishing date 2022-01-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 201387-3
    ISSN 1439-7803 ; 0044-2771 ; 0172-8504
    ISSN (online) 1439-7803
    ISSN 0044-2771 ; 0172-8504
    DOI 10.1055/s-0041-1740739
    Database Thieme publisher's database

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 111: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  6. Article ; Online: BAP1 and PTEN mutations shape the immunological landscape of clear cell renal cell carcinoma and reveal the intertumoral heterogeneity of T cell suppression: a proof-of-concept study.

    Friedhoff, Jana / Schneider, Felix / Jurcic, Christina / Endris, Volker / Kirchner, Martina / Sun, Angela / Bolnavu, Iulia / Pohl, Laura / Teroerde, Miriam / Kippenberger, Maximilian / Schwab, Constantin / Kaczorowski, Adam / Zschäbitz, Stefanie / Jäger, Dirk / Hohenfellner, Markus / Stenzinger, Albrecht / Duensing, Anette / Duensing, Stefan

    Cancer immunology, immunotherapy : CII

    2022  Volume 72, Issue 6, Page(s) 1603–1618

    Abstract: Clear cell renal cell carcinoma (ccRCC) is an immunologically vulnerable tumor entity, and immune checkpoint inhibitors are now widely used to treat patients with advanced disease. Whether and to what extent immune responses in ccRCC are shaped by ... ...

    Abstract Clear cell renal cell carcinoma (ccRCC) is an immunologically vulnerable tumor entity, and immune checkpoint inhibitors are now widely used to treat patients with advanced disease. Whether and to what extent immune responses in ccRCC are shaped by genetic alterations, however, is only beginning to emerge. In this proof-of-concept study, we performed a detailed correlative analysis of the mutational and immunological landscapes in a series of 23 consecutive kidney cancer patients. We discovered that a high infiltration with CD8 + T cells was not dependent on the number of driver mutations but rather on the presence of specific mutational events, namely pathogenic mutations in PTEN or BAP1. This observation encouraged us to compare mechanisms of T cell suppression in the context of four different genetic patterns, i.e., the presence of multiple drivers, a PTEN or BAP1 mutation, or the absence of detectable driver mutations. We found that ccRCCs harboring a PTEN or BAP1 mutation showed the lowest level of Granzyme B positive tumor-infiltrating lymphocytes (TILs). A multiplex immunofluorescence analysis revealed a significant number of CD8 + TILs in the vicinity of CD68 + macrophages/monocytes in the context of a BAP1 mutation but not in the context of a PTEN mutation. In line with this finding, direct interactions between CD8 + TILs and CD163 + M2-polarized macrophages were found in BAP1-mutated ccRCC but not in tumors with other mutational patterns. While an absence of driver mutations was associated with more CD8 + TILs in the vicinity of FOXP3 + Tregs and CD68 + monocytes/macrophages, the presence of multiple driver mutations was, to our surprise, not found to be strongly associated with immunosuppressive mechanisms. Our results highlight the role of genetic alterations in shaping the immunological landscape of ccRCC. We discovered a remarkable heterogeneity of mechanisms that can lead to T cell suppression, which supports the need for personalized immune oncological approaches.
    MeSH term(s) Humans ; Carcinoma, Renal Cell/pathology ; DNA-Binding Proteins/genetics ; Kidney Neoplasms/pathology ; Transcription Factors/genetics ; Mutation ; Prognosis ; Tumor Suppressor Proteins/genetics ; Ubiquitin Thiolesterase/genetics ; PTEN Phosphohydrolase/genetics
    Chemical Substances DNA-Binding Proteins ; Transcription Factors ; BAP1 protein, human ; Tumor Suppressor Proteins ; Ubiquitin Thiolesterase (EC 3.4.19.12) ; PTEN protein, human (EC 3.1.3.67) ; PTEN Phosphohydrolase (EC 3.1.3.67)
    Language English
    Publishing date 2022-12-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 195342-4
    ISSN 1432-0851 ; 0340-7004
    ISSN (online) 1432-0851
    ISSN 0340-7004
    DOI 10.1007/s00262-022-03346-7
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1237: Show issues Location:
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  7. Article ; Online: Is metabolic syndrome a risk factor in hepatectomy? A meta-analysis with subgroup analysis for histologically confirmed hepatic manifestations

    Anastasia Murtha-Lemekhova / Juri Fuchs / Svenja Feiler / Erik Schulz / Miriam Teroerde / Eva Kalkum / Rosa Klotz / Adrian Billeter / Pascal Probst / Katrin Hoffmann

    BMC Medicine, Vol 20, Iss 1, Pp 1-

    2022  Volume 13

    Abstract: Abstract Background Metabolic syndrome (MetS) is a risk factor in surgery. MetS can progress to metabolic (dysfunction)-associated fatty liver disease (MAFLD), a vast-growing etiology of primary liver tumors which are major indications for liver surgery. ...

    Abstract Abstract Background Metabolic syndrome (MetS) is a risk factor in surgery. MetS can progress to metabolic (dysfunction)-associated fatty liver disease (MAFLD), a vast-growing etiology of primary liver tumors which are major indications for liver surgery. The aim of this meta-analysis was to investigate the impact of MetS on complications and long-term outcomes after hepatectomy. Methods The protocol for this meta-analysis was registered at PROSPERO prior to data extraction. MEDLINE, Web of Science, and Cochrane Library were searched for publications on liver resections and MetS. Comparative studies were included. Outcomes encompassed postoperative complications, mortality, and long-term oncologic status. Data were pooled as odds ratio (OR) with a random-effects model. Risk of bias was assessed using the Quality in Prognostic Studies tool (QUIPS), and the certainty of the evidence was evaluated with GRADE. Subgroup analyses for patients with histopathologically confirmed non-alcoholic fatty liver disease (NAFLD) versus controls were performed. Results The meta-analyses included fifteen comparative studies. Patients with MetS suffered significantly more overall complications (OR 1.55; 95% CI [1.05; 2.29]; p=0.03), major complications (OR 1.97 95% CI [1.13; 3.43]; p=0.02; I 2=62%), postoperative hemorrhages (OR 1.76; 95% CI [1.23; 2.50]; p=0.01) and infections (OR 1.63; 95% CI [1.03; 2.57]; p=0.04). There were no significant differences in mortality, recurrence, 1- or 5-year overall or recurrence-free survivals. Patients with histologically confirmed NAFLD did not have significantly more overall complications; however, PHLF rates were increased (OR 4.87; 95% CI [1.22; 19.47]; p=0.04). Recurrence and survival outcomes did not differ significantly. The certainty of the evidence for each outcome ranged from low to very low. Conclusion Patients with MetS that undergo liver surgery suffer more complications, such as postoperative hemorrhage and infection but not liver-specific complications—PHLF and biliary leakage. ...
    Keywords Metabolic syndrome ; liver surgery ; post-hepatectomy liver failure ; meta-analysis ; NASH ; NAFLD ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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