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  1. Article ; Online: Limitations of laparoscopy to assess the peritoneal cancer index and eligibility for cytoreductive surgery with HIPEC in peritoneal metastasis.

    Yurttas, Can / Überrück, Lisa / Nadiradze, Giorgi / Königsrainer, Alfred / Horvath, Philipp

    Langenbeck's archives of surgery

    2022  Volume 407, Issue 4, Page(s) 1667–1675

    Abstract: Purpose: We aimed to determine the value of laparoscopy to assess the intra-abdominal tumor extent and predict complete cytoreduction.: Methods: All patients at our department in the period from 2017 to 2021 that underwent laparoscopy to assess ... ...

    Abstract Purpose: We aimed to determine the value of laparoscopy to assess the intra-abdominal tumor extent and predict complete cytoreduction.
    Methods: All patients at our department in the period from 2017 to 2021 that underwent laparoscopy to assess peritoneal metastasis and subsequent open exploration with the intention to perform cytoreductive surgery (CRS) with HIPEC were retrospectively identified in a continuously maintained database.
    Results: Forty-three patients were analyzed. Peritoneal cancer index (PCI) determination by laparoscopy compared to open surgery was overestimated in five patients (11.6%), identical in eleven patients (25.6%), and underestimated in 27 patients (62.8%). PCI differences were independent of surgeons, tumor entities, and prior chemotherapy. Thirty-four patients (79.1%) were determined eligible for CRS with HIPEC during open exploration, whereas nine patients (20.9%) underwent a non-therapeutic laparotomy. Complete or almost complete cytoreduction was achieved in 33 patients (76.7%). In one patient, completeness of cytoreduction was not documented.
    Conclusions: We demonstrate a moderate agreement according to weighted Cohen's kappa analysis of PCI values calculated during laparoscopy and subsequent open exploration for CRS with HIPEC. Uncertainty of PCI assessment should therefore be kept in mind when performing laparoscopy in patients with peritoneal metastasis.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Laparoscopy ; Peritoneal Neoplasms/secondary ; Retrospective Studies ; Survival Rate
    Language English
    Publishing date 2022-02-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-022-02455-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Attentional bias in individuals with depression and adverse childhood experiences: influence of the noradrenergic system?

    Kuehl, Linn K / Deuter, Christian E / Nowacki, Jan / Ueberrueck, Lisa / Wingenfeld, Katja / Otte, Christian

    Psychopharmacology

    2021  Volume 238, Issue 12, Page(s) 3519–3531

    Abstract: Rationale: Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of ...

    Abstract Rationale: Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of depressive symptoms. MDD is associated with maladaptive changes in the biological stress systems such as dysregulations of central noradrenergic alpha2-receptors in the locus coeruleus-noradrenergic system, which can affect cognitive processes including attention. Patients with adverse childhood experiences (ACE), representing severe stress experiences in early life, might be particularly affected.
    Objectives: With an experimental design, we aimed to gain further knowledge about the role of noradrenergic activity for attentional bias in MDD patients with and without ACE.
    Methods: We tested the effect of increased noradrenergic activity induced by the alpha2-receptor blocker yohimbine on attentional bias in a placebo-controlled repeated measures design. Four groups were included as follows: MDD patients with and without ACE, and healthy participants with and without ACE (total N = 128, all without antidepressant medication).
    Results: A significant effect of MDD on attentional bias scores of sad face pictures (p = .037) indicated a facilitated attentional processing of sad face pictures in MDD patients (compared to non-MDD individuals). However, we found no such effect of ACE. For attentional bias of happy face pictures, we found no significant effects of MDD and ACE. Even though a higher increase of blood pressure and salivary alpha-amylase following yohimbine compared to placebo indicated successful noradrenergic stimulation, we found no significant effects of yohimbine on attentional bias of happy or sad face pictures.
    Conclusions: Our results are consistent with the hypothesis of a negative attentional bias in MDD patients. However, as we found no effect of ACE or yohimbine, further research is needed to understand the mechanisms by which ACE increases the risk of MDD and to understand the biological basis of the MDD-related negative attentional bias.
    MeSH term(s) Attentional Bias ; Depression ; Depressive Disorder, Major ; Humans ; Norepinephrine ; Yohimbine
    Chemical Substances Yohimbine (2Y49VWD90Q) ; Norepinephrine (X4W3ENH1CV)
    Language English
    Publishing date 2021-10-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 130601-7
    ISSN 1432-2072 ; 0033-3158
    ISSN (online) 1432-2072
    ISSN 0033-3158
    DOI 10.1007/s00213-021-05969-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: In-Hospital Mortality and Complication Rates According to Health Insurance Data in Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies in Germany.

    Überrück, Lisa / Nadiradze, Giorgi / Yurttas, Can / Königsrainer, Alfred / Königsrainer, Ingmar / Horvath, Philipp

    Annals of surgical oncology

    2020  Volume 28, Issue 7, Page(s) 3823–3830

    Abstract: Background: Morbidity and in-hospital mortality rates of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Germany are not known.: Methods: From 2009 to 2018 all patients undergoing cytoreductive surgery and ... ...

    Abstract Background: Morbidity and in-hospital mortality rates of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Germany are not known.
    Methods: From 2009 to 2018 all patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Germany were retrospectively analyzed regarding morbidity and in-hospital mortality rates according to nationwide hospital billing data based on diagnosis-related groups (DRG). The "failure to rescue" (FTR) index, characterizing patients who died after severe but potentially manageable complications, was calculated.
    Results: In total, 8463 patients were included and analyzed. Female sex predominated (1.5:1). Colonic origin of peritoneal metastasis was highest throughout all years, reaching its highest level in 2017 (55%; n = 563) and its lowest level in 2012 (40%; n = 349). Median length of hospital stay reached its maximum in 2017 at 23.9 days and its minimum in 2010 at 22.0 days. Analysis of the total FTR index showed a noticeable improvement over the years, reaching its lowest values in 2017 (9.8%) and 2018 (8.8%). The FTR index for sepsis, peritonitis, and pulmonary complications significantly improved over time. Of the 8463 included patients, 290 died during hospital stay, reflecting an in-hospital mortality rate of 3.4%.
    Conclusion: In-hospital mortality after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is reasonably low compared with other surgical procedures. The improvement in the FTR index reflects efforts to centralize treatment at specialized high-volume centers.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Female ; Germany/epidemiology ; Hospital Mortality ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Insurance, Health ; Peritoneal Neoplasms/drug therapy ; Retrospective Studies
    Language English
    Publishing date 2020-11-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-020-09301-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Attentional bias in individuals with depression and adverse childhood experiences

    Kuehl, Linn K. / Deuter, Christian E. / Nowacki, Jan / Ueberrueck, Lisa / Wingenfeld, Katja / Otte, Christian

    Psychopharmacology

    Influence of the noradrenergic system?

    2021  Volume 238, Page(s) 359–3531

    Abstract: Rationale: Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of ... ...

    Title translation Aufmerksamkeitsverzerrung bei Personen mit Depressionen und negativen Kindheitserfahrungen: Einfluss des noradrenergen Systems? (DeepL)
    Abstract Rationale: Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of depressive symptoms. MDD is associated with maladaptive changes in the biological stress systems such as dysregulations of central noradrenergic alpha2-receptors in the locus coeruleus-noradrenergic system, which can affect cognitive processes including attention. Patients with adverse childhood experiences (ACE), representing severe stress experiences in early life, might be particularly affected. Objectives: With an experimental design, we aimed to gain further knowledge about the role of noradrenergic activity for attentional bias in MDD patients with and without ACE. Methods: We tested the effect of increased noradrenergic activity induced by the alpha2-receptor blocker yohimbine on attentional bias in a placebo-controlled repeated measures design. Four groups were included as follows: MDD patients with and without ACE, and healthy participants with and without ACE (total N = 128, all without antidepressant medication). Results: A significant effect of MDD on attentional bias scores of sad face pictures (p = .037) indicated a facilitated attentional processing of sad face pictures in MDD patients (compared to non-MDD individuals). However, we found no such effect of ACE. For attentional bias of happy face pictures, we found no significant effects of MDD and ACE. Even though a higher increase of blood pressure and salivary alpha-amylase following yohimbine compared to placebo indicated successful noradrenergic stimulation, we found no significant effects of yohimbine on attentional bias of happy or sad face pictures. Conclusions: Our results are consistent with the hypothesis of a negative attentional bias in MDD patients. However, as we found no effect of ACE or yohimbine, further research is needed to understand the mechanisms by which ACE increases the risk of MDD and to understand the biological basis of the MDD-related negative attentional bias.
    Keywords Adrenerge Rezeptoren ; Adrenergic Receptors ; Attentional Bias ; Aufmerksamkeits-Bias ; Childhood Adversity ; Major Depression ; Noradrenalin ; Norepinephrine ; Schwierige Kindheit ; Yohimbin ; Yohimbine
    Language English
    Document type Article
    ZDB-ID 123850-4
    ISSN 0033-3158
    ISSN 0033-3158
    DOI 10.1007/s00213-021-05969-7
    Database PSYNDEX

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