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Article ; Online: Schluckstörungen im Alter, Physiologie und Pathophysiologie.

Muhle, P / Wirth, R / Glahn, J / Dziewas, R

2015 Volume 86, Issue 4, Page(s) 440–451

Abstract: The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness ...

Title translation	Age-related changes in swallowing. Physiology and pathophysiology.
Abstract	The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.
MeSH term(s)	Aged ; Aged, 80 and over ; Aging ; Deglutition ; Deglutition Disorders/diagnosis ; Deglutition Disorders/etiology ; Deglutition Disorders/physiopathology ; Diagnosis, Differential ; Female ; Geriatric Assessment/methods ; Humans ; Male ; Neurodegenerative Diseases/complications ; Neurodegenerative Diseases/diagnosis ; Neurodegenerative Diseases/physiopathology ; Sarcopenia/complications ; Sarcopenia/diagnosis ; Sarcopenia/physiopathology
Language	German
Publishing date	2015-04
Publishing country	Germany
Document type	English Abstract ; Journal Article
ZDB-ID	123291-5
ISSN	1433-0407 ; 0028-2804
ISSN (online)	1433-0407
ISSN	0028-2804
DOI	10.1007/s00115-014-4183-7
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Article: Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature.

Philipps, Joerg / Erdlenbruch, Bernhard / Kuschnerow, Michael / Jagoda, Sunil / Salihaj, Blerta / Glahn, Joerg / Schellinger, Peter Dieter

Therapeutic advances in neurological disorders

2022 Volume 15, Page(s) 17562864221102842

Abstract: The safety and efficacy of hyperacute reperfusion therapies in childhood stroke due to focal cerebral arteriopathy (FCA) with an infectious and inflammatory component is unknown. Lyme neuroborreliosis (LNB) is reported as a rare cause of childhood stroke. ...

Abstract	The safety and efficacy of hyperacute reperfusion therapies in childhood stroke due to focal cerebral arteriopathy (FCA) with an infectious and inflammatory component is unknown. Lyme neuroborreliosis (LNB) is reported as a rare cause of childhood stroke. Intravenous thrombolysis (IVT) and endovascular therapy (EVT) have not been reported in LNB-associated stroke in children. We report two children with acute stroke associated with LNB who underwent hyperacute stroke treatment. A systematic review of the literature was performed to identify case reports of LNB-associated childhood stroke over the last 20 years. Patient 1 received IVT within 73 min after onset of acute hemiparesis and dysarthria; medulla oblongata infarctions were diagnosed on magnetic resonance imaging (MRI). Patient 2 received successful EVT 6.5 hr after onset of progressive tetraparesis, coma, and decerebrate posturing caused by basilar artery occlusion with bilateral pontomesencephalic infarctions. Both patients exhibited a lymphocytic cerebrospinal fluid (CSF) pleocytosis and elevated antibody index (AI) to
Language	English
Publishing date	2022-06-20
Publishing country	England
Document type	Case Reports
ZDB-ID	2442245-9
ISSN	1756-2864 ; 1756-2856
ISSN (online)	1756-2864
ISSN	1756-2856
DOI	10.1177/17562864221102842
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Article ; Online: Shunt Dependence after Intraventricular Hemorrhage and Intraventricular Fibrinolysis with uPA versus rt-PA.

Covrig, Raul-Ciprian / Schellinger, Peter D / Glahn, Joerg / Alomari, Ali / Schmieder, Kirsten / Wiese, M / Knappe, Ulrich Johannes

Journal of neurological surgery. Part A, Central European neurosurgery

2022 Volume 84, Issue 3, Page(s) 255–260

Abstract: Background: We compare the effect of urokinase (urokinase-type plasminogen activator [uPA]) versus alteplase (recombinant tissue plasminogen activator [rt-PA]) for intraventricular fibrinolysis (IVF) in patients with intraventricular hemorrhage (IVH) ... ...

Abstract	Background: We compare the effect of urokinase (urokinase-type plasminogen activator [uPA]) versus alteplase (recombinant tissue plasminogen activator [rt-PA]) for intraventricular fibrinolysis (IVF) in patients with intraventricular hemorrhage (IVH) on ventriculoperitoneal shunt (VPS) dependence, functional outcome, and complications in the management of IVH. Methods: We retrospectively reviewed the patients admitted with IVH or intracerebral hemorrhage (ICH) with IVH within 7 years in three different departments and found 102 patients who met the inclusion criteria. The primary end points were VPS dependence and Glasgow outcome score (GOS) at 3 months. Secondary end points were rate of rebleeding under IVF and incidence of treatment-related complications. Patients were divided into three groups: group I comprised patients treated with external ventricular drain (EVD) and IVF with uPA; group II comprised patients treated with EVD and IVF with rt-PA; and group III comprised patients treated with EVD alone. Results: In all, 9.8% patients needed VPS: 12.2% in group I and 15.0% in group II, with no statistically significant difference. VPS patients had higher values of the modified Graeb score (mGS), IVH score, and IVH volume. We saw a trend for a better outcome in group II, with six patients achieving a GOS of 4 or 5 after 3 months. The mortality rate was higher in groups I and III. We found no statistical difference in the complication rate between groups I and II. Logistic regression analysis revealed that higher mGS and age predicted worse prognosis concerning mortality. The risk for death rose by 7.8% for each year of age. Any additional mGS point increased the chances of death by 9.7%. Conclusion: Our data suggest that both uPA and rt-PA are safe and comparable regarding incidence of communicating hydrocephalus, and age and mGS are predictive for mortality.
MeSH term(s)	Humans ; Tissue Plasminogen Activator/therapeutic use ; Urokinase-Type Plasminogen Activator/therapeutic use ; Fibrinolysis ; Retrospective Studies ; Fibrinolytic Agents/therapeutic use ; Cerebral Hemorrhage/drug therapy ; Cerebral Hemorrhage/surgery ; Treatment Outcome
Chemical Substances	Tissue Plasminogen Activator (EC 3.4.21.68) ; Urokinase-Type Plasminogen Activator (EC 3.4.21.73) ; Fibrinolytic Agents
Language	English
Publishing date	2022-01-31
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0041-1741546
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Article ; Online: Capillary Refill-The Key to Assessing Dermal Capillary Capacity and Pathology in Optical Coherence Tomography Angiography.

Casper, M J / Glahn, J / Evers, M / Schulz-Hildebrandt, H / Kositratna, G / Birngruber, R / Hüttmann, G / Manstein, D

Lasers in surgery and medicine

2019 Volume 52, Issue 7, Page(s) 653–658

Abstract: Background/objectives: Standard optical coherence tomography angiography (OCTA) has been limited to imaging blood vessels actively undergoing perfusion, providing a temporary picture of surface microvasculature. Capillary perfusion in the skin is ... ...

Abstract	Background/objectives: Standard optical coherence tomography angiography (OCTA) has been limited to imaging blood vessels actively undergoing perfusion, providing a temporary picture of surface microvasculature. Capillary perfusion in the skin is dynamic and changes in response to the surrounding tissue's respiratory, nutritional, and thermoregulatory needs. Hence, OCTA often represents a given perfusion state without depicting the actual extent of the vascular network. Here we present a method for obtaining a more accurate anatomic representation of the surface capillary network in human skin using OCTA, along with proposing a new parameter, the Relative Capillary Capacity (RCC), a quantifiable proxy for assessing capillary dilation potential and permeability. Methods: OCTA images were captured at baseline and after compression of the skin. Baseline images display ambient capillary perfusion, while images taken upon capillary refill display the network of existing capillaries at full capacity. An optimization-based automated vessel segmentation method was used to automatically analyze and compare OCTA image sequences obtained from two volunteers. RCC was then compared with visual impressions of capillary viability. Results: Our OCTA imaging sequence provides a method for mapping cutaneous capillary networks independent of ambient perfusion. Differences between baseline and refill images clearly demonstrate the shortcomings of standard OCTA imaging and produce the RCC biometric as a quantifiable proxy for assessing capillary dilation potential and permeability. Conclusion: Future dermatological OCTA diagnostic studies should implement the Capillary Refill Methods over standard imaging techniques and further explore the relevance of RCC to differential diagnosis and dermatopathology. Lasers Surg. Med. © The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
MeSH term(s)	Capillaries/diagnostic imaging ; Fluorescein Angiography ; Humans ; Microvessels/diagnostic imaging ; Skin/diagnostic imaging ; Tomography, Optical Coherence
Language	English
Publishing date	2019-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	604493-1
ISSN	1096-9101 ; 0196-8092
ISSN (online)	1096-9101
ISSN	0196-8092
DOI	10.1002/lsm.23188
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Article ; Online: Risk of ADHD, Autism Spectrum Disorder, and Executive Function Impairment in Metopic Craniosynostosis.

Almeida, Mariana N / Alper, David P / Long, Aaron S / Barrero, Carlos / Williams, Mica Cg / Boroumand, Sam / Glahn, Joshua / Shah, Jinesh / Swanson, Jordan / Alperovich, Michael

Plastic and reconstructive surgery

2023

Abstract: Introduction: Favorable behavioral interactions are critical for academic and interpersonal success. An association between metopic synostosis and behavioral impairments has not been fully elucidated. Behavioral dysfunction in school age children with ... ...

Abstract	Introduction: Favorable behavioral interactions are critical for academic and interpersonal success. An association between metopic synostosis and behavioral impairments has not been fully elucidated. Behavioral dysfunction in school age children with surgically corrected metopic synostosis was evaluated using targeted testing to detect the most common behavioral abnormalities in this population. Methods: Parents of children 6-18 years old with metopic synostosis completed the Conners Short 3 rd edition (Conners-3: ADHD), Social Responsiveness Scale 2 nd edition (SRS-2: autism spectrum disorder), Behavior Rating Inventory of Executive Function 2 nd edition (BRIEF-2: executive functioning), and Child's Behavioral Checklist (CBCL: behavioral/emotional functioning). Children also completed neurocognitive testing. Multivariable regression was used to determine predictors of clinically significant behavioral impairments. Results: 60 children were enrolled. Average age at surgery was 9.2 ± 7.9 months, with an average age at assessment of 10.3 ± 3.5 years. Nearly half of patients demonstrated symptoms associated with ADHD, demonstrated by reaching or exceeding borderline clinical levels for inattention and hyperactivity subscales of the Conners-3. Greater age at surgery was associated with worse executive function, measured by reaching or exceeding clinically significant levels of the executive function subscale of the Conners-3 (p=0.04) and subscales of the BRIEF-2 (behavioral regulator index [p=0.05], cognitive regulatory index [p=0.03], and global executive composite [p=0.04]). Conclusions: Nearly half of patients with surgically corrected metopic synostosis reached borderline clinical scores for inattention and hyperactivity. Greater age at surgery was associated with worse executive function. Prompt surgical correction of metopic synostosis may portend improved long-term emotional and behavioral function.
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000011249
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Article ; Online: Schlaganfallversorgung in Deutschland während der frühen Phase der COVID-19-Pandemie: Ergebnisse einer Erhebung der Stroke-Unit-Kommission der Deutschen Schlaganfall-Gesellschaft

Neumann-Haefelin, T. / Faiss, J. / Glahn, J. / Grau, A. / Häusler, K. G. / Thomalla, G. / Busse, O. / Steinmetz, H. / Nabavi, D.

DGNeurologie

Keywords	covid19
Publisher	PMC
Document type	Article ; Online
DOI	10.1007/s42451-020-00253-y
Database	COVID19

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Article: Shunt Dependence after Intraventricular Hemorrhage and Intraventricular Fibrinolysis with uPA versus rt-PA

Covrig, Raul-Ciprian / Schellinger, Peter D. / Glahn, Joerg / Alomari, Ali / Schmieder, Kirsten / Wiese, M. / Knappe, Ulrich Johannes

Journal of Neurological Surgery Part A: Central European Neurosurgery

2022 Volume 84, Issue 03, Page(s) 255–260

Abstract	Background: We compare the effect of urokinase (urokinase-type plasminogen activator [uPA]) versus alteplase (recombinant tissue plasminogen activator [rt-PA]) for intraventricular fibrinolysis (IVF) in patients with intraventricular hemorrhage (IVH) on ventriculoperitoneal shunt (VPS) dependence, functional outcome, and complications in the management of IVH. Methods: We retrospectively reviewed the patients admitted with IVH or intracerebral hemorrhage (ICH) with IVH within 7 years in three different departments and found 102 patients who met the inclusion criteria. The primary end points were VPS dependence and Glasgow outcome score (GOS) at 3 months. Secondary end points were rate of rebleeding under IVF and incidence of treatment-related complications. Patients were divided into three groups: group I comprised patients treated with external ventricular drain (EVD) and IVF with uPA; group II comprised patients treated with EVD and IVF with rt-PA; and group III comprised patients treated with EVD alone. Results: In all, 9.8% patients needed VPS: 12.2% in group I and 15.0% in group II, with no statistically significant difference. VPS patients had higher values of the modified Graeb score (mGS), IVH score, and IVH volume. We saw a trend for a better outcome in group II, with six patients achieving a GOS of 4 or 5 after 3 months. The mortality rate was higher in groups I and III. We found no statistical difference in the complication rate between groups I and II. Logistic regression analysis revealed that higher mGS and age predicted worse prognosis concerning mortality. The risk for death rose by 7.8% for each year of age. Any additional mGS point increased the chances of death by 9.7%. Conclusion: Our data suggest that both uPA and rt-PA are safe and comparable regarding incidence of communicating hydrocephalus, and age and mGS are predictive for mortality.
Keywords	intraventricular fibrinolysis ; shunt dependence ; uPA ; rt-PA ; intraventricular hemorrhage
Language	English
Publishing date	2022-01-31
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0041-1741546
Database	Thieme publisher's database

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Article ; Online: Assessing the impact of aging and blood pressure on dermal microvasculature by reactive hyperemia optical coherence tomography angiography.

Wang-Evers, Michael / Casper, Malte J / Glahn, Joshua / Luo, Tuanlian / Doyle, Abigail E / Karasik, Daniel / Kim, Anne C / Phothong, Weeranut / Nathan, Neera R / Heesakker, Tammy / Kositratna, Garuna / Manstein, Dieter

Scientific reports

2021 Volume 11, Issue 1, Page(s) 13411

Abstract: Visualization and quantification of the skin microvasculature are important for studying the health of the human microcirculation. We correlated structural and pathophysiological changes of the dermal capillary-level microvasculature with age and blood ... ...

Abstract	Visualization and quantification of the skin microvasculature are important for studying the health of the human microcirculation. We correlated structural and pathophysiological changes of the dermal capillary-level microvasculature with age and blood pressure by using the reactive hyperemia optical coherence tomography angiography (RH-OCT-A) technique and evaluated both conventional OCT-A and the RH-OCT-A method as non-invasive imaging alternatives to histopathology. This observational pilot study acquired OCT-A and RH-OCT-A images of the dermal microvasculature of 13 young and 12 old healthy Caucasian female subjects. Two skin biopsies were collected per subject for histological analysis. The dermal microvasculature in OCT-A, RH-OCT-A, and histological images were automatically quantified and significant indications of vessel rarefaction in both old subjects and subjects with high blood pressure were observed by RH-OCT-A and histopathology. We showed that an increase in dermal microvasculature perfusion in response to reactive hyperemia was significantly lower in high blood pressure subjects compared to normal blood pressure subjects (117% vs. 229%). These results demonstrate that RH-OCT-A imaging holds functional information of the microvasculature with respect to physiological factors such as age and blood pressure that may help to monitor early disease progression and assess overall vascular health. Additionally, our results suggest that RH-OCT-A images may serve as a non-invasive alternative to histopathology for vascular analysis.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aging/physiology ; Angiography/methods ; Blood Pressure/physiology ; Disease Progression ; Female ; Forearm/blood supply ; Humans ; Hyperemia/diagnostic imaging ; Hyperemia/physiopathology ; Hypertension/physiopathology ; Microcirculation/physiology ; Microvessels/diagnostic imaging ; Microvessels/physiology ; Microvessels/ultrastructure ; Pilot Projects ; Skin/blood supply ; Tomography, Optical Coherence/methods ; Translational Medical Research ; Young Adult
Language	English
Publishing date	2021-06-28
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-92712-z
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Article ; Online: Platelet Rich Plasma Augments Adipose-Derived Stem Cell Growth and Differentiation.

Gersch, Robert P / Glahn, Joshua / Tecce, Michael G / Wilson, Anthony J / Percec, Ivona

Aesthetic surgery journal

2017 Volume 37, Issue 6, Page(s) 723–729

Abstract: Background: Adipose-derived stem cells (ASCs) are a powerful tool for cosmetic surgery and regenerative medicine. The use of autologous platelet rich plasma (PRP), particularly in combination with ASC-based therapy, has significantly expanded in recent ... ...

Abstract	Background: Adipose-derived stem cells (ASCs) are a powerful tool for cosmetic surgery and regenerative medicine. The use of autologous platelet rich plasma (PRP), particularly in combination with ASC-based therapy, has significantly expanded in recent years. Unfortunately, the mechanisms and optimal dosing responsible for the beneficial effects of PRP remain poorly understood. Here we investigate the effect of PRP on ASC growth and differentiation. Objectives: To assess the impact of different PRP feeding and cryopreservation protocols on ASC isolation, expansion, and differentiation. Methods: Human PRP was isolated using the Magellan System (Arteriocyte). Fresh PRP (fPRP), flash frozen PRP (ffPRP), and cryopreserved PRP (cPRP) were added to human ASCs isolated from healthy patients. A panel of PRP supplementation protocols was analyzed for ASC adherence, proliferation, and osteogenesis. Results: The fresh and cryopreserved PRP groups demonstrated reduced cell adherence compared to control (non-PRP) groups (P < 0.001), while the flash frozen PRP groups showed cell adherence equivalent to or better than controls. After 7 days of growth, ASC populations for fPRP and ffPRP Single Administration protocols were significantly higher than other feeding protocols and controls. This benefit was lost in cPRP groups. Optimized ffPRP protocols showed potential for spontaneous osteogenesis. Conclusions: Addition of ffPRP improves initial ASC adherence while a single administration of either fresh or flash frozen PRP without additional cell manipulation significantly augments subsequent ASC proliferation. The potential for spontaneous osteogenic differentiation upon PRP exposure invokes the need for additional molecular studies of PRP activity prior to further expansion to clinical applications.
MeSH term(s)	Adipose Tissue/cytology ; Cell Adhesion ; Cell Differentiation ; Cell Proliferation ; Cell Separation ; Cells, Cultured ; Cryopreservation ; Female ; Humans ; Middle Aged ; Osteogenesis ; Phenotype ; Platelet-Rich Plasma/metabolism ; Stem Cells/metabolism ; Time Factors
Language	English
Publishing date	2017-03-21
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2087022-X
ISSN	1527-330X ; 1090-820X ; 1084-0761
ISSN (online)	1527-330X
ISSN	1090-820X ; 1084-0761
DOI	10.1093/asj/sjw235
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Article ; Online: European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia.

Dziewas, Rainer / Michou, Emilia / Trapl-Grundschober, Michaela / Lal, Avtar / Arsava, Ethem Murat / Bath, Philip M / Clavé, Pere / Glahn, Jörg / Hamdy, Shaheen / Pownall, Sue / Schindler, Antonio / Walshe, Margaret / Wirth, Rainer / Wright, David / Verin, Eric

European stroke journal

2021 Volume 6, Issue 3, Page(s) LXXXIX–CXV

Abstract: Post-stroke dysphagia (PSD) is present in more than 50% of acute stroke patients, increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration, and is linked to poor outcome and mortality. The aim of this ... ...

Abstract	Post-stroke dysphagia (PSD) is present in more than 50% of acute stroke patients, increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration, and is linked to poor outcome and mortality. The aim of this guideline is to assist all members of the multidisciplinary team in their management of patients with PSD. These guidelines were developed based on the European Stroke Organisation (ESO) standard operating procedure and followed the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. An interdisciplinary working group identified 20 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found moderate quality of evidence to recommend dysphagia screening in all stroke patients to prevent post-stroke pneumonia and to early mortality and low quality of evidence to suggest dysphagia assessment in stroke patients having been identified at being at risk of PSD. We found low to moderate quality of evidence for a variety of treatment options to improve swallowing physiology and swallowing safety. These options include dietary interventions, behavioural swallowing treatment including acupuncture, nutritional interventions, oral health care, different pharmacological agents and different types of neurostimulation treatment. Some of the studied interventions also had an impact on other clinical endpoints such as feedings status or pneumonia. Overall, further randomized trials are needed to improve the quality of evidence for the treatment of PSD.
Language	English
Publishing date	2021-10-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2851287-X
ISSN	2396-9881 ; 2396-9873
ISSN (online)	2396-9881
ISSN	2396-9873
DOI	10.1177/23969873211039721
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