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  1. Article ; Online: Noisy Networks and Autism.

    Winterer, Georg

    Biological psychiatry

    2017  Volume 82, Issue 3, Page(s) 152–154

    Language English
    Publishing date 2017-08-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 209434-4
    ISSN 1873-2402 ; 0006-3223
    ISSN (online) 1873-2402
    ISSN 0006-3223
    DOI 10.1016/j.biopsych.2017.05.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Association of Plasma Leptin, Soluble Leptin Receptor and Total and High-Molecular Weight Adiponectin With the Risk of Perioperative Neurocognitive Disorders.

    Feinkohl, Insa / Janke, Jürgen / Slooter, Arjen J C / Winterer, Georg / Spies, Claudia / Pischon, Tobias

    The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

    2024  

    Abstract: Background: Perioperative neurocognitive disorders (NCD) are poorly characterized in terms of their risk factor profiles. Leptin and adiponectin are adipose-tissue-derived hormones with a role in inflammation and atherosclerosis whose function in ... ...

    Abstract Background: Perioperative neurocognitive disorders (NCD) are poorly characterized in terms of their risk factor profiles. Leptin and adiponectin are adipose-tissue-derived hormones with a role in inflammation and atherosclerosis whose function in perioperative NCD is unclear. Here, we used a cohort of older adults to examine the association of preoperative plasma concentrations of these biomarkers with the risk of perioperative NCD.
    Methods: Prospective analysis of 768 participants aged ≥ 65 years of the BioCog study. Blood was collected before surgery for measurement of plasma total and high-molecular-weight (hmw) adiponectin, leptin, and soluble leptin receptor (sOB-R). The free leptin index (FLI, leptin:sOB-R) was calculated. Postoperative delirium (POD) was assessed twice daily until postoperative day 7/discharge. Five hundred twenty-six patients (68.5%) returned for 3-month follow-up and provided data on postoperative cognitive dysfunction (POCD). POCD was defined as a decline on six neuropsychological tests that exceeded that of a nonsurgical control group. Logistic regression analyses examined the associations of each exposure with POD and POCD risk, in separate models adjusted for age, sex, fasting, surgery type, and body mass index (BMI).
    Results: Of 768 patients, 152 (19.8%) developed POD. Of 526 attendants of the follow-up, 54 (10.3%) had developed POCD. Leptin, sOB-R, and total and hmw adiponectin were each not associated with POD. For POCD, we observed reduced risk in patients in FLI quartile 4 compared with quartile 1 (odds ratio, 0.26; 95% CI 0.08, 0.89). Sensitivity analyses for the outcome POD revealed statistically significant interaction terms of sOB-R and total adiponectin with obesity (BMI≥30kg/m
    Conclusions: We did not find consistent evidence for the role of leptin, its receptor, and total and hmw adiponectin in POD and POCD risk. Future research should be used to support or refute our findings and to fully characterize any differences in the associations of these hormones with POD/POCD between obese and nonobese individuals.
    Language English
    Publishing date 2024-03-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 1278145-9
    ISSN 1545-7214 ; 1064-7481
    ISSN (online) 1545-7214
    ISSN 1064-7481
    DOI 10.1016/j.jagp.2024.03.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Book ; Online ; Thesis: On the use of Single-Trial Response Time in the GLM Analysis of fMRI Data

    Richter, Nils / Winterer, Georg / Fink, Gereon R.

    2011  

    Institution Cologne Center for Genomics
    Author's details vorgelegt von Nils Richter ; 1. Berichterstatter: Privatdozent Dr. med. G. Winterer, 2. Berichterstatter: Universitätsprofessor Dr. med. G. Fink ; aus dem Cologne Center for Genomics der Universität zu Köln
    Subject code 610
    Language English
    Size 82 S. : graph. Darst.
    Publishing country Germany
    Document type Book ; Online ; Thesis
    Thesis / German Habilitation thesis Köln, Univ., Diss., 2011
    HBZ-ID HT017045960
    DOI 10.4126/38m-000000487
    Database Repository for Life Sciences

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  4. Book ; Online ; Thesis: On the use of Single-Trial Response Time in the GLM Analysis of fMRI Data

    Richter, Nils / Winterer, Georg / Fink, Gereon R.

    2011  

    Institution Cologne Center for Genomics
    Author's details vorgelegt von Nils Richter ; 1. Berichterstatter: Privatdozent Dr. med. G. Winterer, 2. Berichterstatter: Universitätsprofessor Dr. med. G. Fink ; aus dem Cologne Center for Genomics der Universität zu Köln
    Language English
    Size 82 S. : graph. Darst.
    Publishing country Germany
    Document type Book ; Online ; Thesis
    Thesis / German Habilitation thesis Köln, Univ., Diss., 2011
    HBZ-ID HT017060540
    Database Catalogue ZB MED Medicine, Health

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  5. Book: Menstruation als Tabu

    Winterer, Georg

    eine theoretisch-empirische Untersuchung über das Verhältnis des Mannes zur menstruierenden Frau

    (Forschung)

    1992  

    Author's details Georg Winterer
    Series title Forschung
    Keywords Menstruation ; Attitude ; Taboo ; Mann ; Einstellung
    Subject Attitüde ; Haltung ; Erwachsener Mann ; Männlicher Erwachsener ; Männer ; Regelblutung ; Monatsblutung ; Periode ; Regel ; Menses
    Language German
    Size 240 S. : graph. Darst.
    Publisher Asanger
    Publishing place Heidelberg
    Document type Book
    Note Literaturverz. S. 210 - 219
    HBZ-ID HT004189275
    ISBN 3-89334-523-X ; 978-3-89334-523-6
    Database Catalogue ZB MED Medicine, Health

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  6. Article ; Online: Metabolic syndrome and the risk of postoperative delirium and postoperative cognitive dysfunction: a multi-centre cohort study.

    Feinkohl, Insa / Janke, Jürgen / Slooter, Arjen J C / Winterer, Georg / Spies, Claudia / Pischon, Tobias

    British journal of anaesthesia

    2023  Volume 131, Issue 2, Page(s) 338–347

    Abstract: Background: Metabolic syndrome and its components are risk factors for cognitive impairment, but their contribution to perioperative neurocognitive disorders is unknown. We examined their associations with the risk of postoperative delirium (POD) and ... ...

    Abstract Background: Metabolic syndrome and its components are risk factors for cognitive impairment, but their contribution to perioperative neurocognitive disorders is unknown. We examined their associations with the risk of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in older patients.
    Methods: In 765 male and female participants aged ≥65 years, we measured preoperative metabolic parameters and screened for POD for 7 days or until discharge. POCD was defined through comparison of cognitive change on six neuropsychological tests with non-surgical controls. Multiple logistic regression analyses examined the association of metabolic parameters with risk of POD and POCD with adjustment for age, sex, and surgery type.
    Results: A total of 149 patients (19.5% of 765) developed POD and 53 (10.1% of 520 attendees) had POCD at 3 months. Patients with metabolic syndrome were at 1.85-fold higher risk of POD (95% confidence interval [CI] 1.26-2.70). Each 1 mM higher high-density lipoprotein cholesterol (HDL-C) was associated with a 0.47-fold lower POD risk (95% CI 0.30-0.74). Each 1 kg m
    Conclusions: Older surgical patients with metabolic syndrome were at increased risk of POD. Only reduced HDL-C was significantly associated with POD. For POCD, a higher preoperative BMI was identified as a risk factor. These findings add to mounting evidence of a distinct epidemiology of POD and POCD. Screening programmes taking advantage of HDL-C and BMI measurements and of metabolic interventions in reducing perioperative neurocognitive disorders should be evaluated.
    Clinical trial registration: NCT02265263.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Emergence Delirium ; Postoperative Cognitive Complications ; Delirium/epidemiology ; Delirium/etiology ; Delirium/diagnosis ; Metabolic Syndrome/complications ; Metabolic Syndrome/epidemiology ; Cohort Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology
    Language English
    Publishing date 2023-06-20
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.04.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Functional connectivity of the supplementary and presupplementary motor areas in postoperative transition between stages of frailty.

    Lammers-Lietz, Florian / Zacharias, Norman / Mörgeli, Rudolf / Spies, Claudia D / Winterer, Georg

    The journals of gerontology. Series A, Biological sciences and medical sciences

    2022  

    Abstract: Background: Frailty is a multi-etiological geriatric syndrome of run-down physical reserves with high vulnerability to stressors. Transitions between physical robustness and frailty often occur in the context of medical interventions. Studies suggest ... ...

    Abstract Background: Frailty is a multi-etiological geriatric syndrome of run-down physical reserves with high vulnerability to stressors. Transitions between physical robustness and frailty often occur in the context of medical interventions. Studies suggest that neurological disorders contribute to faster progression of frailty. In a previous cross-sectional study we found altered functional connectivity of supplementary motor area (SMA) in (pre-)frail compared to robust patients. We analyzed functional connectivity of the SMA and preSMA in patients with postoperative transitions between physical robustness and stages of frailty.
    Methods: We investigated 120 cognitively healthy patients (49.2% robust, 47.5% prefrail, 3.3% frail, 37.5% female, median age 71 [65-87] years) undergoing elective surgery from the BioCog project, a multicentric prospective cohort study on postoperative delirium and cognitive dysfunction.Assessments took place fourteen days before and three months after surgery, comprising assessments of a modified frailty phenotype according to Fried and resting-state fMRI at 3T. The associations between functional connectivity of the SMA and preSMA networks, preoperative frailty stages and postoperative transitions were examined using mixed linear effects models.
    Results: 19 patients showed physical improvement after surgery, 24 patients progressed to (pre-)frailty and in 77 patients no transition was observed. At follow-up, 57 (47.5%) patients were robust, 52 (43.3%) prefrail and 11 (9.2%) frail.Lower functional connectivity in the preSMA network was associated with more unfavorable postoperative transitions types. An exploratory analysis suggested that the association was restricted to patients who were prefrail at baseline. There was no association of transition type with SMA functional connectivity in the primary analysis. In an exploratory analysis, transition from prefrailty to robustness was associated with higher functional connectivity and progression in robust patients was associated with higher SMA network segregation.
    Conclusion: Our findings implicate that dysfunctions of cortical networks involved in higher cognitive control of motion are associated with postoperative transitions between frailty stages. The preSMA may be a target for neurofeedback or brain stimulation in approaches to prevent frailty.
    Language English
    Publishing date 2022-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1223643-3
    ISSN 1758-535X ; 1079-5006
    ISSN (online) 1758-535X
    ISSN 1079-5006
    DOI 10.1093/gerona/glac012
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  8. Article ; Online: Association of cholinesterase activities and POD in older adult abdominal surgical patients.

    Bosancic, Zdravka / Spies, Claudia D / Müller, Anika / Winterer, Georg / Piper, Sophie K / Heinrich, Maria

    BMC anesthesiology

    2022  Volume 22, Issue 1, Page(s) 293

    Abstract: Background: Postoperative delirium (POD) is a frequent complication after surgery. Older adult patients undergoing abdominal surgery are at higher risk for developing POD. Studies on the association of cholinesterase activities and POD are rare, but ... ...

    Abstract Background: Postoperative delirium (POD) is a frequent complication after surgery. Older adult patients undergoing abdominal surgery are at higher risk for developing POD. Studies on the association of cholinesterase activities and POD are rare, but leading hypotheses implicate that the cholinergic pathway might play an important role in neuroinflammation and development of POD. The objective of this study was to figure out if there is an association between the development of POD and acetyl- and butyrylcholinesterase (AChE and BuChE) activities in older adult patients undergoing abdominal surgery.
    Methods: The investigation was performed with a subpopulation of BioCog study patients. The BioCog project ( http://www.biocog.eu ) is a prospective multicenter observational study in older adult surgical patients. Patients ≥ 65 years undergoing elective surgery of at least 60 minutes who scored more than 23 points in the Mini-Mental-State-Examination were included. POD was assessed twice a day on seven consecutive days after the surgery, using the test instruments Nursing Delirium Screening Scale (Nu-Desc) and Confusion Assessment Method (CAM and CAM-ICU) and a patient chart review. Pre- and postoperative blood cholinesterase activities were measured with a photometric rapid-point-of-care-testing. The association between cholinesterase activities and POD was analyzed in a subpopulation of abdominal surgical patients using multivariable logistic regression analysis adjusting for confounders.
    Results: One hundred twenty-seven patients were included for analysis (mean age 73 years, 59% female). Fifty-two patients (41%) fulfilled the criteria of POD. These patients were significantly older, had a longer time of surgery and anesthesia and achieved higher comorbidity scores compared to patients without POD. After adjusting for age, duration of surgery and charlson comorbity index, we found an association between pre- and postoperative AChE activity (U/gHb) and the development of POD (Odds ratio (OR), [95% confidence interval (CI)], preoperative 0.95 [0.89-1.00], postoperative 0.94 [0.89-1.00]).
    Conclusions: We found an association between POD and AChE activity and provided new information considering patients with abdominal surgery. Future analyses should examine course dynamics of postoperative cholinesterase activities in order to clarify interactions between the cholinergic system and pathophysiological mechanisms leading to POD.
    Trial registration: ClinicalTrials.gov: NCT02265263.
    MeSH term(s) Aged ; Butyrylcholinesterase ; Cholinergic Agents ; Delirium/etiology ; Female ; Humans ; Male ; Postoperative Complications/diagnosis ; Prospective Studies ; Sodium Oxybate
    Chemical Substances Cholinergic Agents ; Sodium Oxybate (7G33012534) ; Butyrylcholinesterase (EC 3.1.1.8)
    Language English
    Publishing date 2022-09-16
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2091252-3
    ISSN 1471-2253 ; 1471-2253
    ISSN (online) 1471-2253
    ISSN 1471-2253
    DOI 10.1186/s12871-022-01826-y
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  9. Article ; Online: Why do patients with schizophrenia smoke?

    Winterer, Georg

    Current opinion in psychiatry

    2010  Volume 23, Issue 2, Page(s) 112–119

    Abstract: Purpose of review: Among the mentally ill, smoking prevalence is highest in patients with schizophrenia ( approximately 70-80%). This can impose a significant financial burden on patients, not to speak of increased smoking-related morbidity and ... ...

    Abstract Purpose of review: Among the mentally ill, smoking prevalence is highest in patients with schizophrenia ( approximately 70-80%). This can impose a significant financial burden on patients, not to speak of increased smoking-related morbidity and mortality. Therefore, it is critical for clinicians to understand why patients with schizophrenia smoke in order to adapt treatment schemes. Understanding the reasons may also help to develop new drugs that target the nicotinic system in the brain as well as smoking cessation programs that are specifically designed for this particular patient population.
    Recent findings: So far, several reasons have been identified which are believed to explain tobacco consumption in patients with schizophrenia. Originally, it was widely believed that patients with schizophrenia smoke to increase hepatic clearance and to restore the dopamine blockade of certain antipsychotic drugs to diminish their side effects. However, more recently it became obvious that cigarette smoking may also be reinforcing for patients because it improves psychiatric symptoms, most notably negative and cognitive symptoms. The underlying molecular mechanisms of these nicotine effects are currently under intensive investigation.
    Summary: Heavy smoking in schizophrenia cannot simply be viewed as a 'bad habit'. Rather, self-medication of clinical symptoms and side effects of antipsychotic drugs appear to play a major role.
    MeSH term(s) Adaptation, Psychological ; Cognition Disorders/epidemiology ; Cognition Disorders/prevention & control ; Ganglionic Stimulants/pharmacology ; Humans ; Neurocalcin/drug effects ; Neurocalcin/genetics ; Nicotine/pharmacology ; Prevalence ; Psychological Theory ; Receptors, Cholinergic/drug effects ; Reinforcement (Psychology) ; Schizophrenia/epidemiology ; Schizophrenia/genetics ; Self Medication ; Signal Transduction/drug effects ; Smoking/epidemiology
    Chemical Substances Ganglionic Stimulants ; Neurocalcin ; Receptors, Cholinergic ; VSNL1 protein, human ; Nicotine (6M3C89ZY6R)
    Language English
    Publishing date 2010-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645162-7
    ISSN 1473-6578 ; 0951-7367
    ISSN (online) 1473-6578
    ISSN 0951-7367
    DOI 10.1097/YCO.0b013e3283366643
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Risk gene variants for nicotine dependence: a success story in neuropsychiatric genetics with possible applications to drug development.

    Winterer, Georg

    Pharmacogenomics

    2010  Volume 11, Issue 10, Page(s) 1353–1357

    Language English
    Publishing date 2010-10
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 2019513-8
    ISSN 1744-8042 ; 1462-2416
    ISSN (online) 1744-8042
    ISSN 1462-2416
    DOI 10.2217/pgs.10.144
    Database MEDical Literature Analysis and Retrieval System OnLINE

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