Universitäts Kinder Frauenzentrum

OBJECTIVES: To describe the sequential changes in the circulating concentrations of insulin-like growth factor-I, insulin-like growth factor-II, and insulin-like growth factor binding proteins in critically ill patients. To determine whether critical illness is associated with induction of a specific protease directed against insulin-like growth factor binding protein 3 and to relate these changes to outcome. DESIGN: Prospective, descriptive study. SETTING: Intensive care unit (ICU) of a university hospital. PATIENTS: Eighteen heterogeneous critically ill patients, requiring ventilatory support. INTERVENTIONS: Serial daily blood samples were collected until death or discharge from the ICU. In five patients, samples were also obtained on the ward before discharge from the hospital. MEASUREMENTS AND MAIN RESULTS: Serum concentrations of insulin-like growth factor-I, insulin-like growth factor-II, and insulin-like growth factor binding proteins 1, 2, and 3 were measured by radioimmunoassay. After 5 days, insulin-like growth factor binding protein 3 concentrations were measured on alternate days. Alterations in binding of insulin-like growth factor-I to insulin-like growth factor binding protein 3 and the presence of protease activity directed against insulin-like growth factor binding protein 3 were investigated by Western ligand blotting. Circulating concentrations of insulin-like growth factor-I and insulin-like growth factor-II were low and remained low throughout the 7-day study period. Insulin-like growth factor binding protein 1 concentrations were initially increased to within the fasting range, but subsequently decreased. There was considerable variability in insulin-like growth factor binding protein 2 concentrations, but generally, concentrations were at the upper end of the normal range throughout. Insulin-like growth factor binding protein 3 concentrations were consistently low and Western ligand blotting at the nadir of the insulin-like growth factor-I concentration demonstrated the presence of a protease directed against insulin-like growth factor binding protein 3. The last recorded concentrations of insulin-like growth factor-I and insulin-like growth factor binding protein 3 were higher in survivors than in nonsurvivors (p < .05). Two patients were also studied for a prolonged period. In one patient, a survivor, insulin-like growth factor-I and insulin-like growth factor binding protein 3 were low initially, but later increased in association with recovery and cessation of protease activity over a period of 33 days. In another patient, a nonsurvivor, insulin-like growth factor-I and insulin-like growth factor binding protein 3 remained low and protease activity persisted until the patient died 38 days after admission to the ICU. CONCLUSIONS: Critical illness is associated with low circulating concentrations of insulin-like growth factor-I, insulin-like growth factor-II, and insulin-like growth factor binding protein 3 and these low values are associated with induction of protease activity specifically directed against insulin-like growth factor binding protein 3. In survivors, recovery is associated with increasing insulin-like growth factor-I and insulin-like growth factor binding protein 3 concentrations and cessation of protease activity. The therapeutic effects of exogenous growth factors are likely to be influenced by these changes.

In this paper the existing continuous descent operations (CDO) procedures at three relevant German airports are analyzed with respect to both the achievable (maximum specific range) and the effectively achieved fuel savings, when compared to conventionally flown arrivals. To do so, we applied our highly precise flight performance model Enhanced Jet Performance Model (EJPM) to several thousand flown trajectories before and after CDO implementation, the data of which were provided to us as radar track data. A technique was developed to estimate the individual aircraft gross mass for calculating the optimum rate of descent starting from the computed flight-specific top of descent (ToD). Furthermore, we considered 3D weather and wind data to determine the CDO trajectory. When locating the trajectories within typical ICAO CDO procedure corridors, we found that the current generic design criteria do not allow using the full fuel-saving potential of CDO. Often because of poor CDO execution from the ground and flight deck, only selected aircraft types managed to maintain the defined boundaries. To gain insight on how much detailed procedure guidance is required, a comprehensive weather and aircraft mass sensitivity analysis is also presented. We found analytic models to improve CDO procedures based on local traffic and meteorological conditions, which should supplement current guidance material.

Mastocytoses are characterized by clonal proliferation of mast cells in various tissues. In childhood, cutaneous mastocytosis (CM) occurs almost exclusively. It is confined to the skin, and has a good prognosis. The most common form is the maculopapular cutaneous mastocytosis (MPCM), formerly called urticaria pigmentosa. A distinction is made between a monomorphic variant of MPCM with multiple small, roundish maculopapular skin lesions and the - more common - polymorphic variant with larger lesions of variable size. One quarter of CM diagnosed in childhood are mastocytomas, which often occur solitary or at multiple sites. The diffuse variant of CM (DCM), which affects 5% of children with CM, should be distinguished from these forms. Systemic mastocytoses (SM) with mast cell infiltrates in the bone marrow or other extracutaneous tissues, such as the gastrointestinal tract, occur predominantly in adults. The diagnosis of CM is usually made clinically: Manifestation in infancy, typical morphology and distribution, pathognomonic Darier sign. Basal serum tryptase is determined if DCM or systemic mastocytosis are to be diagnosed. Children with mastocytosis should be managed in a specialized outpatient clinic. For affected families, detailed information about the clinical picture including prognosis assessment is essential. Mast cell mediated symptoms are controlled by oral non-sedating antihistamines if needed.

No abstract available.

In diesem Beitrag widme ich mich der Frage nach den konkreten Belastungen für Wissenschaftler:innen im Forschungsfeld zu sexualisierter Gewalt. Im deutschsprachigen Raum wird sich im Unterschied zur internationalen Forschungslandschaft wenig mit der Rolle von Traumatisierungen in der qualitativen Forschung auseinandergesetzt, obwohl dies mit Blick auf die Prävalenzen in diesem Feld nahezu unumgänglich ist. Ausgehend von dieser Annahme stelle ich die Ansätze der Psychotraumatologie und deren Konzepte der sekundären Traumatisierung, der compassion fatigue theory und des vicarious trauma vor. Diese verknüpfe ich im Anschluss an Georg SIMMEL, Max WEBER, Georges DEVEREUX und der feministischen Tradition mit den Überlegungen zu den erkenntnistheoretischen Möglichkeiten der eigenen Vulnerabilität. Ich plädiere für eine traumasensitive qualitative Forschung insbesondere im Feld sensitiver Themen, um die Belastungen und vor allem erkenntnistheoretischen Chancen der Forschenden in den Blick zu nehmen.

In diesem Beitrag beschftigen wir uns mit der Frage, inwiefern die Wohnsituation einen Effekt auf die Integration und das Wohlbefinden von Geflchteten hat. Quantitative und qualitative Forschungen zu Geflchteten beziehen sich vorwiegend auf in Sammelunterknften lebende Personen. Welche Vernderungen mit dem Erhalt einer eigenen Wohnung einhergehen und welchen Effekt die

INTRODUCTION: Torsion of the spermatic cord is a urological emergency. The torsion of a fixed testis is rare. In the differential diagnosis of acute scrotum it remains a true challenge. CASE REPORT: A 13-year-old boy presented in the emergency service with acute left testicular pain and vomiting. In the patient's history a right orchiectomy due to testicular torsion and a left prophylactic orchidopexy were remarkable. Due to the clinical suspicion of re-torsion an immediate surgical exposure of the testis was performed. Intraoperatively a torsion of the left spermatic cord was found. After detorquation, there was no significant sign of recovery observed. In order to preserve the endocrine function, the single testis was maintained. During follow-up, necrosis of the left testis was noticed, and a secondary left orchiectomy was necessary three weeks after first operation. After loss of both testes the patient was referred to a paediatric endocrinological consultant and testosterone substitution was started. CONCLUSION: Even though very rare, orchidopexy does not exclude re-torsion of a fixed testis, regardless of the employed operative technique and sutures used. It should be considered in the differential diagnosis of acute scrotum. Operative detorquation should not be delayed and, in order to avoid loss of the affected testis, diagnostic procedures should kept short. After orchidopexy the patient and his relatives must be informed about the possibility of a re-torsion.

The study presents a controversy among Czech Catholics, culminating in 1947. It explains the interpersonal and intellectual dynamics of post­-war Catholicism and demonstrates how the so­-called campaign against Catholic writers unfolded the debate on the basic tone of modern Catholicism, i.e. its relationship to the contemporary world, about how believers are to communicate with contemporary society, and about the need to revise this approach. The controversy was led by a reflection on turnovers: integral Catholicism, integral Catholic, religious rightist and leftist. Its main protagonists were Adolf Kajpr SJ, Timotheus Vodička, and Jindřich Středa (Karel František Schwarzenberg).

Longitudinal research on the adverse consequences of childhood maltreatment has recently gained significant traction. However, systematic attrition, partly due to specific subsample recruitment needs, threatens the validity of this research. Furthermore, studies specifically analyzing these factors in the field of maltreatment research remain scarce. We utilized data from a longitudinal study comprising N = 863 participants ( M Age = 10.23 years, 47.5% female) and their caregivers at T1, and 616 participants ( M Age = 17.95 years, 50.0% female) at T2. We determined the attrition rate and analyzed psychosocial and socioeconomic predictors of attrition. Additionally, we examined differences in re-assessment efforts between maltreated and non-maltreated youth for T2. Findings indicate a comparatively low attrition rate of 28.6% over nearly 8 years. Participants’ maltreatment experiences, externalizing symptoms, and lower household income predicted higher attrition risk, while interim subsample study participation reduced this risk. Maltreatment experiences, lower household income, and higher age were also associated with increased re-assessment effort. Our study provides insights into predictors of systematic attrition in a longitudinal study with maltreated and non-maltreated youth. It highlights the need for tailored retention strategies, frequent contact with families, and targeted resource allocation to mitigate systematic attrition.

Study question: Does intracervical and intravaginal application of seminal plasma affect endometrial and subendometrial vascularisation, endometrial volume or life birth rate? Methods: A 1-year prospective study, double blind, placebo controlled, randomized trial, assessed eligibility: 102 patients. Eligible patients: 81, randomized: 66 patients. Sodium chloride (placebo) or seminal plasma was applied just after follicle aspiration. 3-D-power-Doppler Ultrasound examination was performed 30 minutes prior to oocyte collection and embryo transfer. Patients undergoing first or second IVF/ICSI cycle were randomized. 66 patients received embryo transfer and were divided in group I (n = 32, seminal plasma) and II (n = 34, placebo). Virtual organ computer-aided analyses (VOCAL) and shell-imaging were used. Mean value of two serial measurements was recorded. Clinical course of pregnancy was observed. Results: There was no significant difference between group I and II concerning age (31.94 vs. 31.03), endometrial volume on day of follicle aspiration (4.02 ml vs. 3.96 ml) and on day of embryo transfer (4.04 ml vs. 3.95 ml). Also power-Doppler results of subendometrium on the day of oocyte collection seemed not different: vascularization index (VI) (5.64 vs. 4.23), flow index (FI) (29.96 vs. 29.80), vascularization flow index (VFI) (1.73 vs. 1.35), as well as endometrial indices: VI (1.75 vs. 1.53), FI (26.90 vs. 26.83), VFI (0.48 vs. 0.42). On the day of embryo transfer perfusion of subendometrium showed similar results: VI (1.98 vs. 1.83), FI (31.28 vs. 29.57), VFI (0.81vs. 0.68); as well as endometrial perfusion: VI (0.99 vs. 0.73), FI (28.39 vs. 27.28), VFI (0.27 vs. 0.19). Life birth rate was 31.25% (10/32) in group I and 29.41% (10/34) in group II, birth weight was 3054.3 g vs. 3044 g – again no statistical significance was reached. Limitations: preliminary data. Conclusio: Intracervical and intravaginal application of seminal plasma on the day of follicle aspiration shows no significant benefit in good prognosis patients undergoing their first or second IVF/ICSI cycle.

BACKGROUND: Early warning scores (EWS) are considered an effective tool for the early detection of clinical deterioration in hospital settings. However, their implementation poses complex demands on institutional structures, processes, and culture. METHODS: As part of a modified Delphi study, experts from the Initiative Qualitätsmedizin network with practical experience in EWS implementation were invited to identify necessary structures, processes, and common pitfalls across the project phases of preparation, implementation, evaluation, and anchoring. In three rounds, recommendations were collected, thematically clustered, and rated (0-10, 10 = maximally relevant). Finally, the recommendations were consolidated in a consensus meeting. RESULTS: Eight participants completed all rounds. From 505 responses, 51 consolidated recommendations were identified, all considered as highly relevant (≥ 7 points) in the various rounds. Top priorities were the training of all professional groups (mean 9.3) and transparent communication of results and actions (mean 9.0). Common barriers included lack of information technology (IT) integration, unclear responsibilities, and insufficient feedback. Key success factors were interdisciplinary project teams, early evaluation, and embedding into clinical routines. CONCLUSION: The consensus-based recommendations can support decision-makers in the systematic implementation of EWS. Structured project planning, interprofessional training, and continuous feedback are key success factors. For sustainable integration, EWS should be embedded into quality systems, continuing education, and clinical routines.

AÂ group of Quodvultdeus&#8217;s sermons&#8212;specifically De cantico novo, De accedentibus ad gratiam I&#8211;II, De symbolo I&#8211;III, De ultima quarta feria, and De cataclysmo&#8212;is addressed to candidates for baptism (competentes). In the years after the Vandal invasion of Africa and preceding their conquest of Carthage, the Bishop of Carthage prepared new members of the Church for the upcoming persecution, when their Catholic faith would be challenged. In his catecheses, he aims at building up their identity and sense of belonging to the Church. The study focuses on four topics of his formation related to the shared identity of the candidates for baptism: the desire for a new life, the Church, heresies, and the liturgical rite, exemplified by the renunciation of the devil, the scrutinies, and the handing over of the baptismal Creed.

Prior to 1933&#8211;38, more women earned doctorates in German studies at the University of Vienna than at any other German-speaking university. Starting from this observation, the author examines the institutional and academic history of the German studies program from 1848 to 1938 and links it to professional portraits of three University lecturers, Christine Touaillon (1878&#8211;1928), Marianne Thalmann (1888&#8211;1975), and Lily Weiser (1898&#8211;1987). The open access publication has been supported by the Austrian Science Fund (FWF).

Zusammenfassung Für die Insomnie im Kindes- und Jugendalter ist wie für die Erwachsenen auch die kognitive Verhaltenstherapie für Insomnie (CBT‑I; deutsch KVT-I) die erste Wahl, jedoch ist sie für die Familien, Kinder und Jugendliche oft nicht ohne Weiteres verfügbar. Das hier präsentierte Stepped-Care-Modell für das Kindes- und Jugendalter (SCM-KJ; englisch SCM-CA) stellt ein Stufenmodell zur vernetzten und evidenzbasierten Versorgung von Kindern und Jugendlichen mit Insomnie dar. Das SCM-KJ berücksichtigt die unterschiedlichen Altersgruppen und stellt eine Präventions- und Interventionspyramide dar, die auf dem Konzept des gesunden Schlafs und der CBT‑I für Kinder und Jugendliche basiert und allmählich an klinischer Intensität und Komplexität zunimmt. Hierdurch sollen diagnostische und therapeutische Behandlungslücken verringert werden, sodass nicht nur mehr Familien erreicht werden können, sondern auch die klinischen Ressourcen effektiver verteilt werden können. Damit das SCM-KJ angemessen umgesetzt wird, sollten altersspezifische Diagnostikinstrumente und Wissen verbreitet werden. Es sollten nur evidenzbasierte CBT-I-Behandlungen für das Kindes- und Jugendalter im Rahmen des Modells gefördert werden. Die im Rahmen des SCM-KJ beteiligten Kliniker*innen sollten qualifiziert sein, um CBT im Kindes- und Jungendalter (CBT-KJ) durchführen zu können, und über eine entsprechende Fortbildung verfügen. Fachkräfte, die im Rahmen von Präventionsprogrammen oder frühen Interventionen beteiligt sind, die nicht im engeren Sinne zum Behandlungsspektrum des SCM-KJ gehören, aber damit in Verbindung stehen, sollten ebenfalls über gute Diagnostikkenntnisse und differenzialdiagnostisches Wissen verfügen, um eine korrekte Zuweisung oder Weiterleitung zu den entsprechenden Interventionsmöglichkeiten zu gewährleisten.

OBJECTIVE: To examine whether the rate of HLA similarity among 609 primarily infertile couples is higher than would be expected by chance. DESIGN: Clinical Trial. SUBJECTS: 609 primary infertile couples (mean age women: 34.35 years, men: 37.59 years) were recruited before undergoing IVF or ICSI therapy. Couples with former pregnancies, tubal factor, azoospermia or donor therapies were excluded. INTERVENTION: For each of the partners, exons encoding the corresponding antigen recognition sites of HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 were sequenced by using next-generation sequencing. HLA similarity between partners was determined based on the probability of homozygous offspring and the observed probability of heterozygous offspring in the sample of primary infertile couples was comparted to the probability for random pairing using bootstrapping. MAIN OUTCOME MEASURES: HLA similarity of infertile couples compared to randomly assigned couples. RESULTS: In each of the loci, infertile pairs shared more alleles than expected by chance. This result was significant for all HLA class 2 loci (-DRB1, -DQB1, -DPB1), as well as for the HLA class I locus -C, while HLA-A and -B showed a nonsignificant trend towards higher similarity. CONCLUSION: These data suggest that HLA similarity between couples relates to primary infertility.

The contribution explores the faith of the early church in the resurrection and its influence on the Pauline view of man. Examining Paul's understanding of the resurrection concept, it considers the inaugurated eschatology schema and apocalyptic structure of his thought. Paul based all the hope for human life on the story of the risen Jesus. He understands it not only as a way of overcoming death, but it also represents for him a source of hope for a new life. In such a life, man&#8217;s relationship with God is brought to its fulfillment, enabling full self­&#8209;realization of the human personality. Christ, the new Adam, represents both an ideal and a giver of this new mode of human existence: as Christ has always been, man is thus set free of slavery to sin in him and becomes led by the Spirit of God. Although man is already given the Spirit in his earthly life, Paul does not expect his complete spiritualization before the parousia. Man&#8217;s change will happen abruptly and will include his physical transformation. In Pauline thought, Christ&#8217;s resurrection represents a promise of eschatological fulfillment of God&#8217;s creation act.

Neue Schumanniana

This paper is an attempt to re­-read the 1971 pastoral instruction on the media, Communio et progressio, in the context of the digital structural transformation of the public and the encyclical Fratelli tutti (2020). The Pastoral Instruction is considered a key text on the Church&#8217;s relationship with the media. The thesis recalls the document&#8217;s continuity with the social teaching of the Church. It attempts to capture the transformation that the Church&#8217;s relationship with the media has undergone from Communio et progressio to the present day, with particular reference to the encyclical Fratelli tutti, in which Pope Francis emphasises a culture of dialogue.

INTRODUCTION: Safe initial surgery is crucial in treating ectopic ureteroceles that cause subvesical obstruction. This study evaluates the feasibility and effectiveness of pneumovesicoscopic incision of ectopic ureteroceles. METHODS: We conducted a cohort study analyzing outcomes in patients with ectopic ureteroceles and bladder neck obstruction who underwent pneumovesicoscopic surgery between 2013 and 2022. During vesicoscopy, the obstructing portion of the ureterocele adjacent to the bladder neck was resected. Postoperatively, patients were assessed for vesicoureteral reflux and voiding dysfunction. RESULTS: Fourteen patients aged 0-10 years underwent the procedure safely. Ten girls presented with duplex kidneys, and four boys had single moieties. The mean operative time was 57 min. Postoperative resolution of subvesical obstruction was achieved in all cases (100 %). The median follow-up was 5.9 years. Preoperative voiding dysfunction, observed in nine patients, improved in all and completely resolved in four. CONCLUSION: The pneumovesicoscopic approach appears to be a safe and effective surgical option for pediatric patients with obstructive ureteroceles.

This study examines nonverbal IQ scores in young refugee children by relating test performance to formal education, trauma-related experiences, and parental factors. Sixty-one refugee children and 101 children from a German clinical comparison group, aged 3–6 years, completed a nonverbal IQ test (Kaufman Assessment Battery for Children; KABC-II). Refugee children showed lower IQ scores (MIQ = 81.10, CI 76.96–85.23) than the comparison group (MIQ = 90.03, CI 86.61–93.45; U = 2100.50, Z = −3.39, p < 0.001, r = 0.27). Parental (rs = 0.33, p < 0.001) and children’s formal education (rs = 0.26, p = 0.005) were positively correlated to IQ only in the comparison group. In both groups, parental health and children’s traumatic experiences showed no significant correlation with IQ. Multiple-choice-free, adapted IQ calculations yielded age-appropriate test scores for the refugee group (M = 89.66, CI 86.59–92.73), possibly compensating for cross-cultural test differences due to former educational experiences.