Andreas Schötzau

Thermal discomfort with cold extremities in relation to age, gender, and body mass index in a random sample of a Swiss urban population

BackgroundThe aim of this epidemiological study was to investigate the relationship of thermal discomfort with cold extremities (TDCE) to age, gender, and body mass index (BMI) in a Swiss urban population.MethodsIn a random population sample of Basel city, 2,800 subjects aged 20-40 years were asked to complete a questionnaire evaluating the extent of cold extremities. Values of cold extremities were based on questionnaire-derived scores. The correlation of age, gender, and BMI to TDCE was analyzed using multiple regression analysis.ResultsA total of 1,001 women (72.3% response rate) and 809 men (60% response rate) returned a completed questionnaire. Statistical analyses revealed the following findings: Younger subjects suffered more intensely from cold extremities than the elderly, and women suffered more than men (particularly younger women). Slimmer subjects suffered significantly more often from cold extremities than subjects with higher BMIs.ConclusionsThermal discomfort with cold extremities (a relevant symptom of primary vascular dysregulation) occurs at highest intensity in younger, slimmer women and at lowest intensity in elderly, stouter men.

Anatomical and functional outcome in brilliant blue G assisted chromovitrectomy

Purpose:  To evaluate the potential of brilliant blue G (BBG) for intraoperative staining of the inner limiting membrane (ILM) with respect to staining properties and surgical outcome.

Relationship between optic nerve head and finger blood flow.

Purpose To examine the relationship between optic nerve head (ONH) and finger blood flow in subjects with and without a primary vascular dysregulation (PVD). Methods ONH blood flow and finger blood flow was measured in 15 subjects with PVD and in 24 subjects without PVD. PVD was defined as being present if it was detected in patient history as well as by nailfold capillaromicroscopy PVD was defined as being absent if the patient history for PVD was negative and the results of nailfold capillaromicroscopy were negative. Scanning laser Doppler flowmetry (LDF) was used to measure ONH and finger blood flow. Finger temperature was measured in all subjects using a contact sensor. Results ONH blood flow is significantly related to finger blood flow in subjects with PVD (p<0.01), but not in subjects without a PVD. Subjects with PVD had a significantly lower finger skin temperature in comparison to those without PVD (p<0.01) Conclusions The present study indicates a relationship between ONH and finger blood flow in subjects with PVD. This might be an indirect sign of a disturbed autoregulation of ocular blood flow in PVD subjects.

Impact of body mass index on compliance and persistence to adjuvant breast cancer therapy

Several authors found that the prognosis of overweight and obese breast cancer (BC) patients was lower than that of normal weight patients. We present the first study which evaluates the impact of body mass index (BMI) on compliance (i.e. to start a recommended therapy) and persistence to adjuvant BC therapy. An unselected cohort of 766 patients (≤75 years) diagnosed from 1997 to 2009 was analyzed in relevance to the four adjuvant therapy modalities: (A) radiation, (B) chemotherapy, (C) therapy with trastuzumab, and (D) endocrine therapy. With respect to compliance, multivariate analyses calculated Odds ratios (ORs) >1 for increased BMI in all four therapy modalities, i.e. increased BMI had a positive influence on compliance. The results were significant for radiotherapy (OR,2.37;95%CI,1.45-3.88;p < 0.001) and endocrine therapy (OR,1.92;95%CI,1.21-3.04;p = 0.002) and showed a trend in chemotherapy (OR,1.42;95%CI,0.97-2.08;p = 0.063). Analyzing persistence, increasing BMI had ORs <1 for chemotherapy and therapy with trastuzumab, both not reaching statistical significance. For endocrine therapy, increasing BMI was a significant predictor for persistence (OR,1.35;95%CI,1.08-1.80;p = 0.042). Failure of compliance and persistence to adjuvant therapy does not pose a contributing factor for the observed unfavorable prognosis in overweight/obese BC patients. In most therapy modes, patients with increasing BMI demonstrated a higher motivation and perseverance to the recommended treatment.

Breast cancer with non-inflammatory skin involvement : current data on an underreported entity and its problematic classification

We evaluated 166 breast cancer cases with non-inflammatory skin involvement (NISI), which were classified in the TNM classification as T4b. The distribution of tumour sizes and stages was: < or =3 cm:24.1%, 3.1-5 cm:21.7%, 5.1-10 cm:33.1%, >10 cm:21.1%; stages:I/II:21.0%, III:43.4%, IV:35.6%. To assess the impact of NISI on axillary lymph node involvement (ALNI), we analyzed a sub-group of 50 patients with tumours < or =5 cm and compared them with a matched control group. NISI was found to be associated with increased ALNI (HR, 2.66; 95%CI, 1.59-4.63; p<0.0001). According to the inherent rules of tumour classification, only tumours with similar morphologic extent and prognostic significance should be combined. Since there is a high grade of heterogeneity, this basic tenet is clearly violated regarding breast cancer with NISI. Our proposal is to eliminate these tumours from the T4 category and to classify them simply by size (T1-3). Due to its prognostic significance, NISI should be indicated by an optional descriptor (e.g. S1).

Metabolic and functional changes in retinitis pigmentosa: comparing retinal vessel oximetry to full-field electroretinography, electrooculogram and multifocal electroretinography

To determine a relationship between the retinal vessel saturation alterations and the residual retinal function measured by means of full‐field electroretinography (full‐field ERG), electrooculogram (EOG) and multifocal electroretinography (mfERG) in patients with retinitis pigmentosa (RP).

Peripapillary retinal vessel diameter correlates with mfERG alterations in retinitis pigmentosa.

To investigate relationship between the peripapillary retinal vessel diameter and the residual retinal function, measured by mfERG, in patients with retinitis pigmentosa (RP).

Reduced metabolic function and structural alterations in inherited retinal dystrophies: investigating the effect of peripapillary vessel oxygen saturation and vascular diameter on the retinal nerve fibre layer thickness

To evaluate the relationship between the peripapillary metabolic alterations [retinal vessel Oximetry (RO)] and the structural findings [retinal vessel diameter and retinal nerve fibre layer thickness (RNFL)] in patients with inherited retinal dystrophies (IRD).

Optimizing distribution and number of test locations in perimetry

Abstract • Background: Short programs with few test locations have been proposed for glaucoma screening. Program G1x of the Octopus 1-2-3 automated perimeter is divided into four stages and permits the examination to be stopped after 16, 32, 45, or all 59 test locations. We investigated whether such short programs provide information comparable with that supplied by standard programs in glaucoma. • Materials and methods: In 99 visual fields of 81 glaucomatous and 18 glaucoma-suspect right eyes, mean defect (MD) and loss variance (LV) of the entire visual field were compared with MD and LV of the 4 stages of Program G1x. • Results: MD of the entire visual field averaged 0.40 dB, with averages of –0.17 dB, 0.34 dB, 0.47 dB, and 1.04 dB for stages 1, 2, 3, and 4, respectively. LV of the entire visual field averaged 13.0 dB2 and was similar for all four stages. • Conclusions: The results show that the 16 test locations of stage 1 of Program G1x underestimate the visual-field damage present in the entire field. We recommend examination of at least 32 test locations, i.e., two stages of Program G1x. However, a prospective study is required to evaluate the sensitivity and specificity of short programs for glaucoma screening. The selection of test locations for the stages might be improved.

Predictive factors for preterm delivery under rural conditions in post-tsunami Banda Aceh.

Abstract Objective: To assess the risk for preterm deliveries <37 week of gestation and associated prevalence of vaginal infection in a rural setting after the tsunami in Banda Aceh, Indonesia. Methods: Wet mount microscopy, vaginal pH and vaginal swabs for microbiological culture were collected in pregnant women during the 2nd trimester from February to June of 2005 in four temporary outpatient clinics and the patients were followed up until delivery. Results: One hundred and fifty-nine pregnant patients were screened. Sixty-two could be followed up until delivery. Thirty-nine (62.9%) delivered at term and 23 (37.1%) delivered prematurely. Significant risk factors for preterm delivery were a history of preterm delivery and group B streptococcus infection. Increased vaginal pH alone had no significant influence on preterm delivery, although there was a trend. Conclusion: The rate of preterm delivery was high in this cohort. We suggest risk stratification for preterm delivery in rural conditions by performing a vaginal pH and wet mount microscopy. If either is suspect we suggest collecting a vaginal swab for microbiological culture for targeted treatment. Patients with a history of preterm delivery are at increased risk and should be monitored closely.