Increased fibrinogen levels at diagnosis are associated with adverse outcome in patients with acute myeloid leukemia

Increased plasma fibrinogen levels are associated with shortened overall survival (OS) in some solid tumor types. In contrast, the prognostic significance of varying fibrinogen levels in acute myeloid leukemia (AML) at diagnosis is unknown. In this study, we assessed the prognostic significance of fibrinogen levels in AML patients. In a comprehensive retrospective single-center study, we determined the survival rates of 375 consecutive AML patients undergoing at least one cycle of intensive chemotherapy induction treatment. Patients were dichotomized between low (<4.1 g/L) and high fibrinogen levels (≥4.1 g/L) at diagnosis of AML before initiation of treatment. Subsequently, quartile ranges were applied to analyze the association of varying fibrinogen levels on survival. We observed that the rates of complete remission, early death, and admission to intensive care unit were equal in the low versus high fibrinogen group. However, OS was significantly better in the low fibrinogen group (27.3 vs 13.5 months; p = 0.0009) as well as progression-free survival (12.3 vs 7.8 months; p = 0.0076). This survival difference remained significant in the multivariate analysis (p = 0.003). Assessing quartiles of fibrinogen values, we further confirmed this observation. Our data suggest that high fibrinogen levels at diagnosis of AML are associated with unfavorable OS and progression-free survival but not with increased mortality during induction treatment.

Konzept der Webpräsenz „Frauen in der Wissenschaft“ und prototypische Umsetzung

[s.c.]

Immunomodulating effects of environmentally realistic copper concentrations in Mytilus edulis adapted to naturally low salinities, link to supplementary material

The monitoring of organisms' health conditions by the assessment of their immunocompetence may serve as an important criterion for the achievement of the Good Environmental Status (GES) as defined in the Marine Strategy Framework Directive (EU). In this context, the complex role of natural environmental stressors, e.g. salinity, and interfering or superimposing effects of anthropogenic chemicals, should be carefully considered, especially in scenarios of low to moderate contamination. Organisms from the Baltic Sea have adapted to the ambient salinity regime, however energetically costly osmoregulating processes may have an impact on the capability to respond to additional stress such as contamination. The assessment of multiple stressors, encompassing natural and anthropogenic factors, influencing an organisms' health was the main aim of the present study. Immune responses of Mytilus edulis, collected and kept at natural salinities of 12 per mil (LS) and 20 per mil (MS), respectively, were compared after short-term exposure (1, 7 and 13 days) to low copper concentrations (5, 9 and 16 µg/L Cu). A significant interaction of salinity and copper exposure was observed in copper accumulation. LS mussels accumulated markedly more copper than MS mussels. No combined effects were detected in cellular responses. Bacterial clearance was mostly achieved by phagocytosis, as revealed by a strong positive correlation between bacterial counts and phagocytic activity, which was particularly pronounced in LS mussels. MS mussels, on the other hand, seemingly accomplished bacterial clearance by employing additional humoral factors (16 µg/L Cu). The greatest separating factor in the PCA biplot between LS and MS mussels was the proportion of granulocytes and hyalinocytes while functional parameters (phagocytic activity and bacterial clearance) were hardly affected by salinity, but rather by copper exposure. In conclusion, immune responses of the blue mussel may be suitable and sensitive biomarkers for the assessment of ecosystem health in brackish waters (10-20 per mil S).

Scabies mite inactivated serine protease paralogues are present both internally in the mite gut and externally in feces

The scabies mite, Sarcoptes scabiei, is the causative agent of scabies, a disease that is common among disadvantaged populations and facilitates streptococcal infections with serious sequelae. Previously, we encountered large families of genes encoding paralogues of house dust mite protease allergens with their catalytic sites inactivated by mutation (scabies mite inactivated protease paralogues [SMIPPs]). We postulated that SMIPPs have evolved as an adaptation to the parasitic lifestyle of the scabies mite, functioning as competitive inhibitors of proteases involved in the host–parasite interaction. To propose testable hypotheses for their functions, it is essential to know their locations in the mite. Here we show by immunohistochemistry that SMIPPs exist in two compartments: 1) internal to the mite in the gut and 2) external to the mite after excretion from the gut in scybala (fecal pellets). SMIPPs may well function in both of these compartments to evade host proteases.

Cortisol - ein geeigneter physiologischer Indikator für Belastungen am Arbeitsplatz?

Die vorliegende Studie prüft Zusammenhänge zwischen Arbeitsintensität, Tätigkeitsspielraum, sozialer Arbeitsumgebung (Kooperation/Kommunikation, soziale Unterstützung, soziale Stressoren) und Stresserleben am Arbeitsplatz mit der basalen Cortisolsekretion im Speichel (Tagesprofil, Aufwachreaktion und Variation über den Tag). Insgesamt 46 Erwerbstätige aus dem Bankwesen sammelten an zwei aufeinander folgenden Arbeitstagen je vier Speichelproben (beim Aufwachen, 30 min nach dem Aufwachen, 14 Uhr und unmittelbar vor dem Zubettgehen), aus denen die individuelle Cortisolkonzentration (Mittelwert aus den jeweils zugehörigen Proben) bestimmt wurde. Die Tätigkeitsmerkmale wurden sowohl mittels Fragebögen als auch objektiv, d.?h. unabhängig vom Arbeitsplatzinhaber, erhoben. Alter, Geschlecht, Rauchen, Body-Mass-Index, gesundheitliche Beeinträchtigungen sowie eventuelle Abweichungen bei der Probensammlung wurden als mögliche Drittvariablen berücksichtigt. Im Ergebnis zeigte sich, dass subjektiv erlebte, geringe soziale Unterstützung und hohe soziale Stressoren mit einer erhöhten Aufwachreaktion bzw. mit einer erhöhten Variation über den Tag assoziiert waren. Für die Arbeitsintensität, den Tätigkeitsspielraum sowie für die objektiv erhobene Kooperation/Kommunikation waren keine Effekte nachweisbar. Die Ergebnisse lassen vermuten, dass sowohl die Belastungs- als auch deren Erhebungsart für den Nachweis von Effekten im Hinblick auf die Cortisolsekretion bei Erwerbstätigen von Bedeutung sind. The present study examines associations between job demands, job control, social work environment (cooperation/communication, social support, social stressors), and strain at work with basal salivary cortisol (day profiles, cortisol awakening reaction, diurnal variation). Forty-six employees collected four saliva samples (immediately after waking up, 30 min after waking up, at 2 p.m. and immediately before going to bed) each on two consecutive working days. We computed the mean across the two days for each of the four saliva samples per employee. Job characteristics were assessed by self-reports as well as by objective job analysis. Analyses were controlled for possible confounding effects of age, gender, smoking, body-mass index, health impairments, and non compliance with the cortisol protocol. Results show that subjectively experienced low social support and high social stressors at work were associated with elevated cortisol awakening reaction and elevated diurnal variation. We found no effects for job demands, job control or objectively assessed cooperation/communication. Our results suggest that both the type of job characteristic as well as the type of measurement of job characteristics have to be taken into account when relating them to employees’ cortisol secretion.

Gesundheitsrisiken bei Unternehmern

An einer Studie zum Zusammenhang zwischen der Gesundheit von Unternehmern, deren Arbeitsmerkmalen und deren Erfolg nahmen 53 klein- und mittelständische Unternehmer teil. Erfasste Arbeitsmerkmale waren: Handlungs-/Entscheidungsspielraum, Arbeitsintensität, Arbeitszeit, Konkurrenzdruck und Prognose über die Auftragsentwicklung. Der Unternehmenserfolg wurde über das Mitarbeiterwachstum, die Möglichkeit des Unternehmers, von seiner Firma abwesend zu sein (Urlaubstage), und dem erlebten Unternehmenserfolg operationalisiert. Gesundheitsindikatoren waren Depression, Angst, vitale Erschöpfung, Schlafstörungen und Bluthochdruck. Im Vergleich zur Gesamtbevölkerung wiesen die Unternehmer in allen untersuchten Gesundheitsvariablen häufiger Beeinträchtigungen auf. Regressionsanalysen ergaben, dass lange Arbeitszeiten und Konkurrenzdruck mit einer verzögerten Rückstellung des systolischen Blutdrucks (SBD) in der Freizeit und Nacht einhergingen. Alle untersuchten Erfolgsmerkmale waren für die Gesundheit prädiktiv. So war Mitarbeiterwachstum negativ mit dem SBD während der Arbeit sowie Schlafstörungen assoziiert. Je mehr Unternehmenserfolg erlebt wurde, desto geringer waren die Werte für vitale Erschöpfung und Depression. Die Urlaubsdauer war negativ mit Angst und vitaler Erschöpfung korreliert. Insgesamt hatte von den Arbeitsmerkmalen nur die Dauer der Arbeitszeit einen Effekt auf die Gesundheit von Unternehmern. Daneben existieren aber offensichtlich weitere Faktoren, die mit der Unternehmergesundheit in Beziehung stehen. Dies sind neben dem Konkurrenzdruck am Markt insbesondere Indikatoren des Unternehmenserfolgs. The relationship between health and workload as well as entrepreneurial success was analyzed in 53 entrepreneurs. Workload data (decision latitude, job demand, working time, competition, market development) were determined by using structured interviews and Karasek's job content questionnaire. Firm success was operationalized by employee growth, the possibility of absence from the company (days of holiday), and perceived success. Health was measured by questionnaires for sleep disturbances, vital exhaustion, depression, and anxiety, and by 24 hour ambulatory blood pressure monitoring. Regression analyses showed that working time and strength of competition within the market were predictive for systolic blood pressure (SBP) during leisure time and night, but not during work. All variables measuring entrepreneurial success were predictive for health. Employee growth was related to decreasing SBP during work and to fewer sleep disturbances. The duration of holidays was negatively related to vital exhaustion and anxiety. Perceived company success was negatively related to depression and vital exhaustion. In conclusion, only the relationship between working time and bad health conformed to findings reported for the relationship between work and health in employees. However, there were additional indicators, especially indicators of competition and entrepreneurial success, that affected the health of entrepreneurs.