Lost signature: progress and failures in in vivo tracking of implanted stem cells.

Stem cell therapy as a part of regenerative medicine provides promising approaches for the treatment of injuries and diseases. The increasing use of mesenchymal stem cells in various medical treatments created the demand for long-term in vivo cell tracking methods. Therefore, it is necessary to analyze post-transplantational survival, biodistribution, and engraftment of cells. Furthermore, stem cell treatment has been discussed controversially due to possible association with tumor formation in the recipient. For therapeutic purpose, stem cells must undergo substantial manipulation such as differentiation and in vitro expansion, and this can lead to the occurrence of genetic aberrations and altered expression of both tumor suppression and carcinogenic factors. To control therapy, it is necessary to find a reliable and general method to track and identify implanted cells in the recipient. This is especially challenging for autologous transplantations, as standard fingerprinting methods cannot be applied. An optimal technique for in vivo cell monitoring does not yet exist, and its development holds several challenges: small numbers of transplanted cells, possibility of cell number quantification, minimal transfer of the contrast agent to non-transplanted cells, and no genetic modification. This review discusses most of the proposed solutions, including magnetic resonance imaging, magnetic particle imaging, positron emission tomography, single-photon emission computed tomography, and optical imaging methods. Additionally, the recent research on cell labeling for stem cell monitoring after transplantation including in vitro, ex vivo, and in vivo imaging studies is described. Promising future imaging modalities for stem cell monitoring after transplantation are shown.

An assessment of the current Chlamydia trachomatis laboratory practices in Germany.

BACKGROUND AND OBJECTIVES: Currently, no information is available about the number of Chlamydia trachomatis (CT) tests performed, testing facilities available or diagnostic methods used in Germany. This study aimed to map CT diagnostic facilities so that representative laboratories can be recruited for CT sentinel surveillance. METHODS: Using a questionnaire, we collected information about population coverage, the number of tests performed, accreditation and current testing methods and systems for German facilities that potentially offer CT diagnostics. RESULTS: Overall, 725/1,504 (48%) facilities responded; of the respondents, 143 reported that they perform CT diagnostics. Of the laboratories performing diagnostics, 45% were privately owned, and 42% were located in a hospital. Of the laboratories that provided information about their catchment area, 61% received samples from at least one federal state and therefore covered more than their surrounding area. The median length of time that CT diagnostics had been performed was 11.5 years. Over half (54%) of the laboratories that provided information on their accreditation status were accredited, for a median duration of 6 years. In accordance with national guidelines, 77% used nucleic acid amplification tests (NAAT) for acute CT infections. CONCLUSIONS: The long duration since Ct diagnostics have been performed and laboratories have been accredited can be seen as an indication of the high diagnostic quality of German laboratories. Additionally, laboratories mostly serviced doctors and patients from a large region and are not representative for people living in the area where the lab is located. This has to be considered when sampling representative labs for CT sentinel surveillance and further epidemiological studies.

Second European multi-disciplinary conference of national strategies for Chlamydia trach. and human papillomavirus NSCP conf. in Berlin, 2013 enhanced detection, management and surveillance of sexually transmitted infections in Europe are essential!

There is a need for updated guidance on detection, management and surveillance of sexually transmitted infections (STIs). Chlamydia, gonorrhoea and syphilisreporting needs to be mandatory in more European countries to aid collection of data. More widespread Chlamydia screening is needed in many countries as this is the only way to reduce complications. The role of Human Papillomavirus (HPV) screening in a situation where the prevalence of HPV infection has dropped significantly was also discussed in the context of the high cost of screening, the need for a relatively complex infrastructure, particularly in developing countries, and falling vaccination costs. An integrated HPV vaccination and screening policy could be the most appropriate with vaccination at 9-13 years as recommended by WHO and a single HPV screen at 35-39 years, possibly repeated thereafter every 10 years. Female and male HPV vaccination programmes could lead to near elimination of genital warts in both females and males. Surveillance of STIsshould be intensified where needed; additional or better quality data should be collected including reasons for testing, denominator data to estimate positivity rates, diagnostic methods, concurrent STIs, sexual orientation and country of acquisition; more analytical rather than descriptive epidemiology is needed.

Surveillance of human immunodeficiency virus suggests that younger men who have sex with men are at higher risk of infection, European Union, 2003 to 2012.

In 2012, newly reported human immunodeficiency virus diagnoses in the European Union /European Economic Area remained stable at around 30,000 cases. Since 2003, cases in men who have sex with men (MSM) aged 20 to 29 years-old doubled, while the proportion of late presenters in this group remained stable. Persistent declines occurred among older MSM age groups, particularly that between 30 and 39 years-old. Interventions targeting younger MSM are needed to prevent a resurgence of the epidemic in Europe.

Risk factors for Chlamydia trachomatis infection in adolescents: results from a representative population-based survey in Germany, 2003-2006.

Infections with Chlamydia trachomatis (CT) can lead to severe sequelae; however, they are not notifiable in Germany. We tested urine samples from participants of KiGGS (German Health Interview and Examination Survey for Children and Adolescents) for CT infections and linked the results to demographic and behavioural data from 1,925 participants (girls aged 15-17 years and boys aged 16-17 years) to determine a representative prevalence of CT infection in adolescents in Germany and to assess associated risk factors. Prevalence of CT infection was 2.2% (95% CI: 1.4-3.5) in girls and 0.2% (95% CI: 0.1-0.7) in boys. CT infection in girls was associated with higher use of alcohol, marijuana and cigarettes, lower social status, oral contraceptive use, pregnancy, repeated lower abdominal pain and higher rates of doctors' consultations within the preceding three months and consultation of gynaecologists within the last 12 months. In multiple logistic regression, we identified two predictors for CT infection: marijuana consumption often or several times within the last 12 months (F(1,164)=7.56; p<0.05) and general health status less than 'very good' (F(1,164)=3.83; p=0.052). Given our findings, we recommend enhancing sex education before sexual debut and promoting safe sex practices regardless of the contraceptive method used. Well-informed consumption of alcohol should be promoted, the risky behaviour of people intoxicated through consumption of marijuana highlighted and doctors' awareness of CT screening enhanced.

Rehabilitation after severe head injury.

123 survivors of severely head injured patients presenting with coma grade III show a decreasing mean duration of coma with increasing age. The numbers and frequency of good recovery decrease, whereas poor recovery increases with age. Increase of the duration of coma grade III produces an increase of the mean latency and time of recovery and of the frequency of poor recovery, regardless of the age of the patients. Increasing age does not increase the mean latency and time of recovery systematically. The important conclusion of this analysis is, that the clinical feature of coma grade III, corresponding to GCS score of 4 and RLS of 6 and 7, indicates a different kind of brain damage at various age groups. It represents a lesser degree of brain damage for younger patients under 20, than for those over 20. In our opinion our observations do not demonstrate a better capacity of recovery of the young patients: but the young patients show a more severe clinical picture than the older patients do, if only the clinical syndrome of coma grade III with extensor rigidity, is considered as a yardstick for comparison.

[Surgery for asymptomatic carotid stenosis: a contribution to a controversial discussion]. / Operation der asymptomatischen Carotisstenose: ein Beitrag zur kontroversen Diskussion.

From 1 January 1982 to 30. June 1986, 436 operations on the internal carotid artery were performed: 164 were asymptomatic (37.6%). Morphologic indication was stenoses greater than 70% only. Supra-aortic multivessel disease played a major role. The operative mortality amounted to 0.6% (total 0.9%) and the perioperative mortality, 1.8%. The cumulative morbidity was 1.6% after the first and 1.8% after the second year, whereas the cumulative survival rate measured 89.8% after one and 80.4% after three years. Therefore surgery for asymptomatic carotid internal stenoses is justified under conditions of the restrictive indication. It also seems to be more favorable as regards early and late results.

Intracranial arteriovenous malformations and aneurysms in childhood and adolescence.

Clinical data of 19 arteriovenous malformations (AVM) and 15 aneurysms (AN) are presented. Combined clinical, neurophysiological and neuroradiological follow-up studies have been carried out on the surviving patients (14 AVM and 10 AN). Two patients with multiple AN had coarctation of the aorta. Three AVM of the Vein of Galen showed typical symptoms within the 1st year of life, all other lesions became evident later than 5 years of age. In the acute phase of the disease clinical history and neurological deficits of AVM and AN tend to be very similar. Subarachnoid hemorrhage with or without intracranial hematoma is the most frequent initial symptom. A CT scan is valuable as a first orientating investigation but morphology and operability of the vascular lesion is only demonstrated by angiography. The prognosis of AVM and AN is promising as soon as the first critical period has been survived. AVM patients show significantly less severe residual neurological and psychiatric defects than AN cases. EEG-follow-up studies and CT scans are helpful for controlling residual functional and morphological cerebral damage in survivors.