Training of physical examination techniques in video conferences.

Objective: The COVID-19 pandemic also called for the teaching of practical skills to develop teaching formats outside of classroom teaching. Methods: Selected physical examination techniques (musculoskeletal system, neurological system) were taught via video conference using a modified Peyton method. The core element was the mutual, real demonstration of the respective skill by student tutor and student with immediate possible correction. Results: The IT requirements turned out to be sufficient, direct feedback from tutors and students was positive. Conclusion: Whether this method can be a substitute for classroom courses must be evaluated in more extensive studies.

Role of progranulin in adipose tissue innate immunity.

Regulation of progranulin in adipocytes and its role in inflammation is poorly understood. AIM: (i) to investigate regulation of progranulin in adipocyte differentiation and adipose tissue compartments, (ii) to address progranulin expression in two murine (C57BL/6) models of inflammation. RESULTS: Progranulin expression was induced during adipocyte differentiation. Neither estradiol nor testosterone or metabolic stimuli such as glucose and insulin modified progranulin synthesis. Fatty acids, bile acids and incretins GLP-1 and GIP-1 exerted potent and differential effects on progranulin secretion. LPS, TNF and IL6 significantly increased progranulin secretion. TLR9 agonists decreased and TLR1/2, TLR3, TLR5, and TLR2/6 ligands increased progranulin expression. TLR3-mediated progranulin induction was abrogated by inhibitors of NF-κB and PI3K pathways. Progranulin expression between murine epididymal and subcutaneous adipose tissue did not differ in total adipose tissue, in isolated adipocytes or in the stromal-vascular cell fraction (SVC). However, SVC expressed significantly higher levels of progranulin than adipocytes at all sites. In adipocytes, female mice had significantly higher progranulin expression at all sites. An intra-peritoneal LPS challenge in mice did not affect adipose tissue progranulin expression, whereas peritoneal infection by S. aureus increased progranulin expression after 24 h. CONCLUSIONS: There are relevant sex-, site- and cell-specific effects on progranulin gene expression that is induced during adipocyte differentiation and modulated by various inflammatory and metabolic factors. Most importantly, ligands for TLR1/2 and TLR2/6 (recognizing S. aureus) in vitro and infection by S. aureus in vivo induce progranulin expression suggesting a role of adipocytes in protection against infection by gram-positive bacteria.