Institution
University of Münster
Education•Münster, Germany•
About: University of Münster is a education organization based out in Münster, Germany. It is known for research contribution in the topics: Population & Transplantation. The organization has 35609 authors who have published 69059 publications receiving 2278534 citations. The organization is also known as: University of Munster & University of Muenster.
Topics: Population, Transplantation, Lithium, Mass spectrometry, Electrolyte
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TL;DR: This review focuses on the multidirectional impact of low testosterone associated with obesity and the metabolic syndrome and its effects on erectile dysfunction and CVD risk in men with type 2 diabetes.
Abstract: Men with obesity, the metabolic syndrome, and type 2 diabetes have low total and free testosterone and low sex hormone–binding globulin (SHBG). Conversely, the presence of low testosterone and/or SHBG predicts the development of metabolic syndrome and type 2 diabetes. Visceral adiposity present in men with low testosterone, the metabolic syndrome, and/or type 2 diabetes acts through proinflammatory factors. These inflammatory markers contribute to vascular endothelial dysfunction with adverse sequelae such as increased cardiovascular disease (CVD) risk and erectile dysfunction. This review focuses on the multidirectional impact of low testosterone associated with obesity and the metabolic syndrome and its effects on erectile dysfunction and CVD risk in men with type 2 diabetes. Whenever possible in this review, we will cite recent reports (after 2005) and meta-analyses.
### Epidemiological studies of low testosterone, obesity, metabolic status, and erectile dysfunction
Epidemiological studies support a bidirectional relationship between serum testosterone and obesity as well as between testosterone and the metabolic syndrome. Low serum total testosterone predicts the development of central obesity and accumulation of intra-abdominal fat (1–3). Also, low total and free testosterone and SHBG levels are associated with an increased risk of developing the metabolic syndrome, independent of age and obesity (1–3). Lowering serum T levels in older men with prostate cancer treated with androgen deprivation therapy increases body fat mass (4). Conversely, high BMI, central adiposity, and the metabolic syndrome are associated with and predict low serum total and to a lesser extent free testosterone and SHBG levels (1–3,5). Because obesity suppresses SHBG and as a result total testosterone concentrations, alterations in SHBG confound the relationship between testosterone and obesity.
Low total testosterone or SHBG levels are associated with type 2 diabetes, independent of age, race, obesity, and criteria for diagnosis of diabetes (6,7). In longitudinal studies, low serum total and free testosterone …
309 citations
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TL;DR: New insights are provided about the biochemical regulation, physiological functions and of newly identified target proteins of the major plant Ca2+ sensor families that enable specific, robust and flexible information processing in plants.
309 citations
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01 Jan 2000
TL;DR: Versteht man unter „Routinelabor“ das Anforderungsprofil, das unabhangig von Anamnese und klinischem Befund bei jedem Patienten mit zunachst unbekannter Diagnose oder unbeknter Komplikation eines Patienten with bekannter diagnosis sinnvoll und notwendig ist, so sind vereinfacht zwei Situationen zu unterscheiden:
Abstract: Versteht man unter „Routinelabor“ das Anforderungsprofil, das unabhangig von Anamnese und klinischem Befund bei jedem Patienten mit zunachst unbekannter Diagnose oder unbekannter Komplikation eines Patienten mit bekannter Diagnose sinnvoll und notwendig ist, so sind vereinfacht zwei Situationen zu unterscheiden:
309 citations
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TL;DR: The results indicate that the N200 primarily reflects conflict-related effects whereas the P300 predominantly represents motor inhibition.
309 citations
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University of Regensburg1, Goethe University Frankfurt2, University of Padua3, Ludwig Maximilian University of Munich4, Heidelberg University5, University of Jena6, University of Mainz7, University of Alberta8, Leiden University9, Sahlgrenska University Hospital10, University of Edinburgh11, Centre Hospitalier Universitaire de Nice12, University of Münster13, Université de Montréal14, University of Duisburg-Essen15, University of Tübingen16, University of Genoa17, University of Cambridge18, University of Oslo19, University of Kiel20, Karolinska University Hospital21, Helsinki University Central Hospital22, Medical University of Vienna23, Katholieke Universiteit Leuven24, Innsbruck Medical University25, Leipzig University26, University of Sydney27, Hannover Medical School28, Ghent University Hospital29, Mario Negri Institute for Pharmacological Research30, Cliniques Universitaires Saint-Luc31, Humboldt University of Berlin32
TL;DR: This trial provides the first high-level evidence base for selecting immunosuppression in LTx recipients with HCC and reveals that low-risk, rather than high- risk, patients benefited most from sirolimus; furthermore, younger recipients (age ⩽60) also benefited, as well siro Limus monotherapy patients.
Abstract: Background We investigated whether sirolimus-based immunosuppression improves outcomes in liver transplantation (LTx) candidates with hepatocellular carcinoma (HCC). Methods In a prospective-randomized open-label international trial, 525 LTx recipients with HCC initially receiving mammalian target of rapamycin inhibitor-free immunosuppression were randomized 4 to 6 weeks after transplantation into a group on mammalian target of rapamycin inhibitor-free immunosuppression (group A: 264 patients) or a group incorporating sirolimus (group B: 261). The primary endpoint was recurrence-free survival (RFS); intention-to-treat (ITT) analysis was conducted after 8 years. Overall survival (OS) was a secondary endpoint. Results Recurrence-free survival was 64.5% in group A and 70.2% in group B at study end, this difference was not significant (P = 0.28; hazard ratio [HR], 0.84; 95% confidence interval [95% CI], 0.62; 1.15). In a planned analysis of RFS rates at yearly intervals, group B showed better outcomes 3 years after transplantation (HR, 0.7; 95% CI, 0.48-1.00). Similarly, OS (P = 0.21; HR, 0.81; 95% CI, 0.58-1.13) was not statistically better in group B at study end, but yearly analyses showed improvement out to 5 years (HR, 0.7; 95% CI, 0.49-1.00). Interestingly, subgroup (Milan Criteria-based) analyses revealed that low-risk, rather than high-risk, patients benefited most from sirolimus; furthermore, younger recipients (age 60) also benefited, as well sirolimus monotherapy patients. Serious adverse event numbers were alike in groups A (860) and B (874). Conclusions Sirolimus in LTx recipients with HCC does not improve long-term RFS beyond 5 years. However, a RFS and OS benefit is evident in the first 3 to 5 years, especially in low-risk patients. This trial provides the first high-level evidence base for selecting immunosuppression in LTx recipients with HCC.
309 citations
Authors
Showing all 36075 results
Name | H-index | Papers | Citations |
---|---|---|---|
Hyun-Chul Kim | 176 | 4076 | 183227 |
Klaus Müllen | 164 | 2125 | 140748 |
Giacomo Bruno | 158 | 1687 | 124368 |
Anders M. Dale | 156 | 823 | 133891 |
Holger J. Schünemann | 141 | 810 | 113169 |
Joachim Heinrich | 136 | 1309 | 76887 |
Markus Merschmeyer | 132 | 1188 | 84975 |
Klaus Ley | 129 | 495 | 57964 |
Robert W. Mahley | 128 | 363 | 60774 |
Robert J. Kurman | 127 | 397 | 60277 |
Bart Barlogie | 126 | 779 | 57803 |
Thomas Schwarz | 123 | 701 | 54560 |
Carlos Caldas | 122 | 547 | 73840 |
Klaus Weber | 121 | 524 | 60346 |
Andrey L. Rogach | 117 | 576 | 46820 |