In this study, based on the known vestibulo-hippocampal connections, we asked whether mild chronic vestibulopathy leads only to vestibular-related deficits or whether there are effects on hippocampal ...function, structure, and cognition in general. In more detail, we assessed whether chronic vestibulopathy leads to (a) deficits in vestibular tasks without cognitive demand (balancing), (b) deficits in spatial cognitive tasks that require vestibular input (path integration, rotational memory), (c) deficits in spatial cognitive tasks that do not rely on vestibular input, (d) deficits in general cognitive function, and (e) atrophy in the brain.
A total of 15 patients with chronic uni- or bilateral vestibulopathy (56.8 ± 10.1 years; 4 females) were included in this study and were age- and gender-matched by the control participants (57.6 ± 10.5) in a pairwise manner. Given their clinical symptoms and their deficits of the vestibulo-ocular reflex (VOR) the patients could be classified as being mildly affected. All participants of the underwent the following tests: clinical balance (CBT), triangle completion (TCT) for path integration, rotational memory (RM), the visuo-spatial subset of the Berlin intelligence structure test (BIS-4) and d2-R for attention and concentration, and a structural MRI for gray matter analysis using voxel-based morphometry (VBM).
Compared to the healthy controls, the vestibulopathy patients performed significantly worse in terms of CBT, TCT, and RM but showed no differences in terms of the BIS-4 and d2-R. There were also no significant volumetric gray matter differences between the two groups.
This study provides evidence that both non-cognitive and cognitive functions that rely on vestibular input (balancing, path integration, rotational memory) are impaired, even in mild chronic vestibulopathy, while other cognitive functions, which rely on visual input (visuo-spatial memory, attention), are unimpaired in this condition, together with an overall intact brain structure. These findings may reflect a segregation between vestibular- and visual-dependent processes in the medial temporal lobe on the one hand and a structure-function dissociation on the other.
Autoimmune gastritis (AIG) is a chronic immune-mediated inflammation of the gastric corpus/fundus mucosa leading to progressive atrophy of the oxyntic gastric glands (AOM) and their consecutive loss ...of function. Possible clinical consequences of AIG include iron deficiency anemia, pernicious anemia, gastric neuroendocrine tumors (gNET), and gastric adenocarcinoma. This article provides a review of interdisciplinary aspects of the diagnosis and treatment of AIG.
Zusammenfassung
Symptom- und Belastungsscreenings mittels Patientenselbsteinschätzung („patient-reported outcomes“, PROs) für Diagnose, Behandlungsplanung, Monitoring und Nachsorge werden zunehmend ...bedeutsamer. Die strukturierte Erfassung der Patientenperspektive fördert die frühere Problemidentifikation, eine schnellere bedarfsadaptierte Initiierung von unterstützenden therapeutischen Maßnahmen und auch die Selbstwirksamkeit. „Patient-reported outcomes“ werden anhand entsprechender Instrumente („patient-reported outcome measures“, PROMs) erhoben. Die aktuellen Querschnittsleitlinien empfehlen an verschiedenen Stellen die Erfassung von Symptomen, Belastungen, Funktionseinschränkungen oder Risiken mithilfe spezifischer validierter Erhebungsinstrumente (Selbst- und Fremdeinschätzung). In Hinblick auf die Prozesse und Zuständigkeiten fehlen einheitliche Standards. Elektronische PROMs werden derzeit vorwiegend zum Monitoring der Krebsbehandlung eingesetzt. Trotz nachweislicher Kosteneffizienz ist die Inanspruchnahme von Ressourcen nicht zu unterschätzen.
Purpose
Modern, personalized treatment concepts in oncology require an interdisciplinary and multiprofessional collaboration. In addition to its relevance in patient care, interdisciplinary ...collaboration is also becoming increasingly important in clinical research as well as medical education and resident training in oncology.
Methods
Between November 2021 and March 2022, an online survey was conducted among German early career research groups, represented by Young Oncologists United (YOU). The aim was to identify the status and need for interdisciplinarity at clinic, educational, and research levels.
Results
A total of 294 participants completed the questionnaire in full. 90.7% of the respondents fully or predominantly agreed with the statement that interdisciplinary work plays a major role in their daily clinical work. 78.9% wished for more interdisciplinary collaboration. Of the 49.7% of participants who have never participated in an interdisciplinary research project, 80.1% said they would like to participate in such a study project in the future. Lack of time resources, too much organizational effort, and possible political conflicts between institutions were identified as factors that make practical implementation difficult. 74.1% declared their willingness to become active in an oncology early career research group.
Conclusion
Interdisciplinary collaboration has become increasingly important in oncology. Networks that span different disciplines could help to promote interdisciplinary research projects among young scientists and improve exchange in professional practice and education with the implication of improved patient care.
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