Impact of anthropogenous environmental factors on the marine ecosystem of trophically transmitted helminths and hosting seabirds: Focus on North Atlantic, North Sea, Baltic and the Arctic seas.

Alongside natural factors, human activities have a major impact on the marine environment and thus influence processes in vulnerable ecosystems. The major purpose of this review is to summarise the current understanding as to how manmade factors influence the marine biocenosis of helminths, their intermediate hosts as well as seabirds as their final hosts. Moreover, it highlights current knowledge gaps regarding this ecosystem, which should be closed in order to gain a more complete understanding of these interactions.

Depression in primary care and the role of evidence-based guidelines: cross-sectional data from primary care physicians in Germany.

Background: Depression is the most common mental health burden worldwide. Primary care physicians (PCPs) play a key role in the care provision for people with depression. The first objective of the present study was to examine the health care situation of depression in primary care, focusing on the cooperation between PCPs and mental health specialists.

Impact of Parallel Topical Treatment with Nadifloxacin and Adapalene on Acne Vulgaris Severity and Quality of Life: A Prospective, Uncontrolled, Multicentric, Noninterventional Study.

Introduction: Daily parallel application of adapalene and nadifloxacin has been determined to be effective and well tolerated in patients with acne vulgaris in randomized, controlled clinical studies. Here, the authors report the results from a large, prospective, uncontrolled, multicentric, noninterventional study under real-life conditions in Germany. The effect of treatment on acne severity, safety, and, for the first time, health-related quality of life (HRQoL) was investigated.

[The association of job satisfaction with self-reported burnout among urologists with migration background working at German hospitals : Results of the EUTAKD study].

Introduction: Urologists with a migration background currently provide patient care in German hospitals. Study results on job satisfaction and burnout of this important professional group have not been available so far.

Materials And Methods: Between August and October 2020, a questionnaire (SurveyMonkey® with 101 items) was conducted among urologists with migration background working in German hospitals regarding professional satisfaction and a validated survey of burnout (Maslach Burnout Inventory), among others.

Effect of a newly developed pastille on the salivary flow rate in subjects with dry mouth symptoms: a randomized, controlled, monocentric clinical study.

Background: Xerostomia is associated with several diseases and is a side effect of certain drugs, resulting from reduced saliva secretion. Often, aged and sometimes younger people suffer from (idiopathic) xerostomia. Chewing gum and sucking pastilles may relieve symptoms of xerostomia by increasing the salivary flow rate due to the mechanical effect of sucking and gustatory stimulation.

Pharmacokinetic Drug-Drug Interactions Between Trospium Chloride and Ranitidine Substrates of Organic Cation Transporters in Healthy Human Subjects.

Trospium chloride, a muscarinic receptor blocker, is poorly absorbed with different rates from areas in the jejunum and the cecum/ascending colon. To evaluate whether organic cation transporter (OCT) 1, OCT2 and multidrug and toxin extrusion (MATE) 1 and MATE2-K are involved in pharmacokinetics, competitions with ranitidine, a probe inhibitor of the cation transporters, were evaluated in transfected HEK293 cells. Furthermore, a drug interaction study with trospium chloride after intravenous (2 mg) and oral dosing (30 mg) plus ranitidine (300 mg) was performed in 12 healthy subjects and evaluated by noncompartmental analysis and population pharmacokinetic modeling.

Expression of components of the urothelial cholinergic system in bladder and cultivated primary urothelial cells of the pig.

Background: Porcine urinary bladders are widely used for uro-pharmacological examinations due to their resemblance to the human organ. However, characterisations of the porcine urothelium at the molecular level are scarce up to now. As it has become clear over the last years that this tissue plays an important role in the signaling-pathways of the bladder, we examined whether the transporter and receptor pattern (with focus on the transmitter acetylcholine) is comparable to the human urothelium.

[Psychopharmaceutical Medication in Brandenburgian Nursing Homes - An Exploratory Study].

Objective: Psychopharmaceuticals are often prescribed in nursing homes for elderly. Together with the general polypharmacy, the risk for adverse drug reactions and interactions is increased.

Methods: Medication data of 398 nursing home residents were analyzed.

Effects of the P-Glycoprotein Inhibitor Clarithromycin on the Pharmacokinetics of Intravenous and Oral Trospium Chloride: A 4-Way Crossover Drug-Drug Interaction Study in Healthy Subjects.

The quaternary ammonium compound trospium chloride is poorly absorbed from 2 "absorption windows" in the jejunum and cecum/ascending colon, respectively. To confirm whether intestinal P-glycoprotein (P-gp) is involved, a 4-period, crossover drug interaction study with trospium chloride after intravenous (2 mg) and oral administration (30 mg) without and after comedication of clarithromycin (500 mg), an inhibitor for P-gp, was initiated in 12 healthy subjects. Pharmacokinetics of trospium was evaluated using gas chromatography-mass spectrometry, noncompartmental evaluation, and pharmacokinetic modeling.

Interplay of the Organic Cation Transporters OCT1 and OCT2 with the Apically Localized Export Protein MATE1 for the Polarized Transport of Trospium.

The anticholinergic drug trospium is secreted into urine and, to a smaller extent, into bile. Chemically, it is an organic cation, and it is a substrate of the uptake transporters OCT1 and OCT2 as well as for the export proteins MATE1 and MATE2-K as determined in uptake studies using HEK293 cells. So far, neither MATE-mediated export nor the interplay of OCT-mediated uptake and MATE-mediated export have been investigated.

Antibiotic prescribing behavior among general practitioners - a questionnaire-based study in Germany.

Background: This study investigates the barriers and facilitators of the use of antibiotics in acute respiratory tract infections by general practitioners (GPs) in Germany.

Methods: A multidisciplinary team designed and pre-tested a written questionnaire addressing the topics awareness of antimicrobial resistance (7 items), use of antibiotics (9 items), guidelines/sources of information (9 items) and sociodemographic factors (7 items), using a five-point-Likert-scale ("never" to "very often"). The questionnaire was mailed by postally to 987 GPs with registered practices in eastern Germany in May 2015.

Trospium chloride is absorbed from two intestinal "absorption windows" with different permeability in healthy subjects.

Intestinal P-glycoprotein is regio-selectively expressed and is a high affinity, low capacity efflux carrier for the cationic, poorly permeable trospium. Organic cation transporter 1 (OCT1) provides lower affinity but higher capacity for trospium uptake. To evaluate regional intestinal permeability, absorption profiles after gastric infusion of trospium chloride (30mg/250ml=[I]) for 6h and after swallowing 30mg immediate-release tablets in fasted and fed healthy subjects, were evaluated using an inverse Gaussian density function to model input rate and mean absorption time (MAT).

Rupatadine in Established Treatment Schemes Improves Chronic Spontaneous Urticaria Symptoms and Patients' Quality of Life: a Prospective, Non-interventional Trial.

Introduction: Chronic spontaneous urticaria (CSU) is a common and hard to treat condition associated with a substantial negative impact on patients' quality of life (QoL). Clinical studies have shown that rupatadine is effective and safe in the treatment of CSU, but data from routine clinical care are scarce. Therefore, we assessed the effectiveness and tolerability of rupatadine in established dosages on CSU activity and patients' QoL in a routine daily practice setting.

Disability and functional burden of disease because of mental in comparison to somatic disorders in general practice patients.

Background: Severity of illness is not only depending on the symptom load, but also on the burden in life. Mental disorders are among those illnesses, which in particular cause suffering to the individual and society.

Method: To study burden of disease for mental in comparison to somatic disorders, 2099 patients from 40 general practitioners filled in (a) the Burvill scale which measures acute and chronic illnesses in ten different body systems and (b) the IMET scale which measures impairment in ten different areas of life.

Refractory overactive bladder: a common problem?

Introduction And Hypothesis: Unsatisfactory treatment outcome sometimes is described as frequently occurring in patients treated with first-line therapy for overactive bladder (OAB). The present article reviews the different circumstances which may result in failure to respond to lifestyle interventions, behavioral therapy, and/or antimuscarinic treatment.

Methods: An extensive literature search was conducted to identify relevant articles on pathophysiological, clinical, and pharmacological aspects of refractory OAB.

Expression of drug transporters and drug metabolizing enzymes in the bladder urothelium in man and affinity of the bladder spasmolytic trospium chloride to transporters likely involved in its pharmacokinetics.

The cationic, water-soluble quaternary trospium chloride (TC) is incompletely absorbed from the gut and undergoes wide distribution but does not pass the blood-brain barrier. It is secreted by the kidneys, liver, and intestine. To evaluate potential transport mechanisms for TC, we measured affinity of the drug to the human uptake and efflux transporters known to be of pharmacokinetic relevance.

[Medical rehabilitation by general practitioners in patients with chronic mental disorders].

Background: Rehabilitation medicine is the medical specialty for the prevention, diagnosis and treatment of chronic disorders. This is especially relevant in mental disorders. Treatment of chronic disorders requires a complex and multidisciplinary long-term-treatment which is regularly done by general practitioners.

Expression of nicotinic acetylcholine receptor subunit mRNA in mouse bladder afferent neurons.

Nicotinic acetylcholine receptors (nAChR) influence bladder afferent activity and reflex sensitivity, and have been suggested as potential targets for treating detrusor overactivity. Mechanisms may include indirect effects, e.g.

Lack of irritative potential of nadifloxacin 1% when combined with other topical anti-acne agents.

Background: Diverse options are available for the treatment of acne. Topical therapy is standard, especially in cases of mild to moderate acne, while the current treatments for acne vulgaris are topical keratolytics and topical antibiotics. Tolerability is a critical factor in patient compliance with topical acne therapies.

Family practice web sites: new perspectives for patient care and health information?

Background And Objectives: To cater to the needs of informed and proactive patients in family medicine, health care providers could offer access to care and health information via practice Web sites. To determine the content and quality of family medicine Web sites, we performed a cross-sectional study on a large sample of family practices' Web sites in Berlin, Germany.

Methods: After screening of all family medicine practices in Berlin for the provision of their own practice Web site, we determined the content and quality using a predefined checklist based on a review of literature.

Muscarinic acetylcholine receptor subtypes expressed by mouse bladder afferent neurons.

Cell bodies of afferent neurons located in lumbosacral dorsal root ganglia (DRG) provide Adelta- and C-fibres to the urinary bladder, reporting bladder wall tension, volume and noxious stimuli. Recent studies suggested an involvement of muscarinic acetylcholine receptors (mAChRs) not only in detrusor contractility but also in modulating afferent function, and this has been linked to the beneficial effects of muscarinic antagonists in the treatment of overactive bladder. Here, we aimed to determine the inventory of mAChR subtypes expressed by bladder afferent neurons in the mouse.

[The public's perception of doctors is changing].

The public's perception of doctors is the subject of continuous change. The physician's image loses its uniformity to the extent that increasing knowledge and technical ability generate a multitude of different specialisations. A high complexity arises from the accompanying necessary regulations with the professional image considerably varying across perspectives.

[Health screening and vaccination status--results from a patient survey in German general practices].

The vaccination status of German adults needs improvement. Low participation is also known in health screening programmes like the "Check up 35" which is offered every two years for adults aged 35 or above. However, the number of participants in health screening increases with age whereas vaccination status decreases.

Counseling overweight in primary care: an analysis of patient-physician encounters.

Objective: The aim of this study was to assess general practitioners' (GPs') and patients' practices and attitudes regarding overweight encountered during preventive counseling talks.

Methods: Twelve GPs audiotaped their preventive counseling talks with overweight patients, including the assessment of individual risk profiles and further medical recommendations. Fifty-two dialogues were transcribed and submitted to qualitative content analysis.