Publications by authors named "Stengel S"

Background: A significant number of individuals diagnosed with SARS-CoV-2 continue to suffer from persistent symptoms, a condition commonly referred to as Post-COVID syndrome (PCS). The most common manifestations are fatigue, post-exertional malaise, respiratory problems and cognitive deficits due to the lack of a causal treatment, therapeutic options remain symptom oriented. The aim of this study was to develop a low-threshold group therapy concept for patients with PCS and to test its feasibility in face-to-face and online format.

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Objective: In Germany, the rotation into the general practitioner's practice (GPP) as part of postgraduate medical training in general practice traditionally takes place at the end of the training period. The aim of this study was to explore possible subsequent effects of beginning training in the GPP from the perspective of general practitioners (GPs) and GP trainees.

Methods: Nationwide, GPs and GP trainees were recruited who started specialization in GP in the GPP.

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Background & Aims: Gut bacterial translocation contributes to immune dysfunction and spontaneous bacterial peritonitis (SBP) in cirrhosis. We hypothesized that exposure of peritoneal macrophages (PMs) to bacterial DNA results in type-I interferon (IFN) production, shaping subsequent immune responses, inflammasome activation, and the release of damage-associated molecular patterns (DAMPs).

Methods: PMs from patients with cirrhosis were stimulated with E.

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Introduction: Worldwide, the primary care sector played a key role in coping with the challenges of the SARS-CoV-2 pandemic.

Methods: The aim of this study was to explore the resilience of the German primary healthcare system during the second wave of the pandemic from the perspective of identified interface stakeholders, i.e.

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Article Synopsis
  • Inflammatory bowel diseases (IBD) cause long-lasting inflammation in the digestive system, and scientists are looking into how stress inside cells (called ER stress) affects this.
  • They found that when cells experience ER stress, the way they use certain nutrients changes, which might affect how severe IBD is and how well treatments work.
  • The researchers discovered that not having enough of a nutrient called serine can mess up a signaling system that helps cells fight infections, but giving antioxidants can help improve this issue.
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Background: Post-acute sequelae after COVID-19 are still associated with knowledge gaps and uncertainties at the end of 2022, e.g., prevalence, pathogenesis, treatment, and long-term outcomes, and pose challenges for health providers in medical management.

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Background: "Core values" help to guide practice of health care delivery. The core values of general practice are described in the European definition of general practice by WONCA, e.g.

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Article Synopsis
  • The paper discusses effective strategies for managing long COVID through integrated primary care and multidisciplinary approaches, highlighting two successful regional networks in Southern Germany, Rhein-Neckar and Ludwigsburg.
  • An observational study was conducted in 2023, analyzing documents and engaging health care professionals in discussions to evaluate these networks' practices over a 24-month period.
  • Findings revealed both networks established clear goals and communication channels, with Ludwigsburg focusing more on individual patient care and Rhein-Neckar emphasizing a collaborative, broader approach involving specialized healthcare institutions; challenges included reimbursement issues and the need for sustained motivation among professionals.
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All--retinoic acid (ATRA)-based differentiation therapy of acute promyelocytic leukemia (APL) represents one of the most clinically effective examples of precision medicine and the first example of targeted oncoprotein degradation. The success of ATRA in APL, however, remains to be translated to non-APL acute myeloid leukemia (AML). We previously showed that aberrant histone modifications, including histone H3 lysine 4 (H3K4) and lysine 27 (H3K27) methylation, were associated with this lack of response and that epigenetic therapy with small molecule inhibitors of the H3K4 demethylase LSD1/KDM1A could reprogram AML cells to respond to ATRA.

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Article Synopsis
  • - Disease tolerance is a vital survival strategy that minimizes physical damage from infections without directly killing the pathogens, and this tolerance shifts as an organism ages.
  • - Research using a polymicrobial sepsis model revealed distinct health responses in young and old mice after infection, highlighting different disease courses related to their age.
  • - Young mice utilized a protective mechanism involving FoxO1 that helped them survive, while the same mechanism contributed to heart issues and death in older mice, underscoring the need for age-specific therapy in infections.
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Intelectin-1 (ITLN1) is a lectin secreted by intestinal epithelial cells (IECs) and upregulated in human ulcerative colitis (UC). We investigated how ITLN1 production is regulated in IECs and the biological effects of ITLN1 at the host-microbiota interface using mouse models. Our data show that ITLN1 upregulation in IECs from UC patients is a consequence of activating the unfolded protein response.

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Genetic variants in the DNA methyltransferase 3 A (DNMT3A) locus have been associated with inflammatory bowel disease (IBD). DNMT3A is part of the epigenetic machinery physiologically involved in DNA methylation. We show that DNMT3A plays a critical role in maintaining intestinal homeostasis and gut barrier function.

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Background: Most COVID-19 patients with severe symptoms are treated in hospitals. General practices are responsible for assessing most ambulatory patients. However, they face several challenges managing COVID-19 patients, and those with non-COVID-19 conditions.

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Background: Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective.

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Article Synopsis
  • Hosts utilize both aggressive and cooperative strategies to defend against infections, with Leptin playing a key role in resistance mechanisms but its impact on cooperation with pathogens not fully understood.
  • In a study on mice infected with Yersinia pseudotuberculosis, a lack of Leptin signaling resulted in increased cooperation between the host and pathogen, leading to protection against infection, though it wasn't due to resistance or changes in energy metabolism.
  • The findings suggest that in certain situations, it may be more advantageous for hosts to tolerate organ damage caused by infection rather than solely focusing on preventing damage or killing the pathogen.
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Objectives: We aimed to assess general practice (GP) trainees' self-perception of surgical competencies and to explore longitudinal effects of a compact intervention.

Design: We performed a mixed-methods study including a before and after comparison in the intervention group (IG), a comparison of attendees and non-attendees (control group (CG)) and a qualitative evaluation of the intervention. Competencies were self-assessed through surveys.

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Introduction: The approaches to cope with the challenges of providing medical care to patients with symptoms of long COVID are multidisciplinary and involve primary care worldwide. The aim of this study was to explore the experiences and ideas for continued development of medical care of long COVID from the patients' (PAT) and primary care practitioners' (PCP) perspective.

Methods: Between the third and fourth COVID-19 wave in Germany (July to September 2021), a mixed methods study was conducted by inviting patients and PCPs in two neighboring districts (urban and rural) in Baden-Wuerttemberg to a paper-based questionnaire with both closed and open questions.

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Background: In acute pancreatitis (AP), microcirculatory dysfunction and leukocyte activation contribute to organ damage, inflammation, and mortality. Given the role of macrophage activation, monocyte recruitment, and microthrombus formation in the early pathogenesis of AP, we examined the macrophage activation marker soluble mannose receptor (sCD206) and the endothelial function marker von Willebrand factor (vWF) in patients admitted for AP.

Methods: In an exploratory analysis, serum sCD206 and plasma vWF were prospectively analyzed on day 1 and day 3 in 81 patients with AP admitted to the hospital.

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Aberrant activity of the phosphatidylinositol-3 kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR [PAM]) pathway, as well as suppressed retinoic acid signalling, contribute to enhanced proliferation and the differentiation blockade of immature myeloid cells in acute myeloid leukaemia (AML). Inhibition of the PAM pathway was shown to affect especially mixed-lineage leukaemia-rearranged AML. Here, we sought to test a combined strategy using small molecule inhibitors against members of the PAM signalling pathway in conjunction with all-trans retinoic acid (ATRA) to target a larger group of different AML subtypes.

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Background & Aims: V-set Ig-domain-containing 4 (VSIG4) is an immunomodulatory macrophage complement receptor modulating innate and adaptive immunity and affecting the resolution of bacterial infections. Given its expression on peritoneal macrophages (PMs), we hypothesised a prognostic role of peritoneal VSIG4 concentrations in patients with spontaneous bacterial peritonitis (SBP).

Methods: We isolated PMs from patients with cirrhosis and analysed VSIG4 expression and release by flow cytometry, quantitative real-time PCR, ELISA, and confocal microscopy.

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Background & Aims: Throughout life, the intestinal epithelium undergoes constant self-renewal from intestinal stem cells. Together with genotoxic stressors and failing DNA repair, this self-renewal causes susceptibility toward malignant transformation. X-box binding protein 1 (XBP1) is a stress sensor involved in the unfolded protein response (UPR).

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Background: The Competence Centers for Postgraduate Medical Education (KW) established throughout Germany represent complex programs to increase the efficiency and quality of postgraduate medical education in general practice. So-called Logic Models serve as the framework for evaluations and quality management processes of complex programs in many areas. The aim of this article is to develop such a model, using the example of the Competence Center in Baden-Württemberg (KWBW) in order to structure its complex program logic and use it as a framework for future evaluations and quality management processes.

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Background: A SARS-CoV-2 infection can lead from asymptomatic through to critical disease in a dynamic and unpredictable course within a few days. The challenge in outpatient monitoring the highly contagious COVID-19 disease during the ongoing pandemic is to filter severe courses followed by admission to hospital with the aim of preventing an overburdening of clinics. However, little is known of the effect of risk factors on the course of the infection of outpatient patients.

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