
Marc WeidenbuschLudwig-Maximilians-Universität in Munich | LMU · Department of Internal Medicine IV
Marc Weidenbusch
MD PhD MME
About
53
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Introduction
Publications
Publications (53)
Background
Individual reflection and interdisciplinary collaboration can be critical for high-quality diagnostic outcomes. However, empirical findings on using instructional approaches to facilitate reflection and collaboration in collaborative diagnostic reasoning are inconclusive and limited. Previous studies on structured reflection and collabor...
Citation: Colonnello, V.; Zodl, A.; Agnoletti, D.; Lischeid, K.; Cimbalnik, L.; Weidenbusch, M.; Fischer, M.R.; De Ponti, F.; Rausch, C. Implementing Clinical Case Discussions to Enhance Clinical Reasoning Skills: A Pilot Study in an Italian Medical School. Int. Med. Educ. 2024, 3, 306-315.
Abstract:
Background: Clinical reasoning (CR) is fundam...
Fragestellung/Zielsetzung: Ziel der vorliegenden Studie war es, den aktuellen Wissensstand, insbesondere Wissensdefizite und -unterschiede, von Pflegefachpersonen und Ärzt*innen in Deutschland zum interprofessionellen Entlassungsmanagement (EM) in Akutkrankenhäusern zu ermitteln und zu vergleichen.
Methoden: Basierend auf EM-Leitlinien und Lehrplä...
Alport syndrome (AS) shows a broad phenotypic spectrum ranging from isolated microscopic hematuria (MH) to end‐stage kidney disease (ESKD). Monoallelic disease‐causing variants in COL4A3/COL4A4 have been associated with autosomal dominant AS (ADAS) and biallelic variants with autosomal recessive AS (ARAS). The aim of this study was to analyze clini...
Simulated diagnostic situations function as learning environments and research tools to deepen the understanding of diagnostic processes. In this conceptual paper, we present a framework that fulfils two purposes. First, we categorize simulations of diagnostic situations using six descriptive components: physical environment, social embeddedness, d...
Introduction
Mentoring is an effective method for human resource development. Monitoring the process is important for individual mentee/mentor pairs as well as for program directors. Due to individual personality differences of both mentees and mentors and their respective interactions, it is challenging to monitor the individual development proces...
This study examined the effects of structured reflection and collaboration scripts on the collaborative diagnostic skills of medical students with varying levels of prior knowledge in simulations. 151 advanced medical students were asked to diagnose five patients in collaboration with an agent-based radiologist. Meanwhile, learners either received...
Collaborative diagnostic reasoning refers to knowledge and skills involved in
complex individual and collaborative activities with which medical students and physicians
often struggle. This study examined the effects of structured reflection and collaboration scripts
on collaborative diagnostic reasoning in medical students depending on their prior...
After impasses, the adjustment strategies learners can use in simulations differ from the ones that are available in real-life situations. An open question is whether learners with different levels of prior knowledge use different strategies to adjust their behavior and whether the chosen adjustment strategy helps their learning. In addition, it is...
Background
The cell surface interleukin 22 (IL-22) receptor complex is mainly expressed in epithelial and tissue cells like pancreatitis cells. Recent studies described that IL-22R was overexpressed in malignant diseases and was associated with a poor overall survival (OS). The role of IL-22RA1 gene expression in muscle invasive bladder cancer (MIB...
Background: Due to the ban on classroom teaching during the pandemic, the Munich “Anamnesegruppen” had to be switched to e-learning at short notice. There were no established concepts for this, which is why digitalization was piloted and evaluated for feasibility.
Student “Anamnesegruppen”: “Anamnesegruppen” have existed for over 50 years and are o...
Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills.
Methods: For medical students of LMU and TU Munich, the interact...
Objectives
For the professional development of junior employees, sufficient competence is decisive for their career. The mentoring programme Urology Roadmap provides residents career planning in various roles (junior staff member, developer, networker, multiplier). To date, no data are available on the extent to which the role matrix instrument is...
Background: Clinical reasoning (CR) is a clinical core competence for medical students to acquire. While the necessity for CR teaching has been recognized since the early 20th century, to this day no consensus on how to best educate students in CR exists. Hence, few universities have incorporated dedicated CR teaching formats into their medical cur...
In about 30% of infantile, juvenile, or adolescent patients with steroid-resistant nephrotic syndrome (SRNS), a monogenic cause can be identified. The histological finding in SRNS is often focal segmental glomerulosclerosis (FSGS). Genetic data on adult patients are scarce with low diagnostic yields. Exome sequencing (ES) was performed in patients...
Zusammenfassung
Hintergrund Urologische OberärztInnen in Deutschland stellen eine heterogene Berufsgruppe mit verschiedenen klinischen Schwerpunkten und Karriereabsichten dar. Bisher gibt es keine gesicherten Kenntnisse darüber, welchen Einfluss die Anzahl der Berufsjahre in dieser Position auf die aktuelle Berufsausübung und Zufriedenheit hat.
Mat...
Rationale & Objective
Hereditary nephropathies are clinically and genetically heterogeneous disorders. For some patients, the clinical phenotype corresponds to a specific hereditary disease but genetic testing reveals that the expected genotype is not present (phenocopy). The aim of this study was to evaluate the spectrum and frequency of phenocopi...
Background:
In the past years evidence has been growing about the interconnection of chronic kidney disease and acute kidney injury. The underlying pathophysiological mechanisms remain unclear. We hypothesized, that a threshold ischemia time in unilateral ischemia/reperfusion injury sets an extent of ischemic tubule necrosis, which as "point of no...
Objective:
Fostering clinical reasoning is a mainstay of medical education. Based on the clinicopathological conferences, we propose a case-based peer teaching approach called clinical case discussions (CCDs) to promote the respective skills in medical students. This study compares the effectiveness of different CCD formats with varying degrees of...
To evaluate learning motivation barriers in infection control and feedback competences, we conducted a national online survey in Germany. Among 767 healthcare workers, overconfidence effects could be detected independent from age, gender, profession, education, and hospital-size. The identified effects may impair learning motivation relevant for su...
Was ist neu?
Kontrastmittel-induzierte vs. Kontrastmittel-assoziierte Nephropathie Seit neuere jodhaltige, nicht ionische Kontrastmittel (KM) angewendet werden, kommt es seltener zu akuten Nierenschädigungen (acute kidney injury, AKI) nach KM-Gabe. In aktuellen großen retrospektiven Analysen (in Summe > 100 000 Patienten) gibt es bei stationären Pa...
Refractory lupus nephritis' is a frequently used term but poorly defined. We conducted a survey among nephrologists and rheumatologists to spot the diversity of perceptions of this term and to better understand the clinical practice related to 'refractory lupus nephritis'. A total of 145 questionnaires completed by lupus nephritis experts were avai...
IL-22, a member of the IL-10 cytokine family, accelerates tubule regeneration upon acute kidney injury, hence we speculated on a protective role also in chronic kidney disease. We quantified intrarenal IL-22 expression after unilateral ureteral (UUO) in wild-type mice and performed UUO in IL-22 knock-out animals. Obstruction phenotypic differences...
Background
Several tumour necrosis factor (TNF) based therapeutics have already been approved for human use and several others are emerging. Therefore, we determined the mRNA expression levels of the TNF superfamily ligands (TNFSF) – e.g. TNF-α, lymphotoxin (LT)-α, LT-β, Fas-L (CD95-L), TNF-related apoptosis-inducing ligand (TRAIL), TNF-related wea...
Notch and Interleukin-22 signaling are known to regulate tissue homeostasis and response to injury in humans and mice, and the induction of endogenous arylhydrocarbon receptor ligands through Notch links the two pathways in a hierarchical fashion. However, in adults the species-, organ- and injury-specific gene expression of the Notch-AhR-IL22 axis...
Development and validation of Clinical Reasoning analysis tool for the context of medical education.
Diabetic nephropathy (DN) develops in up to 1/3 of diabetic patients and leads to end stage renal disease (ESRD) in 20%. Although the risk for macrovascular complications has almost halved in the last 20 years the incidence of ESRD in DN patients remained nearly constant. The pathogenesis of DN has not been fully explored but risk factors for the d...
Although the role of adaptive immune mechanisms, e.g. autoantibody formation and abnormal T-cell activation, has been long noted in the pathogenesis of human systemic lupus erythematosus (SLE), the role of innate immunity has been less well characterized. An intricate interplay between both innate and adaptive immune elements exists in protective a...
Although the role of adaptive immune mechanisms, e.g. autoantibody formation and abnormal T-cell activation, has been long noted in the pathogenesis of human systemic lupus erythematosus (SLE), the role of innate immunity has been less well characterized. An intricate interplay between both innate and adaptive immune elements exists in protective a...
The species-specific, as well as organ-specific expression of regulated necrosis (RN)-related molecules, is not known. We determined the expression levels of TNFR1, RIPK1, RIPK3, MLKL, CASP8, FADD, CIAP1, CIAP2, GPX4, CYPD, CASP1, NLRP3, and PARP1 in human and mouse solid organs. We observed significant differences in expression of these molecules...
Background/Objectives: The role of the immune system and its interplay with tumour cells
in osteosarcoma (OS) is poorly defined.
Design/Methods: We investigated the expression profile of 34 primary and metastatic paediatric
OS. Data was compared to a customized body map of 852 samples and 27 healthy human
tissues. Different gene sets were defined t...
Intrarenal crystals trigger inflammation and renal cell necroptosis, processes that involve TNF receptor (TNFR) signaling. Here, we tested the hypothesis that TNFRs also have a direct role in tubular crystal deposition and progression of hyperoxaluria-related CKD. Immunohistochemical analysis revealed upregulated tubular expression of TNFR1 and TNF...
Often the cause of refractory lupus nephritis (RLN) remains unclear. We performed next-generation sequencing for podocyte genes in an RLN patient and identified compound heterozygosity for APOL1 risk alleles G1 and G2 and a novel homozygous c.[1049C>T]+[1049C>T] NPHS1 gene variant of unknown significance. To test for causality renal progenitor cell...
Neutrophil extracellular trap (NET) formation contributes to gout, autoimmune vasculi-tis, thrombosis, and atherosclerosis. The outside-in signaling pathway triggering NET formation is unknown. Here, we show that the receptor-interacting protein kinase (RIPK)-1-stabilizers necrostatin-1 or necrostatin-1s and the mixed lineage kinase domain-like (ML...
Neutrophil extracellular trap (NET) formation contributes to gout, autoimmune vasculitis, thrombosis, and atherosclerosis. The outside-in signaling pathway triggering NET formation is unknown. Here we show that the receptor-interacting protein kinase (RIPK)-1-stabilizers necrostatin-1 or necrostatin-1s and the mixed lineage kinase domain-like (MLKL...
Lupus nephritis (LN) remains a kidney disease with significant unmet medical needs despite extensive clinical and translational
research over the past decade. These include the need to (i) predict the individual risk for LN in a patient with systemic
lupus erythematosus, (ii) identify the best therapeutic option for an individual patient, (iii) dis...
Interleukins have become well known regulators of innate and adaptive immunity-related tissue inflammation. Recently, IL-22 has gained a lot of interest for its unique functions in maintaining and regaining epithelial integrity. IL-22 is exclusively secreted by different immune cell subsets, while IL-22 receptors are mainly expressed by epithelial...
Most tissues harbor resident mononuclear phagocytes, that is, dendritic cells and macrophages. A classification that sufficiently covers their phenotypic heterogeneity and plasticity during homeostasis and disease does not yet exist because cell culture-based phenotypes often do not match those found
in vivo
. The plasticity of mononuclear phagocyt...
Background
The treatment of lupus nephritis (LN) remains problematic because the current treatment regimen based on unspecific immunosuppressants such as steroids, cyclophosphamide and mycophenolate has significant side effects and is often inefficient. B-cell ablation with the chimeric anti-CD20 antibody rituximab (RTX) has been considered as an a...
Current macrophage phenotype classifications are based on distinct in vitro culture conditions that do not adequately mirror complex tissue environments. In vivo monocyte progenitors populate all tissues for immune surveillance which supports the maintenance of homeostasis as well as regaining homeostasis after injury. Here we propose to classify m...
The IFN-regulatory factors IRF1, IRF3, IRF5, and IRF7 modulate processes involved in the pathogenesis of systemic lupus and lupus nephritis, but the contribution of IRF4, which has multiple roles in innate and adaptive immunity, is unknown. To determine a putative pathogenic role of IRF4 in lupus, we crossed Irf4-deficient mice with autoimmune C57B...