Monika Heinzel-Gutenbrunner

Philipps University of Marburg | PUM · Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie (Marburg)

Background: Self-assembling peptide (SAP) P11-4 was introduced to treat initial caries lesions by means of guiding hydroxyapatite regeneration within the lesion. The objective of this study was to assess its effectiveness in a practical clinical setting. Methods: Caries lesions in permanent teeth treated with monomeric and polymeric SAP P11-4 fr...

Objectives Mindfulness-based programs (MBPs) at the workplace have attracted increasing interest due to their positive effects on health and work-related outcomes. However, it is unclear whether these effects translate into reductions in cost-related and objectively assessed outcomes, such as sick days. The aim of this study was to evaluate the eff...

Self-assembling peptide (SAP) P 11 -4 was introduced to treat initial caries lesions by guiding hydroxyapatite regeneration within the lesion. The objective was to assess the effectiveness in a practical clinical setting. Caries lesions in permanent teeth treated with monomeric and polymeric SAP P 11 -4 between May 2015 and October 2020 were retros...

Zusammenfassung Ziel der Studie Die Studie verfolgt das Ziel, die Effekte der psychischen Belastung auf die Höhe und die Zusammensetzung der Krankheitskosten (ambulante Kosten, Krankenhauskosten, Rehabilitationskosten, Arzneimittelkosten) im Zeitverlauf zu überprüfen. Methodik Im Längsschnittdesign untersuchten wir die psychische Belastung von 3.28...

Metabolic reprogramming mediated by hypoxia-inducible factors play a crucial role in many human cancers. HIF-1α is activated under hypoxic conditions and is considered a key regulator of oxygen homoeostasis during tumor proliferation under hypoxia. Aim of this research was to analyze the immunohistochemical expression of HIF-1α, VEGF-A, Glut-1, MCT...

Background: With modern intensive care medicine, even older patients and those with pre-existing conditions can survive critical illnesses and major operations; however, unreflected application of intensive care treatment might lead to a state called chronic critical illness. Today, withholding treatment and/or treatment withdrawal precede many de...

Dental caries constitutes a public health challenge. As preventive strategies are desirable, this retrospective cohort study aimed to assess the caries experience and increment in children attending kindergartens with an early childhood caries (ECC) preventive program (intervention group, IG) compared to basic prophylaxis measures (control group, C...

Studies on children’s nutritional behaviour (CNB) rarely compare children’s answers regarding the frequency of their sugar intake with the respective statements of their parents. Therefore, data from a prevention study were used to analyse this aspect, as well as a potential correlation between Marburg Sugar Index (MSI) values and caries experience...

Objective The application of media on lifestyle-related risk factors (LRRFs) by healthcare providers to educate women may improve women’s adherence, health literacy, and awareness of LRRFs, as well as offspring’s health outcomes. This study investigated whether exposure to media-based education in gynecological and obstetric care is associated with...

Objectives Understanding of lifelong control of disease processes associated with caries and its management is an essential part of dental education. This study evaluated the dental students’ knowledge of caries diagnosis and management using the International Caries Classification and Management System (ICCMS). Methods A survey was conducted amon...

Background: Caries lesion activity is typically assessed by visual-tactile criteria. Regular monitoring is required to detect the transition of lesions and to ensure that the initial assessment was valid. This clinical study aimed to evaluate the agreement of bioluminescence measurements (Calcivis imaging system, Cis) with visual examination to as...

Zusammenfassung Metabolische Anpassungsprozesse, vermittelt durch sog. Hypoxie-induzierbare Faktoren und deren Zielgene, spielen in zahlreichen Malignomen eine wichtige Rolle. Rasch wachsende Tumoren können ihre Stoffwechselvorgänge an eine auftretende Hypoxie anpassen. So werden beispielsweise nach der Aktivierung des „Hypoxia inducible-factors-1α...

Background There are only few, but controversial data on the prognostic role of upfront primary tumor resection and mesenteric lymph node dissection (PTR) in patients with diffuse metastasized small intestinal neuroendocrine neoplasia (SI-NEN). Therefore, the prognostic role of PTR and other factors was determined in this setting. Methods This ret...

Introduction The quality of healthcare in childhood and adolescence is of key importance, in order to foster a healthy development and to avoid chronic health problems. Yet, data for Germany regarding the quality of healthcare for this patient group are lacking. The QualiPäd research project aims to estimate the quality of outpatient healthcare for...

Zusammenfassung Hintergrund Gesundheit, Freude/Spaß, Figur und Gesellschaft sind Motive für sportliche Aktivitäten. Es ist unklar, welcher Zusammenhang zwischen ihrer Ausprägung, Alter, Geschlecht, Schmerzen und Trainingsumfang besteht. Material und Methoden In dieser Untersuchung wurden 792 sportlich aktive Männer und Frauen (68 % Frauen und 32...

This study aimed to investigate factors affecting (1) women’s media use regarding health-related behaviors during pregnancy and lactation, (2) women’s preferences for media format, and (3) the content of media-based interventions on lifestyle-related risk factors during pregnancy and lactation. A cross-sectional observational multi-center study of...

Background: Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific...

Background: The creation of control groups in the evaluation of statutory health insurances is a key issue. Randomization represents both an ethical and a legal problem with legally guaranteed services. Matching procedures are relevant alternatives in the construction of control groups. Matchings are mostly based on secondary data from statutory h...

This study analysed the expression of vascular endothelial growth factor-A (VEGF), VEGFR-2, and VEGFR-3 in primary cutaneous melanomas with positive and negative sentinel node status (SLN) (a total of 58 specimens divided into 2 groups of 29 for each status). A quantification score was developed for protein expression, by considering the percentage...

Background: Exercise is considered an effective intervention to relieve chronic back pain. However, it is still unknown whether specific exercise patterns vary in terms of their efficiency and effectiveness. Aim: To investigate the differential health and economic effects of intensity, specificity and degree of subjective perceived physical exer...

Background Metabolic reprogramming and altered gene expression mediated by hypoxia inducible‐factors play crucial roles during tumour growth and progression. Nevertheless, studies analysing the expression of hypoxia inducible factor‐1α, and its downstream targets in Merkel cell carcinoma (MCC) are lacking but are warranted to shed more light on MCC...

Non-invasive caries treatment is a major focus in modern dentistry. The present study was designed to evaluate the effectiveness of monomeric self-assembling peptide P11-4 (SAP P11-4) in combination with fluoride varnish or polymeric self-assembling peptide matrix (SAPM) in treatment of non-cavitated occlusal caries. Ninety children and adolescents...

Purpose: For surgical treatment of inguinal hernia, large-pore, lightweight mesh has been shown to offer advantages over small-pore, heavyweight options in terms of chronic post-operative inguinal pain, but without the disadvantage of having to deal with an increased recurrence rate. Limited data are available for the mesh plug repair technique. T...

Objectives This prospective, randomised, split-mouth, clinical trial compared the efficacy of the self-assembling peptide P11-4 to fluoride varnish in the treatment of early buccal carious lesions. Materials and methods Subjects presenting at least two clinically affected teeth were treated at D0 (day 0) and D90 with P11-4 (test) or fluoride varni...

Purpose Standard dosing and intermittent bolus application (IB) are important risk factors for pharmacokinetic (PK) target non-attainment during empirical treatment with β-lactams in critically ill patients, particularly in those with sepsis and septic shock. We assessed the effect of therapeutic drug monitoring-guided (TDM), continuous infusion (C...

Background For various psychiatric and somatic disorders, there is evidence of an association between patients’ socioeconomic status (SES), healthcare utilisation, and the resulting costs. In the field of child and adolescent psychiatric disorders, studies on this topic are lacking.Objectives To exploratively analyse the association of healthcare e...

Background: Shared decision-making is a well-established approach to increasing patient participation in medical decisions. Increasingly, using lifetime-risk or time-to-event (TTE) formats has been suggested, as these might have advantages in comparison with a 10-year risk prognosis, particularly for younger patients, whose lifetime risk for some...

The aim was to investigate the ability of self-assembling Peptide P11-4 Matrix (SAPM) to remineralize artificial initial caries lesions compared to the use of fluoride varnish. Volunteers were recruited for this randomised, cross-over in situ trial. Bovine specimens, half including orthodontic brackets, were recessed on the buccal aspects of mandib...

Background Active exercising can effectively reduce low back pain but the mechanisms of action are still unclear. Objective What are the influences of training frequency, increased physical performance, age and gender on the effectiveness of a multimodal back training? Material and methods A total of 1395 persons with back pain (mean age 46.9 ± 1...

Objectives: The aim of this study was to test the relationship between a newly developed sugar index and caries experience in 4th- and 6th-graders. Materials and methods: A total of 1,019 fourth-graders and 925 sixth-graders from 2 regions in Northern Germany participated in the study. Caries experience was recorded by applying the ICDAS criteri...

Aims/Methods: At present, there is no information about the course of psychological adjustment in young subjects with Möbius sequence (MS) and their parents' strain and life satisfaction. To fill this gap, we performed a four-year follow-up study. Parents were anonymously asked to fill out the Child Behavior Checklist 4-18 [CBCL/ 4-18] or the Young...

To compare the cost-effectiveness of a multimodal back exercise programme for non-specific back pain with that of standard treatment. Medical costs were measured in euros (EUR) and effectiveness was measured using Graded Chronic Pain Status (GCPS). A controlled multicentre study (39 sites) with a 6-month intervention phase and follow-up at 6, 12 an...

Background: Shared decision making (SDM) is a well-accepted concept to increase patients' participation regarding diagnostic or therapeutic issues. Increasingly , lifetime risk or time-to-event (TTE) formats have been suggested as they might have advantages, e.g. in younger patients to better show consequences of unhealthy behaviour compared to a 1...

Background For children and adolescents with mental health problems, there is a lack of data as to whether the type of residential area (urban vs. rural) influences healthcare costs for affected individuals. The aim of this study was therefore to explore potential urban vs. rural healthcare cost differences in children and adolescents with conduct...

Background: This study investigated the effects of three different risk displays used in a cardiovascular risk calculator on patients' motivation for shared decision-making (SDM). We compared a newly developed time-to-event (TTE) display with two established absolute risk displays (i.e. emoticons and bar charts). The accessibility, that is, how un...

Supplementary Information

Supplementary table with blank corrected endpoint data.

A higher capacity to grow under hypoxic conditions can lead to a more aggressive behavior of tumor cells. Determining tumor activity under hypoxia may identify chronic lymphocytic leukemia (CLL) with aggressive clinical course and predict response to chemo-immunotherapy (CIT). A metabolic score was generated by determining pyruvate kinase and lacta...

Background: Integrated Management of Childhood Illness (IMCI) is regarded as a standard public health approach to lowering child mortality in developing countries. However, little is known about how health workers adhere to the guidelines at the national level in sub-Saharan African countries. Methods: Data from the Service Provision Assessment...

Objective The objective of this study was to assess the ability of alternating current impedance spectroscopy technique (ACIST) to monitor sound tooth surfaces and incipient carious lesions. Subjects and methodsTwo hundred ninety-two teeth were examined in 30 patients. Occlusal surfaces were classified according to International Caries Detection an...

The multiple causal pathways model on the etiology of attention-deficit/hyperactivity disorder (ADHD) is well established. However, developmental implications of the model are not yet sufficiently analyzed. The model implies that critical neural and neuropsychological deviations from normative development precede secondarily developing ADHD symptom...

Background: The Wender Utah Rating Scale (WURS) is recommended for retrospective recording of childhood attention deficit hyperactivity disorder (ADHD) symptoms. Hence the present study explored the validity of the WURS and its short forms (WURS-25, WURS-k, WURS-15-G, IDA items) by screening adult subjects who had been diagnosed with either ADHD o...

The link between symptoms of attention deficit hyperactivity disorder (ADHD) and increased body weight is well established, while the underlying mechanisms are not yet clear. Since increased body weight and ADHD symptoms have been found to be associated with psychosocial risk factors in childhood, we analyzed whether the psychosocial risks explain...

Background: Pain is a common symptom in patients with depressive disorders, which, if present, worsens the prognosis. However, there is little empirical knowledge of the therapeutic effects of antidepressants on painful physical symptoms of patients with depressive disorders. Furthermore, tricyclic/tetracyclic antidepressants (TCAs) have not yet b...

Background The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study,...

Einführung: Schmerz ist ein verbreitetes Symptom bei Patienten mit einer depressiven Störung und wirkt sich ungünstig auf die Prognose aus. Dennoch ist bei dieser Patientengruppe noch wenig zum Zusammenhang von antidepressiver und schmerzlindernder Wirkung unterschiedlicher Antidepressivagruppen bekannt. Methode: Systematische PubMed-Literatur-Su...

Introduction: Early-onset schizophrenia (EOS) has a poor prognosis and is difficult to treat, which often leads to the initiation of clozapine treatment. Studies in adults have shown that the initiation of clozapine treatment is often delayed. There is a lack of studies concerning the initiation of clozapine in children and adolescents with EOS. Th...

Background: Sound teeth and incipient lesions require regular monitoring to detect possible progression of caries early on. Aim: To evaluate the ability of the VistaProof (VP) fluorescence-based camera for monitoring occlusal surfaces. Design: A total of 419 posterior teeth (205 primary molars, 145 permanent molars, and 69 premolars) of 35 pat...

Background In order to investigate correlations between specific parameters and dental caries, it is useful to record incipient and dentine lesions.AimThe aim of this study was to evaluate the effect of a selective intensified preventive program (SIP) on oral health of fourth graders using ICDAS.DesignA cohort study was performed. ICDAS and DMFT in...

Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skill...

Background: Pain is a common symptom in patients with depressive disorders and is prognostically unfavorable. However, the available data on therapy effects of dual-action antidepressants are still few to date. Above all, tricyclic antidepressants (TCA) have not been included in existing meta-analyses, yet. Methods: A broad pubmed-literature resea...

Objective: Various different questionnaires are available for the screening of autism spectrum disorders (ASD). These screening instruments show high sensitivity and are able to identify a large number of individuals with ASD, but they lack the specificity to differentiate individuals with ASD from those children and adolescents with other complex...

The aim of the present study was to evaluate the influence of various risk factors on dental caries increment in deciduous teeth of preschool children over 2.5 years. A longitudinal study was carried out in kindergartens in two German counties in Northern Hesse. At baseline examination in 2006-2007, the mean age of the children was 3.5 years. Carie...

Die Effektivitat des Elterntrainings „Stepping Stones/Triple P” als erganzende Behandlung von Kindern mit einer Autismus-Spektrum-Storung (ASS) wurde untersucht. Die Eltern von 13 Kindern mit ASS (neun Jungen, vier Madchen) zwischen vier und zwolf Jahren (M=6.7 Jahre, SD=2.61) nahmen an der Studie teil. Das Training fand uber einen Zeitraum von 14...

Background: The goal of this study was to follow the further legal development of young people who undergo adolescent psychiatric and psychological assessment because of an attempted or actual homicide and are convicted of the crime. We were able to do this over a mean follow-up duration of 12.8 years after conviction through the use of excerpts fr...

Zusammenfassung Fragestellung: Berichtet wird über eine Verlaufsuntersuchung an jugendlichen und heranwachsenden Gewalt- und Tötungsdelinquenten (n=114), deren legale Entwicklung über einen Zeitraum von 12,8 Jahren verfolgt werden konnte. Ergebnisse: Unter den psychiatrischen Diagnosen nach ICD-10 (nur in 18 Fällen war keine solche zu stellen) stan...

The management of white-spot lesions remains a challenge, especially during and after fixed orthodontic treatment. The aim of this in vitro study was to evaluate the efficacy of the newly introduced self-assembling peptide P11-4 (Curodont™) for regenerating demineralized tooth tissue on smooth surfaces. Another aim was to evaluate whether the DIAGN...

Background From current theories on the etiology of attention deficit hyperactivity disorder (ADHD), it can be inferred that delay aversion (DA) and deficits in inhibitory control (IC) constitute basic deficits or endophenotypes of the disorder that already occur in the preschool period. This implies an occurrence of the characteristics in unaffect...

Background: Presentation of a 12,8 years follow-up register study on juvenile delinquents (n=114) sentenced for murder and attempted murder and manslaughter. Results: Only in 18 cases no psychiatric diagnoses could be given. Among the psychiatric diagnoses personality and behaviour disorders were most prominent (41,2%), followed by conduct disorder...

The aim of this study was to evaluate the in-vivo performance of the VistaProof fluorescence-based camera (VP) on occlusal surfaces. The study was approved by the ethics committee and informed consent was given by the participants. The study included 306 unrestored permanent teeth of 26 patients. The occlusal surfaces of the teeth were examined vis...

The link between attention deficit/hyperactivity disorder (ADHD) and elevated body weight/obesity can be regarded as well established. Because oppositional defiant disorder (ODD)/conduct disorder (CD) has also been found to be associated with these characteristics and ADHD and ODD/CD often occur comorbidly, we investigated whether ODD/CD and ADHD a...

Our study investigated the effect of a selective intensive prevention (SIP) programme on dental health of pupils in comparison to a control group. While no differences were observed in respect to dental health of first graders, the DMF-T values of fourth and 6 graders participating in SIP were significantly lower. Concerning the psychometric variab...

Despite the official exclusion criteria for autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) in the DSM-IV and ICD-10, patients with ASD often show ADHD symptoms. We aimed to examine the potential influence of ADHD symptoms on autistic psychopathology in a large sample of patients with ASD. We tested the hypothesis...

Objectives: The OPTION scale ("observing patient involvement in decision making") assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorporate active patient behavior in consulta...

Aim: The aim of this study was to assess caries prevalence among 12-year-olds, including initial lesions and dentine caries (ICDAS-II criteria, Codes 0-6). Methods: The study was conducted in 2 regions of Hesse with different group prevention programmes (in region 1 children receive regular school-based prophylaxis using fluoride varnish twice a...

Background: A growing body of evidence suggests an association between altered hypothalamic-pituitary-adrenal axis reactivity and the development of persistent antisocial behavior in children. However the effects of altered cortisol levels remain poorly understood in the complex context of conduct disorder, callous-unemotional (CU) personality tra...

Objectives A selective intensified prevention (SIP) was introduced at individual schools in deprived areas in Marburg County (Germany) in 1995. The outcome of the program was evaluated in sixth graders (mean age: 12.06 years) in comparison to a control region. Materials and methods Caries experience was recorded by applying International Caries Det...

When the International Caries Detection and Assessment System (ICDAS-II) was introduced, a two-number coding system that identifies restorations/sealants with the first digit and scores the caries lesions with a second digit was suggested. The aim of this study was, first, to assess the intra- and interexaminer reproducibility of this method applie...

This study was designed to identify items of the ADI-R that allow an early and sensitive identification of children with possible Asperger syndrome (AS). The aim was to obtain an economic short interview suitable for screening purposes. The study was based on data from a clinical sample of 5-18-year-old children and adolescents (mean age 10.9years)...

Aim. To use visual inspection (ICDAS-II), laser fluorescence (LF), fluorescence based camera (FC) and radiographic examination (BW) for detection of caries and for treatment decision. Methods. The occlusal sites of 84 extracted permanent teeth were examined using all methods and treatment decisions (preventive or operative care) were recorded based...