Kooperativer Bibliotheksverbund

In: Journal of the Society of Architectural Historians, University of California Press, Vol. 31, No. 3 ( 1972-10-01), p. 221-237

Type of Medium: Online Resource

ISSN: 0037-9808

URL: Article

DOI: 10.2307/988768

Language: English

Publisher: University of California Press

Publication Date: 1972

detail.hit.zdb_id: 2130567-5

detail.hit.zdb_id: 300394-2

SSG: 9,10

In: Der Anaesthesist, Springer Science and Business Media LLC, Vol. 70, No. 4 ( 2021-04), p. 298-307

Abstract: Die medikamentöse Therapie mit Sympathomimetika bildet einen Grundpfeiler der Behandlung relevanter Blutdruckabfälle, so auch der intraoperativen Hypotonie (IOH). Dieses häufige Problem ist mit Endorganschäden assoziiert, wobei Nierenversagen und eine erhöhte Rate kardiovaskulärer Komplikationen am besten dokumentiert sind. Die Datenlage verdeutlicht die Notwendigkeit, dass eine IOH schnell und konsequent therapiert werden muss. Obwohl Cafedrin/Theodrenalin (C/T) in Deutschland häufig in dieser Indikation eingesetzt wird, fehlte bislang ein Wirksamkeitsvergleich mit international verfügbaren Alternativen wie Ephedrin (E). Methoden HYPOTENS ist eine prospektive, nationale, multizentrische (53 Kliniken mit 66 operativen Abteilungen), offene, zweiarmige, nicht-interventionelle Studie zum Vergleich der Wirksamkeit von C/T und E bei der IOH-Therapie unter klinischen Routinebedingungen. Diese Studie beschreibt eine prospektiv definierte Kohorte von Patienten im Alter von ≥50 Jahren mit Komorbiditäten, deren Allgemeinanästhesie mit Propofol und Fentanyl (≥0,2 mg oder Äquivalent) eingeleitet wurde. Alle Patienten hatten intraoperativ eine therapiepflichtige IOH entwickelt und wurden nach dem jeweiligen lokalen Standard mit C/T oder E therapiert. Die primären Studienziele waren Präzision und Schnelligkeit des Blutdruckanstiegs auf einen vor der Behandlung individuell festgelegten Mindest-Zielblutdruck, ohne dabei einen relevanten Anstieg der Herzfrequenz zu verursachen. Die Therapiezufriedenheit der Anästhesisten und die Anzahl zusätzlicher Bolusinjektionen oder weiterer kreislaufstabilisierender Maßnahmen waren sekundäre Endpunkte. Ergebnisse Insgesamt 1496 Patienten wurden protokollgemäß behandelt und ausgewertet. Eine Kreislaufstabilisierung wurde mit beiden Therapieoptionen erreicht. Post-hoc-Analysen zeigen, dass der Blutdruckanstieg unter C/T ausgeprägter war und gleichzeitig weniger zusätzliche Boli der jeweiligen Substanz appliziert und zusätzliche kreislaufstabilisierende Interventionen durchgeführt werden mussten. Die Inzidenz von Tachykardien war in beiden Behandlungsgruppen vergleichbar. Unter E kam es jedoch zu einer dosisabhängigen Erhöhung der Herzfrequenz, während bei den mit C/T behandelten Patienten die Herzfrequenz stabil blieb. Die Therapiezufriedenheit der Anästhesisten war im C/T-Arm höher. Schlussfolgerung Hinsichtlich der Kreislaufstabilisierung war keine der beiden Therapieoptionen überlegen. Post-hoc-Analysen deuten darauf hin, dass C/T unter Routinebedingungen eine zielorientiertere und einfacher zu steuernde Kreislaufstabilisierung ermöglicht. Die seltener erforderlichen erweiterten Therapiemaßnahmen zur ergänzenden IOH-Korrektur stellen einen möglichen Grund für die höhere Anwenderzufriedenheit dar.

Type of Medium: Online Resource

ISSN: 0003-2417 , 1432-055X

URL: Article

DOI: 10.1007/s00101-020-00877-5

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2021

detail.hit.zdb_id: 3122926-8

detail.hit.zdb_id: 1458421-9

In: Brain, Oxford University Press (OUP), Vol. 146, No. 3 ( 2023-03-01), p. 977-990

Abstract: Autoimmune neurological syndromes (AINS) with autoantibodies against the 65 kDa isoform of the glutamic acid decarboxylase (GAD65) present with limbic encephalitis, including temporal lobe seizures or epilepsy, cerebellitis with ataxia, and stiff-person-syndrome or overlap forms. Anti-GAD65 autoantibodies are also detected in autoimmune diabetes mellitus, which has a strong genetic susceptibility conferred by human leukocyte antigen (HLA) and non-HLA genomic regions. We investigated the genetic predisposition in patients with anti-GAD65 AINS. We performed a genome-wide association study (GWAS) and an association analysis of the HLA region in a large German cohort of 1214 individuals. These included 167 patients with anti-GAD65 AINS, recruited by the German Network for Research on Autoimmune Encephalitis (GENERATE), and 1047 individuals without neurological or endocrine disease as population-based controls. Predictions of protein expression changes based on GWAS findings were further explored and validated in the CSF proteome of a virtually independent cohort of 10 patients with GAD65-AINS and 10 controls. Our GWAS identified 16 genome-wide significant (P & lt; 5 × 10−8) loci for the susceptibility to anti-GAD65 AINS. The top variant, rs2535288 [P = 4.42 × 10−16, odds ratio (OR) = 0.26, 95% confidence interval (CI) = 0.187–0.358], localized to an intergenic segment in the middle of the HLA class I region. The great majority of variants in these loci ( & gt;90%) mapped to non-coding regions of the genome. Over 40% of the variants have known regulatory functions on the expression of 48 genes in disease relevant cells and tissues, mainly CD4+ T cells and the cerebral cortex. The annotation of epigenomic marks suggested specificity for neural and immune cells. A network analysis of the implicated protein-coding genes highlighted the role of protein kinase C beta (PRKCB) and identified an enrichment of numerous biological pathways participating in immunity and neural function. Analysis of the classical HLA alleles and haplotypes showed no genome-wide significant associations. The strongest associations were found for the DQA1*03:01-DQB1*03:02-DRB1*04:01HLA haplotype (P = 4.39 × 10−4, OR = 2.5, 95%CI = 1.499–4.157) and DRB1*04:01 allele (P = 8.3 × 10−5, OR = 2.4, 95%CI = 1.548–3.682) identified in our cohort. As predicted, the CSF proteome showed differential levels of five proteins (HLA-A/B, C4A, ATG4D and NEO1) of expression quantitative trait loci genes from our GWAS in the CSF proteome of anti-GAD65 AINS. These findings suggest a strong genetic predisposition with direct functional implications for immunity and neural function in anti-GAD65 AINS, mainly conferred by genomic regions outside the classical HLA alleles.

Type of Medium: Online Resource

ISSN: 0006-8950 , 1460-2156

URL: Article

DOI: 10.1093/brain/awac119

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2023

detail.hit.zdb_id: 1474117-9

SSG: 12

In: Brain, Oxford University Press (OUP), Vol. 146, No. 2 ( 2023-02-13), p. 600-611

Abstract: Anti-IgLON5 disease is a newly defined clinical entity characterized by a progressive course with high disability and mortality rate. While precise pathogenetic mechanisms remain unclear, features characteristic of both autoimmune and neurodegenerative diseases were reported. Data on immunotherapy are limited, and its efficacy remains controversial. In this study, we retrospectively investigated an anti-IgLON5 disease cohort with special focus on clinical, serological and genetic predictors of the immunotherapy response and long-term outcome. Patients were recruited from the GENERATE (German Network for Research on Autoimmune Encephalitis) registry. Along with clinical parameters, anti-IgLON5 immunoglobulin (Ig)G in serum and CSF, anti-IgLON5 IgG1-4, IgA and IgM in serum, neurofilament light chain and glial fibrillary acidic protein in serum as well as human leukocyte antigen-genotypes were determined. We identified 53 patients (symptom onset 63.8 ± 10.3 years, female:male 1:1.5). The most frequent initial clinical presentations were bulbar syndrome, hyperkinetic syndrome or isolated sleep disorder [at least one symptom present in 38% (20/53)]. At the time of diagnosis, the majority of patients had a generalized multi-systemic phenotype; nevertheless, 21% (11/53) still had an isolated brainstem syndrome and/ or a characteristic sleep disorder only. About one third of patients [28% (15/53)] reported subacute disease onset and 51% (27/53) relapse-like exacerbations during the disease course. Inflammatory CSF changes were evident in 37% (19/51) and increased blood-CSF-barrier permeability in 46% (21/46). CSF cell count significantly decreased, while serum anti-IgLON5 IgG titre increased with disease duration. The presence of human leukocyte antigen-DRB1*10:01 [55% (24/44)] was associated with higher serum anti-IgLON5 IgG titres. Neurofilament light chain and glial fibrillary acidic protein in serum were substantially increased (71.1 ± 103.9 pg/ml and 126.7 ± 73.3 pg/ml, respectively). First-line immunotherapy of relapse-like acute-to-subacute exacerbation episodes resulted in improvement in 41% (11/27) of patients and early initiation within the first 6 weeks was a predictor for therapy response. Sixty-eight per cent (36/53) of patients were treated with long-term immunotherapy and 75% (27/36) of these experienced no further disease progression (observation period of 20.2 ± 15.4 months). Long-term immunotherapy initiation during the first year after onset and low pre-treatment neurofilament light chain were significant predictors for a better outcome. In conclusion, subacute disease onset and early inflammatory CSF changes support the primary role of autoimmune mechanisms at least at initial stages of anti-IgLON5 disease. Early immunotherapy, prior to advanced neurodegeneration, is associated with a better long-term clinical outcome. Low serum neurofilament light chain at treatment initiation may serve as a potential biomarker of the immunotherapy response.

Type of Medium: Online Resource

ISSN: 0006-8950 , 1460-2156

URL: Article

DOI: 10.1093/brain/awac090

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2023

detail.hit.zdb_id: 1474117-9

SSG: 12

In: Critical Care, Springer Science and Business Media LLC, Vol. 26, No. 1 ( 2022-12)

Abstract: It remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic. Methods Prospective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic. Results Four thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60–63] years vs 64 [62–66] years, p   〈  0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6–9.0] vs 5.8 [5.3–6.4] , p   〈  0.001) and increased, while more female patients (26 [23–29]% vs 41 [35–48] %, p   〈  0.001) were admitted. The time span between symptom onset and hospitalization as well as ICU admission became longer later in the pandemic (6.7 [6.2–7.2| days vs 9.7 [8.9–10.5] days, p   〈  0.001). The PaO 2 /FiO 2 at admission was lower (132 [123–141] mmHg vs 101 [91–113] mmHg, p   〈  0.001) but showed faster improvements over the initial 5 days of ICU stay in late 2021 compared to early 2020 (34 [20–48] mmHg vs 70 [41–100] mmHg, p  = 0.05). The number of patients treated with steroids and tocilizumab increased, while the use of therapeutic anticoagulation presented an inverse U-shaped behaviour over the course of the pandemic. The proportion of patients treated with high-flow oxygen (5 [4–7]% vs 20 [14–29] , p   〈  0.001) and non-invasive mechanical ventilation (14 [11–18]% vs 24 [17–33] %, p   〈  0.001) throughout the pandemic increased concomitant to a decrease in invasive mechanical ventilation (82 [76–86]% vs 74 [64–82] %, p   〈  0.001). The ICU mortality (23 [19–26]% vs 17 [12–25] %, p   〈  0.001) and length of stay (14 [13–16] days vs 11 [10–13] days, p   〈  0.001) decreased over 19 months of the pandemic. Conclusion Characteristics and disease course of critically ill COVID-19 patients have continuously evolved, concomitant to the clinical management, throughout the pandemic leading to a younger, less severely ill ICU population with distinctly different clinical, pulmonary and inflammatory presentations than at the onset of the pandemic.

Type of Medium: Online Resource

ISSN: 1364-8535

URL: Article

DOI: 10.1186/s13054-022-04065-2

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 2051256-9

In: International Journal of Stroke, SAGE Publications, Vol. 15, No. 6 ( 2020-08), p. 609-618

Abstract: Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran reversing its anticoagulant effects within minutes. Thereby, patients with acute ischemic stroke who are on dabigatran treatment may become eligible for thrombolysis with recombinant tissue-type plasminogen activator (rt-PA). In patients on dabigatran with intracerebral hemorrhage idarucizumab could prevent lesion growth. Aims To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of acute ischemic stroke or intracranial hemorrhage. Methods Retrospective data collected from German neurological/neurosurgical departments administering idarucizumab following product launch from January 2016 to August 2018 were used. Results One-hundred and twenty stroke patients received idarucizumab in 61 stroke centers. Eighty patients treated with dabigatran presented with ischemic stroke and 40 patients suffered intracranial bleeding (intracerebral hemorrhage (ICH) in n = 27). In patients receiving intravenous thrombolysis with rt-PA following idarucizumab, 78% showed a median improvement of 7 points in National Institutes of Health Stroke Scale. No bleeding complications were reported. Hematoma growth was observed in 3 out of 27 patients with ICH. Outcome was favorable with a median National Institutes of Health Stroke Scale improvement of 4 points and modified Rankin score 0–3 in 61%. Six out of 40 individuals (15%) with intracranial bleeding died during hospital stay. Conclusion Administration of rt-PA after reversal of dabigatran activity with idarucizumab in case of acute ischemic stroke seems feasible, effective, and safe. In dabigatran-associated intracranial hemorrhage, idarucizumab appears to prevent hematoma growth and to improve outcome.

Type of Medium: Online Resource

ISSN: 1747-4930 , 1747-4949

URL: Article

DOI: 10.1177/1747493019895654

Language: English

Publisher: SAGE Publications

Publication Date: 2020

detail.hit.zdb_id: 2211666-7

In: Phytoparasitica, Springer Science and Business Media LLC, Vol. 24, No. 1 ( 1996-3), p. 69-86

Type of Medium: Online Resource

ISSN: 0334-2123 , 1876-7184

URL: Article

DOI: 10.1007/BF02981455

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 1996

detail.hit.zdb_id: 1469840-7

In: Kyklos, Wiley, Vol. 36, No. 4 ( 1983-11), p. 638-690

Abstract: Baranzini, Mauro (ed.): Advances in Economic Theory , Oxford: Basil Blackwell 1982. 321 pp. £19.50. Béteille, André: The Backward Classes and the New Social Order , Delhi: Oxford 1981. 51 pp. Rs. 12.–. Blattner, Niklaus; Maillat, Denis und Ratti, Remigio (eds.): Regionale Arbeitsmarktprozesse (Nationales Forschungsprogramm «Regionalprobleme» des Schweizerischen Nationalfonds), Diessenhofen: Rüegger 1981. 448 S. sFr. 45.00. Bray, Jeremy: Production Purpose and Structure. Towards a Socialist Theory of Production, London: Frances Pinter 1982. 173 pp. £8.95. Breton, Albert and Wintrobe, Ronald: The Logic of Bureaucratic Conduct. An Economic Analysis of Competition, Exchange, and Efficiency in Private and Public Organizations, Cambridge: Cambridge University Press 1982. 195 pp. £15.00 (hard). Brinkmann, Gerhard: Ökonomik der Arbeit. Band I: Grundlagen; Band II: Die Allokation der Arbeit, Stuttgart: Klett‐Cotta 1981. 344 + 340 S. je DM 64.00. Casson, Mark: The Entrepreneur: An Economic Theory , Oxford: Martin Robertson 1982. 418 pp. £17.50. Domenghino, Claus‐Michael: Die Weiterentwicklung der postkeynesianischen Verteilungstheorie. Ein theoretischer und empirischer Beitrag zu den Verteilungsansätzen von N. Kaldor und L. Pasinetti (Europäische Hochschulschriften, V/342), Bern: Peter Lang 1981. 301 S. sFr. 52.00 (kart.). Ginsburgh, Victor A. and Waelbroeck, Jean L.: Activity Analysis and General Equilibrium Modelling (Contributions to Economic Analysis, 125), Amsterdam/New York/Oxford: North‐Holland 1981. 364 pp. $65.75. Gupta, Sanjeev: Black Market Exchange Rates (Kieler Studien, Institut für Weltwirtschaft an der Universität Kiel, Nr. 167), Tübingen: Mohr 1981. 100 pp. DM 49.00 (Ln.), DM 31.00 (brosch.). Häberle, Lothar: Wirtschaftspolitik bei rationalen Erwartungen. Konsequenzen einer kritischen Analyse der Theorie rationaler Erwartungen für die Wahl wirtschaftspolitischer Strategien (Untersuchungen des Instituts für Wirtschaftspolitik an der Universität zu Köln, 49), Köln 1982. 341 S. DM 38.00. Hirschman, Albert O.: Essays in Trespassing. Economics to Politics and Beyond, Cambridge: Cambridge University Press 1981. 310 pp. £20.00 (hard), £6.95 (paper). Hughes Hallett, Andrew and Rees, Hedley: Quantitative economic policies and interactive planning. A reconstruction of the theory of economic policy, Cambridge: Cambridge University Press 1983. 374 pp. £30.00. Just, Richard E.; Hueth, Darrell L. and Schmitz, Andrew: Applied Welfare Economics and Public Policy , Englewood Cliffs, N.J.: Prentice‐Hall 1982. 491 pp. $47.20 (hard). Klanberg, Frank und Krupp, Hans‐Jürgen (Hrsg.): Einkommensverteilung (Neue Wissenschaftliche Bibliothek. Wirtschaftswissenschaften, 92), Königstein/Ts.: Anton Hain 1981. 304 S. DM 54.00 (geb.), DM 39.80 (kart.). Lewin, Ralph: Arbeitsmarktsegmentierung und Lohnstruktur. Theoretische Ansätze und Hauptergebnisse einer Überprüfung am Beispiel der Schweiz (Basler sozialökonomische Studien, Band 17), Zürich: Schulthess 1982. 115 S. sFr. 21.00 (brosch.). McNeill, Desmond: The Contradictions of Foreign Aid , London: Croom Helm 1981. 115 pp. £10.95 (H/B). Nagatani, Keizo: Macroeconomic dynamics , Cambridge: Cambridge University Press 1981. 245 pp. £20.00 (hard), £7.95 (paper). Nobel, Klaus: Aussenhandelseffekte in linearen Wachstumsmodellen. Eine Analyse der Beziehungen zwischen Wachstum, Verteilung und Aussenhandel bei internationaler Kapitalmobilität (Volkswirtschaftliche Schriften, Heft 324), Berlin: Duncker & Humblot 1982. 265 S. DM 128.00. Olson, Mancur: The Rise and Decline of Nations. Economic Growth, Stagflation, and Social Rigidities, New Haven/London: Yale University Press 1982. 273 pp. £8.95. Piesch, Walter und Förster, Wolfgang (Hrsg.): Angewandte Statistik und Wirtschaftsforschung heute. Ausgewählte Beiträge (Angewandte Statistik und Ökonometrie, Heft 21), Göttingen: Vandenhoeck & Ruprecht 1982. 268 S. DM 64.00 (kart.). Ringwald, Karl: A Critique of Models in Linear Aggregation Structures (Athenaeum Economics, 1), Königstein/Ts.: Anton Hain/Oelgeschlager, Gunn & Hain 1981. 139 pp. Roemer, John E.: Analytical foundations of Marxian economic theory , Cambridge: Cambridge University Press 1981. 220 pp. Rugman, Alan M.: Inside the Multinationals. The Economics of Internal Markets, London: Croom Helm 1981. 179 pp. £11.95 (hard). Sauter‐Servaes, Florian: Über die Ablösung einer erschöpfbaren Ressource durch ihr Substitut (Mathematical systems in economics, No. 77), Königstein/Ts.: Athenäum/Hain/Scriptor/Hanstein 1982. 86 S. DM 29.80. Schiller, Christian: Staatsausgaben und crowding‐out‐Effekte. Zur Effizienz einer Finanzpolitik keynesianischer Provenienz (Finanzwissenschaftliche Schriften, Band 21), Frankfurt a.M./Bern: Peter Lang 1983. 204 S. sFr. 49.00. Sharkey, William W.: The theory of natural monopoly , Cambridge/London/New York: Cambridge University Press 1982. 229 pp. £17.50 (hard), £6.95 (paper). Stachowiak, Herbert; Ellwein, Thomas; Herrmann, Theo und Stapf, Kurt (Hrsg.): Bedürfnisse, Werte und Normen im Wandel. Band I: Grundlagen, Modelle und Prospektiven; Band II: Methoden und Analysen, München/Paderborn/Wien: Wilhelm Fink & Ferdinand Schöning. Band I: 473 S. DM 78.00, Band II: 351 S. DM 68.00. Stein, Jerome L.: Monetarist, Keynesian and New Classical Economics , Oxford: Basil Blackwell 1982. 228 pp. £15.00. Sugden, Robert: The Political Economy of Public Choice. An Introduction to Welfare Economics, Oxford: Martin Robertson 1981. 217 pp. £15.00 (hard), £5.95 (paper). Timmermann, Vincenz: Entwicklungstheorie und Entwicklungspolitik (Grundriss der Sozialwissenschaft, Band 30), Göttingen: Vandenhoeck & Ruprecht 1982. 232 S. DM 36.00 (kart.). Weeks, John: Capital and Exploitation , Princeton: Princeton University Press 1981. 223 pp. $21.00 (cloth), $9.95 (paper).

Type of Medium: Online Resource

ISSN: 0023-5962 , 1467-6435

URL: Issue

URL: Article

DOI: 10.1111/kykl.v36.4

DOI: 10.1111/j.1467-6435.1983.tb00007.x

Language: English

Publisher: Wiley

Publication Date: 1983

detail.hit.zdb_id: 3292-X

detail.hit.zdb_id: 2021217-3

In: European Journal of Pediatrics, Springer Science and Business Media LLC, Vol. 182, No. 2 ( 2022-11-30), p. 697-706

Type of Medium: Online Resource

ISSN: 1432-1076

URL: Article

DOI: 10.1007/s00431-022-04718-y

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 2647723-3

In: European Journal of Pediatrics, Springer Science and Business Media LLC, Vol. 182, No. 2 ( 2023-01-23), p. 707-707

Type of Medium: Online Resource

ISSN: 1432-1076

URL: Article

DOI: 10.1007/s00431-022-04787-z

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2023

detail.hit.zdb_id: 2647723-3