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  • 1
    In: International Wound Journal, December 2011, Vol.8(6), pp.578-584
    Description: We analysed the effect of different body features on contact area, interface pressure and pressure distribution of three different mattresses. Thirty‐eight volunteers (age ranged from 17 to 73 years, 23 females) were asked to lie on three different mattresses in a random order: I, standard hospital foam mattresses; II, higher specification foam mattresses (Viscorelax Sure); III, constant low pressure devices (CareMedx, AirSystems). Measurements were performed in supine position and in a 90° left‐ and right‐sided position, respectively, using a full‐body mat (pressure mapping device Xsensor X2‐Modell). Outcome variables were contact area (CA) in cm, mean interface pressure (IP) in mmHg and pressure distribution (PD) estimated as rate of low pressures between 5 and 33 mmHg on each mattress in percent. Mean CA was lowest in the standard hospital foam mattresses and increased in the higher specification foam mattresses and was highest in the constant low pressure device (supine position: 491 ± 86 cm, 615 ± 95 cm, 685 ± 116 cm). Mean IP was highest in the standard hospital foam mattresses and lower but similar in the higher specification foam mattresses and the constant low pressure devices (supine position: 22·3 ± 1·5 mmHg, 17·6 ± 1·7 mmHg, 17·6 ± 2·2 mmHg). Models were estimated for CA, IP and PD including the independent variables height, weight and waist‐to‐hip‐ratio (WHR). They show that body morphology seems to play a minor role for CA, IP and PD, but very thin and tall patients and very small and obese people might benefit from different mattresses. Our data show that CA increases with increasing specification of mattresses. Higher specification foam mattresses and constant low pressure devices show similar IP, but constant low pressure devices show a wider pressure distribution. Body morphology should be considered to optimise prevention for single patients.
    Keywords: Interface Pressure ; Mattresses ; Pressure Ulcer ; Waist‐To‐Hip‐Ratio
    ISSN: 1742-4801
    E-ISSN: 1742-481X
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  • 2
    Language: English
    In: Clinical Research in Cardiology, 2013, Vol.102(8), pp.607-614
    Description: Byline: Undine Pittl (1), Alexandra Schratter (2), Steffen Desch (1), Raluca Diosteanu (1), Denise Lehmann (1), Katharina Demmin (1), Jacqueline Horig (3), Gerhard Schuler (1), Thorsten Klemm (4), Meinhard Mende (5), Holger Thiele (1) Keywords: Resuscitation; Cardiac arrest; Hypothermia; Neuron-specific enolase; Outcome; Cooling-associated complications Abstract: Introduction Mild induced hypothermia (MIH) is indicated for comatose survivors of sudden cardiac arrest (SCA) to improve clinical outcome. In this study, we compared the efficacy of two different cooling devices for temperature management in SCA survivors. Methods Between April 2008 and August 2009, 80 patients after survived in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) were included in this prospective, randomized, single center study. Hypothermia was induced after randomization by either invasive Coolgard.sup.(r) cooling or non-invasive ArcticSun.sup.(r) surface cooling at 33.0 degC core body temperature for 24 h followed by active rewarming. The primary endpoint was defined as the efficacy of both cooling systems, measured by neuron-specific enolase (NSE) levels as a surrogate parameter for brain damage. Secondary efficacy endpoints were the clinical and neurological outcome, time to start of cooling and reaching the target temperature, target temperature-maintenance and hypothermia-associated complications. Results NSE at 72 h did not differ significantly between the 2 groups with 16.5 ng/ml, interquartile range 11.8--46.5 in surface-cooled patients versus 19.0 ng/ml, interquartile range 11.0--42.0 in invasive-cooled patients, p = 0.99. Neurological and clinical outcome was similar in both groups. Target temperature of 33.0 degC was maintained more stable in the invasive group (33.0 versus 32.7 degC, p 〈 0.001). Bleeding complications were more frequent with invasive cooling (n = 17 [43.6 %] versus n = 7 [17.9 %] p = 0.03). Conclusion Invasive cooling has advantages with respect to temperature management over surface cooling however, did not result in different outcome as measured by NSE release in SCA survivors. Bleeding complications were more frequently encountered by invasive cooling. Author Affiliation: (1) Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Strumpellstr. 39, 04289, Leipzig, Germany (2) Hospital Hietzing, Vienna, Austria (3) Hospital Freudenstadt, Freudenstadt, Germany (4) MVZ Laboratory Dr. Reising-Ackermann and Colleagues, Leipzig, Germany (5) University of Leipzig, Coordination Centre for Clinical Trials, Leipzig, Germany Article History: Registration Date: 17/04/2013 Received Date: 09/03/2013 Accepted Date: 17/04/2013 Online Date: 05/05/2013 Article note: Trial registration: ClinicalTrials.gov NCT: 00843297.
    Keywords: Resuscitation ; Cardiac arrest ; Hypothermia ; Neuron-specific enolase ; Outcome ; Cooling-associated complications
    ISSN: 1861-0684
    E-ISSN: 1861-0692
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  • 3
    Language: English
    In: Virchows Archiv, 2010, Vol.457(3), pp.369-380
    Description: Obliterative airway remodelling is a morphological sequence in a variety of pulmonary diseases. Notably, bronchiolitis obliterans represents one of the key complications of lung transplantation, induced by (immigrating) myofibroblasts. A comparative expression analysis of obliterative airway remodelling in transplanted and non-transplanted patients has not been reported so far. Obliterated and unremodelled airways from explanted lungs ( n  = 19) from patients suffering from chronic allograft dysfunction, infection, graft-versus-host disease and toxic exposure were isolated by laser-assisted microdissection. Airways from lung allografts harvested shortly before and after transplantation ( n  = 4) as well as fibroblastic foci from lungs with interstitial pulmonary fibrosis ( n  = 4) served as references. Pre-amplified cDNA was analysed by quantitative real-time RT-PCR for expression of fibrosis, inflammation and apoptosis-associated genes. Composition of infiltrating cells and protein expression were assessed by conventional histology and immunohistochemistry. Bronchiolitis obliterans in transplanted patients showed a significant increase of BMP-7 expression ( p  = 0.0141 compared with controls), while TGF-β1 and FGF-2 as well as BMP-4 and BMP-7 were up-regulated in fibroblastic foci in interstitial pulmonary fibrosis ( p  〈 0.0424 compared with controls). Regarding other fibrosis-associated genes (BMP-6, SMAD-3, CASP-3 and CASP-9, FASLG, NF-KB1, IL-1 and IL-2) as well as cellularity and cellular composition, no significant differences between obliterative airway remodelling in transplanted and non-transplanted patients could be shown. Obliterative airway remodelling in lung allografts and in non-transplanted patients share many morphological and genetic traits. BMPs, especially BMP-7, warrant further investigation as possible markers for the aggravation of airway remodelling.
    Keywords: Bronchiolitis obliterans ; Lung transplantation ; Fibrosis ; Airway remodelling
    ISSN: 0945-6317
    E-ISSN: 1432-2307
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  • 4
    In: Circulation, 2017, Vol.135(9), pp.881-897
    Description: BACKGROUND:: Chronic heart failure (HF) is associated with altered signal transduction via β-adrenoceptors and G proteins and with reduced cAMP formation. Nucleoside diphosphate kinases (NDPKs) are enriched at the plasma membrane of patients with end-stage HF, but the functional consequences of this are largely unknown, particularly for NDPK-C. Here, we investigated the potential role of NDPK-C in cardiac cAMP formation and contractility. METHODS:: Real-time polymerase chain reaction, (far) Western blot, immunoprecipitation, and immunocytochemistry were used to study the expression, interaction with G proteins, and localization of NDPKs. cAMP levels were determined with immunoassays or fluorescent resonance energy transfer, and contractility was determined in cardiomyocytes (cell shortening) and in vivo (fractional shortening). RESULTS:: NDPK-C was essential for the formation of an NDPK-B/G protein complex. Protein and mRNA levels of NDPK-C were upregulated in end-stage human HF, in rats after long-term isoprenaline stimulation through osmotic minipumps, and after incubation of rat neonatal cardiomyocytes with isoprenaline. Isoprenaline also promoted translocation of NDPK-C to the plasma membrane. Overexpression of NDPK-C in cardiomyocytes increased cAMP levels and sensitized cardiomyocytes to isoprenaline-induced augmentation of contractility, whereas NDPK-C knockdown decreased cAMP levels. In vivo, depletion of NDPK-C in zebrafish embryos caused cardiac edema and ventricular dysfunction. NDPK-B knockout mice had unaltered NDPK-C expression but showed contractile dysfunction and exacerbated cardiac remodeling during long-term isoprenaline stimulation. In human end-stage HF, the complex formation between NDPK-C and Gαi2 was increased whereas the NDPK-C/Gαs interaction was decreased, producing a switch that may contribute to an NDPK-C–dependent cAMP reduction in HF. CONCLUSIONS:: Our findings identify NDPK-C as an essential requirement for both the interaction between NDPK isoforms and between NDPK isoforms and G proteins. NDPK-C is a novel critical regulator of β-adrenoceptor/cAMP signaling and cardiac contractility. By switching from Gαs to Gαi2 activation, NDPK-C may contribute to lower cAMP levels and the related contractile dysfunction in HF.
    Keywords: Heart Failure ; Myocardial Contraction ; Receptors, Adrenergic, Beta ; Signal Transduction ; Cyclic Amp -- Analysis ; Heart Failure -- Pathology ; Nm23 Nucleoside Diphosphate Kinases -- Analysis;
    ISSN: 0009-7322
    E-ISSN: 15244539
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  • 5
    In: Journal of Computer Assisted Tomography, 2017, Vol.41(1), pp.121-124
    Description: OBJECTIVE: The aims were to study the acromion parameters in the population and to assess the extremity or sex variation in the acromion morphology. METHODS: The lateral acromion angle (LAA) and the acromion index (AI) were assessed in a computed tomographic scan database of 250 individuals in the age group of 20 to 49 years. For the analysis of LAA and AI, 286 and 234 shoulders were available, respectively. RESULTS: The LAA was 73.6 ± 6.6 degrees; 73.7 ± 6.9 and 72.5 ± 6.1 degrees for the right and left shoulder, respectively. The AI was 0.755 ± 0.12; 0.82 ± 0.12 and 0.69 ± 0.12 for the left and the right shoulder, respectively. The AI of the right shoulder was significantly different between the 2 sexes (P = 0.04). The difference in the AI and the LAA of the right and left shoulders was significant (P 〈 0.0001, P = 0.04). CONCLUSIONS: The morphology of the acromion differs between the right and the left shoulders as well as between sexes.
    Keywords: Acromion–Anatomy & Histology ; Adult–Diagnostic Imaging ; Female–Epidemiology ; Germany–Statistics & Numerical Data ; Humans–Statistics & Numerical Data ; Male–Statistics & Numerical Data ; Middle Aged–Statistics & Numerical Data ; Reproducibility of Results–Statistics & Numerical Data ; Sensitivity and Specificity–Statistics & Numerical Data ; Sex Distribution–Statistics & Numerical Data ; Sex Factors–Statistics & Numerical Data ; Tomography, X-Ray Computed–Statistics & Numerical Data;
    ISSN: 0363-8715
    E-ISSN: 15323145
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  • 6
    In: PLoS ONE, 2017, Vol.12(4)
    Description: Aims In infective endocarditis (IE), a severe inflammatory disease of the endocardium with an unchanged incidence and mortality rate over the past decades, only 1% of the cases have been described as polymicrobial infections based on microbiological approaches. The aim of this study was to identify potential biodiversity of bacterial species from infected native and prosthetic valves. Furthermore, we compared the ultrastructural micro-environments to detect the localization and distribution patterns of pathogens in IE. Material and methods Using next-generation sequencing (NGS) of 16S rDNA, which allows analysis of the entire bacterial community within a single sample, we investigated the biodiversity of infectious bacterial species from resected native and prosthetic valves in a clinical cohort of 8 IE patients. Furthermore, we investigated the ultrastructural infected valve micro-environment by focused ion beam scanning electron microscopy (FIB-SEM). Results Biodiversity was detected in 7 of 8 resected heart valves. This comprised 13 bacterial genera and 16 species. In addition to 11 pathogens already described as being IE related, 5 bacterial species were identified as having a novel association. In contrast, valve and blood culture-based diagnosis revealed only 4 species from 3 bacterial genera and did not show any relevant antibiotic resistance. The antibiotics chosen on this basis for treatment, however, did not cover the bacterial spectra identified by our amplicon sequencing analysis in 4 of 8 cases. In addition to intramural distribution patterns of infective bacteria, intracellular localization with evidence of bacterial immune escape mechanisms was identified. Conclusion The high frequency of polymicrobial infections, pathogen diversity, and intracellular persistence of common IE-causing bacteria may provide clues to help explain the persistent and devastating mortality rate observed for IE. Improved bacterial diagnosis by 16S rDNA NGS that increases the ability to tailor antibiotic therapy may result in improved outcomes.
    Keywords: Research Article ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Research And Analysis Methods ; Biology And Life Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences
    E-ISSN: 1932-6203
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  • 7
    Language: English
    In: Clinical chemistry, November 2018, Vol.64(11), pp.1646-1656
    Description: Measurements of plasma or urinary metanephrines are recommended for diagnosis of pheochromocytoma and paraganglioma (PPGL). What test offers optimal diagnostic accuracy for patients at high and low risk of disease, whether urinary free metanephrines offer advantages over deconjugated metanephrines, and what advantages are offered by including methoxytyramine in panels all remain unclear. A population of 2056 patients with suspected PPGLs underwent prospective screening for disease using mass spectrometric-based measurements of plasma free, urinary deconjugated, and urinary free metanephrines and methoxytyramine. PPGLs were confirmed in 236 patients and were excluded in others on follow-up evaluation. Measurements of plasma free metabolites offered higher ( 〈 0.01) diagnostic sensitivity (97.9%) than urinary free (93.4%) and deconjugated (92.9%) metabolites at identical specificities for plasma and urinary free metabolites (94.2%) but at a lower ( 〈 0.005) specificity for deconjugated metabolites (92.1%). The addition of methoxytyramine offered little value for urinary panels but provided higher ( 〈 0.005) diagnostic performance for plasma measurements than either urinary panel according to areas under ROC curves (0.991 vs 0.972 and 0.964). Diagnostic performance of urinary and plasma tests was similar for patients at low risk of disease, whereas plasma measurements were superior to both urinary panels for high-risk patients. Diagnosis of PPGLs using plasma or urinary free metabolites provides advantages of fewer false-positive results compared with commonly measured deconjugated metabolites. The plasma panel offers better diagnostic performance than either urinary panel for patients at high risk of disease and, with appropriate preanalytics, provides the test of choice. Measurements of methoxytyramine in urine show limited diagnostic utility compared with plasma.
    Keywords: Metanephrine ; Adrenal Gland Neoplasms -- Diagnosis ; Chromaffin Cells -- Metabolism ; Dopamine -- Analogs & Derivatives ; Paraganglioma -- Diagnosis
    ISSN: 00099147
    E-ISSN: 1530-8561
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  • 8
    In: Thrombosis and Haemostasis, 2014, Vol.112(04)
    In: Thrombosis and Haemostasis, 2017, Vol.112(04), pp.834-836
    Keywords: Administration, Oral–Diagnosis ; Chromatography, High Pressure Liquid–Chemistry ; Drug Overdose–Immunology ; Factor Xa–Administration & Dosage ; Hemorrhage–Poisoning ; Humans–Administration & Dosage ; Male–Poisoning ; Middle Aged–Blood ; Morpholines–Diagnosis ; Rivaroxaban–Blood ; Suicide, Attempted–Diagnosis ; Tandem Mass Spectrometry–Diagnosis ; Thiophenes–Diagnosis ; Treatment Outcome–Diagnosis ; Venous Thromboembolism–Diagnosis ; Venous Thrombosis–Diagnosis ; Morpholines ; Thiophenes ; Rivaroxaban ; Factor Xa;
    ISSN: 0340-6245
    E-ISSN: 2567-689X
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  • 9
    Language: English
    In: International Journal of Environmental Research and Public Health, 01 December 2018, Vol.15(12), p.2855
    Description: The consequences of mushroom poisoning range from mild, mostly gastrointestinal, disturbances to organ failure or even death. This retrospective study describes presentations related to mushroom poisoning at an emergency department in Bern (Switzerland) from January 2001 to October 2017. Gastrointestinal disturbances were reported in 86% of the 51 cases. The National Poisons Information Centre and mycologists were involved in 69% and 61% of the cases, respectively. Identification of the mushroom type/family was possible in 43% of the cases. The most common mushroom family was Boletaceae (n = 21) and the most common mushrooms Xerocomus chrysenteron (n = 7; four being part of a cluster), Clitocybe nebularis, Lepista nuda and Lactarius semisanguifluus (n = 5 each, four being part of a cluster). Poisonous mushrooms included Amanita phalloides (n = 3, all analytically confirmed), Boletus satanas (n = 3), Amanita muscaria (n = 2) and Amanita pantherina (n = 2). There were no fatalities and 80% of the patients were discharged within 24 h. Mushroom poisoning does not appear to be a common reason for emergency consultation and most presentations were of minor severity and related to edible species (e.g., due to incorrect processing). Nevertheless, poisonous mushrooms and severe complications were also recorded. Collaboration with a poison centre and/or mycologists is of great importance, especially in high risk cases.
    Keywords: Mushroom Poisoning ; Mushroom Toxicity ; Emergency Department ; Public Health
    ISSN: 16617827
    E-ISSN: 1660-4601
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  • 10
    Language: English
    In: BMC Veterinary Research, 01 September 2017, Vol.13(1), pp.1-7
    Description: Abstract Background Glucocorticoids influence the synthesis and metabolism of catecholamines (epinephrine and norepinephrine) and metanephrines (metanephrine and normetanephrine). The aim of this study was to measure urinary catecholamines and metanephrines in dogs with hypercortisolism before and during trilostane therapy. Urine samples were collected during initial work up and during therapy with trilostane in 14 dogs with hypercortisolism and in 25 healthy dogs. Epinephrine, norepinephrine, metanephrine and normetanephrine were measured using high-pressure liquid chromatography and expressed as ratios to urinary creatinine concentration. Results Untreated dogs with hypercortisolism had significantly higher epinephrine, norepinephrine, and normetanephrine:creatinine ratios compared to healthy dogs. During trilostane therapy, urinary catecholamines and their metabolites did not decrease significantly. However, dogs with low post-ACTH cortisol concentrations during trilostane therapy had less increased epinephrine, norepinephrine and normetanephrine:creatinine ratios compared to healthy dogs. There was no correlation of urinary catecholamines and their metabolites with baseline or post-ACTH cortisol or endogenous ACTH concentrations during trilostane therapy. Conclusion Influences between steroid hormones and catecholamines seem to occur, as dogs with hypercortisolism have significantly higher urinary epinephrine, norepinephrine, and normetanephrine:creatinine ratios. Once-daily trilostane therapy does not lead to a significant decrease in catecholamines and their metabolites. Trilostane-treated dogs still have increased urinary epinephrine, norepinephrine and normetanephrine:creatinine ratios during trilostane therapy.
    Keywords: ACTH ; Metanephrines ; Pheochromocytoma ; Trilostane Therapy ; Canine ; Veterinary Medicine
    E-ISSN: 1746-6148
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