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Hankinson T, Fields E, Handler M, Foreman N, Liu A, Muller HL, Gebhardt U, Warmuth-Metz M, Kortmann RD, Faldum A, Pietsch T, Sorensen N, Calaminus G, Muller HL, Gebhardt U, Maroske J, Hanisch E, Muller HL, Gebhardt U, Pohl F, Kortmann RD, Faldum A, Warmuth-Metz M, Pietsch T, Calaminus G, Sorensen N, Muller HL, Enriori PJ, Gebhardt U, Hinney A, Hebebrandt J, Reinehr T, Cowley M, Roth C, Rosenfeld A, Arrington D, Etzl M, Miller J, Gieseking A, Dvorchik I, Kaplan A, Jakacki R, Yeung J, Panigrahy A, Pollack I, Mallucci C, Pizer B, Didi M, Blair J, Upadrasta S, Doss A, Avula S, Pettorini B, Alapetite C, Puget S, Ruffier A, Habrand JL, Bolle S, Noel G, Nauraye C, De Marzy L, Boddaert N, Brisse H, Sainte-Rose C, Zerah M, Boetto S, Laffond C, Chevignard M, Grill J, Doz F, Jalali R, Gupta T, Goswami S, Shah N, Golambade N, Ikazoboh EC, Dattani M, Spoudeas H, Confer M, McNall-Knapp R, Krishnan S, Gross N, Keole S, Ormandy D, Alston R, Kamaly-Asl I, Gattamaneni R, Birch J, Estlin E, Kiehna E, Laws E, Oldfield E, Jane J. CRANIOPHARYNGIOMA. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kostopoulos P, Walter S, Haass A, Papanagiotou P, Roth C, Yilmaz U, Körner H, Alexandrou M, Viera J, Dabew E, Ziegler K, Schmidt K, Kubulus D, Grunwald I, Schlechtriemen T, Liu Y, Volk T, Reith W, Fassbender K. Mobile stroke unit for diagnosis-based triage of persons with suspected stroke. Neurology 2012; 78:1849-52. [PMID: 22592363 DOI: 10.1212/wnl.0b013e318258f773] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In this feasibility study, we tested whether prehospital diagnostic stroke workup enables rational decision-making regarding treatment and the target hospital in persons with suspected stroke. METHODS A mobile stroke unit that delivers imaging (including multimodal brain imaging with CT angiography and CT perfusion), point-of-care-laboratory analysis, and neurologic expertise directly at the emergency site was analyzed for its use in prehospital diagnosis-based triage of suspected stroke patients. RESULTS We present 4 complementary cases with suspected stroke who underwent prehospital diagnostic workup that enabled direct diagnosis-based treatment decisions and reliable triage regarding the most appropriate medical facility for that individual, e.g., a primary hospital vs specialized centers of a tertiary hospital. CONCLUSIONS This preliminary report demonstrates the feasibility of prehospital diagnostic stroke workup for immediate etiology-specific decision-making regarding the necessary time-sensitive stroke treatment and the most appropriate target hospital.
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Belmin J, Min L, Roth C, Reuben D, Wenger N. Assessment and management of patients with cognitive impairment and dementia in primary care. J Nutr Health Aging 2012; 16:462-7. [PMID: 22555792 DOI: 10.1007/s12603-012-0026-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To evaluate care provided by primary care physicians in community practice to older patients presenting with cognitive impairment and dementia. DESIGN Secondary analysis of an intervention study. SETTING Primary care clinics. PARTICIPANTS 101 patients 75 years and older enrolled in the ACOVE-2 study who presented with a new cognitive problem, new dementia, or prevalent dementia. MEASUREMENTS Patients assessment and management were evaluated from medical record review and caregiver interviews. RESULTS Among 34 patients presenting with a new cognitive problem, half received a cognitive assessment comprising of a test of memory and one other cognitive task, 41% were screened for depression and 29% were referred to a consultant. Of the 27 patients with newly diagnosed dementia, 15% received the components of a basic neurological examination, one-fifth received basic laboratory testing and for one third the medical record reflected an attempt to classify the type of dementia. Counseling was under-reported in the medical record compared to the caregiver interview for the 101 patients with dementia, but even the interview revealed that about half or fewer patients received counseling about safety and accident prevention, caregiver support or managing conflicts. Less than 10% were referred to a social worker. CONCLUSION This small but detailed evaluation suggests patients presenting with cognitive problems to primary care physicians do not consistently receive basic diagnosis and management.
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Roth C, Ferbert A. The posterior reversible encephalopathy syndrome: what's certain, what's new? Pract Neurol 2012; 11:136-44. [PMID: 21551107 DOI: 10.1136/practneurol-2011-000010] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The posterior reversible encephalopathy syndrome is an increasingly recognised disorder. Most patients have several symptoms; seizures are the most frequent, often multiple or status epilepticus. A combination of seizures, visual disturbance and/or headache, in particular, should lead to an early brain MRI to reveal the typical pattern of bilateral hyperintensities on fluid attenuated inversion recovery imaging, predominantly in the parieto-occipital region. There seem to be many possible triggers, including abrupt arterial hypertension, impaired renal function, pregnancy, immunosuppressive therapies and various inflammatory conditions. The clinical outcome is excellent, with recovery within a few days, while the MRI abnormalities resolve much more slowly. Little is known about the best management. Seizures do not normally progress to chronic epilepsy so antiepileptic drugs should be discontinued after about 3 months.
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Held M, Walthelm J, Baron S, Roth C, Jany B. Pulmonale Hypertonie bei chronischer alveolärer Hypoventilation – Funktionelle und hämodynamische Verbesserung durch nicht-invasive Beatmung. Pneumologie 2012. [DOI: 10.1055/s-0032-1302556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Held M, Meintz S, Baron S, Roth C, Wilkens H, Schäfers HJ, Jany B. Zentrale Schlafapnoe bei Chronisch-thrombembolischer pulmonaler Hypertonie – Komplette Rückbildung nach pulmonaler Thrombendatherektomie. Pneumologie 2012. [DOI: 10.1055/s-0032-1302783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Held M, Walthelm J, Baron S, Roth C, Jany B. Pathophysiologie der pulmonalen Hypertonie bei alveolärer Hypoventilation – Korrelation von nächtlichem C02, Hämodynamik und Leistungsfähigkeit. Pneumologie 2012. [DOI: 10.1055/s-0032-1302637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Held M, Walthelm J, Baron S, Roth C, Jany B. Schwere pulmonale Hypertonie bei Hypothyreose, alveolärer Hypoventilation und Adipositas: Korrelation von mPAP, TSH-Spiegel und Gehstrecke. Pneumologie 2012. [DOI: 10.1055/s-0032-1302682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Roth C, Junk D, Papanagiotou P, Keuler A, Körner H, Schumacher M, Reith W. A comparison of 2 stroke devices: the new Aperio clot-removal device and the solitaire AB/FR. AJNR Am J Neuroradiol 2012; 33:1317-20. [PMID: 22300938 DOI: 10.3174/ajnr.a2962] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Several studies have shown promising results for the use of self-expandable intracranial stents for the treatment of acute ischemic stroke. This new technique combines immediate flow restoration after stent deployment with high recanalization rates. In the present study, the safety and efficacy of the new Aperio clot-removal device was tested in comparison with the Solitaire AB device. MATERIALS AND METHODS The experiments were performed in swine with a weight of 35-50 kg following established models. The experimental thrombi were prepared by using a new flow model (Thrombus Loop) to produce radiopaque thrombi. Thrombi were cut into lengths of 10 mm and injected into the target vessel. The occlusion was verified by DSA and rated with the help of the TICI score. A microcatheter was placed distal to the thrombus. The devices were placed with the proximal third within the thrombus and were retrieved under continuous aspiration in their released state into the guiding sheath. We performed 23 procedures with the Aperio device and 18 procedures with the Solitaire AB and FR devices. Control angiograms were obtained 3 and 5 minutes after device deployment to evaluate the flow restoration. The number of attempts to reach a TICI 2/3 score was recorded as well as the time to recanalization and the device-related complications. Vasospasm, vascular perforation, intramural arterial dissection, or embolization of a previously uninvolved territory was defined as a device-related complication. RESULTS Defined radiopaque thrombi from whole blood could reliably be created by using the Thrombus Loop. Both devices demonstrated a high recanalization rate of 100% (TICI 3) in the target vessel with no device-related complications. No significant differences were found between the 2 devices. CONCLUSIONS In this small study, we could show that radiopaque thrombi of whole blood with a defined diameter could be reliably created by using the Thrombus Loop. The new "stent-retriever" (Aperio System) seems to be a very efficient and safe addition to the existing repertoire of clot-removal devices.
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Roth C. [Posterior reversible encephalopathy syndrome (PRES)]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2011; 80:111-9; quiz 120. [PMID: 22183744 DOI: 10.1055/s-0031-1281908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kleffmann J, Roth C, Hügens-Penzel M, Deinsberger W, Ferbert A. [Mimikry of herpes encephalitis by glioblastoma multiforme]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2011; 80:162-6. [PMID: 22173966 DOI: 10.1055/s-0031-1281962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Herpes encephalitis (HSE) is an acute illness. Imaging is an important part of the diagnostic work-up of HSE. In early stages one can see a manifestation in the insular cortex as well as in the fornix. These MRI findings are rather typical for HSE. We present three cases treated in our hospital over the past ten years. In these cases the clinical symptoms and signs as well as the morphological findings were compatible with the HSE diagnostic criteria. Later on, a glioblastoma multiforme was found in all three cases.
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Hansen A, Prapotnik M, Roth C. Olanzapine-induced anaphylactic shock: a case report. PHARMACOPSYCHIATRY 2011; 45:36-7. [PMID: 22086743 DOI: 10.1055/s-0031-1287777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Olanzapine is a second-generation antipsychotic, which is also used as a mood stabilizer. We report a case of a 33-year-old psychiatric patient, with bipolar affective disorder, who developed anaphylaxis as a late reaction to olanzapine. This case report shows the possibility, although rare, of a severe late anaphylactic reaction to olanzapine.
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Roth C, Kaschabek S, Gröning JAD, Schlömann M, Sträter N. Structure and mechanism of chloromomuconolactone dehalogenase from Rhodococcus opacus1CP. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311080561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Kim B, Roth C, Young VL, Chung KC, van Busum K, Schnyer C, Mattke S. Anaplastic large-cell lymphoma and breast implants: Results from a structured expert consultation process. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gaspard P, Mosnier A, Cohen JM, Gunther D, Roth C, Stoll-Keller F, Gayet S, Bertrand X, Talon D. Cas groupés d’infections respiratoires aiguës et stratégie d’alerte en institutions de personnes âgées. Med Mal Infect 2011; 41:253-61. [DOI: 10.1016/j.medmal.2010.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 09/30/2010] [Accepted: 12/27/2010] [Indexed: 11/29/2022]
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Hansen A, Mielke A, Roth C, Grautoff S, Ferbert A. Hantavirusassoziiertes Guillain-Barré-Syndrom. AKTUELLE NEUROLOGIE 2011. [DOI: 10.1055/s-0030-1266147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Held M, Meintz S, Baron S, Roth C, Jany B. Zentrale Schlaf bezogene Atmungsstörungen bei PH und PAH - Abhängigkeit von der Rechtsherzfunktion. Pneumologie 2011. [DOI: 10.1055/s-0031-1272232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Held M, Baron S, Roth C, Jany B. Fehlender Therapieeffekt einer CPAP-Therapie bei Schlafapnoe: 2 Fälle mit PAH. Pneumologie 2011. [DOI: 10.1055/s-0031-1272126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Held M, Walthelm J, Baron S, Roth C, Jany B. Pulmonale Hypertonie bei alveolärer Hypoventilation: Erfolgreiche PA-Drucksenkung und funktionelle Verbesserung durch nicht-invasive Beatmung. Pneumologie 2011. [DOI: 10.1055/s-0031-1272210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Roth C. Wertigkeit der CT- und MR-Angiographie zur Diagnostik intrakranieller Aneurysmen. Radiologe 2011; 51:106-12. [DOI: 10.1007/s00117-010-2050-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Roth C, Mielke A, Siekmann R, Ferbert A. First Experiences with a New Device for Mechanical Thrombectomy in Acute Basilar Artery Occlusion. Cerebrovasc Dis 2011; 32:28-34. [DOI: 10.1159/000324948] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 02/07/2011] [Indexed: 11/19/2022] Open
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Histing T, Kristen A, Roth C, Holstein J, Garcia P, Matthys R, Menger M, Pohlemann T. In vivo gait analysis in a mouse femur fracture model. J Biomech 2010; 43:3240-3. [DOI: 10.1016/j.jbiomech.2010.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 06/25/2010] [Accepted: 07/24/2010] [Indexed: 11/25/2022]
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Gaspard P, Bertrand X, Gunther D, Roth C, Talon D. Exposure to bacteria of healthcare workers’ forearms during care in geriatric units. J Hosp Infect 2010; 76:275-7. [DOI: 10.1016/j.jhin.2010.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 05/11/2010] [Indexed: 11/16/2022]
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Roth C, Papanagiotou P, Behnke S, Walter S, Haass A, Becker C, Fassbender K, Politi M, Körner H, Romann MS, Reith W. Stent-assisted mechanical recanalization for treatment of acute intracerebral artery occlusions. Stroke 2010; 41:2559-67. [PMID: 20947848 DOI: 10.1161/strokeaha.110.592071] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to demonstrate a new approach to the use of a self-expanding stent in the treatment of acute ischemic stroke. METHODS Twenty-two consecutive patients with acute intracerebral artery occlusions were treated with a self-expandable intracranial stent, which was withdrawn in its unfolded state. For this technique, we used the Solitaire AB/FR, which is the only intracranial stent that is fully recoverable. Eight patients had an occlusion of the basilar artery, 12 had a middle cerebral artery occlusion, and 2 had terminal carotid artery occlusions; 6 of these had to be treated first for an acute occlusion originating in the internal carotid artery. Recanalization results were assessed by follow-up angiography immediately after the procedure. Neurologic status was evaluated before and after treatment (90-day follow-up) according to the National Institutes of Health Stroke Scale and modified Rankin scale. RESULTS Successful revascularization was achieved in 20 of 22 (90.9%) patients (thrombolysis in cerebral infarction [TICI] 2a/b and 3), a TICI 3 state was accomplished in 12 patients, and partial recanalization or slow distal branch filling with filling of more than two-thirds of the vessel territory was achieved in 8 patients (TICI 2b). There was immediate flow restoration in 21 of 22 (95.4%) cases after deployment of the device. The stent was removed in its unfolded state in all patients. The mean time from stroke symptom onset to recanalization was 277 minutes, with a standard deviation of 118 minutes. Mean National Institutes of Health Stroke Scale score on admission was 19.4, with a standard deviation of 5.7. Almost two-thirds of the patients (63.6%) improved by > 10 points on the National Institutes of Health Stroke Scale at discharge, and 50% showed a modified Rankin scale score of ≤ 2 at 90 days (59% with a modified Rankin scale ≤ 3). Mortality was 18.1%. In 1 case, an asymptomatic intracranial hemorrhage was detected on control computed tomography, and 2 patients had a symptomatic intracranial hemorrhage. CONCLUSIONS Withdrawal of an unfolded, fully recoverable, intracranial stent yielded very promising angiographic and clinical results. It combines the advantages of prompt flow restoration and mechanical thrombectomy.
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Roth C, Sonnenfeld A, Rudolf von Rohr P. Fließprobleme bei Pulvern - Ein Plasmaprozess als Lösung? CHEM-ING-TECH 2010. [DOI: 10.1002/cite.201050141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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