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Hoffenberg S, Pond SK, Carpov A, Wagner D, Wilson A, Powell R, Lindsay R, Arendt H, DeStefano J, Poignard P, Simek M, Fling S, Phogat S, Labranche C, Montefiori D, Burton D, Parks C, King C, Koff W, Caulfield M. Identification of a clade A HIV envelope immunogen from Protocol G that elicits neutralizing antibodies to tier 2 viruses. Retrovirology 2012. [PMCID: PMC3441378 DOI: 10.1186/1742-4690-9-s2-o7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wagner D, Pasko D, Phillips K, Waldvogel J, Annich G. In vitro clearance of dexmedetomidine in extracorporeal membrane oxygenation. Perfusion 2012; 28:40-6. [DOI: 10.1177/0267659112456894] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dexmedetomidine (DMET) is a useful agent for sedation, both alone and in combination with other agents, in critically ill patients, including those on extracorporeal membrane oxygenation (ECMO) therapy. The drug is a clonidine-like derivative with an 8-fold greater specificity for the alpha 2-receptor while maintaining respiratory and cardiovascular stability. An in vitro ECMO circuit was used to study the effects of both “new” and “old” membrane oxygenators on the clearance of dexmedetomidine over the course of 24 hours. Once primed, the circuit was dosed with 840 μg of dexmedetomidine for a final concentration of 0.9 μg/ml. Serial samples, both pre- and post-oxygenator, were taken at 5, 60, 360, and 1440 minutes. Concentrations of the drug were expressed as a percentage of the original concentration remaining at each time point, both for new and old circuits. The new circuits were run at a standard flow for 24 hours, after which time the circuit was considered old and re-dosed with dexmedetomidine and the trial repeated. Results show that dexmedetomidine losses occur early in the circuits and then continue to decline. Initial losses in the first hour were 11+-65% and 59-73% pre- and post-oxygenator in the new circuit and 36-50% and 42-72% in the old circuit. The clearance of the drug through the membrane oxygenator exhibits no statistical difference between pre and post or new and old circuits. Dexmedetomidine can be expected to exhibit concentration changes during ECMO therapy. This effect appears to be more related to adsorption to the polyvinyl chloride (PVC) tubing rather than the membrane oxygenator. Dosage adjustments during dexmedetomidine administration during ECMO therapy may be warranted in order to maintain adequate serum concentrations and, hence, the desired degree of sedation.*(Lack of equilibrium)
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Rommens P, Wagner D, Hofmann A. Osteoporotische Frakturen des Beckenrings. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2012; 150:e107-18; quiz e119-20. [DOI: 10.1055/s-0032-1314948] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Durch die Alterung der Bevölkerung sind wir mit einer Zunahme an osteoporotischen und Ermüdungsfrakturen des Beckenrings konfrontiert. Sie werden durch niedrigenergetische Traumen verursacht. Die konventionelle Diagnostik ist weniger aufschlussreich als bei Jugendlichen und Erwachsenen, eine CT- oder MRT-Diagnostik ist erforderlich. Die Erscheinungsformen sind multipel und bieten ein ganzes Spektrum von Instabilitäten. Die konventionelle Klassifikation trifft nicht auf alle Erscheinungsformen dieser Frakturen zu. Die Behandlung umfasst sowohl konservative als auch operative Verfahren. Entscheidend dabei sind der Grad und die Lokalisation der Instabilität. Die Osteosyntheseformen unterscheiden sich von denen der Beckenringfrakturen bei Erwachsenen. Der transsakrale Positionsstab, die iliolumbale Fixation und die winkelstabile Plattenosteosynthese kommen zunehmend zum Einsatz.
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Lange B, Vavra M, Kern WV, Wagner D. Development of tuberculosis in immunocompromised patients with a positive tuberculosis-specific IGRA [Short communication]. Int J Tuberc Lung Dis 2012; 16:492-5. [DOI: 10.5588/ijtld.11.0416] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Meszaros K, Mächler H, Zirngast B, Czerny M, Rienmüller R, Wagner D, Reineke D, Sodeck G, König T, Tscheliessnigg K, Carrel T. Liver cirrhosis cured by pericardectomy – a very rare case of non-calcifying constrictive pericarditis – case report and review of literature. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Stammet P, Collas D, Werer C, Muenster L, Clarens C, Wagner D. Impact of initial intervention on long-term neurological recovey after cardiac arrest: data from the Luxembourg "North Pole" cohort. BULLETIN DE LA SOCIETE DES SCIENCES MEDICALES DU GRAND-DUCHE DE LUXEMBOURG 2012:60-70. [PMID: 22822564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Prognosis after cardiac arrest is variable and difficult to predict. Early prognostic markers would facilitate the care of these patients. AIMS Therefore, we evaluated the impact of initial interventions after resuscitation on neurological outcome at 6 months. MATERIAL AND METHODS We conducted a retrospective analysis of the patient charts from consecutive cardiac arrest patients admitted to our intensive care unit and treated with induced hypothermia. RESULTS Over a 3-year period, 90 patients were included in our study. Sixty-four percent of the patients had bystander cardio-pulmonary resuscitation. An automated external defibrillator (AED) was used in 19% of the patients and the mean time to first defibrillation was 11 +/- 8.9 minutes. Patients being resuscitated and defibrillated by bystanders did better than those who had CPR only and far better than those patients in whom no rescue measures where attempted at all (73% vs. 56% vs. 32% for good neurological outcome, respectively, p= 0.03). Witnessed cardiac arrest was more frequent in patients with a good outcome than in those who collapsed without a witness (91% vs 75%, p = 0.03). In 76% of the patients with good outcome, CPR was performed whereas only 52% benefited from these measures in the bad outcome group (p = 0.01). Although the use of an AED was not significantly different between good and bad outcome groups (26% vs. 11%, p = 0.06), time to first defibrillation was significantly lower in patients with good outcome (8.7 +/- 6.3 vs. 13.3 +/- 11.3 minutes, p = 0.05). In the 17 patients in whom an AED was used, 12 (71%) recovered without major sequelae whereas in the 73 cases where no AED was used, only 34 (47%) had a good outcome (p = 0.06). At 6 months follow-up, 46 (51%) survivors had a good outcome (cerebral performance category 1-2), 5 (6%) survived with severe neurological sequelae or stayed in coma and 39 (43%) died. CONCLUSIONS Our local data confirm that early interventions have a major impact on survival of cardiac arrest patients. Efforts should concentrate on delivering rapid and high quality CPR as well as early defibrillation by AED's to every patient in cardiac arrest. Besides large scale Basic life support training, the introduction of dispatcher assisted CPR and the implementation and use of public AED's could considerably help to improve outcome in these patients.
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Wagner D, Kniepeiss D, Stiegler P, Sereinigg M, Zitta S, Schaffellner S, Jakoby E, Mueller H, Iberer F, Rosenkranz A, Tscheliessnigg KH. Serum cystatin C, serum creatinine and the MDRD as predictors for renal function defined by the inulin clearance after orthotopic liver transplantation*. Eur Surg 2011. [DOI: 10.1007/s10353-011-0052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Scharlach M, Wagner D, Dreesman J, Pulz M. [Antimicrobial resistance monitoring in Lower Saxony (ARMIN): first trends for MRSA, ESBL-producing Escherichia coli and VRE from 2006 to 2010]. DAS GESUNDHEITSWESEN 2011; 73:744-7. [PMID: 22113383 DOI: 10.1055/s-0031-1291265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Antimicrobial resistance is one of the most important health topics of the past few years. To identify regional trends of antimicrobial resistance in inpatient and outpatient care, the Governmental Institute of Public Health of Lower Saxony (Germany) launched the sentinel system ARMIN (Antimicrobial Resistance Monitoring in Lower Saxony). Currently 9 laboratories participate as sentinel sites and contribute single case data of their microbiological results. Data are presented by an interactive data query in the internet. From 2006 to 2010 laboratories reported about 800 000 diagnostic test results. The proportion of MRSA (methicillin-resistant Staphylococcus aureus) among all Staphylococcus aureus increased from 19.5% in 2006 to 23.4% in 2010 for inpatient care in Lower Saxony. During the same period Escherichia coli resistance to cefotaxime for inpatient care increased from 3.0% to 8.8%. Enterococcus faecium resistance to vancomycin decreased from 13.6% to 5.6%. Currently the emphasis of ARMIN is on the description of trends and on the information of prescribing physicians. A quality circle was established to improve standardisation.
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Koch S, Wagner D, Wetzel D, Hager D. Peripartales Outcome eines Feten mit Fehlbildungen nach erfolgter Chemotherapie und Avastingabe in der Frühgravidität. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Bottaro M, Veloso J, Wagner D, Gentil P. Resistance training for strength and muscle thickness: Effect of number of sets and muscle group trained. Sci Sports 2011. [DOI: 10.1016/j.scispo.2010.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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111
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Koch S, Wagner D, Wetzel D, Hager D. Akute Schwangerschaftsfettleber bei Langketten–3-hydroxyacyl-CoA-Dehydrogenase (LCHAD)-Defekt. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Held J, Wagner D. β-d-Glucan kinetics for the assessment of treatment response in Pneumocystis jirovecii pneumonia. Clin Microbiol Infect 2011; 17:1118-22. [DOI: 10.1111/j.1469-0691.2010.03452.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Konda R, Osawa T, Nozawa T, Sugimura J, Fujioka T, Ishimoto Y, Ohki T, Uchida L, Kotera N, Tanaka M, Tanaka S, Sugimoto T, Mise N, Wu HY, Ko MJ, Yang JY, Hu FC, Chen SI, Jee SH, Chiu HC, Zumrutdal A, Hur E, Toz H, Ozkahya M, Usta M, Kayikcioglu LM, Sezis M, Asci G, Kahvecioglu S, Duman S, Ok E, Sakaguchi Y, Sonoda M, Kawabata H, Niihata K, Suzuki A, Shoji T, Tsubakihara Y, Emami Naini A, Moradi M, Mortazavi M, Shirani F, Gholamrezaei A, Demir S, San M, Koken T, Seok SJ, Gil HW, Yang JO, Lee EY, Hong SY, Stavroulopoulos A, Kossivakis A, Aresti V, Stamogiannos G, Kalliaropoulos A, Mentis A, Azak A, Huddam B, Kocak G, Altas AB, Sakaci M, Yalcin F, Ortabozkoyun L, Duranay M, Korukluoglu G, Eitner F, Scheithauer S, Mankartz J, Haefner H, Nowicki K, Floege J, Lemmen S, Hara S, Tanaka K, Suwabe T, Ubara Y, Takaichi K, Deleuze S, Bargnoux AS, Rivory JP, Rouanet C, Maurice F, Selcer I, Cristol JP, Dou Y, Thijssen S, Ouellet G, Kruse A, Rosales L, Kotanto P, Levin NW, Shahidi S, Sajjadieh S, Gholamrezaei A, Scholmann T, Straub M, Wagner D, Fliser D, Sester M, Sester U, Sikole A, Trajceska L, Selim G, Gelev S, Dzekova P, Amitov V, Arsov S, Strempska B, Bilinska M, Weyde W, Koszewicz M, Madziarska K, Golebiowski T, Klinger M, Ochi A, Ishimura E, Tsujimoto Y, Kakiya R, Tabata T, Mori K, Shoji T, Yasuda H, Nishizawa Y, Inaba M, Ezeonyeji A, Borg F, Harnett P, Dasgupta B, Raikou VD, Kyriaki D, Zeggos N, Skalioti C, Tzanatou H, Boletis JN, Viaene L, Meijers B, Bammens B, Vanrenterghem Y, Vanderschueren D, Evenepoel P, Ryu DR, An HR, Ryu JH, Yu M, Kim SJ, Kang DH, Choi KB, Miyamoto T, Rashid Qureshi A, Anderstam B, Yamamoto T, Alvestrand A, Stenvinkel P, Lindholm B, Axelsson J, Zitt E, Manamley N, Vervloet M, Georgianos P, Sarafidis P, Kanaki A, Divani M, Haidich AB, Sioulis A, Liakopoulos V, Papagianni A, Nikolaidis P, Lasaridis A, Morgado E, Pinho A, Guedes A, Guerreiro R, Mendes P, Bexiga I, Silva A, Marques J, Neves P. Pathophysiology and clinical studies in CKD 5D. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moehler M, Al-Batran SE, Andus T, Anthuber M, Arends J, Arnold D, Aust D, Baier P, Baretton G, Bernhardt J, Boeing H, Böhle E, Bokemeyer C, Bornschein J, Budach W, Burmester E, Caca K, Diemer WA, Dietrich CF, Ebert M, Eickhoff A, Ell C, Fahlke J, Feussner H, Fietkau R, Fischbach W, Fleig W, Flentje M, Gabbert HE, Galle PR, Geissler M, Gockel I, Graeven U, Grenacher L, Gross S, Hartmann JT, Heike M, Heinemann V, Herbst B, Herrmann T, Höcht S, Hofheinz RD, Höfler H, Höhler T, Hölscher AH, Horneber M, Hübner J, Izbicki JR, Jakobs R, Jenssen C, Kanzler S, Keller M, Kiesslich R, Klautke G, Körber J, Krause BJ, Kuhn C, Kullmann F, Lang H, Link H, Lordick F, Ludwig K, Lutz M, Mahlberg R, Malfertheiner P, Merkel S, Messmann H, Meyer HJ, Mönig S, Piso P, Pistorius S, Porschen R, Rabenstein T, Reichardt P, Ridwelski K, Röcken C, Roetzer I, Rohr P, Schepp W, Schlag PM, Schmid RM, Schmidberger H, Schmiegel WH, Schmoll HJ, Schuch G, Schuhmacher C, Schütte K, Schwenk W, Selgrad M, Sendler A, Seraphin J, Seufferlein T, Stahl M, Stein H, Stoll C, Stuschke M, Tannapfel A, Tholen R, Thuss-Patience P, Treml K, Vanhoefer U, Vieth M, Vogelsang H, Wagner D, Wedding U, Weimann A, Wilke H, Wittekind C. [German S3-guideline "Diagnosis and treatment of esophagogastric cancer"]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2011; 49:461-531. [PMID: 21476183 DOI: 10.1055/s-0031-1273201] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Wagner D, Adunka C, Kniepeiss D, Jakoby E, Schaffellner S, Kandlbauer M, Fahrleitner-Pammer A, Roller RE, Kornprat P, Müller H, Iberer F, Tscheliessnigg KH. Serum albumin, subjective global assessment, body mass index and the bioimpedance analysis in the assessment of malnutrition in patients up to 15 years after liver transplantation. Clin Transplant 2011; 25:E396-400. [PMID: 21457329 DOI: 10.1111/j.1399-0012.2011.01442.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The subjective global assessment (SGA) or the body mass index (BMI) is used to determine the nutritional state after LTX. Bioelectrical impedance analysis (BIA) is used as tool to determine body composition by nutritional care professionals. METHODS BIA, SGA, BMI, and serum albumin (SA) levels were performed to assess malnutrition following liver transplantation. BIA measurement was used as reference standard to determine existing malnutrition. A phase angle (PA) <5 was used to define potentially existing chronic disease-related malnutrition as a standard. All other measured parameters were compared with respect to their prognostic accuracy regarding the prediction of malnutrition as compared to the mentioned standard. RESULTS Seventy-one recipients (51 men, 20 women) were included. Median age was 58, weight 77 kg, BMI 26 kg/m(2) , PA 4.1°, and SA 4.3 g/dL. According to the Nutritional Risk Screening 2002, 9.4% (6/71), to BMI 15.4% (11/71), to SA 30.9% (22/71), and to BIA 36.5% (28/71) of the patients were malnourished. PA did not correlate with BMI or NA, there was a significant correlation with SA (p = 0.001). Univariate analysis revealed SA as independent predictor for malnutrition. ROC analysis for all parameters revealed a significantly (p < 0.05) better area under the receiver operating characteristic curve for SA (0.812) than for BMI (0.603) for the prediction of malnutrition. CONCLUSION SGA or BMI calculation alone does not suffice to evaluate the nutritional status. SA seems to play a crucial role in the prediction of severe disease-related malnutrition in this special patient cohort.
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Wagner D, Kern WV. [Tuberculosis and nontuberculous mycobacterial infections]. Dtsch Med Wochenschr 2011; 136:691-4. [PMID: 21448828 DOI: 10.1055/s-0031-1274565] [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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117
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Hofmann A, Dreesmann J, Wagner D. Eine Erhebung zu Durchführung und Umfang von Tuberkulose -Umgebungsuntersuchungen in Niedersachsen. DAS GESUNDHEITSWESEN 2011. [DOI: 10.1055/s-0031-1274415] [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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118
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Scharlach M, Wagner D, Dreesmann J. Antibiotika-Resistenz-Monitoring in Niedersachsen: Das Sentinel-System ARMIN. DAS GESUNDHEITSWESEN 2011. [DOI: 10.1055/s-0031-1274421] [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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119
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Amrein K, Putz-Bankuti C, Mader J, Amegah-Sakotnik A, Urbanic T, Wagner D, Prandl E, Sareban N, Amrein S, Langmann A. Female authors in top-rank journals of different medical specialties. Crit Care 2011. [PMCID: PMC3068466 DOI: 10.1186/cc9957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Pearce J, Kirby G, Lacinska A, Bateson L, Wagner D, Rochelle C, Cassidy M. Reservoir-scale CO2 -fluid rock interactions: Preliminary results from field investigations in the Paradox Basin, Southeast Utah. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.egypro.2011.02.479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stammet P, Devaux Y, Zhang L, Kirchmeyer M, Leners B, Wagner D. The chemokine receptor CX3CR1 predicts neurological outcome after cardiac arrest. Resuscitation 2010. [DOI: 10.1016/j.resuscitation.2010.09.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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122
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Schaffellner S, Wagner D, Sereinigg M, Jakoby E, Kniepeiss D, Stiegler P, Valentin T, Iberer F, Tscheliessnigg KH. First case of Toxocara eosinophilic ascites after combined pancreas and kidney transplantation. Am J Transplant 2010; 10:2727. [PMID: 21087413 DOI: 10.1111/j.1600-6143.2010.03325.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Diel R, Goletti D, Ferrara G, Bothamley G, Cirillo D, Kampmann B, Lange C, Losi M, Markova R, Migliori GB, Nienhaus A, Ruhwald M, Wagner D, Zellweger JP, Huitric E, Sandgren A, Manissero D. Interferon-γ release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis. Eur Respir J 2010; 37:88-99. [PMID: 21030451 DOI: 10.1183/09031936.00115110] [Citation(s) in RCA: 355] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB® Gold In-Tube (QFT-G-IT) and the T-SPOT®.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). The Medline, Embase and Cochrane databases were explored for relevant articles in November 2009. Specificities, and negative (NPV) and positive (PPV) predictive values of interferon-γ release assays (IGRAs) and the TST, and the exposure gradient influences on test results among bacille Calmette-Guérin (BCG) vaccinees were evaluated. Specificity of IGRAs varied 98-100%. In immunocompetent adults, NPV for progression to tuberculosis within 2 yrs were 97.8% for T-SPOT®.TB and 99.8% for QFT-G-IT. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA-positive individuals followed for 19-24 months varied 8-15%, exceeding those reported for the TST (2-3%). In multivariate analyses, the odd ratios for TST positivity following BCG vaccination varied 3-25, whereas IGRA results remained uninfluenced and IGRA positivity was clearly associated with exposure to contagious tuberculosis cases. IGRAs may have a relative advantage over the TST in detecting LTBI and allow the exclusion of M. tuberculosis infection with higher reliability.
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Daumann J, Wagner D, Heekeren K, Neukirch A, Thiel CM, Gouzoulis-Mayfrank E. Neuronal correlates of visual and auditory alertness in the DMT and ketamine model of psychosis. J Psychopharmacol 2010; 24:1515-24. [PMID: 19304859 DOI: 10.1177/0269881109103227] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Deficits in attentional functions belong to the core cognitive symptoms in schizophrenic patients. Alertness is a nonselective attention component that refers to a state of general readiness that improves stimulus processing and response initiation. The main goal of the present study was to investigate cerebral correlates of alertness in the human 5HT(2A) agonist and N-methyl-D-aspartic acid (NMDA) antagonist model of psychosis. Fourteen healthy volunteers participated in a randomized double-blind, cross-over event-related functional magnetic resonance imaging (fMRI) study with dimethyltryptamine (DMT) and S-ketamine. A target detection task with cued and uncued trials in both the visual and the auditory modality was used. Administration of DMT led to decreased blood oxygenation level-dependent response during performance of an alertness task, particularly in extrastriate regions during visual alerting and in temporal regions during auditory alerting. In general, the effects for the visual modality were more pronounced. In contrast, administration of S-ketamine led to increased cortical activation in the left insula and precentral gyrus in the auditory modality. The results of the present study might deliver more insight into potential differences and overlapping pathomechanisms in schizophrenia. These conclusions must remain preliminary and should be explored by further fMRI studies with schizophrenic patients performing modality-specific alertness tasks.
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Wagner D, Scharlach M, Sielski J, Dreesman J, Pulz M. [Implementation of the interferon-γ release assay for contact tracing: a 2-year project in lower Saxony, Germany]. DAS GESUNDHEITSWESEN 2010; 73:363-8. [PMID: 20814857 DOI: 10.1055/s-0030-1255080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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126
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Wagner D, Loffler G, Manahilov V, Gordon GE, Gordon GN, Storch P. Shape discrimination in migraineurs. J Vis 2010. [DOI: 10.1167/10.7.1373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Scholman T, Straub M, Sester U, Wagner D, Sester M. ANALYSIS OF AGREEMENT BETWEEN IGRAS AND TUBERCULIN SKIN-TESTING BY THE USE OF PPD AS THE SAME ANTIGEN. Transplantation 2010. [DOI: 10.1097/00007890-201007272-01007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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128
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Meo F, Stejner M, Salewski M, Bindslev H, Eich T, Furtula V, Korsholm SB, Leuterer F, Leipold F, Michelsen PK, Moseev D, Nielsen SK, Reiter B, Stober J, Wagner D, Woskov P, team TAU. First results and analysis of collective Thomson scattering (CTS) fast ion distribution measurements on ASDEX Upgrade. ACTA ACUST UNITED AC 2010. [DOI: 10.1088/1742-6596/227/1/012010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Toepfner N, Lange B, Wagner D, Schumacher M, Henneke P, Nieters A. Aufbau einer multinationalen Wirt-Pathogen-Interaktionsstudie zu Infektionen durch Nicht-tuberkulöse Mykobakterien im Kindesalter. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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130
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Lange B, Vavra M, Kern WV, Wagner D. Indeterminate results of a tuberculosis-specific interferon- release assay in immunocompromised patients. Eur Respir J 2010; 35:1179-82. [DOI: 10.1183/09031936.00122109] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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131
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Phogat SK, Walker L, Wagner D, Chan-Hui P, Simek M, Phung P, Wrin T, Mitcham J, Investigator P, Kaminsky S, Zamb T, Moyle M, Koff W, Burton D. S021-06 OA. Potent and broad neutralizing antibodies from HIV-1 non-clade B infected donor reveal a new HIV-1 vaccine target. Retrovirology 2009. [PMCID: PMC2767577 DOI: 10.1186/1742-4690-6-s3-o6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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132
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Vargas Hein O, Staegemann M, Wagner D, von Heymann C, Martin M, Morgera S, Spies C. Torsemide Versus Furosemide After Continuous Renal Replacement Therapy Due to Acute Renal Failure in Cardiac Surgery Patients. Ren Fail 2009; 27:385-92. [PMID: 16060124 DOI: 10.1081/jdi-65298] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Diuretic therapy in ARF (acute renal failure) is mainly done with loop diuretics, first of all furosemide. Torsemide has a longer duration of action and does not accumulate in renal failure. In chronic and acute renal failure, both diuretics have been effectively applied, with a more pronounced diuretic effect for torsemide. In this study, the effects of torsemide versus furosemide on renal function in cardiac surgery patients recovering from ARF after continuous renal replacement therapy (CRRT) were studied. Twenty-nine critically ill patients admitted to an intensive care unit at a university teaching hospital after cardiac surgery recovering from ARF after CRRT were included in this prospective, controlled, single-center, open-labeled, randomized clinical trial. Inclusion criteria were urine output >0.5 mL/kg/h over 6 h under CRRT. Torsemide and furosemide dosages were adjusted with the target urine output being 0.8-1.5 mL/kg/h. Hemodynamic data, urine output, volume balance, serum creatinine clearance, electrolytes, blood urea nitrogen, serum creatinine, renin, and aldosterone concentrations were measured. Fourteen patients were included in the furosemide group and 15 patients in the torsemide group. Dosages of 29 (0-160) mg torsemide and a dosage of 60 (0-240) mg furosemide were given every 6 h in each group, respectively. The dosage given at the end of the study decreased significantly in furosemide and torsemide treated patients. Urine output, 24 h balance, and serum creatinine clearance did not differ significantly between groups. Urine output decreased in both groups, mostly dose-dependent in the torsemide group. The intragroup comparison of the first time-interval after inclusion with the last time-interval showed a significant increase in serum creatinine and blood urea nitrogen in the furosemide group. Renin and aldosterone concentrations did not show significant differences. In conclusion, torsemide and furosemide were effective in increasing urine output. Torsemide might show a better dose-dependent diuretic effect in ARF patients after CRRT treatment. Serum creatinine and blood urea nitrogen elimination were less pronounced in the furosemide group.
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133
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Georgieff M, Moldawer L, Wagner D, Geiger K, Fekl W, Blackburn G, Bistrian B, Lutz H. Stoffwechselorientierte postoperative Ernährungstherapie – Möglichkeiten und Grenzen der Anwendung von Glukose und Xylit. Transfus Med Hemother 2009. [DOI: 10.1159/000226157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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134
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Segers P, Wagner D, Ludwig K, Cates A, Georgakopoulos D. 8.6 ELECTRICAL CAROTID BARORECEPTOR ACTIVATION LOWERS RENAL ARTERY IMPEDANCE AND STIFFNESS IN AN ACUTE CANINE MODEL. Artery Res 2009. [DOI: 10.1016/j.artres.2009.10.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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135
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Scharlach M, Gross C, Wagner D, Dreesmann J, Claussen K, Kirchner M, Repotente A, Wermes G, Sadowski H, Pulz M, Lütgehölter M. [Comparison of the tuberculin skin test with the interferon-gamma test in the framework of a surroundings investigation in a prison]. DAS GESUNDHEITSWESEN 2008; 70:684-9. [PMID: 19039729 DOI: 10.1055/s-0028-1100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
After the occurrence of a multidrug-resistant tuberculosis in a prison of Lower Saxony (Germany), 223 contact persons (178 inmates, 45 staff members) were identified. To detect latent tuberculosis infections, all contact persons were tested with the tuberculin skin test (TST) and the interferon-gamma release assay (IGRA). An additional standardised questionnaire on anamnestic information and risk factors was completed by the participants. The statistical analysis included 149 male inmates with a mean age of 39 years. 61.1% of the inmates were born in Germany, 14.8% were born in the USSR or, respectively, its follow-up states. With the TST 29.5% of the inmates were tested positive, whereas with the IGRA the positive rate was 18.1%. For 7 inmates there was a positive IGRA despite a negative TST. The positive predictive value of TST with respect to IGRA was 45.5%, agreement was 79.2% (kappa=0.44). The agreement found in this study is comparable to studies within populations with lower incidence. Numerous investigations outside Europe indicate a high risk of tuberculosis infection among inmates.
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Fu L, Wagner D, Hanwell H, Sidhom G, Zhu J, Wong B, Vieth R, Cole D. Functional T436K SNP in DBP is a predictor of serum 25(OH)D: A replicate study in a young healthy adult population. Clin Biochem 2008. [DOI: 10.1016/j.clinbiochem.2008.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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137
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Griswold-Theodorson S, Hannan H, Handly N, Fojtik J, Pugh B, Saks M, Wagner D. 419: Improving Patient Safety Using Ultrasound Guidance During Internal Jugular Central Venous Catheter Placement by Novice Practioners. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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138
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Meo F, Bindslev H, Korsholm SB, Furtula V, Leuterer F, Leipold F, Michelsen PK, Nielsen SK, Salewski M, Stober J, Wagner D, Woskov P. Commissioning activities and first results from the collective Thomson scattering diagnostic on ASDEX Upgrade (invited). THE REVIEW OF SCIENTIFIC INSTRUMENTS 2008; 79:10E501. [PMID: 19044487 DOI: 10.1063/1.2989140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The collective Thomson scattering (CTS) diagnostic installed on ASDEX Upgrade uses millimeter waves generated by the newly installed 1 MW dual frequency gyrotron as probing radiation at 105 GHz. It measures backscattered radiation with a heterodyne receiver having 50 channels (between 100 and 110 GHz) to resolve the one-dimensional velocity distribution of the confined fast ions. The steerable antennas will allow different scattering geometries to fully explore the anisotropic fast ion distributions at different spatial locations. This paper covers the capabilities and operational limits of the diagnostic. It then describes the commissioning activities carried out to date. These activities include gyrotron studies, transmission line alignment, and beam pattern measurements in the vacuum vessel. Overlap experiments in near perpendicular and near parallel have confirmed the successful alignment of the system. First results in near perpendicular of scattered spectra in a neutral beam injection (NBI) and ion cyclotron resonance heating (ICRH) plasma (minority hydrogen) on ASDEX Upgrade have shown evidence of ICRH heating phase of hydrogen.
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139
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Urbański P, Jankowska M, Kowalska E, Wagner D. Determination of Calcium and Iron and Measurements of Ash Content in the Brown Coal. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/10256018308544911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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140
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Scharlach M, Groß C, Wagner D, Dreesman J, Claussen K, Kirchner M, Repotente A, Wermes G, Sadowski H, Pulz M, Lütkehölter M. Vergleich von Tuberkulin-Hauttests und Interferon-Gamma-Tests im Rahmen einer Umgebungsuntersuchung in einer JVA. DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-2008-1076529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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141
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142
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Abstract
Recently an increasing number of antibiotic-resistant MYCOBACTERIUM TUBERCULOSIS (MTB) strains have been described worldwide. The term XDR- (extensively drug-resistant) tuberculosis (TB) has been introduced by the World Health Organisation (WHO) to characterize multi-drug-resistant MTB strains that are in vitro resistant against fluorochinolones and one of the injectible substances amikacin, capreomycin or kanamycin in addition to isoniazid and rifampin. Strains of XDR-MTB are currently increasingly seen in HIV-seropositive individuals with tuberculosis in southern Africa, where these strains are passed by person-to person contact. XDR-TB has become a serious problem for the health administrations in this region. In contrast, cases of XDR-TB are only rarely seen in Germany so far, mainly among the population of pre-treated migrants from eastern Europe. The development of rapid diagnostic tests for resistance testing and new drugs for the treatment of tuberculosis has lacked support for several decades. The sudden emergence of XDR-MTB strains now warrants immediate action for the development of such tests and new classes of antibiotics to give all patients with TB a chance for a successful treatment.
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Wagner D, Hörster R, Lange B, Lange C. [Evaluation of T-cell interferon-gamma-release assays for the diagnosis of latent and active tuberculosis]. Dtsch Med Wochenschr 2008; 133:354-7. [PMID: 18270916 DOI: 10.1055/s-2008-1046718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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144
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Manini A, Berrino J, Cirant S, D’Antona G, Gandini F, Grünwald G, Leuterer F, Maraschek M, Monaco F, Neu G, Raupp G, Sormani D, Stober J, Suttrop W, Treutterer W, Wagner D, Zohm H. Development of a feedback system to control MHD instabilities in ASDEX Upgrade. FUSION ENGINEERING AND DESIGN 2007. [DOI: 10.1016/j.fusengdes.2007.07.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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145
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Heidinger R, Danilov I, Meier A, Piosczyk B, Späh P, Thumm M, Bongers W, Graswinckel M, Henderson M, Leuterer F, Verhoeven A, Wagner D. Development of high power window prototypes for ECH&CD launchers. FUSION ENGINEERING AND DESIGN 2007. [DOI: 10.1016/j.fusengdes.2007.04.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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146
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Hammadeh ME, Fischer-Hammadeh C, Alexides F, Wagner D, Rosenbaum P, Schmidt W. Akrosomale Kryoschäden von humanen Spermatozoen nach Kryokonservierung mittels biologischer Gefriermaschine oder Stickstoffdampf. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-984650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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147
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Krüger K, Wagner D, Gawenda M, Strohe D, Uedelhoven J, Brunkwall J, Lackner K. [Coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses: success rate and complications]. ROFO-FORTSCHR RONTG 2007; 179:587-92. [PMID: 17492541 DOI: 10.1055/s-2007-962922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the success and complication rate of coil embolization of arteriovenous fistulae on in situ saphenous vein bypasses. MATERIALS AND METHOD 82 AV-fistulae on 30 bypasses (28 patients, 20 men, age 62.5 +/- 8.3 years) were treated using coils. The success rate, complications, duration, amount of contrast material and radiation exposure were measured. Color-coded duplex sonography was performed 1 - 2 days and up to 6 - 18 months after embolization. RESULTS The success rate was 68.3 %. The reasons for persistent fistula perfusion were: 96 % fistula not accessible, 4 % reperfusion during thrombolysis. 7 complications were observed in 6 bypasses: failure of placement and retrieving of coil (n = 4), thrombembolic complications with thrombolysis (n = 3). The duration of intervention was 118.3 +/- 46.6 min, the contrast material need was 277.03 +/- 94.0 ml, and the radiation exposure was 10 966 +/- 11 295 cGy/cm (2). Additional balloon dilatation was performed in 30 % of the bypasses. All bypasses were open 1-2 days after intervention. During follow-up, 11 persistent fistulae were detected. CONCLUSIONS Coil-embolization of arteriovenous fistulae on saphena magna bypasses proved to be a method with moderate success and complication rates.
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Linder K, Zia M, Kern W, Pfau R, Wagner D. P1515 Relapses versus reactions in multibacillary leprosy: proposal of new relapse criteria. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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149
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Kleinschmidt M, Wagner D, Bering R. Klientel und Behandlungsanlässe in einem großstädtischen Krisenzentrum. PPMP - PSYCHOTHERAPIE · PSYCHOSOMATIK · MEDIZINISCHE PSYCHOLOGIE 2007. [DOI: 10.1055/s-2007-970662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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150
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Eiring P, Wagner D. Peptostreptococcus ivorii-associated skin abscess in a HIV-infected patient. Anaerobe 2006; 5:1-3. [PMID: 16887655 DOI: 10.1006/anae.1998.0185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/1998] [Accepted: 12/29/1998] [Indexed: 11/22/2022]
Abstract
Peptostreptococcus ivorii, a recently described species of gram-positive anaerobic coccus, has so far rarely been found in human infections. The isolation of this anaerobe from a polybacterial skin abscess in a HIV-infected patient, which formed after antiretroviral therapy had been discontinued is reported. Local treatment led to the abscess healing without specific antibiotics. As the type strain was isolated from a mixed infected leg ulcer, Peptostreptococcus ivorii could play an important role in synergistic infections of the skin.
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