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Besser M, Dietrich M, Weber L, Rembe JD, Stuermer EK. Efficacy of antiseptics in a novel 3-dimensional human plasma biofilm model (hpBIOM). Sci Rep 2020; 10:4792. [PMID: 32179838 PMCID: PMC7075952 DOI: 10.1038/s41598-020-61728-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/26/2020] [Indexed: 11/09/2022] Open
Abstract
The increasing incidence of non-healing wounds constitutes a pivotal socio-economic burden. 60-80% of chronic wounds are colonized by pathogenic microorganisms within a protective extracellular polymeric substance, bearing a great challenge in wound management. Human plasma was used to prepare the biofilm model (hpBIOM), adding pathogens to the plasma and forming Coagula-like discs with integrated pathogens were produced. The antiseptics Octenisept and Lavasorb were tested regarding their antibacterial properties on clinically relevant biofilm-growing bacteria (MRSA, P. aeruginosa) in the hpBIOM. Biofilm-typical glycocalyx-formation was confirmed using immunohistochemical staining. Treatment of a 12 h-maturated biofilm with Octenisept resulted in complete eradication of P. aeruginosa and MRSA after 48 h. Lavasorb proved less effective than Octenisept in this setting. In more mature biofilms (24 h), both antiseptics showed a delayed, partially decreased efficacy. Summarized, the hpBIOM provides essential factors for a translational research approach to be used for detailed human biofilm analyses and evaluation of antimicrobial/-biofilm properties of established and novel therapeutic strategies and products. Octenisept and Lavasorb showed an attenuated efficacy in the hpBIOM compared to planktonic conditions and previously published biofilm-studies, prompting the question for the necessity of introducing new international standards and pre-admission requirements on a translational base.
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Michalski D, Jungk C, Brenner T, Dietrich M, Nusshag C, Weigand MA, Reuß CJ, Beynon C, Bernhard M. Neurologische Intensivmedizin. Anaesthesist 2020; 69:129-136. [DOI: 10.1007/s00101-019-00643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dietrich M, Reuß CJ, Beynon C, Hecker A, Jungk C, Michalski D, Nusshag C, Schmidt K, Bernhard M, Brenner T, Weigand MA. Beatmung und Sauerstofftherapie. Anaesthesist 2019; 68:770-776. [DOI: 10.1007/s00101-019-00640-5] [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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Loos M, Strobel O, Legominski M, Dietrich M, Hinz U, Brenner T, Heininger A, Weigand MA, Büchler MW, Hackert T. Postoperative pancreatic fistula: Microbial growth determines outcome. Surgery 2018; 164:1185-1190. [PMID: 30217397 DOI: 10.1016/j.surg.2018.07.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/07/2018] [Accepted: 07/11/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Postoperative pancreatic fistula is a dangerous complication in pancreatic surgery. This study assessed the impact of microbiologic pathogens detected in postoperative pancreatic fistula on clinical outcomes after partial pancreatoduodenectomy and distal pancreatectomy. METHODS Microorganisms in postoperative pancreatic fistula were identified by microbiologic analyses from abdominal drains or intraoperative swabs during relaparotomy. Demographic, operative, and microbiologic data, as well as postoperative outcomes were examined. RESULTS Of 2,752 patients undergoing partial pancreatoduodenectomy and distal pancreatectomy, 256 patients with clinically relevant postoperative pancreatic fistula (International Study Group of Pancreatic Surgery [ISGPS] grades B and C) were identified (9.3%) and microbiologic cultures were positive in 210 patients (82.0%), with a higher rate after partial pancreatoduodenectomy (95.8%) than after distal pancreatectomy (64.3%; P < .001). Microbiologic spectra differed distinctively between partial pancreatoduodenectomy and distal pancreatectomy. Detection of microorganisms in postoperative pancreatic fistula resulted in a higher morbidity and mortality, including postpancreatectomy hemorrhage (42.4% vs 21.7%; P = .009), sepsis (38.1% vs 6.5%; P < .001), wound infection (30.0% vs 6.5%; P = .001), reoperation (48.1% vs 10.9%; P < .001), hospital stay (median 42 vs 26 days; P < .001), and overall 90-day mortality (19.5% vs 4.3%; P = .013) and was identified as an independent risk factor for sepsis, wound infection, and reoperation in the multivariate analysis. CONCLUSION Detection of microorganisms in postoperative pancreatic fistula is frequent after pancreatic resection and indicates a turning point in the development of postoperative pancreatic fistula into a life-threatening condition. Whether early anti-infective therapy in combination with interventional measures or a surgical reintervention are warranted, has yet to be elucidated.
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Wang J, Dietrich M, Bell S, Maxwell C, Simmons S, Kripalani S. CHANGE IN VULNERABILITY AMONG OLDER CARDIAC ADULTS AFTER HOSPITAL DISCHARGE: ROLE OF POST-ACUTE HOME HEALTH. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mion L, Fan J, Beuscher L, Dietrich M, Newhouse P, Sarkar N. OLDER ADULTS’ VIEWPOINTS ON SOCIALLY ASSISTIVE ROBOTS DESIGNED TO PROMOTE ENGAGEMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gregg J, Baik C, Dietrich M, Dubinett S, Gerber D, Husain H, Shiller M, Miranda M, Chehab N, West H. P3.01-32 An Open-Label, Non-Randomized, Biomarker Study of Concordance in Non-Invasive and Tissue Tests for T790M Detection in NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1592] [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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Feldman R, Vanderwalde A, Liu S, Dietrich M, Gadgeel S, Korn W, Nieva J, Spira A, Kim E. MA21.01 Cbl Mutations (mt) as Important Mediators of Oncogenic RTK Signaling in NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.491] [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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Hemmer CJ, Bierhaus A, Riedesel JV, Gabat S, Liliensiek B, Pitronik P, Lin J, Grauer A, Amiral J, Ziegler R, Schieffer S, Kern P, Seitz R, Egbring R, Dietrich M, Nawroth PP. Elevated Thrombomodulin Plasma Levels as a Result of Endothelial Involvement in Plasmodium falciparum Malaria. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648889] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryWe used thrombomodulin (TM) to assess the participation of the vascular endothelium in human Plasmodium falciparum (P. F.) malaria. Before therapy TM plasma levels were elevated in P. F. malaria and fell to normal values during therapy. Parasitemia, TNFα, elastase and TAT levels correlated directly with TM. Elevated TM levels can not be explained by increased synthesis, since incubating HUVEC with pretherapy serum of patients with P. F. malaria, but not reconvalescence serum, suppressed TM transcription. This was partially prevented by adding a TNFα neutralizing antibody to patient serum before incubation with HUVEC. However, TNFα does not release TM from cultured HUVEC in vitro. Coincubation of HUVEC with pretherapy serum together with neutrophils resulted in endothelial cell destruction, which could be partly prevented by a TNFα neutralizing antibody. Hence the increase of TM during P. F. malaria might reflect the concerted action of cytokines and neutrophils on HUVEC.
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von Tempelhoff GF, Heilmann L, Dietrich M, Schneider D, Niemann F, Hommel G. Plasmatic Plasminogen Activator Inhibitor Activity in Patients with Primary Breast Cancer. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1656017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bierhaus A, Hemmer CJ, Mackman N, Kutob R, Ziegler R, Dietrich M, Nawroth PP. Antiparasitic Treatment of Patients with P. falciparum Malaria Reduces the Ability of Patient Serum to Induce Tissue Factor by Decreasing NF-κB Activation. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1653723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummarySerum from patients with P. falciparum malaria at day 1 (pretherapy) induces tissue factor (TF) in cultured endothelial cells. TF induction depends on de novo transcription as shown in Nuclear Run On assays. Electrophoretic mobility shift assays demonstrated binding of AP-1 and NF- κB/Rel proteins to their recognition sites in the TF promotor. After therapy (day 28), stimulation of TF antigen by patient serum is reduced by 70%. When serum obtained before and after therapy was compared, a decrease of NF-κB activation was evident. Activation of NF-κB-like proteins was in part dependent on TNFα in patient serum, since a TNFα neutralizing antibody reduced induction of TF transcription and translation and induction of NF-κB-like proteins. Induction of TF activity was suppressed by pDTC, an inhibitor of NF-κB activation. When different promotor constructs of the TF gene were tested, induction was dependent upon the presence of the intact NF-κB-like binding site in the TF promotor. A mutant with deleted NF-κB, but intact AP-1 sites was not inducible. Mutation of the AP-1 sites did not prevent induction, but reduced inducibility by pretherapy serum. Therefore, NF-κB/Rel proteins are responsible for induction of TF transcription by pretherapy serum, but AP-1 is needed for highest inducibility. The effect of antiparasitic therapy on the induction of TF by serum from patients with complicated P. falciparum malaria is dependent on a therapy-mediated loss of activation of NF-κB-like proteins in post-treatment patient serum.
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Hüttener M, Prieto A, Aznar S, Dietrich M, Paytubi S, Juárez A. Tetracycline alters gene expression in Salmonella strains that harbor the Tn10 transposon. ENVIRONMENTAL MICROBIOLOGY REPORTS 2018; 10:202-209. [PMID: 29393572 DOI: 10.1111/1758-2229.12621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this report, we show that bacterial plasmids that harbor the Tn10 transposon (i.e., the IncHI1 plasmid R27) modify expression of different Salmonella regulons responding to the presence of tetracycline (Tc) in the medium. By using as a model the Tc-dependent upregulation of the ibpAB operon (which belongs to the heat shock regulon), we have identified Tn10-tetA (coding for a Tc efflux pump) and adjacent tetC sequences as required for ibpAB upregulation. Characterization of transcripts in the tetAC region showed that tetA transcription can continue into tetC sequences, generating a long 3'UTR sequence, which can protect transcripts from RNA processing, thus increasing the expression of TetA protein. In the presence of Tc, the DnaK and IbpA chaperones are overexpressed and translocated to the periplasm and to the membrane fraction respectively. DnaK targeting unfolded proteins is known to induce heat shock by avoiding RpoH proteolysis. We correlate expression levels of Tn10-encoded TetA protein with heat shock induction in Salmonella, likely because TetA activity compromises protein secretion.
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Raez L, Mekhail T, Rodriguez E, Hunis B, Nashed A, Dietrich M, Nagy R, Kiedrowski L. MA 15.02 Plasma CfDNA next Generation Sequencing in Non-Small Cell Lung Cancer: Clinical Outcomes and Comparison to Tissue. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Raez L, Danenberg K, Castrellon A, Rabizadeh S, Usher J, Jaimes Y, Hunis B, Dietrich M, Habaue C, Danenberg P. P2.01-056 Use of Cell-Free Circulating RNA (cfRNA) Expression of PD-L1 and ERCC1 in Plasma to Monitor Response to Therapy in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bingisser R, Dietrich M, Nieves Ortega R, Malinovska A, Bosia T, Nickel CH. Systematically assessed symptoms as outcome predictors in emergency patients. Eur J Intern Med 2017; 45:8-12. [PMID: 29074217 DOI: 10.1016/j.ejim.2017.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/11/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION It is known that symptoms are predictive of mortality in "nonsurgical" emergency patients. It is unknown whether a prospective, systematic, and "unscreened" assessment of all symptoms is of any prognostic value. Therefore, we aimed to examine the association between symptoms and outcomes in an all-comer population. METHODS Data were acquired during 6weeks at the ED of the University Hospital Basel, a tertiary hospital. Consecutive patients presenting to the ED were included. Symptoms at presentation were systematically assessed using a comprehensive questionnaire. RESULTS A consecutive sample of 3960 emergency patients with a median age of 51years (51.7% male) was studied. The median number of symptoms was two. In the group of patients with the most prevalent symptoms, the median number of symptoms ranged between two and five. Overall, hospitalisation rate was 31.2%, referral to intensive care was 5.5%, in-hospital-mortality was 1.4%, and one-year mortality was 5.8%. In-hospital mortality ranged from 0% to 4.3%, and one-year mortality from 0% to 14.4% depending on the presenting symptoms. Dyspnoea and weakness were significant predictors of one-year mortality (14.4% and 9.2%, respectively). DISCUSSION Most emergency patients indicated two or more symptoms. Systematically assessed symptoms at presentation can be used for prediction of outcomes. While dyspnoea is a known predictor, weakness has not been identified as predictor of mortality before. This knowledge could be used to improve risk stratification- thereby reducing the risk of adverse outcomes.
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Ridner S, Shah C, Dietrich M, Vicini F. Abstract OT3-07-01: A randomized trial evaluating bioimpedance spectroscopy vs. tape measurement in the prevention of lymphedema following breast cancer treatment. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-07-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer related lymphedema (BCRL) represents a common treatment associated complication following surgery, radiation and/or chemotherapy. Increasing data has demonstrated the ability of new diagnostic modalities to detect BCRL in the subclinical phase of the process allowing for early intervention.
Trial Design: This 2-group stratified randomized clinical trial evaluates the effectiveness of bioimpedance spectroscopy (BIS) for early detection and prevention of BCRL compared to tape measurement (TM). Baseline assessments are made pre-operatively. Two-months post-op, patients are censored out if they have developed any of the exclusion conditions, did not have a mastectomy, axillary dissection, >6 sentinel nodes removed, radiation therapy, or taxane. Remaining patients are randomized within site to either BIS or TM; monitored at 3 to 6-month intervals up to 36-months post-op for a change over baseline specified to trigger a compression sleeve & gauntlet intervention. Cohort trigger thresholds are change of ≥10 L-Dex units or 5 to <10% volume. If the intervention is triggered, measurements by the other method are taken before initiating the 4-week intervention. Post intervention, patients are monitored only with TM. Volume change of ≥10% results in study removal and physician referral. At the 2 study endpoints (36 month visit or volume change of ≥10%) measurements are taken with each method.
Eligibility Criteria: Inclusion criteria: ≥ 18 with histologically confirmed stage I-III breast cancer (BC) or DCIS with planned surgery. Exclusion criteria include history of BC therapy or lymphedema.
Specific Aims: The primary hypothesis is that subclinical detection of BCRL with BIS and early intervention will reduce the rate of lymphedema progression (as measured by referral to complex decongestive physiotherapy) compared to TM. Secondary outcomes include BCRL risk factors, quality of life, and time to treatment.
Statistical Methods: Sample size and powering were based on the hypothesis that BIS would reduce progression rate by 20%. A rate of 50% progression in the TM group was used as the standard. 1100 patients will be enrolled to result in randomized groups of 100 (Total N=200) Statistics include relative risks with respective bootstrapped 95% C.I. and Cochran-Mantel-Haenszel tests.
Present Accrual and Target Accrual: Overall, the study target or expected enrollment as of the end of March 31, 2016 was 690 participants, 534 were actually enrolled (actual accrual 77% of target). Accrual at the study sites ranged from 15 to 104% of target.
Contact Information: Sheila Ridner: 615-322-0831, Sheila.ridner@vanderbilt.edu
Support: ImpediMed Limited, ImpediMed, Inc. and medi USA.
Citation Format: Ridner S, Shah C, Dietrich M, Vicini F. A randomized trial evaluating bioimpedance spectroscopy vs. tape measurement in the prevention of lymphedema following breast cancer treatment [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-07-01.
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Markotter W, Dietrich M, Geldenhuys M, Kearney T, McCulloch S, Mortlock M, Seamark E, van Vuren PJ, Weyer J, Paweska J. Potential zoonotic pathogens in bat species in South Africa. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Friedman J, Ber R, Ridner S, Dietrich M, Johnson K. PrimeMD, a Real-Time Symptom Management Smartphone Application for Head and Neck Cancer Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grünwald V, Dietrich M, Pond G. Prognostic ability of HR-QoL parameters in metastatic renal cell carcinoma (mRCC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pond G, Dietrich M, Grünwald V. Prognostic ability of early tumor shrinkage on overall survival (OS) in metastatic renal cell carcinoma (mRCC) – a validation study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Spross C, Grueninger P, Gohil S, Dietrich M. Open Reduction and Internal Fixation of Fractures of the Proximal Part of the Humerus. JBJS Essent Surg Tech 2015; 5:e15. [PMID: 30473923 PMCID: PMC6221419 DOI: 10.2106/jbjs.st.n.00106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction We describe the surgical technique for open reduction and internal fixation (ORIF) of proximal humeral fractures with a locking plate. Step 1 Preoperative Planning To choose the right candidate, obtain a full understanding of the patient's fracture pattern, activity level and demands, and bone quality; be aware of predictors of complications and poor outcomes. Step 2 Patient Positioning Place the patient in the beach-chair position with the arm draped free or in a hydraulic device with good access for the image intensifier. Step 3 Approach The deltopectoral approach is generally preferred because of the exposure obtained, the possibility of distal extension, and the minimal risk of nerve injury. Step 4 Reduction and Fixation of the Tuberosities the Key to Obtaining Marionette-Like Control The control, reduction, and fixation of the tuberosities are crucial to restore the anterior-posterior force couple of the shoulder and must therefore be done properly no matter what the fracture pattern looks like. Step 5 Fracture Reduction After carrying out Steps 1 through 4, perform the reduction techniques for the specific fracture type as described below for types that we think suitable for ORIF with a locking plate. Step 6 Fixation Implant-Specific Considerations Plate length and positioning, humeral head screw placement, distal locking, confirming the screw tip position with the image intensifier, and securing the tuberosities. Step 7 Tenotomy or Tenodesis of the Long Biceps Tendon Perform a biceps tenotomy if the biceps is displaced out of the groove by the fracture pattern or if you have to open the rotator interval. Step 8 Wound Closure Do not close the deltopectoral interval. Step 9 Rehabilitation As the failure rate of ORIF of proximal humeral fractures is high, do not force an active rehabilitation protocol. Results In our analysis of 269 fractures followed for twelve months, we found that the Constant-Murley score (CMS) and Short Form-36 (SF-36) score improved continuously during the first six months postoperatively.IndicationsContraindicationsPitfalls & Challenges.
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Edelson R, Gelbord JM, Horne K, McHardy IM, Peterson BM, Arévalo P, Breeveld AA, Rosa GD, Evans PA, Goad MR, Kriss GA, Brandt WN, Gehrels N, Grupe D, Kennea JA, Kochanek CS, Nousek JA, Papadakis I, Siegel M, Starkey D, Uttley P, Vaughan S, Young S, Barth AJ, Bentz MC, Brewer BJ, Crenshaw DM, Dalla Bontà E, Cáceres ADL, Denney KD, Dietrich M, Ely J, Fausnaugh MM, Grier CJ, Hall PB, Kaastra J, Kelly BC, Korista KT, Lira P, Mathur S, Netzer H, Pancoast A, Pei L, Pogge RW, Schimoia JS, Treu T, Vestergaard M, Villforth C, Yan H, Zu Y. SPACE TELESCOPE AND OPTICAL REVERBERATION MAPPING PROJECT. II.SWIFTANDHSTREVERBERATION MAPPING OF THE ACCRETION DISK OF NGC 5548. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/806/1/129] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rosa GD, Peterson BM, Ely J, Kriss GA, Crenshaw DM, Horne K, Korista KT, Netzer H, Pogge RW, Arévalo P, Barth AJ, Bentz MC, Brandt WN, Breeveld AA, Brewer BJ, Dalla Bontà E, Lorenzo-Cáceres AD, Denney KD, Dietrich M, Edelson R, Evans PA, Fausnaugh MM, Gehrels N, Gelbord JM, Goad MR, Grier CJ, Grupe D, Hall PB, Kaastra J, Kelly BC, Kennea JA, Kochanek CS, Lira P, Mathur S, McHardy IM, Nousek JA, Pancoast A, Papadakis I, Pei L, Schimoia JS, Siegel M, Starkey D, Treu T, Uttley P, Vaughan S, Vestergaard M, Villforth C, Yan H, Young S, Zu Y. SPACE TELESCOPE AND OPTICAL REVERBERATION MAPPING PROJECT. I. ULTRAVIOLET OBSERVATIONS OF THE SEYFERT 1 GALAXY NGC 5548 WITH THE COSMIC ORIGINS SPECTROGRAPH ONHUBBLE SPACE TELESCOPE. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/806/1/128] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Rohacek M, Nickel CH, Dietrich M, Bingisser R. Clinical intuition ratings are associated with morbidity and hospitalisation. Int J Clin Pract 2015; 69:710-7. [PMID: 25689155 PMCID: PMC5024066 DOI: 10.1111/ijcp.12606] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate how the rating of the severity of sickness - as performed by the physician, nurse and patient - is associated with hospitalisation and acute morbidity. METHODS Prospective observational study, performed in the emergency department of a tertiary hospital. Patients, physicians and nurses were interviewed separately after the first contact from 21 October through to 11 November 2013. RESULTS Of 2426 presenting patients, 1861 were screened, and 1196 were included. A total of 299 (25%) were hospitalised, 504 (42%) suffered acute morbidity. In the univariate analysis, the physician's, nurse's and patient's rating of severity of sickness, expressed on a scale from 0 to 10, was significantly associated with hospitalisation (physicians: OR 1.61, 95% CI 1.50-1.73; nurses: OR 1.52, 1.41-1.64; patients: OR 1.16, 1.10-1.22), and with acute morbidity (OR 1.49, 1.40-1.59; OR 1.39, 1.30-1.48 and OR 1.05, 1.003-1.09 respectively). The area under the curve of the receiver operating characteristic curves was 0.77, 0.72 and 0.61 for hospitalisation, and 0.72, 0.68 and 0.54 for acute morbidity. The interrater reliability was estimated by the intraclass correlation, which was 0.49 for physician/nurse, 0.17 for nurse/patient and 0.07 for physician/patient. In a multivariable analysis model consisting of age, male sex, ethnic origin, ratings of severity of sickness, symptoms, ability to go home and hospitalisation during the preceding 12 months, only age, and the physician's and nurses' rating of severity of sickness remained significantly associated with both outcomes. CONCLUSION The first impression of severity of sickness was associated with hospitalisation and morbidity.
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