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Huang CY, Metz A, Lange R, Artico N, Potot C, Hazemann J, Müller M, Dos Santos M, Chambovey A, Ritz D, Eris D, Meyer S, Bourquin G, Sharpe M, Mac Sweeney A. Fragment-based screening targeting an open form of the SARS-CoV-2 main protease binding pocket. Acta Crystallogr D Struct Biol 2024; 80:123-136. [PMID: 38289714 PMCID: PMC10836397 DOI: 10.1107/s2059798324000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
To identify starting points for therapeutics targeting SARS-CoV-2, the Paul Scherrer Institute and Idorsia decided to collaboratively perform an X-ray crystallographic fragment screen against its main protease. Fragment-based screening was carried out using crystals with a pronounced open conformation of the substrate-binding pocket. Of 631 soaked fragments, a total of 29 hits bound either in the active site (24 hits), a remote binding pocket (three hits) or at crystal-packing interfaces (two hits). Notably, two fragments with a pose that was sterically incompatible with a more occluded crystal form were identified. Two isatin-based electrophilic fragments bound covalently to the catalytic cysteine residue. The structures also revealed a surprisingly strong influence of the crystal form on the binding pose of three published fragments used as positive controls, with implications for fragment screening by crystallography.
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Affiliation(s)
- Chia Ying Huang
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI, Switzerland
| | - Alexander Metz
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | - Roland Lange
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | - Nadia Artico
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | - Céline Potot
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | | | - Manon Müller
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | | | | | - Daniel Ritz
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | - Deniz Eris
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI, Switzerland
| | - Solange Meyer
- Idorsia Pharmaceuticals Ltd, 4123 Allschwil, Switzerland
| | | | - May Sharpe
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen PSI, Switzerland
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Guguchia Z, Das D, Simutis G, Adachi T, Küspert J, Kitajima N, Elender M, Grinenko V, Ivashko O, Zimmermann MV, Müller M, Mielke C, Hotz F, Mudry C, Baines C, Bartkowiak M, Shiroka T, Koike Y, Amato A, Hicks CW, Gu GD, Tranquada JM, Klauss HH, Chang JJ, Janoschek M, Luetkens H. Designing the stripe-ordered cuprate phase diagram through uniaxial-stress. Proc Natl Acad Sci U S A 2024; 121:e2303423120. [PMID: 38150501 PMCID: PMC10769840 DOI: 10.1073/pnas.2303423120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/02/2023] [Indexed: 12/29/2023] Open
Abstract
The ability to efficiently control charge and spin in the cuprate high-temperature superconductors is crucial for fundamental research and underpins technological development. Here, we explore the tunability of magnetism, superconductivity, and crystal structure in the stripe phase of the cuprate La[Formula: see text]Ba[Formula: see text]CuO[Formula: see text], with [Formula: see text] = 0.115 and 0.135, by employing temperature-dependent (down to 400 mK) muon-spin rotation and AC susceptibility, as well as X-ray scattering experiments under compressive uniaxial stress in the CuO[Formula: see text] plane. A sixfold increase of the three-dimensional (3D) superconducting critical temperature [Formula: see text] and a full recovery of the 3D phase coherence is observed in both samples with the application of extremely low uniaxial stress of [Formula: see text]0.1 GPa. This finding demonstrates the removal of the well-known 1/8-anomaly of cuprates by uniaxial stress. On the other hand, the spin-stripe order temperature as well as the magnetic fraction at 400 mK show only a modest decrease under stress. Moreover, the onset temperatures of 3D superconductivity and spin-stripe order are very similar in the large stress regime. However, strain produces an inhomogeneous suppression of the spin-stripe order at elevated temperatures. Namely, a substantial decrease of the magnetic volume fraction and a full suppression of the low-temperature tetragonal structure is found under stress, which is a necessary condition for the development of the 3D superconducting phase with optimal [Formula: see text]. Our results evidence a remarkable cooperation between the long-range static spin-stripe order and the underlying crystalline order with the three-dimensional fully coherent superconductivity. Overall, these results suggest that the stripe- and the SC order may have a common physical mechanism.
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Affiliation(s)
- Z. Guguchia
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - D. Das
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - G. Simutis
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
| | - T. Adachi
- Department of Engineering and Applied Sciences, Sophia University, Tokyo102-8554, Japan
| | - J. Küspert
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - N. Kitajima
- Department of Applied Physics, Tohoku University, Sendai980-8579, Japan
| | - M. Elender
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - V. Grinenko
- Tsung-Dao Lee Institute, Shanghai Jiao Tong University, Pudong, 201210Shanghai, China
| | - O. Ivashko
- Deutsches Elektronen-Synchrotron, 22607Hamburg, Germany
| | | | - M. Müller
- Condensed Matter Theory Group, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. Mielke
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - F. Hotz
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. Mudry
- Condensed Matter Theory Group, Paul Scherrer Institute, CH-5232Villigen, Switzerland
- Institut de Physique, École Polytechnique Fédérale de Lausanne, LausanneCH-1015, Switzerland
| | - C. Baines
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - M. Bartkowiak
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
| | - T. Shiroka
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
- Laboratorium für Festkörperphysik, ETH Zürich, CH-8093Zürich, Switzerland
| | - Y. Koike
- Department of Applied Physics, Tohoku University, Sendai980-8579, Japan
| | - A. Amato
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
| | - C. W. Hicks
- Max Planck Institute for Chemical Physics of Solids, D-01187Dresden, Germany
- School of Physics and Astronomy, University of Birmingham, BirminghamB15 2TT, United Kingdom
| | - G. D. Gu
- Condensed Matter Physics and Materials Science Division, Brookhaven National Laboratory, Upton, NY11973
| | - J. M. Tranquada
- Condensed Matter Physics and Materials Science Division, Brookhaven National Laboratory, Upton, NY11973
| | - H.-H. Klauss
- Institute for Solid State and Materials Physics, Technische Universitat Dresden, D-01069Dresden, Germany
| | - J. J. Chang
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - M. Janoschek
- Laboratory for Neutron and Muon Instrumentation, Paul Scherrer Institut, CH-5232Villigen, Switzerland
- Physik-Institut, Universität Zürich, CH-8057Zürich, Switzerland
| | - H. Luetkens
- Laboratory for Muon Spin Spectroscopy, Paul Scherrer Institute, CH-5232Villigen, Switzerland
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Kempa S, Tessmann V, Prantl L, Schmid S, Müller M, Jung EM, Tews HC. The value of sonographic microvascular imaging in the diagnosis of lipedema. Clin Hemorheol Microcirc 2024; 86:99-108. [PMID: 37638423 DOI: 10.3233/ch-238103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
BACKGROUND Lipedema is a chronic disease marked by symmetric enlargement of painful nodular and fibrotic adipose tissue, predominantly affecting the limbs. Since there is no specific test or biomarker for this condition, years often pass before the diagnosis of lipedema is established for the first time, thereby causing psychosocial distress, including depression, eating disorders, and social isolation. Over the last few years several advanced Doppler-based technologies have been developed to visualize slow flow blood vessels and superficial microvascular architecture undetectable by traditional color Doppler flow imaging (CDFI). OBJECTIVE The aim of this study was to evaluate the superficial microvascular anatomy in lipedema patients compared to healthy controls and investigate the clinical significance of the Ultra Micro Angiography (UMA) technology in the diagnosis of lipedema. This new technique may contribute to reduce the diagnostic delay and, eventually, establish and guide treatment strategies toward a better therapeutic outcome in lipedema patients. METHODS 25 patients with lipedema and ten healthy controls with no history of lipedema were included in this study. All ultrasound examinations were performed on a novel high-performance ultrasound system (Resona R9/Mindray) using CDFI and the UMA technique. RESULTS In all of the patients, Ultra Micro Angiography achieved the excellent visualization of microvascular structures, revealing that most lipedema patients showed grade 3 (n = 13) or grade 2 (n = 8) flow. UMA was superior to CDFI for depicting the microvascular structures. CONCLUSIONS Here we show that UMA imaging characterizes the subcutaneous microvasculature with an unprecedented accuracy. The method has the advantage of being sensitive to small, slow-flowing vessels. This allows for the assessment of the course of vessels and vascular pathologies in great detail. Thus, UMA as a non-invasive diagnostic method can improve diagnostic accuracy in lipedema.
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Affiliation(s)
- S Kempa
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V Tessmann
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Prantl
- Department for Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - E-M Jung
- Institute for Diagnostic Radiology and Interdisciplinary Ultrasound, University Hospital Regensburg, Regensburg, Germany
| | - H C Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Müller M, Bullinger Y, Pohlemann T, Orth M. [Clavicle fractures: practical approach in clinical routine]. Chirurgie (Heidelb) 2023; 94:1045-1056. [PMID: 37702744 DOI: 10.1007/s00104-023-01958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/14/2023]
Abstract
Fractures of the clavicle are among the most common fractures. They typically result from a fall onto the lateral shoulder or the extended arm and are often related to sports and bicycle accidents. Obtaining the exact trauma mechanism, proper clinical findings and adequate X‑rays usually lead to the correct diagnosis. Non-displacement fractures can be treated conservatively with good results. Unstable and displaced fractures should be treated operatively. Open fractures or looming penetration are emergencies und should be treated immediately. In addition to fracture classification and morphology, other factors such as additional injuries and patient-related factors need to be considered in order to make an individualized therapy decision. In operative treatment, angular stable plating is the therapy of choice, and in most cases early functional aftercare is possible.
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Affiliation(s)
- M Müller
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland.
| | - Y Bullinger
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
| | - T Pohlemann
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
| | - M Orth
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, 66421, Homburg/Saar, Deutschland
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Nies L, Canete L, Dao DD, Giraud S, Kankainen A, Lunney D, Nowacki F, Bastin B, Stryjczyk M, Ascher P, Blaum K, Cakirli RB, Eronen T, Fischer P, Flayol M, Girard Alcindor V, Herlert A, Jokinen A, Khanam A, Köster U, Lange D, Moore ID, Müller M, Mougeot M, Nesterenko DA, Penttilä H, Petrone C, Pohjalainen I, de Roubin A, Rubchenya V, Schweiger C, Schweikhard L, Vilen M, Äystö J. Further Evidence for Shape Coexistence in ^{79}Zn^{m} near Doubly Magic ^{78}Ni. Phys Rev Lett 2023; 131:222503. [PMID: 38101393 DOI: 10.1103/physrevlett.131.222503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/16/2023] [Accepted: 10/25/2023] [Indexed: 12/17/2023]
Abstract
Isomers close to doubly magic _{28}^{78}Ni_{50} provide essential information on the shell evolution and shape coexistence near the Z=28 and N=50 double shell closure. We report the excitation energy measurement of the 1/2^{+} isomer in _{30}^{79}Zn_{49} through independent high-precision mass measurements with the JYFLTRAP double Penning trap and with the ISOLTRAP multi-reflection time-of-flight mass spectrometer. We unambiguously place the 1/2^{+} isomer at 942(10) keV, slightly below the 5/2^{+} state at 983(3) keV. With the use of state-of-the-art shell-model diagonalizations, complemented with discrete nonorthogonal shell-model calculations which are used here for the first time to interpret shape coexistence, we find low-lying deformed intruder states, similar to other N=49 isotones. The 1/2^{+} isomer is interpreted as the bandhead of a low-lying deformed structure akin to a predicted low-lying deformed band in ^{80}Zn, and points to shape coexistence in ^{79,80}Zn similar to the one observed in ^{78}Ni. The results make a strong case for confirming the claim of shape coexistence in this key region of the nuclear chart.
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Affiliation(s)
- L Nies
- European Organization for Nuclear Research (CERN), Meyrin, 1211 Geneva, Switzerland
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - L Canete
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Department of Physics, University of Surrey, Guildford GU2 7X5, United Kingdom
| | - D D Dao
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - S Giraud
- GANIL, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - A Kankainen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - D Lunney
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - F Nowacki
- Université de Strasbourg, CNRS, IPHC UMR 7178, F-67000 Strasbourg, France
| | - B Bastin
- GANIL, Bd Henri Becquerel, BP 55027, F-14076 Caen Cedex 5, France
| | - M Stryjczyk
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - P Ascher
- Université de Bordeaux, CNRS/IN2P3-Université, CNRS/IN2P3, LP2I Bordeaux, UMR 5797, F-33170 Gradignan, France
| | - K Blaum
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - R B Cakirli
- Department of Physics, Istanbul University, Istanbul 34134, Turkey
| | - T Eronen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - P Fischer
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - M Flayol
- Université de Bordeaux, CNRS/IN2P3-Université, CNRS/IN2P3, LP2I Bordeaux, UMR 5797, F-33170 Gradignan, France
| | | | - A Herlert
- FAIR GmbH, Planckstraße 1, 64291 Darmstadt, Germany
| | - A Jokinen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - A Khanam
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Department of Applied Physics, Aalto University, P.O. Box 15100, FI-00076 Aalto, Finland
- Department of Physics, University of Helsinki, P.O. Box 43, FI-00014 Helsinki, Finland
| | - U Köster
- European Organization for Nuclear Research (CERN), Meyrin, 1211 Geneva, Switzerland
- Institut Laue-Langevin, 38000 Grenoble, France
| | - D Lange
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - I D Moore
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - M Müller
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - M Mougeot
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - D A Nesterenko
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - H Penttilä
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - C Petrone
- IFIN-HH, P.O. Box MG-6, 077125 Bucharest-Magurele, Romania
| | - I Pohjalainen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - A de Roubin
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - V Rubchenya
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - Ch Schweiger
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - L Schweikhard
- Institut für Physik, Universität Greifswald, 17487 Greifswald, Germany
| | - M Vilen
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
| | - J Äystö
- University of Jyvaskyla, Department of Physics, Accelerator laboratory, P.O. Box 35(YFL), FI-40014, University of Jyvaskyla, Finland
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Müller M, Förschler S, Wehrmann T, Marini F, Gockel I, Eckardt AJ. Atypical presentations and pitfalls of achalasia. Dis Esophagus 2023; 36:doad029. [PMID: 37158189 DOI: 10.1093/dote/doad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/04/2023] [Indexed: 05/10/2023]
Abstract
Achalasia is a rare disease with significant diagnostic delay and association with false diagnoses and unnecessary interventions. It remains unclear, whether atypical presentations, misinterpreted symptoms or inconclusive diagnostics are the cause. The aim of this study was the characterization of typical and atypical features of achalasia and their impact on delays, misinterpretations or false diagnoses. A retrospective analysis of prospective database over a period of 30 years was performed. Data about symptoms, delays and false diagnoses were obtained and correlated with manometric, endoscopic and radiologic findings. Totally, 300 patients with achalasia were included. Typical symptoms (dysphagia, regurgitation, weight loss and retrosternal pain) were present in 98.7%, 88%, 58.4% and 52.4%. The mean diagnostic delay was 4.7 years. Atypical symptoms were found in 61.7% and led to a delay of 6 months. Atypical gastrointestinal symptoms were common (43%), mostly 'heartburn' (16.3%), 'vomiting' (15.3%) or belching (7.7%). A single false diagnosis occurred in 26%, multiple in 16%. Major gastrointestinal misdiagnoses were GERD in 16.7% and eosinophilic esophagitis in 4%. Other false diagnosis affected ENT-, psychiatric, neurologic, cardiologic or thyroid diseases. Pitfalls were the description of 'heartburn' or 'nausea'. Tertiary contractions at barium swallows, hiatal hernias and 'reflux-like' changes at endoscopy or eosinophils in the biopsies were misleading. Atypical symptoms are common in achalasia, but they are not the sole source for diagnostic delays. Misleading descriptions of typical symptoms or misinterpretation of diagnostic studies contribute to false diagnoses and delays.
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Affiliation(s)
- M Müller
- Department of Gastroenterology, University Hospital Giessen and Marburg, Marburg, Germany
| | - S Förschler
- Department of General and Visceral Surgery, St. Josefs-Hospital, Wiesbaden, Germany
| | - T Wehrmann
- Department of Gastroenterology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| | - F Marini
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Division Biostatistics and Bioinformatics, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - I Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Medical Center of Leipzig, Leipzig, Germany
| | - A J Eckardt
- Department of Gastroenterology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
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Boldt J, Müller M, Heesen M, Martin K, Hempelmann G. Retraction Note: The effects of pentoxifylline on circulating adhesion molecules in critically ill patients with acute renal failure treated by continuous veno-venous hemofiltration. Intensive Care Med 2023; 49:1154. [PMID: 37490057 DOI: 10.1007/s00134-023-07158-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen, Anesthesiology and Intensive Care Medicine, Bremerstrasse 79, D-67063, Ludwigshafen am Rhein, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - M Heesen
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - K Martin
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, D-35392, Giessen, Germany
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Schwarz F, Klee E, Schenk P, Katscher S, Schnake KJ, Bäumlein M, Zimmermann V, Schmeiser G, Scherer MA, Müller M, Sprengel K, Spiegl U, Osterhoff G, Schramm S, Siekmann H, Franck A, Scheyerer MJ, Ullrich BW. Impact of Anxiety During Hospitalization on the Clinical Outcome of Patients With Osteoporotic Thoracolumbar Vertebral Fracture. Global Spine J 2023:21925682231192847. [PMID: 37549640 DOI: 10.1177/21925682231192847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
STUDY DESIGN Multicenter prospective cohort study. OBJECTIVES Anxiety in combination with osteoporotic vertebral compression fractures (OVCFs) of the spine remains understudied. The purpose of this study was to analyze whether anxiety has an impact on the short-term functional outcome of patients with an OVCF. Furthermore, a direct impact of the fracture on the patient's anxiety during hospitalization should be recognized. METHODS All inpatients with an OVCF of the thoracolumbar spine from 2017 to 2020 were included. Trauma mechanism, analgetic medication, anti-osteoporotic therapy, timed-up-and-go test (TuG), mobility, Barthel index, Oswestry-Disability Index (ODI) and EQ5D-5L were documented.For statistical analysis, the U test, chi-square independence test, Spearman correlation, General Linear Model for repeated measures, Bonferroni analysis and Wilcoxon test were used. The item anxiety/depression of the EQ5D-5L was analyzed to describe the patients' anxiousness. RESULTS Data from 518 patients from 17 different hospitals were evaluated. Fracture severity showed a significant correlation (r = .087, P = .0496) with anxiety. During the hospital stay, pain medication (P < .001), anti-osteoporotic medication (P < .001), and initiation of surgical therapy (P < .001) were associated with less anxiety. The anxiety of a patient at discharge was negatively related to the functional outcomes at the individual follow-up: TuG (P < .001), Barthel index (P < .001), ODI (P < .001) and EQ5D-5L (P < .001). CONCLUSIONS Higher anxiety is associated with lower functional outcome after OVCF. The item anxiety/depression of the EQ5D-5L provides an easily accessible, quick and simple tool that can be used to screen for poor outcomes and may also offer the opportunity for a specific anxiety intervention.
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Affiliation(s)
- F Schwarz
- Department of Neurosurgery, University Hospital Jena, Jena, Germany
| | - E Klee
- Department of Neurosurgery, University Hospital Jena, Jena, Germany
| | - P Schenk
- Department of Science and Research, BG Clinic Bergmannstrost Halle (Saale), Halle, Deutschland
| | - S Katscher
- Interdisciplinary Center for Spine and Neurotrauma, Sana Clinic Borna, Borna, Germany
| | - K J Schnake
- Interdisciplinary Center for Spinal and Scoliosis Surgery, Waldkrankenhaus Erlangen, Erlangen, Germany
- Department of Orthopaedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
| | - M Bäumlein
- Department of Orthopaedics and Traumatology, University Hospital Marburg, Marburg, Germany
| | - V Zimmermann
- Department of Trauma and Orthopedic Surgery, Klinikum Traunstein, Traunstein, Germany
| | - G Schmeiser
- Department of Spinal Surgery, Schön Clinic Hamburg Eilbek, Hamburg, Germany
| | - M A Scherer
- Medical Practice Clinic Orthopedics and Surgery Munich West, Munich, Germany
| | - M Müller
- Department of Orthopaedics and Traumatology, University Hospital Kiel, Kiel, Germany
| | - K Sprengel
- Department of Traumatology, Hirslanden Clinic St. Anna, University of Lucerne, Lucerne, Switzerland
- Department of Traumatology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - U Spiegl
- Department of Orthopaedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - G Osterhoff
- Department of Orthopaedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - S Schramm
- Department of Trauma and Orthopaedic Surgery, University Hospital Erlangen, Erlangen, Germany
| | - H Siekmann
- Department of Traumatology and Reconstructive Surgery, AMEOS Klinikum Halberstadt, Halberstadt, Germany
| | - A Franck
- Department of Orthopaedics and Traumatology, Regiomed-Clinic of Coburg, Coburg, Germany
| | - M-J Scheyerer
- Department of Orthopaedics and Traumatology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - B W Ullrich
- Department of Traumatology and Reconstructive Surgery, BG Clinic Bergmannstrost Halle (Saale), Halle, Germany
- Department of Hand, Trauma- and Reconstructive Surgery, University Hospital Jena, Jena, Germany
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9
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Kalitukha IV, Yalcin E, Ken OS, Korenev VL, Akimov IA, Harkort C, Dimitriev GS, Kudlacik D, Sapega VF, Nedelea V, Zhukov EA, Yakovlev DR, Banshchikov AG, Kaveev AK, Karczewski G, Wojtowicz T, Müller M, Bayer M. Universal magnetic proximity effect in ferromagnet-semiconductor quantum well hybrid structures. J Chem Phys 2023; 159:014702. [PMID: 37403857 DOI: 10.1063/5.0153310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/12/2023] [Indexed: 07/06/2023] Open
Abstract
Hybrid ferromagnet-semiconductor systems possess new outstanding properties, which emerge when bringing magnetic and semiconductor materials into contact. In such structures, the long-range magnetic proximity effect couples the spin systems of the ferromagnet and semiconductor on distances exceeding the carrier wave function overlap. The effect is due to the effective p-d exchange interaction of acceptor-bound holes in the quantum well with d-electrons of the ferromagnet. This indirect interaction is established via the phononic Stark effect mediated by the chiral phonons. Here, we demonstrate that the long-range magnetic proximity effect is universal and observed in hybrid structures with diverse magnetic components and potential barriers of various thicknesses and compositions. We study hybrid structures consisting of a semimetal (magnetite Fe3O4) or dielectric (spinel NiFe2O4) ferromagnet and a CdTe quantum well separated by a nonmagnetic (Cd,Mg)Te barrier. The proximity effect is manifested in the circular polarization of the photoluminescence corresponding to the recombination of photoexcited electrons with holes bound to shallow acceptors in the quantum well induced by magnetite or spinel itself, in contrast to interface ferromagnet in case of metal-based hybrid systems. A nontrivial dynamics of the proximity effect is observed in the studied structures due to recombination-induced dynamic polarization of electrons in the quantum well. It enables the determination of the exchange constant Δexch ≈ 70 μeV in a magnetite-based structure. The universal origin of the long-range exchange interaction along with the possibility of its electrical control offers prospects for the development of low-voltage spintronic devices compatible with existing solid-state electronics.
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Affiliation(s)
- I V Kalitukha
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - E Yalcin
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - O S Ken
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - V L Korenev
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - I A Akimov
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - C Harkort
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - G S Dimitriev
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - D Kudlacik
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - V F Sapega
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - V Nedelea
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
| | - E A Zhukov
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - D R Yakovlev
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - A G Banshchikov
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
| | - A K Kaveev
- Ioffe Institute, Russian Academy of Sciences, 194021 St. Petersburg, Russia
- Saint-Petersburg Alferov University, 194021 St. Petersburg, Russia
| | - G Karczewski
- Institute of Physics, Polish Academy of Sciences, PL-02668 Warsaw, Poland
| | - T Wojtowicz
- International Research Centre MagTop, Institute of Physics, Polish Academy of Sciences, PL-02668 Warsaw, Poland
| | - M Müller
- Fachbereich Physik, Universität Konstanz, 78457 Konstanz, Germany
| | - M Bayer
- Experimentelle Physik 2, Technische Universität Dortmund, 44227 Dortmund, Germany
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10
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Asadollahi R, Delvendahl I, Muff R, Tan G, Rodríguez DG, Turan S, Russo M, Oneda B, Joset P, Boonsawat P, Masood R, Mocera M, Ivanovski I, Baumer A, Bachmann-Gagescu R, Schlapbach R, Rehrauer H, Steindl K, Begemann A, Reis A, Winkler J, Winner B, Müller M, Rauch A. Pathogenic SCN2A variants cause early-stage dysfunction in patient-derived neurons. Hum Mol Genet 2023; 32:2192-2204. [PMID: 37010102 PMCID: PMC10281746 DOI: 10.1093/hmg/ddad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/23/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023] Open
Abstract
Pathogenic heterozygous variants in SCN2A, which encodes the neuronal sodium channel NaV1.2, cause different types of epilepsy or intellectual disability (ID)/autism without seizures. Previous studies using mouse models or heterologous systems suggest that NaV1.2 channel gain-of-function typically causes epilepsy, whereas loss-of-function leads to ID/autism. How altered channel biophysics translate into patient neurons remains unknown. Here, we investigated iPSC-derived early-stage cortical neurons from ID patients harboring diverse pathogenic SCN2A variants [p.(Leu611Valfs*35); p.(Arg937Cys); p.(Trp1716*)] and compared them with neurons from an epileptic encephalopathy (EE) patient [p.(Glu1803Gly)] and controls. ID neurons consistently expressed lower NaV1.2 protein levels. In neurons with the frameshift variant, NaV1.2 mRNA and protein levels were reduced by ~ 50%, suggesting nonsense-mediated decay and haploinsufficiency. In other ID neurons, only protein levels were reduced implying NaV1.2 instability. Electrophysiological analysis revealed decreased sodium current density and impaired action potential (AP) firing in ID neurons, consistent with reduced NaV1.2 levels. In contrast, epilepsy neurons displayed no change in NaV1.2 levels or sodium current density, but impaired sodium channel inactivation. Single-cell transcriptomics identified dysregulation of distinct molecular pathways including inhibition of oxidative phosphorylation in neurons with SCN2A haploinsufficiency and activation of calcium signaling and neurotransmission in epilepsy neurons. Together, our patient iPSC-derived neurons reveal characteristic sodium channel dysfunction consistent with biophysical changes previously observed in heterologous systems. Additionally, our model links the channel dysfunction in ID to reduced NaV1.2 levels and uncovers impaired AP firing in early-stage neurons. The altered molecular pathways may reflect a homeostatic response to NaV1.2 dysfunction and can guide further investigations.
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Affiliation(s)
- R Asadollahi
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
- Faculty of Engineering and Science, University of Greenwich London, Medway Campus, Chatham Maritime ME4 4TB, UK
| | - I Delvendahl
- Department of Molecular Life Sciences, University of Zurich, Zurich 8057, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
| | - R Muff
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - G Tan
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - D G Rodríguez
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - S Turan
- Department of Stem Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - M Russo
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - B Oneda
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - P Joset
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - P Boonsawat
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Masood
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - M Mocera
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - I Ivanovski
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Baumer
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Bachmann-Gagescu
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - R Schlapbach
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - H Rehrauer
- Functional Genomics Center Zurich, ETH Zurich and University of Zurich, Zurich 8057, Switzerland
| | - K Steindl
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Begemann
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
| | - A Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - J Winkler
- Department of Molecular Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
- Center for Rare Diseases Erlangen, University Hospital Erlangen, Erlangen 91054, Germany
| | - B Winner
- Department of Stem Cell Biology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
- Center for Rare Diseases Erlangen, University Hospital Erlangen, Erlangen 91054, Germany
| | - M Müller
- Department of Molecular Life Sciences, University of Zurich, Zurich 8057, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
- University of Zurich Clinical Research Priority Program (CRPP) Praeclare – Personalized prenatal and reproductive medicine, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) AdaBD: Adaptive Brain Circuits in Development and Learning, Zurich 8006, Switzerland
| | - A Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zurich 8952, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich 8057, Switzerland
- University of Zurich Clinical Research Priority Program (CRPP) Praeclare – Personalized prenatal and reproductive medicine, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) AdaBD: Adaptive Brain Circuits in Development and Learning, Zurich 8006, Switzerland
- University of Zurich Research Priority Program (URPP) ITINERARE: Innovative Therapies in Rare Diseases, Zurich 8006, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich 8057, Switzerland
- University Children's Hospital Zurich, University of Zurich, Zurich 8032, Switzerland
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11
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Luisi CA, Amiri A, Büsen M, Sichermann T, Nikoubashman O, Wiesmann M, Steinseifer U, Müller M, Neidlin M. Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup. Cardiovasc Eng Technol 2023; 14:393-403. [PMID: 36814059 PMCID: PMC10412675 DOI: 10.1007/s13239-023-00660-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration. METHODS We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions. RESULTS Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data. CONCLUSION The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.
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Affiliation(s)
- C A Luisi
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - A Amiri
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Büsen
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - T Sichermann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - O Nikoubashman
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Wiesmann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - U Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Müller
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany.
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12
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Biller ML, Böhm M, Kolb C, Bucur J, Müller M, Kohnen T. [Pneumocephalus after high-pressure trauma to the conjunctiva]. Ophthalmologie 2023; 120:660-662. [PMID: 35925342 DOI: 10.1007/s00347-022-01671-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 06/13/2023]
Affiliation(s)
- M L Biller
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | | | | | | | | | - T Kohnen
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
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13
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Müller M, Passegger O, Zehnder P, Hanschen M, Muggleton E, Biberthaler P, Wegmann H, Greve F. [Use of regional anesthesia for preoperative analgesia for proximal femoral fractures in the emergency department : A survey on current practice in German-speaking countries and the United Kingdom]. Unfallchirurgie (Heidelb) 2023; 126:456-462. [PMID: 37084002 DOI: 10.1007/s00113-023-01315-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Regional anesthesia (RA) techniques such as femoral nerve block (FNB) or fascia iliaca compartment block (FICB) are effective analgesia techniques in the treatment of pain from proximal femoral fractures (PFF). While in Great Britain (GB) these are already frequently used in the emergency department for preoperative analgesia, in the German-speaking D‑A-CH area (Germany, Austria, Switzerland) this seems to occur much less frequently. Therefore, the aim of this study was to survey the type and frequency of RA procedures used and to compare international practice. MATERIAL AND METHODS In the D‑A-CH area as well as in GB, registered emergency departments were contacted and invited to participate in an online survey. The survey included questions on the frequency and type of RA procedures, reasons for non-use, equipment used, person performing the procedure and medications used. RESULTS The participation rate was 17.4% (142/818 emergency departments). RA procedures for preoperative analgesia in PFF were used in 18.3% (21/115) of hospitals in the D‑A-CH region and in 96.3% (26/27) in GB. The most commonly used block was the FICB in GB at 96.2% (25/26) and the FNB in Germany at 66.7% (14/21). In the D‑A-CH area, RA procedures are primarily performed by anesthesiology specialists 71.4% (15/21), and in GB by emergency department residents 65.4% (17/26). DISCUSSION RA procedures are still performed too rarely following PFF in emergency departments in the D‑A-CH area. In international comparison with GB there is potential for improvement.
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Affiliation(s)
- M Müller
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - O Passegger
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - P Zehnder
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - M Hanschen
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - E Muggleton
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik für Anästhesiologie, Technische Universität München, München, Deutschland
- Anästhesie am Josephinum, Klinik Josephinum, München, Deutschland
| | - P Biberthaler
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - H Wegmann
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - F Greve
- Fakultät für Medizin, Klinikum rechts der Isar, Klinik und Poliklinik für Unfallchirurgie, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
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14
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Boldt J, Müller M, Rothe A, Lenzen P, Hempelmann G. Retraction Note: Does continuous heparinization influence platelet function in the intensive care patient? Intensive Care Med 2023:10.1007/s00134-023-07057-0. [PMID: 37039886 DOI: 10.1007/s00134-023-07057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Affiliation(s)
- J Boldt
- Department of Anesthesiology and Intensive Care Medicine, Bremserstrasse 79, 67063, Ludwigshafen, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - A Rothe
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - P Lenzen
- Department of Neurosurgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
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15
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Boldt J, Müller M, Heesen M, Heyn O, Hempelmann G. Retraction Note: Influence of different volume therapies on platelet function in the critically ill. Intensive Care Med 2023:10.1007/s00134-023-07056-1. [PMID: 37041369 DOI: 10.1007/s00134-023-07056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen Anesthesiology and Intensive Care Medicine, Bremserstrasse 79, D-67063, Ludwigshafen am Rhein, Germany
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - M Müller
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - M Heesen
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - O Heyn
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
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16
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Von Matthey F, Rammensee J, Müller M, Biberthaler P, Abel H. Can elderly patients regain their preoperative functional level after distal radius fracture type A? Results from a fracture register study using PROM. Front Surg 2023; 10:877252. [PMID: 37091269 PMCID: PMC10113482 DOI: 10.3389/fsurg.2023.877252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/08/2023] [Indexed: 04/09/2023] Open
Abstract
IntroductionAlthough distal radius fractures (DRFs) are the most common fractures of the human body, there are still ongoing debates concerning the treatment for type A fractures, especially in elderly patients. In spite of good clinical outcomes, it remains unclear whether elderly patients, especially, could regain the preoperative functional level of the wrist. Therefore, we have quantified wrist function within a retrospective study design using patient-reported outcome measures (PROM) and we have analyzed the influence of age between control and patient collective and young vs. old, respectively.Patients and methodsThe retrospective study included all patients with a surgically treated DRF type A and a control group of healthy patients, age and gender matched. The function of the wrist was examined by using a self-assessment questionnaire called the Munich Wrist Questionnaire (MWQ) according to the patient-related outcome measurements PROM.ResultsWe could enroll 110 patients and controls, and the average follow-up was 66 months. Subgroup matching induced similar age group distribution: in both groups, 7 individuals <30 years, 67 between 31 and 64 years, 29 between 65 and 79 years, and 7 individuals >80 years, were enrolled, respectively. In the fracture group, women were significantly older than men (59 ± 15 vs. 47 ± 17 (M ± SD). There was no significant difference between the control and the patient groups (96 ± 6 vs. 95 ± 7). The function was significantly different between controls and patients <30 years (100 ± 1 vs. 98 ± 2). In the control group, there was a functional difference in the age group <30 compared with 65–79 and >80 and in the age group 30–64 compared with 65–79 and >80. In the control group, the function was found to be significantly decreasing with advancing age, whereas in the patient group, this influence was absent. A correlation analysis showed a worse function with increasing age in the control group and therefore a negative correlation. In the fracture group, a similar result could not be obtained.DiscussionAge has a relevant influence on wrist function. Although the wrist function decreases significantly with aging, in the patient group, this influence is absent, and the functional results after surgery are excellent. Even elderly patients can regain their preoperative functional level.
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17
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Boldt J, Müller M, Kuhn D, Linke LC, Hempelmann G. Retraction Note: Circulating adhesion molecules in the critically ill: A comparison between trauma and sepsis patients. Intensive Care Med 2023; 49:612. [PMID: 37016204 DOI: 10.1007/s00134-023-07055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- J Boldt
- Klinikum der Stadt Ludwigshafen, Anesthesiology and Intensive Care Medicine, Bremserstr. 79, D-67063, Ludwigshafen, Germany
| | - M Müller
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - D Kuhn
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - L C Linke
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
| | - G Hempelmann
- Department of Anesthesiology and, Intensive Care Medicine, Justus-Liebig-University, Giessen Klinikstr. 29, D-35392, Giessen, Germany
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Maier J, Kandulski A, Donlon NE, Werner JM, Mehrl A, Müller M, Doenecke A, Schlitt HJ, Hornung M, Weiss ARR. Endoscopic vacuum therapy significantly improves clinical outcomes of anastomotic leakages after 2-stage, 3-stage, and transhiatal esophagectomies. Langenbecks Arch Surg 2023; 408:90. [PMID: 36790506 PMCID: PMC9931828 DOI: 10.1007/s00423-023-02826-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Anastomotic leakages after esophagectomies continue to constitute significant morbidity and mortality. Intrathoracic anastomoses pose a high risk for mediastinitis, sepsis, and death, if a leak is not addressed timely and appropriately. However, there are no standardized treatment recommendations or algorithms as for how to treat these leakages. METHODS The study included all patients at the University Hospital Regensburg, who developed an anastomotic leakage after esophagectomy with gastric pull-up reconstruction from 2007 to 2022. Patients receiving conventional treatment options for an anastomotic leakage (stents, drainage tubes, clips, etc.) were compared to patients receiving endoscopic vacuum-assisted closure (eVAC) therapy as their mainstay of treatment. Treatment failure was defined as cervical esophagostomy formation or death. RESULTS In total, 37 patients developed an anastomotic leakage after esophagectomy with a gastric pull-up reconstruction. Twenty patients were included into the non-eVAC cohort, whereas 17 patients were treated with eVAC. Treatment failure was observed in 50% of patients (n = 10) in the non-eVAC cohort and in 6% of patients (n = 1) in the eVAC cohort (p < 0.05). The 90-day mortality in the non-eVAC cohort was 15% (n = 3) compared to 6% (n = 1) in the eVAC cohort. Cervical esophagostomy formation was required in 40% of cases (n = 8) in the non-eVAC cohort, whereas no patient in the eVAC cohort underwent cervical esophagostomy formation. CONCLUSION eVAC therapy for leaking esophagogastric anastomoses appears to be superior to other treatment strategies as it significantly reduces morbidity and mortality. Therefore, we suggest eVAC as an essential component in the treatment algorithm for anastomotic leakages following esophagectomies, especially in patients with intrathoracic anastomoses.
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Affiliation(s)
- Jonas Maier
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - N E Donlon
- Department of Surgery, Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - J M Werner
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A Mehrl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Doenecke
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - H J Schlitt
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - M Hornung
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - A R R Weiss
- Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
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Tews HC, Kandulski A, Schmid S, Schlosser S, Schirner S, Putz FJ, Cosma L, Gülow K, Müller M, Jung EM. Multimodal ultrasound imaging with conventional B-mode, elastography, and parametric analysis of contrast-enhanced ultrasound (CEUS): A novel approach to assess small bowel manifestation in severe COVID-19 disease. Clin Hemorheol Microcirc 2022; 82:341-360. [PMID: 35871323 DOI: 10.3233/ch-221540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim was to describe the small bowel morphology with conventional B-mode and elastography and additionally to evaluate dynamic effects of COVID-19 associated small bowel microvascularization using CEUS with color coded perfusion parameters.Thirteen patients with severe COVID-19 acute respiratory distress syndrome (ARDS) were investigated. 13 patients required intensive care treatment with mechanical ventilation. Five patients required extracorporeal membrane oxygenation (ECMO). Contrast-enhanced ultrasound (CEUS) was performed by an experienced investigator as a bolus injection of up to 2.4 ml sulfur hexafluoride microbubbles via a central venous catheter. In the parametric analysis of CEUS, the flare of microbubbles over time is visualized with colors. This is the first work using parametric analysis of CEUS to detect perfusion differences in the small bowel.Parametric analysis of CEUS in the intestinal phase was carried out, using DICOM loops for 20 seconds. In 5 patients, parametric analysis revealed intraindividual differences in contrast agent behavior in the small bowel region. Analogous to the computed tomography (CT) images parametric analysis showed regions of simultaneous hyper- and hypoperfusion of the small intestine in a subgroup of patients. In 5 patients, the parametric image of transmural global contrast enhancement was visualized.Our results using CEUS to investigate small bowel affection in COVID-19 suggest that in severe COVID-19 ARDS systemic inflammation and concomitant micro embolisms may lead to disruption of the epithelial barrier of the small intestine.This is the first study using parametric analysis of CEUS to evaluate the extent of small bowel involvement in severe COVID-19 disease and to detect microemboli. In summary, we show that in COVID-19 the small bowel may also be an important interaction site. This is in line with the fact that enterocytes have been shown to a plenitude of angiotensin converting enzyme (ACE)-2 receptors as entry sites of the virus.
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Affiliation(s)
- H C Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - A Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schlosser
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S Schirner
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - F J Putz
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - L Cosma
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - K Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Müller M. Hybrid photon-counting detectors – black boxes or powerful tools? Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322089860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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21
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Birrenbach T, Bühlmann F, Exadaktylos AK, Hautz WE, Müller M, Sauter TC. Virtual Reality for Pain Relief in the Emergency Room (VIPER) - a prospective, interventional feasibility study. BMC Emerg Med 2022; 22:113. [PMID: 35729502 PMCID: PMC9210626 DOI: 10.1186/s12873-022-00671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including acute and chronic pain management, as well as anxiety disorders. However, studies in the busy environment of an adult ED are scarce. The aim of this study is to explore the feasibility and effectiveness of a VR simulation for pain and anxiety control in a convenience sample of adult ED patients presenting with traumatic and non-traumatic pain triaged 2–5 (i.e., urgent to non-urgent) with a pain rating of ≥ 3 on a numeric rating scale (NRS 0–10). Methods Prospective within-subject, repeated measures interventional feasibility pilot study at a Swiss University ED. The intervention consisted of a virtual reality simulation in addition to usual care. Pain and anxiety levels were measured using a verbally administered numeric rating scale (NRS) before and after the intervention. Information on patient experience was collected using established rating scales. Results Fifty-two patients were enrolled. The most common pain localisations were extremities (n = 15, 28.8%) and abdomen (n = 12, 23.1%). About one third of patients presented with trauma-associated pain (n = 16, 30.8%). Duration of pain was mainly acute (< 24 h) (n = 16, 30.8%) or subacute (> 24 h) (n = 32, 61.5%). The majority of patients were triage category 3, i.e. semi-urgent (n = 48, 92.3%). Significant reduction in pain (NRS median pre-VR simulation 4.5 (IQR 3–7) vs. median post-VR simulation 3 (IQR 2–5), p < 0.001), and anxiety levels (NRS median pre-VR simulation 4 (IQR 2–5) vs. median post-VR simulation 2 (IQR 0–3), p < 0.001) was achieved, yielding moderate to large effect sizes (Cohen’s d estimate for pain reduction = 0.59 (95% CI 0.19—0.98), for anxiety level on NRS = 0.75 (95% CI 0.34—1.15). With medium immersion and good tolerability of the VR simulation, user satisfaction was high. Conclusions Virtual reality analgesia for pain and anxiety reduction in the busy setting of an ED is feasible, effective, with high user satisfaction. Further randomized controlled studies are needed to better characterize its impact on pain perception and resource utilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-022-00671-z.
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Affiliation(s)
- T Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland.
| | - F Bühlmann
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - A K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - W E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - M Müller
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - T C Sauter
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
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22
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Mey F, Treccani G, Schmitt U, Müller M. Distinct behavior in early life stress dams predicts heterogeneity in future stress response in offspring over lifespan. Eur Psychiatry 2022. [PMCID: PMC9565095 DOI: 10.1192/j.eurpsy.2022.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Exposure to early life stress (ELS) strongly predicts prevalent, impairing, and costly psychiatric illness throughout life including mental disorders. The reason, some individuals are more vulnerable to ELS whereas others remain resilient, is poorly understood. There is a need for better understanding of early biological changes triggered by ELS with responsibility to negative outcomes in health. Objectives We stratify animals after ELS according to corticosterone levels. [1] Re-challenging the animals to a second stressor, chronic social defeat (CSD) [2], in adulthood was performed to understand individual trajectories depending on corticosterone exposure during early adverse conditions. Methods We performed ELS as previously reported [1]. Behavior of mothers was observed during ELS. Correlation between level of corticosterone and behavior observed in dams. ELS animals were exposed to a second stress in adulthood. A battery of tests for different behavioral domains was performed. Behavioral analyses was combined with assessment of litter HPA system reactivity and observed behavior in dams. Results Stress dams where significantly higher in number of sorties over whole observation period, time dams spent outside the nest differed. We could correlate the number of sorties on p3 with corticosterone plasma level at p9. Control dams spent significantly more time outside in 9pm recordings than stress animals. We could show reduced interaction with social juvenile targets in sociability test for CSD mice. Light dark transition was significantly higher for control mice compared to CSD but lower for control vs ELS animals. Conclusions Behavior in dams during ELS correlates with chronic stress coping mechanisms in offspring’s adulthood. Disclosure No significant relationships.
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Wasser C, Schmid N, Müller M, Günther M, Beller C, Rudolph B. [Management of critically ill nontrauma patients in a nonuniversity emergency department]. Notf Rett Med 2022:1-11. [PMID: 35502426 PMCID: PMC9045234 DOI: 10.1007/s10049-022-01027-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
Purpose Today there exists only limited knowledge regarding the care of critically ill nontrauma (CINT) patients in the resuscitation room (RR) in Germany. The goal of this observational study was to describe the management of CINT patients in the RR of a nonuniversity emergency department. Methods Data of adult nontrauma patients in the RR were prospectively collected in this study from 26 January 2019 to 18 May 2021 using the OBSERvE‑2 evaluation protocol. Results In all, 213 patients were included in the study (age: 70 ± 15 years, 55% male; admission to the RR by emergency medical service 93%). 28% were brought in after out-of-hospital cardiac arrest. Leading admission causes were C (47%) and B problems (39%). Diagnoses at the end of RR treatment were 30% pulmonary and 26% cardiovascular diseases without myocardial infarction as well as pulmonary embolism (8% and 5%, respectively). Measures performed were airway protection (20%), invasive (46%) and noninvasive ventilation (25%), cardiopulmonary resuscitation (13%), catecholamine therapy (34%), emergency ultrasound (62%). The initial treatment lasted for 41 ± 22 min. Computed tomography was subsequently performed in 51%. On average 4-5 persons were involved in the treatment during the RR period. In total, 9% of the patients died during RR treatment and 40% in the hospital. Conclusion Patients in a nonuniversity nontrauma RR are resource-intensive and have a high in-hospital lethality. RR care can be completed within 60 min. In order to achieve better comparability between patient populations of different locations, it is necessary to uniformly define admission criteria for the nontrauma resuscitation room.
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Affiliation(s)
- C. Wasser
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - N. Schmid
- AG IT-Forschung, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - M. Müller
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - M. Günther
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - C. Beller
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
| | - B. Rudolph
- Notaufnahmezentrum, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376 Stuttgart, Deutschland
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Raspe K, Müller M, Iwe N, Wolf RN, Oelßner P, Martinez F, Schweikhard L, Meiwes-Broer KH, Tiggesbäumker J. A versatile setup for studying size and charge-state selected polyanionic nanoparticles. Rev Sci Instrum 2022; 93:043301. [PMID: 35489944 DOI: 10.1063/5.0085187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Using the example of metal clusters, an experimental setup and procedure is presented, which allows for the generation of size and charge-state selected polyanions from monoanions in a molecular beam. As a characteristic feature of this modular setup, the further charging process via sequential electron attachment within a three-state digital trap takes place after mass-selection. In contrast to other approaches, the rf-based concept permits access to heavy particles. The procedure is highly flexible with respect to the preparation process and potentially suitable for a wide variety of anionic species. By adjusting the storage conditions, i.e., the radio frequency, to the change in the mass-to-charge ratio, we succeeded in producing clusters in highly negative charge states, i.e., Ag800 7-. The capabilities of the setup are demonstrated by experiments extracting electronic and optical properties of polyanionic metal clusters by analyzing the corresponding photoelectron spectra.
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Affiliation(s)
- K Raspe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - M Müller
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - N Iwe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - R N Wolf
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - P Oelßner
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - F Martinez
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - L Schweikhard
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - K-H Meiwes-Broer
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - J Tiggesbäumker
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
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Juselius T, Ravolainen V, Zhang H, Piilo S, Müller M, Gallego-Sala A, Väliranta M. Newly initiated carbon stock, organic soil accumulation patterns and main driving factors in the High Arctic Svalbard, Norway. Sci Rep 2022; 12:4679. [PMID: 35304558 PMCID: PMC8933566 DOI: 10.1038/s41598-022-08652-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
High latitude organic soils form a significant carbon storage and deposition of these soils is largely driven by climate. Svalbard, Norway, has experienced millennial-scale climate variations and in general organic soil processes have benefitted from warm and humid climate phases while cool late Holocene has been unfavourable. In addition to direct effect of cool climate, the advancing glaciers have restricted the vegetation growth, thus soil accumulation. Since the early 1900's climate has been warming at unprecedented rate, assumingly promoting organic soil establishment. Here we present results of multiple organic soil profiles collected from Svalbard. The profiles have robust chronologies accompanied by soil property analyses, carbon stock estimations and testate amoeba data as a proxy for soil moisture. Our results reveal relatively recent initiation of organic soils across the Isfjorden area. The initiation processes could be linked to glacier retreat, and improvement of growing conditions and soil stabilization. Carbon stock analyses suggested that our sites are hot spots for organic matter accumulation. Testate amoebae data suggested drying of soil surfaces, but the reason remained unresolved. If continued, such a process may lead to carbon release. Our data suggest that detailed palaeoecological data from the Arctic is needed to depict the on-going processes and to estimate future trajectories.
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Affiliation(s)
- T. Juselius
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
| | - V. Ravolainen
- grid.418676.a0000 0001 2194 7912Fram Centre, Norwegian Polar Institute (NPI), 9296 Tromsø, Norway
| | - H. Zhang
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland ,grid.9227.e0000000119573309Key Laboratory of Cenozoic Geology and Environment, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
| | - S. Piilo
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
| | - M. Müller
- grid.7737.40000 0004 0410 2071Department of Geosciences and Geography, Faculty of Science, University of Helsinki, Yliopistonkatu 3, P.O. Box 4, 00014 Helsinki, Finland
| | - A. Gallego-Sala
- grid.8391.30000 0004 1936 8024Geography, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - M. Väliranta
- grid.7737.40000 0004 0410 2071Environmental Change Research Unit (ECRU), Ecosystems, Environment Research Programme, Faculty of Biological and Environmental Sciences, and Helsinki Institute of Sustainability Science (HELSUS), University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014 Helsinki, Finland
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Oeckenpöhler S, Domnick C, Raschke MJ, Müller M, Wähnert D, Kösters C. A lateral fracture step-off of 2mm increases intra-articular pressure following tibial plateau fracture. Injury 2022; 53:1254-1259. [PMID: 35016775 DOI: 10.1016/j.injury.2021.12.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of increasing posttraumatic step-offs after lateral tibial plateau fracture reduction on the intra-articular pressure. MATERIALS AND METHODS In eight fresh-frozen human cadaveric knees with intact menisci, a standardized sagittal osteotomy of the lateral tibial condyle was performed as an OTA/AO type 41-B1 fracture-model. The fragment was fixed by a customized sled including an angular stable tibia plate to evaluate step-offs from 0 mm to 8 mm in 1mm increments. In a servo-hydraulic testing machine, an axial force was applied to the tibial plateau in 0° (700N), 15° (700N), 30° (700N), 60° (350N), and 90 ° (350N) of flexion while the joint pressure was recorded by two pressure sensors. RESULTS A 1mm step-off did not result in an increased joint pressure. At 60° of flexion a 2mm step-off increased the lateral joint pressure by 61.84kPa (P = 0.0027). In 30° of flexion, a 3mm step raised the lateral joint pressure by 66.80kPa (p = 0.0017), whereas in 0°, 15° and 90° of flexion, a 4mm step increased the pressure by >50kPa (P < 0.05). Concomitant medial joint pressure increments were lower than those in the lateral plateau. A significant increase of 19-24kPa in the medial joint pressure was detected in 90° of flexion with a 1mm lateral step (P = 0.0075), in 15° and 60° of flexion with a 2mm step (P < 0.05), in 0° of flexion with a 4mm step (P = 0.0215) and in 30° of flexion with a 7mm step (P = 0.0487). CONCLUSION Lateral fracture step-offs of 2mm or larger should be reduced intraoperatively to avoid large increases in lateral joint pressure.
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Affiliation(s)
- S Oeckenpöhler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - C Domnick
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Department of Trauma, Hand and Orthopedic Surgery, Euregio-Hospital, Nordhorn, Germany.
| | - M J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - M Müller
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - D Wähnert
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Institute for Musculoskeletal Medicine, Westfaelische-Wilhelms-University Muenster, Muenster, Germany; Department of Trauma and Orthopedic Surgery, Protestant Hospital of Bethel Foundation, Burgsteig 13, 33617 Bielefeld, Germany
| | - C Kösters
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany; Department of Trauma and Orthopedic Surgery, Maria and Joseph Hospital Greven, Greven, Germany
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Müller M, Kutscherauer M, Böcklein S, Wehinger G, Turek T, Mestl G. Modeling the selective oxidation of n-butane to maleic anhydride: From active site to industrial reactor. Catal Today 2022. [DOI: 10.1016/j.cattod.2021.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Tews H, Kandulski A, Schmid S, Peschel G, Gülow K, Schlosser S, Schirner S, Stroszczynski C, Müller M, Jung E. Contrast enhanced ultrasonography (CEUS) a novel tool to detect intestinal epithelial barrier dysfunction in severe COVID-19 disease. Clin Hemorheol Microcirc 2022; 81:177-190. [DOI: 10.3233/ch-221407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ten patients with confirmed COVID-19 disease were studied. Nine patients required intensive care treatment, among them four needed extracorporeal membrane oxygenation (ECMO). Contrast enhanced ultrasonography (CEUS) was performed by one experienced investigator as a bolus injection of up to 2.4 ml of sulphur hexafluoride microbubbles via a central venous catheter. B-Mode evaluation and strain elastography showed mural edema of the small bowel with a thickness of up to 10 mm in all patients. We applied color coded Doppler sonography (CCDS) and power mode with flow-adapted parameters and early, dynamic capillary arterial contrast enhancement of bowel wall structures <10 s to assess perfusion of the small bowel. In all patients, reactive hyperemia was seen in the entire small bowel. In a subgroup of seven patients microbubbles translocated into the intestinal lumen. Thus, high-grade intestinal barrier disruption secondary to SARSCoV-2 infection can be postulated in these patients. This is the first description of perfusion changes and a disruption of the small bowel epithelial barrier in COVID-19 Patients using contrast ultrasonography and elastography.
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Affiliation(s)
- H.C. Tews
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - A. Kandulski
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - S. Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - G. Peschel
- Departement of Internal Medicine, Fürstenfeldbruck, Germany
| | - K. Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | | | - S. Schirner
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - C. Stroszczynski
- Institute of Diagnostic Radiology, University Hospital, Regensburg, Germany
| | - M. Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious diseases, University Hospital, Regensburg, Germany
| | - E.M. Jung
- Institute of Diagnostic Radiology, University Hospital, Regensburg, Germany
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Blank AE, Zajonz TS, Herrmann R, Akintürk H, Müller M, Jux C, Neuhäuser C, Backhoff DJ. Postoperative Heart Rate Control with Esmolol in Newborn Cardiac Surgery with Cardiopulmonary Bypass. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A.-E. Blank
- Pediatric Heart Center, Giessen, Deutschland
| | - T. S. Zajonz
- Department of Anesthesiology, Pediatric Heart Center, Giessen, Deutschland
| | - R. Herrmann
- Pediatric Heart Center, Giessen, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Department of Anesthesiology, Pediatric Heart Center, Giessen, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
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Lanmueller P, Eulert-Grehn JJ, Unbehaun A, Klein C, Hommel M, Kofler M, Kempfert J, Hörmadinger C, Kaufmann F, Stawowy P, Dreysse S, Mulzer J, Müller M, Falk V, Schönrath F, Potapov E, Just I. Transcatheter Aortic Valve Implantation for Severe Aortic Regurgitation in Patients with Left Ventricular Assist Device Support. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - C. Klein
- Augustenburger Platz 1, Berlin, Deutschland
| | - M. Hommel
- German Heart Institute Berlin, Berlin, Deutschland
| | - M. Kofler
- Augustenburger Platz 1, Berlin, Deutschland
| | - J. Kempfert
- German Heart Institute Berlin, Berlin, Deutschland
| | | | - F. Kaufmann
- German Heart Center Berlin, Berlin, Deutschland
| | - P. Stawowy
- German Heart Institute Berlin, Berlin, Deutschland
| | - S. Dreysse
- German Heart Center Berlin, Berlin, Deutschland
| | - J. Mulzer
- German Heart Institute Berlin, Berlin, Deutschland
| | - M. Müller
- German Heart Institute Berlin, Berlin, Deutschland
| | - V. Falk
- Department of Cardiovascular Surgery, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Schönrath
- German Heart Institute Berlin, Berlin, Deutschland
| | - E. Potapov
- Augustenburger Platz 1, Berlin, Deutschland
| | - I. Just
- German Heart Institute Berlin, Berlin, Deutschland
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Brunner CF, Harres E, Yörüker U, Sen-Hild B, Valeske K, Müller M, Thul J, Hahn A, Pons-Kühnemann J, Schranz D, Jux C, Akintürk H. Neurological Outcome of Aortic Arch Reconstruction Using Selective Cerebral Perfusion Compared to Standard Open-Heart Surgery in Pediatric Patients: A Prospective Single-Center Study. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - E. Harres
- Pediatric Heart Center, Giessen, Deutschland
| | - U. Yörüker
- Pediatric Heart Center, Giessen, Deutschland
| | - B. Sen-Hild
- Pediatric Heart Center, Giessen, Deutschland
| | - K. Valeske
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Pediatric Heart Center, Giessen, Deutschland
| | - J. Thul
- Pediatric Heart Center, Giessen, Deutschland
| | - A. Hahn
- Kinderneurologie Gießen, Gießen, Deutschland
| | - J. Pons-Kühnemann
- Institute for Medical Statistics, University of Giessen, Gießen, Deutschland
| | - D. Schranz
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
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32
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Müller M, Biermann D, Righa M, Carstens H, Kozlik-Feldmann R, Hübler M, Sachweh JS. The Bigger, the Better! Does Biological Valve Diameter Influence Longevity of Right Ventricular Outflow Tract (RVOT) Reconstruction in Tetralogy of Fallot (ToF)? Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Müller
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Interdisziplinäres Kinderherzprogramm, Hamburg, Deutschland
| | - D. Biermann
- Department of Pediatric Cardiac Surgery, University Heart and Vascular Center, Hamburg, Deutschland
| | - M. Righa
- Universitäres Herzzentrum Hamburg GmbH Abteilung für Interdisziplinäres Kinderherzprogramm, Hamburg, Deutschland
| | - H. Carstens
- Heart Centre Huttrop, Essen University Hospital, Essen, Deutschland
| | | | - M. Hübler
- University Hospital of Zürich, Zürich, Switzerland
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Yörüker U, Khalil M, Müller M, Kerst G, Esmaeili A, Jux C, Schranz D, Akintürk H. Nonsurgical Palliation for Hypoplastic Left Heart. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- U. Yörüker
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Khalil
- Pediatric Heart Center, Giessen, Deutschland
| | - M. Müller
- Pediatric Heart Center, Giessen, Deutschland
| | - G. Kerst
- Department of Pediatric Cardiology, University Hospital RWTH Aachen, Pauwelsstr. 30, Aachen, Deutschland
| | - A. Esmaeili
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - C. Jux
- Pediatric Heart Center, Giessen, Deutschland
| | - D. Schranz
- Goethe University Frankfurt, Frankfurt, Deutschland
| | - H. Akintürk
- Pediatric Heart Center, Giessen, Deutschland
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Müller M, Greve F, Crönlein M, Zyskowski M, Pesch S, Biberthaler P, Kirchhoff C, Beirer M. Correction to: Reconstruction or replacement? A challenging question in surgical treatment of complex humeral head fractures in the elderly. Arch Orthop Trauma Surg 2022; 142:3255. [PMID: 34817671 PMCID: PMC9522736 DOI: 10.1007/s00402-021-04267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Müller
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - F. Greve
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Crönlein
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Zyskowski
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - S. Pesch
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - P. Biberthaler
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - C. Kirchhoff
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Beirer
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
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Glasbrenner J, Fischer M, Raschke MJ, Briese T, Müller M, Herbst E, Kittl C, Schliemann B, Kösters C. Primary stability of single-stage revision reconstruction of the anterior cruciate ligament in case of failure of dynamic intraligamentary stabilization depends on implant position during ACL repair. Arch Orthop Trauma Surg 2022; 142:1589-1595. [PMID: 34331580 PMCID: PMC9217861 DOI: 10.1007/s00402-021-04088-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The object of this study was to evaluate the primary stability of tibial interference screw (IFS) fixation in single-stage revision surgery of the anterior cruciate ligament (ACL) in the case of recurrent instability after ACL repair with dynamic intraligamentary stabilization (DIS), dependent on the implant position during DIS. MATERIALS AND METHODS Tibial aperture fixation in ACL reconstruction (ACL-R) was performed in a porcine knee model using an IFS. Native ACL-R was performed in the control group (n = 15). In the intervention groups DIS and subsequent implant removal were performed prior to single-stage revision ACL-R. A distance of 20 mm in group R-DIS1 (n = 15) and 5 mm in group R-DIS2 (n = 15) was left between the joint line and the implant during DIS. Specimens were mounted in a material-testing machine and load-to-failure was applied in a worst-case-scenario. RESULTS Load to failure was 454 ± 111 N in the R-DIS1 group, 154 ± 71 N in the R-DIS2 group and 405 ± 105 N in the primary ACL-R group. Load-to-failure, stiffness and elongation of the group R-DIS2 were significantly inferior in comparison to R-DIS1 and ACL-R respectively (p < 0.001). No significant difference was found between load-to-failure, stiffness and elongation of R-DIS1 and the control group. CONCLUSION Primary stability of tibial aperture fixation in single-stage revision ACL-R in case of recurrent instability after DIS depends on monobloc position during ACL repair. Primary stability is comparable to aperture fixation in primary ACL-R, if a bone stock of 20 mm is left between the monobloc and the tibial joint line during the initial procedure.
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Affiliation(s)
- J Glasbrenner
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany.
| | - M Fischer
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - M J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - T Briese
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - M Müller
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - E Herbst
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - C Kittl
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - B Schliemann
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - C Kösters
- Department of Traumatology and Orthopedics, Maria-Josef-Hospital Greven, Lindenstraße 29, 48268, Greven, Germany
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Müller M, Greve F, Crönlein M, Zyskowski M, Pesch S, Biberthaler P, Kirchhoff C, Beirer M. Reconstruction or replacement? A challenging question in surgical treatment of complex humeral head fractures in the elderly. Arch Orthop Trauma Surg 2022; 142:3247-3254. [PMID: 34432097 PMCID: PMC9522728 DOI: 10.1007/s00402-021-04124-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/12/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Surgical treatment of complex humeral head fractures in the elderly is challenging due to osteoporotic bone, comorbidities and reduced compliance. The treatment strategy (reconstruction versus replacement) should allow for a functional aftercare and result in a high patient satisfaction. Major complications leading to surgical revision are crucial and should be avoided. The purpose of this study was to analyse the major complication rate leading to surgical revision and the patient-based outcome in complex humeral head fractures of the elderly population treated either using locking plate fixation (LCP) or reversed total shoulder arthroplasty (rTSA). MATERIALS AND METHODS All patients older than 65 years surgically treated due to a four-part fracture of the proximal humerus between 2003 and 2015 were enrolled in our retrospective study. Major complications and revision rates were recorded and functional outcome was assessed using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self-assessment of the Shoulder Pain and Disability Index (SPADI), of the Disability of the Arm, Shoulder and Hand (DASH) score and of the Constant Score. RESULTS A cohort of 103 patients with a mean age of 73.4 ± 6.2 years suffering from four-part fractures of the humeral head were enrolled. 63 patients were treated using the LCP fixation compared to 40 rTSAs. There were no significant differences in the patient-reported functional outcome. The revision rate was significantly higher in the LCP group (10/63; 15.9%) compared to the rTSA group (1/40; 2.5%). Reasons for revision were avascular head necrosis, cut-out of screws, secondary dislocation of the greater tuberosity and hypersensitivity to metal. CONCLUSIONS Reversed total shoulder arthroplasty and locking plate fixation are both established surgical procedures for the management of complex proximal humerus fractures in the elderly leading to similar functional results. However the revision rate in the rTSA group was significantly lower. Primary rTSA should, therefore, be favoured in multimorbid elderly patients with an increased complication risk to avoid repeated anaesthesia.
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Affiliation(s)
- M. Müller
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - F. Greve
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Crönlein
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Zyskowski
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - S. Pesch
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - P. Biberthaler
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - C. Kirchhoff
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
| | - M. Beirer
- grid.6936.a0000000123222966Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstraße 22, 81675 München, Germany
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Müller M, Igarashi A, Hashiguchi K, Kappel M, Paolini F, Yoshisue H, Funakubo M, Sharma H, Okano M. The impact of omalizumab on paid and unpaid work productivity among severe Japanese cedar pollinosis (JCP) patients. J Med Econ 2022; 25:220-229. [PMID: 35072591 DOI: 10.1080/13696998.2022.2033051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS Japanese cedar pollinosis (JCP) is a form of seasonal allergic rhinitis that affects 38.8% of the Japanese population. Particularly severe and most severe symptoms among JCP patients can lead to impairments of paid work productivity and unpaid work activities. Indeed, the current standard of care (SoC) is not always able to relieve these symptoms. Omalizumab, a novel JCP treatment recently approved in Japan, provides an effective add-on therapy to the SoC. This study estimates the effect of omalizumab on paid and unpaid work activities (i.e. its social impact) in patients with severe and most severe JCP symptoms in Japan. METHODS The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties. RESULTS Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD. CONCLUSIONS Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.
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Affiliation(s)
- M Müller
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - A Igarashi
- Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Yokohama, Japan
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - K Hashiguchi
- Unit of Otorhinolaryngology, Futaba Clinic, Tokyo, Japan
| | - M Kappel
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - F Paolini
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - H Yoshisue
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - M Funakubo
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - H Sharma
- Novartis Corporation Sdn. Bhd, Selangor, Malaysia
| | - M Okano
- School of Medicine, International University of Health and Welfare, Narita, Japan
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Holfelder I, Wansleben M, Kayser Y, Gnewkow R, Müller M, Weser J, Zech C, Beckhoff B. A double crystal von Hamos spectrometer for traceable x-ray emission spectroscopy. Rev Sci Instrum 2021; 92:123105. [PMID: 34972394 DOI: 10.1063/5.0061183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/21/2021] [Indexed: 06/14/2023]
Abstract
A novel double full-cylinder crystal x-ray spectrometer for x-ray emission spectroscopy (XES) has been realized based on a modified von Hamos geometry. The spectrometer is characterized by its compact dimensions, its versatility with respect to the number of crystals used in series in the detection path, and the option to perform calibrated XES measurements. The full-cylinder crystals used are based on highly annealed pyrolytic graphite with a thickness of 40 μm, which was bent to a radius of curvature of 50 mm. The flexible design of the spectrometer allows for an easy change-within the same setup-between measurements with one crystal for maximized efficiency or two crystals for increased spectral resolving power. The spectrometer realized can be used at different end-stations of synchrotron radiation beamlines or can be laboratory-based. The main application focus of the spectrometer is the determination of x-ray fundamental atomic parameters in the photon energy range from 2.4 to 18 keV. The evaluation of chemical speciation is also an area of application, as demonstrated in the example of battery electrodes using resonant inelastic x-ray scattering.
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Affiliation(s)
- I Holfelder
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - M Wansleben
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - Y Kayser
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - R Gnewkow
- Analytical X-ray Physics, TU Berlin, Hardenbergstr. 36, 10623 Berlin, Germany
| | - M Müller
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - J Weser
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - C Zech
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
| | - B Beckhoff
- Physikalisch-Technische Bundesanstalt (PTB), Abbestr. 2-12, 10587 Berlin, Germany
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Von Cossel M, Lebendig F, Müller M, Hieber C, Iqbal Y, Cohnen J, Jablonowski ND. Comparison of thermochemical conversion and anaerobic digestion of perennial flower-rich herbaceous wild plant species for bioenergy production. Bioresour Technol 2021; 340:125724. [PMID: 34391188 DOI: 10.1016/j.biortech.2021.125724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
The combustion quality of three perennial wild plant species Tanacetum vulgare L., Centaurea nigra L. and Artemisia vulgaris L. was investigated in comparison to the energy yield obtained from anaerobic digestions of these biomasses. Combustion resulted in 1.5-2.8 times higher energy yield compared to anaerobic digestion. All wild plants showed a similar higher heating value to Miscanthus × giganteus Greef et Deuter and Panicum virgatum L. (16.0-17.0 MJ kg-1). The ash-melting behavior of all wild plants was like Sida hermaphrodita L. Rusby, since the ash did not sinter at 1200 °C. However, Artemisia vulgaris L. had highest ash content (5.2-5.7% of dry matter) with a low ash melting behavior (1000 °C) attributed to a high potassium content and calculated phase composition. Therefore, careful consideration should be given to select the wild plants to meet the requirements for their use as solid biofuels in residential and commercial applications.
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Affiliation(s)
- M Von Cossel
- Biobased Resources in the Bioeconomy (340b), Institute of Crop Science, University of Hohenheim, Stuttgart, Germany.
| | - F Lebendig
- Institute of Energy and Climate Research, IEK-2, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - M Müller
- Institute of Energy and Climate Research, IEK-2, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - C Hieber
- Biobased Resources in the Bioeconomy (340b), Institute of Crop Science, University of Hohenheim, Stuttgart, Germany
| | - Y Iqbal
- College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha 410128, China
| | - J Cohnen
- Institute of Bio- and Geosciences, IBG-2: Plant Sciences, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - N D Jablonowski
- Institute of Bio- and Geosciences, IBG-2: Plant Sciences, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
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Lakatos LB, Christ M, Müller M, Bolognese M. „Stroke mimics“ – Differenzialdiagnose des Schlaganfalls in der Notfallmedizin. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00877-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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41
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Iwe N, Raspe K, Müller M, Martinez F, Schweikhard L, Meiwes-Broer KH, Tiggesbäumker J. Size and charge-state dependence of detachment energies of polyanionic silver clusters. J Chem Phys 2021; 155:164303. [PMID: 34717355 DOI: 10.1063/5.0068278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The electronic properties of silver clusters (N up to 800) charged by attachment of up to z = 7 excess electrons are investigated. As an essential preparation step, the technique of in-trap electron attachment to size-selected monoanions within a linear Paul trap is applied. By taking advantage of tunable laser pulses, the photoelectron spectra allow us to evaluate details of the electronic structure of polyanionic metal clusters, giving a multidimensional dataset. The subsequent analysis based on the liquid drop model provides information about the atomic structure and the bulk work function at a hitherto unknown quality.
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Affiliation(s)
- N Iwe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - K Raspe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - M Müller
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - F Martinez
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - L Schweikhard
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - K-H Meiwes-Broer
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - J Tiggesbäumker
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
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42
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Evert K, Kocher T, Schindler A, Müller M, Müller K, Pink C, Holtfreter B, Schmidt A, Dombrowski F, Schubert A, von Woedtke T, Rupf S, Calvisi DF, Bekeschus S, Jablonowski L. Repeated exposure of the oral mucosa over 12 months with cold plasma is not carcinogenic in mice. Sci Rep 2021; 11:20672. [PMID: 34667240 PMCID: PMC8526716 DOI: 10.1038/s41598-021-99924-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/28/2021] [Indexed: 01/20/2023] Open
Abstract
Peri-implantitis may result in the loss of dental implants. Cold atmospheric pressure plasma (CAP) was suggested to promote re-osseointegration, decrease antimicrobial burden, and support wound healing. However, the long-term risk assessment of CAP treatment in the oral cavity has not been addressed. Treatment with two different CAP devices was compared against UV radiation, carcinogen administration, and untreated conditions over 12 months. Histological analysis of 406 animals revealed that repeated CAP exposure did not foster non-invasive lesions or squamous cell carcinoma (SCCs). Carcinogen administration promoted non-invasive lesions and SCCs. Molecular analysis by a qPCR screening of 144 transcripts revealed distinct inflammatory profiles associated with each treatment regimen. Interestingly, CAP treatment of carcinogen-challenged mucosa did not promote but instead left unchanged or reduced the proportion of non-invasive lesions and SCC formation. In conclusion, repeated CAP exposure of murine oral mucosa was well tolerated, and carcinogenic effects did not occur, motivating CAP applications in patients for dental and implant treatments in the future.
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Affiliation(s)
- K Evert
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - T Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schindler
- Leibniz Institute of Surface Modification (IOM Leipzig), Leipzig, Germany.,Consultants PILOTO, Ion Beam & Plasma Surface Technologies, Grimma, Germany
| | - M Müller
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - K Müller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Schmidt
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - F Dombrowski
- Institute of Pathology, University Medicine Greifswald, Greifswald, Germany
| | - A Schubert
- Department of Immunology, Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
| | - T von Woedtke
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany.,Department of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - S Rupf
- Clinic of Operative Dentistry, Saarland University, Homburg, Germany
| | - D F Calvisi
- Institute of Pathology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - S Bekeschus
- ZIK Plasmatis, Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany
| | - L Jablonowski
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Sachno D, Carstensen S, Dahlmann F, Tillmann T, Sewald K, Müller M, Dasenbrock C, Bitsch A. Childhood Leukemia - Influence of Extremely Low Frequency Magnetic Fields on the Development of the Disease. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00691-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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44
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Pahmeier K, Denkinger M, Seufferlein T, Klaus J, Bauer J, Katus H, Bahrmann A, Geisler T, Muche R, Müller M, Suhr R, Frankenhauser-Mannuß J, Flagmeier AL, Dallmeier D, Leinert C, Wasem J, Biermann-Stallwitz J, Neumann A. Studiendesign – Gesundheitsökonomische Evaluation einer Interventionsstudie zur Delirreduktion (TRADE). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Pahmeier
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
| | - M Denkinger
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - T Seufferlein
- Universitätsklinikum Ulm, Klinik für Innere Medizin I
| | - J Klaus
- Universitätsklinikum Ulm, Klinik für Innere Medizin I
| | - J Bauer
- AGAPLESION BETHANIEN Krankenhaus Heidelberg, Klinik für Akutgeriatrie
| | - H Katus
- Universitätsklinikum Heidelberg, Klinik für Kardiologie, Angiologie, Pneumologie
| | - A Bahrmann
- Universitätsklinikum Heidelberg, Klinik für Kardiologie, Angiologie, Pneumologie
| | - T Geisler
- Universitätsklinikum Tübingen, Deutsches Herzkompetenzzentrum, Medizinische Klinik III
| | - R Muche
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie
| | - M Müller
- Technische Hochschule Rosenheim, Fakultät für Angewandte Gesundheits- und Sozialwissenschaften
| | - R Suhr
- Zentrum für Qualität in der Pflege
| | | | - AL Flagmeier
- AOK Baden-Württemberg, Rehabilitations- und Pflegeforschung
| | - D Dallmeier
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - C Leinert
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
| | | | - A Neumann
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
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45
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Nguyen N, Thalhammer R, Skudlik S, Müller M, Meyer G, Beutner K. PECAN- ein Konzept zur Förderung der sozialen Teilhabe und Aktivität von Pflegeheimbewohner*innen mit Kontrakturen: eine cluster-randomisierte kontrollierte Studie. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N Nguyen
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - R Thalhammer
- Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, Technische Hochschule Rosenheim
| | - S Skudlik
- Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, Technische Hochschule Rosenheim
| | - M Müller
- Fakultät für Angewandte Gesundheits- und Sozialwissenschaften, Technische Hochschule Rosenheim
| | - G Meyer
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - K Beutner
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
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46
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Tanislav C, El Ansari T, Meyer M, Müller M, Grübener R, Stein T, Niemöller U, Baaske J, Kostev K, Rolfs A, Rosenbauer J. Effect of SARS-CoV-2 vaccination among health care workers in a geriatric care unit after a B.1.1.7-variant outbreak. Public Health 2021; 198:e20-e22. [PMID: 34284878 PMCID: PMC8214170 DOI: 10.1016/j.puhe.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/06/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany.
| | - T El Ansari
- Department of Anesthesia, Diakonie Hospital Jung Stilling Siegen, Germany
| | - M Meyer
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany
| | - M Müller
- Department of Internal Medicine, Diakonie Hospital Jung-Stilling Siegen, Germany
| | - R Grübener
- Department of Internal Medicine, Diakonie Hospital Jung-Stilling Siegen, Germany
| | - T Stein
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany
| | - U Niemöller
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany
| | - J Baaske
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany
| | - K Kostev
- Epidemiology, Philipps University Marburg, Germany
| | | | - J Rosenbauer
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Germany
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47
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Peschel G, Grimm J, Buechler C, Gunckel M, Pollinger K, Aschenbrenner E, Kammerer S, Jung EM, Haimerl M, Werner J, Müller M, Weigand K. Liver stiffness assessed by shear-wave elastography declines in parallel with immunoregulatory proteins in patients with chronic HCV infection during DAA therapy. Clin Hemorheol Microcirc 2021; 79:541-555. [PMID: 34120896 DOI: 10.3233/ch-211193] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND A rapid decline of liver stiffness (LS) was detected by non-invasive methods in patients with chronic hepatitis C (HCV) infection during treatment with direct-acting antivirals (DAA). OBJECTIVE To investigate the influence of inflammation on LS. METHODS We prospectively examined LS by sonographic shear-wave elastography in 217 patients during DAA therapy from treatment initiation (BL) to 12 weeks after end of therapy (SVR12). Demographic data, laboratory findings and serum levels of cytokines were determined. RESULTS Values of LS decreased from 1.86 m/s to 1.68 m/s (p = 0.01) which was most pronounced in patients who had F4 fibrosis at BL (3.27 m/s to 2.37 m/s; p < 0.001). Initially elevated values of aminotransferases, ferritin, IgG (p < 0.001 each) and international normalized ratio (p < 0.003) declined, thrombocyte count (p = 0.007) increased. Correlations of these laboratory parameters with BL levels of LS measurement (LSM) were most apparent in patients with F1-F3 fibrosis. Tumor necrosis factor (TNF)-α (p = 0.031), interleukin (IL)-10 (p = 0.005) and interferon y inducible protein (IP)-10 (p < 0.001) decreased in parallel with LSM under DAA therapy and corelated with BL values. CONCLUSION Decrease of systemic inflammatory parameters correlated with LSM under DAA therapy. We conclude that regression of LSM is attributable to the decline of inflammation rather than reflecting fibrosis.
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Affiliation(s)
- G Peschel
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J Grimm
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Buechler
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Gunckel
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - K Pollinger
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - E Aschenbrenner
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - S Kammerer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - J Werner
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - K Weigand
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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48
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Heinzelbecker J, Spieler N, Kühn M, Fischer C, Volkmer B, Von Rundstedt FC, Albers P, Becht E, Bannowsky A, Weber H, Hofmann R, Müller M, Langbein S, Steiner G, Retz M, Kamradt J, Wellek S, Lehmann J, Stöckle M. Adjuvant vs. progression-triggered treatment with gemcitabine after radical cystectomy in platinum-ineligible patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (AUO-AB 22-00): Long-term follow-up of a randomized multicenter phase 3 trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01203-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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49
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Peschel G, Jung EM, Fisser C, Putz FJ, Wertheimer T, Sinner B, Lunz D, Jung F, Müller M. Interstitial lung opacities in patients with severe COVID-19 pneumonia by bedside high-resolution ultrasound in association to CO2 retention. Clin Hemorheol Microcirc 2021; 77:355-365. [PMID: 33285628 DOI: 10.3233/ch-200925] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) can cause acute respiratory distress syndrome (ARDS). OBJECTIVE This single centre cross-section study aimed to grade the severity of pneumonia by bed-side lung ultrasound (LUS). METHODS A scoring system discriminates 5 levels of lung opacities: A-lines (0 points),≥3 B-line (1 point), coalescent B-lines (2 points), marked pleural disruptions (3 points), consolidations (4 points). LUS (convex 1-5 MHz probe) was performed at 6 defined regions for each hemithorax either in supine or prone position. A lung aeration score (LAS, maximum 4 points) was allocated for each patient by calculating the arithmetic mean of the examined lung areas. Score levels were correlated with ventilation parameters and laboratory markers. RESULTS LAS of 20 patients with ARDS reached from 2.58 to 3.83 and was highest in the lateral right lobe (Mean 3.67). Ferritin levels (Mean 1885μg/l; r = 0.467; p = 0.051) showed moderate correlation in spearman roh calculation. PaCO2 level (Mean 46.75 mmHg; r = 0.632; p = 0.005) correlated significantly with LAS, while duration of ventilation, Horovitz index, CRP, LDH and IL-6 did not. CONCUSIONS The proposed LAS describes severity of lung opacities in COVID-19 patients and correlates with CO2 retention in patients with ARDS.
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Affiliation(s)
- G Peschel
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C Fisser
- Department of Cardiology and Pulmonology, University Hospital Regensburg, Regensburg, Germany
| | - F J Putz
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| | - T Wertheimer
- Department of Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - B Sinner
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - D Lunz
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - F Jung
- Institute of Biotechnology, Department of Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - M Müller
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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50
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Martinez F, Iwe N, Müller M, Raspe K, Schweikhard L, Tiggesbäumker J, Meiwes-Broer KH. Cresting the Coulomb Barrier of Polyanionic Metal Clusters. Phys Rev Lett 2021; 126:133001. [PMID: 33861113 DOI: 10.1103/physrevlett.126.133001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/20/2020] [Accepted: 02/09/2021] [Indexed: 05/28/2023]
Abstract
Combining photoelectron spectroscopy with tunable laser pulse excitation allows us to characterize the Coulomb barrier potential of multiply negatively charged silver clusters. The spectra of mass- and charge-selected polyanionic systems, with z=2-5 excess electrons, show a characteristic dependence on the excitation energy, which emphasizes the role of electron tunneling through the barrier. By evaluating experimental data from an 800-atom system, the electron yield is parametrized with respect to tunneling near the photoemission threshold. This analysis results in the first experimentally based potential energy functions of polyanionic metal clusters.
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Affiliation(s)
- F Martinez
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - N Iwe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - M Müller
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - K Raspe
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
| | - L Schweikhard
- Institute of Physics, University of Greifswald, 17489 Greifswald, Germany
| | - J Tiggesbäumker
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
- Department of Life, Light and Matter, University of Rostock, 18059 Rostock, Germany
| | - K-H Meiwes-Broer
- Institute of Physics, University of Rostock, 18059 Rostock, Germany
- Department of Life, Light and Matter, University of Rostock, 18059 Rostock, Germany
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