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Delabays B, de La Harpe R, Vollenweider P, Fournier S, Müller O, Strambo D, Graham I, Visseren FLJ, Nanchen D, Marques-Vidal P, Vaucher J. Comparison of the European and US guidelines for lipid-lowering therapy in primary prevention of cardiovascular disease. Eur J Prev Cardiol 2023; 30:1856-1864. [PMID: 37290056 DOI: 10.1093/eurjpc/zwad193] [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: 02/03/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
AIMS Population-wide impacts of new guidelines in the primary prevention of atherosclerotic cardiovascular disease (ASCVD) should be explored in independent cohorts. Assess and compare the lipid-lowering therapy eligibility and predictive classification performance of 2016 and 2021 European Society of Cardiology (ESC), 2019 American Heart Association/American College of Cardiology (AHA/ACC), and 2022 US Preventive Services Task Force (USPSTF) guidelines. METHODS AND RESULTS Participants from the CoLaus|PsyCoLaus study, without ASCVD and not taking lipid-lowering therapy at baseline. Derivation of 10-year risk for ASCVD using Systematic COronary Risk Evaluation (SCORE1), SCORE2 [including SCORE2-Older Persons (SCORE2-OP)], and pooled cohort equation. Computation of the number of people eligible for lipid-lowering therapy based on each guideline and assessment of discrimination and calibration metrics of the risk models using first incident ASCVD as an outcome. Among 4,092 individuals, 158 (3.9%) experienced an incident ASCVD during a median follow-up of 9 years (interquartile range, 1.1). Lipid-lowering therapy was recommended or considered in 40.2% (95% confidence interval, 38.2-42.2), 26.4% (24.6-28.2), 28.6% (26.7-30.5), and 22.6% (20.9-24.4) of women and in 62.1% (59.8-64.3), 58.7% (56.4-61.0), 52.6% (50.3-54.9), and 48.4% (46.1-50.7) of men according to the 2016 ESC, 2021 ESC, 2019 AHA/ACC, and 2022 USPSTF guidelines, respectively. 43.3 and 46.7% of women facing an incident ASCVD were not eligible for lipid-lowering therapy at baseline according to the 2021 ESC and 2022 USPSTF, compared with 21.7 and 38.3% using the 2016 ESC and 2019 AHA/ACC, respectively. CONCLUSION Both the 2022 USPSTF and 2021 ESC guidelines particularly reduced lipid-lowering therapy eligibility in women. Nearly half of women who faced an incident ASCVD were not eligible for lipid-lowering therapy.
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Affiliation(s)
- Benoît Delabays
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Roxane de La Harpe
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Stephane Fournier
- Heart and Vessel Department, Division of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Olivier Müller
- Heart and Vessel Department, Division of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Davide Strambo
- Department of Clinical Neurosciences, Division of Neurology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Ian Graham
- School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2 D02 PN40, Ireland
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, Utrecht 3584 CX, Netherlands
| | - David Nanchen
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, Lausanne 1011, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
| | - Julien Vaucher
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne 1011, Switzerland
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Dürig M, Arroyo D, Bedossa M, Commeau P, Fournier S, Müller O, Barragan P, Le Breton H, Puricel S, Cook S. Clinical outcomes after unprotected left main coronary artery occlusion: A retrospective multicentre cohort analysis. Catheter Cardiovasc Interv 2023; 101:679-686. [PMID: 36786485 DOI: 10.1002/ccd.30585] [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] [Received: 09/09/2022] [Revised: 01/05/2023] [Accepted: 01/23/2023] [Indexed: 02/15/2023]
Abstract
AIMS Unprotected left main coronary artery (ULMCA) occlusion is a rare and disastrous condition with scarce data on presentation and outcomes. Herein, we report data on patients presenting with acute coronary syndrome due to ULMCA occlusion at four different institutions. METHODS This is an international multicentre observational study. Baseline characteristics were retro- and prospectively collected. Clinical follow-up was prospective. The primary outcome was in-hospital death. Patients surviving the index hospitalization were compared with nonsurvivors to find predictors of survival. RESULTS The study population consisted of 55 patients. Eight patients (15%) died in the cath lab, and 23 (42%) died in hospital. Three (6%) deaths were noncardiac and due to major bleeding. Thirty-two (58%) patients survived the index hospitalization and were discharged. These patients were followed for a median of 17.5 months during which three cardiac deaths occurred. Repeat revascularization was performed in 25% (n = 8). Overall mortality at maximum follow-up was 47% (n = 26). The only significant predictor for hospital survival was left ventricular ejection fraction (odds ratio [OR]: 1.10 (per 1 point increase); 95% confidence interval [CI]: 1.02-1.19; p = 0.02). CONCLUSION ULMCA occlusion carries a high short-term mortality. Patients who survive index hospitalization have similar mortality rates as compared with other st elevation myocardial infarction patients.
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Affiliation(s)
- Marco Dürig
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Diego Arroyo
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Marc Bedossa
- Department of Cardiology and Vascular Diseases, University of Rennes, Rennes, France
| | - Philippe Commeau
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Müller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Paul Barragan
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | - Hervé Le Breton
- Department of Cardiology and Vascular Diseases, University of Rennes, Rennes, France
| | - Serban Puricel
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Stéphane Cook
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
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de La Harpe R, Thorball CW, Redin C, Fournier S, Müller O, Strambo D, Michel P, Vollenweider P, Marques-Vidal P, Fellay J, Vaucher J. Combining European and U.S. risk prediction models with polygenic risk scores to refine cardiovascular prevention: the CoLaus|PsyCoLaus Study. Eur J Prev Cardiol 2023; 30:561-571. [PMID: 36652418 DOI: 10.1093/eurjpc/zwad012] [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] [Received: 10/06/2022] [Revised: 12/10/2022] [Accepted: 12/18/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Polygenic risk score (PRS) have potential to improve individual atherosclerotic cardiovascular disease (ASCVD) risk assessment. AIMS To determine whether a PRS combined with two clinical risk scores, the Systematic COronary Risk Evaluation 2 (SCORE2) and the Pooled Cohort Equation (PCE), improves prediction of ASCVD. METHODS Using a population-based European prospective cohort, with 6733 participants at baseline (2003-2006), the PRS presenting the best predictive accuracy was combined with SCORE2 and PCE to assess their joint performances for predicting ASCVD Discrimination, calibration, Cox proportional hazard regression and net reclassification index were assessed. RESULTS 4,218 subjects (53% women; median age, 53.4 years), with 363 prevalent and incident ASCVD, were used to compare four PRSs. The metaGRS_CAD PRS presented the best predictive capacity (AUROC=0.77) and was used in the following analyses. 3,383 subjects (median follow-up of 14.4 years), with 190 first incident ASCVD, were employed to test ASCVD risk prediction. The changes in C statistic between SCORE2 and PCE models and those combining metaGRS_CAD with SCORE2 and PCE were 0.008 (95% CI, -0.00008-0.02, P =0.05), and 0.007 (95% CI, 0.005-0.01, P=0.03), respectively.Reclassification was improved for people at clinically-determined intermediate-risk for both clinical scores (NRI of 9.6% (95% CI, 0.3-18.8) and 12.0% (95%CI, 1.5-22.6) for SCORE2 and PCE, respectively). CONCLUSION Combining a PRS with clinical risk scores significantly improved the reclassification of risk for incident ASCVD for subjects in the clinically-determined intermediate-risk category. Introducing PRSs in clinical practice may refine cardiovascular prevention for subgroups of patients in whom prevention strategies are uncertain.
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Affiliation(s)
- Roxane de La Harpe
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Christian W Thorball
- Precision Medicine Unit, Biomedical Data Science Center, Lausanne University Hospital and University of Lausanne, Chemin des Roches 1a/1b, 1010 Lausanne, Switzerland
| | - Claire Redin
- Precision Medicine Unit, Biomedical Data Science Center, Lausanne University Hospital and University of Lausanne, Chemin des Roches 1a/1b, 1010 Lausanne, Switzerland
| | - Stephane Fournier
- Heart and Vessel Department, Division of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Olivier Müller
- Heart and Vessel Department, Division of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Davide Strambo
- Department of Neurosciences, Division of Neurology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrik Michel
- Department of Neurosciences, Division of Neurology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Jacques Fellay
- Precision Medicine Unit, Biomedical Data Science Center, Lausanne University Hospital and University of Lausanne, Chemin des Roches 1a/1b, 1010 Lausanne, Switzerland.,School of Life Sciences, École Polytechnique Fédérale de Lausanne, Station 19, 1015 Lausanne, Switzerland
| | - Julien Vaucher
- Department of Medicine, Division of Internal Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Hullin R, Tzimas G, Barras N, Abdurashidova T, Soborun N, Aur S, Regamey J, Hugelshofer S, Lu H, Crisinel V, Daux A, Vinet E, Mekoa‐Mbarga SJ, Kirsch M, Müller O, Hugli O, Monney P. Decongestion improving right heart function ameliorates prognosis after an acute heart failure episode. ESC Heart Fail 2022; 9:3814-3824. [PMID: 35923106 PMCID: PMC9773654 DOI: 10.1002/ehf2.14077] [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: 08/11/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prognostic role of decongestion-related change of cardiac morphology and in particular right heart function has not been investigated comprehensively in AHF patients. METHODS AND RESULTS This prospective observational single-centre study included consecutive patients hospitalized for treatment of AHF with reduced, mildly-reduced or preserved left ventricular ejection fraction (LVEF). Comprehensive transthoracic echocardiography at admission and discharge assessed decongestion-related change of cardiac function and morphology. The combined endpoint of 1 year all-cause mortality and cardiovascular rehospitalization explored the prognostic importance of decongestion-related change. The 176 study participants were 83 years old [74-87] and 54% were men. Fifty one (29%) had rLVEF, 65 (37%) mrLVEF, and 60 (34%) pLVEF. The proportion of de novo or worsening chronic HF was not different between LVEF groups. HF aetiology and cardiovascular risk factors were equally distributed across all groups except for a higher BMI in the pLVEF group. Decongestion equally reduced body weight, heart rate, systolic and diastolic blood pressure, tricuspid regurgitation gradient, and inferior vena cava diameter across all groups (P < 0.004 for all). Decongestion-related increase in TAPSE independent of the LVEF was associated with improvement of right-ventricular-pulmonary artery coupling and a lower incidence of the combined outcome in the Cox proportional hazard risk analysis (unadjusted HR 0.50 95% CI 0.33-0.78, P = 0.002; adjusted HR 0.46 95% CI: 0.33-0.78, P = 0.001). CONCLUSIONS Decongestion-related increase in TAPSE and recovery of RV/pulmonary artery coupling was observed across all LVEF groups and associated with a risk reduction for the combined endpoint highlighting the important prognostic role of right heart recovery after an AHF episode.
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Affiliation(s)
- Roger Hullin
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Georgios Tzimas
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Nicolas Barras
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Tamila Abdurashidova
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Nisha Soborun
- Department of Cardiac Surgery, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Stefania Aur
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Julien Regamey
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Sarah Hugelshofer
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Henri Lu
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Vanessa Crisinel
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Aurelien Daux
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Elise Vinet
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | - Matthias Kirsch
- Department of Cardiac Surgery, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Olivier Müller
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Olivier Hugli
- Emergency DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Pierre Monney
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
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Dun-Dery F, Kuunibe N, Meissner P, Winkler V, Jahn A, Müller O. OUP accepted manuscript. Int Health 2022; 14:619-631. [PMID: 35064966 PMCID: PMC9623492 DOI: 10.1093/inthealth/ihab087] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 11/14/2022] Open
Abstract
Background Malaria in pregnancy remains a significant cause of morbidity and mortality, affecting the highly endemic countries of sub-Saharan Africa (SSA). Insecticide-treated nets (ITNs) are effective for malaria prevention. However, poor adherence in SSA remains a challenge. Methods We conducted a standard questionnaire survey among 710 pregnant women from 37 primary care clinics in the Upper West Region of Ghana from January through May 2019. Using a sequential explanatory design, we integrated the survey data from six focus group discussions with pregnant women. Results While 67% of women had some general knowledge about malaria prevention, only 19% knew the specific risks in pregnancy. Determinants of ITN use included ITN ownership (odds ratio [OR] 2.4 [95% confidence interval {CI} 1.3 to 4.4]), good maternal knowledge of the risks of malaria in pregnancy (OR 2.4 [95% CI 1.3 to 4.3]) and more antenatal care (ANC) contacts (OR 1.3 [95% CI 1.0 to 1.5)]. Focus group discussions showed that non-use of ITNs resulted from inappropriate hanging infrastructure, a preference for other malaria prevention alternatives, allergy and heat. Conclusions Specific maternal knowledge of malaria risks in pregnancy was low and influenced the regular use of ITNs. Community and ANC-based malaria interventions should prioritize increasing knowledge of the specific risks of malaria.
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Affiliation(s)
- F Dun-Dery
- Corresponding author: Tel: +233248710709/+4915213599531; E-mail: ;
| | - N Kuunibe
- Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
| | - P Meissner
- Pediatric Clinic, Klinikum Konstanz, Mainaustraße 35, 78464 Konstanz, Germany
| | - V Winkler
- Heidelberg Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 130.3 Heidelberg, Germany
| | - A Jahn
- Heidelberg Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 130.3 Heidelberg, Germany
| | - O Müller
- Heidelberg Institute of Global Health, Medical School, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 130.3 Heidelberg, Germany
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Delabays B, Cavassini M, Damas J, Beuret H, Calmy A, Hasse B, Bucher HC, Frischknecht M, Müller O, Méan M, Vollenweider P, Marques-Vidal P, Vaucher J. Cardiovascular risk assessment in people living with HIV compared to the general population. Eur J Prev Cardiol 2021; 29:689-699. [PMID: 34893801 DOI: 10.1093/eurjpc/zwab201] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 08/17/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 12/16/2022]
Abstract
AIMS We prospectively assessed and compared the accuracy of cardiovascular risk scores in people living with HIV (PLWH) and individuals from the general population. METHODS AND RESULTS The Systematic Coronary Risk Evaluation Score 2 (SCORE2), the Pooled Cohort Equations (PCE), and the HIV-specific Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) score were calculated in participants free from atherosclerotic cardiovascular disease (ASCVD) between 2003 and 2009. In total, 6373 [mean age, 40.6 years (SD, 9.9)] PLWH from the Swiss HIV Cohort Study (SHCS) and 5403 [52.8 years (SD, 10.7)] individuals from the CoLaus|PsyCoLaus study were eligible for analysis. We tested discrimination and calibration, and the value of adding HIV-specific factors to scores using the net reclassification improvement (NRI). During mean follow-ups of 13.5 (SD, 4.1) in SHCS and 9.9 (SD, 2.3) years in CoLaus|PsyCoLaus study, 533 (8.4%) and 374 (6.9%) people developed an incident ASCVD, respectively. This translated into age-adjusted incidence rates of 12.9 and 7.5 per 1000 person-year, respectively. In SHCS, SCORE2, PCE, and D:A:D presented comparable discriminative capacities [area under the receiver operating characteristic curve of 0.745 (95% confidence interval, CI, 0.723-0.767), 0.757 (95% CI, 0.736-0.777), and 0.763 (95% CI, 0.743-0.783)]. Adding HIV-specific variables (CD4 nadir and abacavir exposure) to SCORE2 and PCE resulted in an NRI of -0.1% (95% CI, -1.24 to 1, P = 0.83) and of 2.7% (95% CI, 0.3-5.1, P = 0.03), respectively. CONCLUSIONS PLWH present a two-fold higher rate of incident ASCVD compared to individuals from the general population. SCORE2 and PCE, which are clinically easier to use (reduced set of variables without adding HIV-specific factors), are valid to predict ASCVD in PLWH.
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Affiliation(s)
- Benoît Delabays
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Jose Damas
- Division of Infectious Diseases, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Hadrien Beuret
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, Department of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Barbara Hasse
- Department of Infectious Diseases and Hospital Epidemiology, Zürich University Hospital, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Heiner C Bucher
- Basel Institute for Clinical Epidemiology & Biostatistics, Basel University Hospital, Spitalstrasse 12, 4031 Basel, Switzerland
| | - Manuel Frischknecht
- Division of Infectious Diseases and Hospital Epidemiology, Department of Internal Medicine, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland
| | - Olivier Müller
- Division of Cardiology, Heart and Vessel Department, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Marie Méan
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Peter Vollenweider
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Julien Vaucher
- Division of Internal Medicine, Department of Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Cimci M, Witassek F, Radovanovic D, Rickli H, Pedrazzini GB, Erne P, Müller O, Eberli FR, Roffi M. Temporal trends in cardiovascular risk factors' prevalence in patients with myocardial infarction. Eur J Clin Invest 2021; 51:e13466. [PMID: 33258133 DOI: 10.1111/eci.13466] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/21/2020] [Accepted: 11/28/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known about changes in cardiovascular risk factors (CVRF) profile over time in patients presenting with acute myocardial infarction (AMI). METHODS We assessed changes in age and CVRF profile in consecutive AMI patients enrolled in the Swiss nationwide AMIS Plus registry between 1 January 1997 and 31 December 2018. RESULTS A total of 57 995 AMI patients were included in the analysis. Mean age at presentation was 71.5 ± 11.3 years for women and 63.9 ± 12.8 years for men and did not change over time. Overall, the mean (standard deviation) number of CVRF increased from 1.76 (1.07) in 1997/98 to 2.26 (1.10) in 2017/18 in men (Ptrend < .001), while the corresponding rates in females were 1.83 (1.11) and 2.24 (1.08) (Ptrend < .001). In terms of active smoking, no significant trend was detected for males, while there was a significant increase in females (P < .001). As a result, the gap in smoking rates between men and women presenting with AMI decreased from 19.9% (45.3% vs 25.4%) in 1997/98 to 7.9% (41.2% vs 33.3%) in 2017/18. Reassuring was the stability in terms of diabetes prevalence for both genders. Obesity was more prevalent over time in men, while the prevalence of hypertension and dyslipidemia increased in both genders. CONCLUSION Among patients with AMI in Switzerland over two decades, age at presentation remained stable, while the mean number of CVRF increased in both men and women. Striking was the increase in the prevalence of smoking in women, leading to a reduction of the gender gap over time.
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Affiliation(s)
- Murat Cimci
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Fabienne Witassek
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dragana Radovanovic
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Hans Rickli
- Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Paul Erne
- AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Olivier Müller
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Franz R Eberli
- Division of Cardiology, Triemli Hospital, Zurich, Switzerland
| | - Marco Roffi
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
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Röther J, Busse O, Berlis A, Dörfler A, Groden C, Hamann G, Jansen O, Meixensberger J, Müller O, Regelsberger J, Steinmetz H, Vatter H, Weber W, Hänggi D, Nabavi D. [Erratum to: Interdisciplinary neurovascular networks: state of the art]. Nervenarzt 2020; 91:1169. [PMID: 33156367 DOI: 10.1007/s00115-020-01016-6] [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] [Indexed: 06/11/2023]
Affiliation(s)
- J Röther
- Kopf- und Neurozentrum, Neurologische Abteilung mit überregionaler Stroke Unit, Neurophysiologie und Neurologischer Intensivmedizin, Asklepios Klinik Hamburg Altona, Asklepios Campus Hamburg der Semmelweis Universität, Hamburg, Deutschland.
| | - O Busse
- Deutsche Schlaganfall-Gesellschaft, Berlin, Deutschland
| | - A Berlis
- Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklink Augsburg, Augsburg, Deutschland
| | - A Dörfler
- Neuroradiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Ch Groden
- Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - G Hamann
- Klinik für Neurologie und Neurologische Rehabilitation, Bezirkskrankenhaus Günzburg der Bezirkskliniken Schwaben, Günzburg, Deutschland
| | - O Jansen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - J Meixensberger
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
| | - O Müller
- Klinik für Neurochirurgie, Klinikum Dortmund, Dortmund, Deutschland
| | - J Regelsberger
- Neurochirurgische Klinik, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
| | - H Steinmetz
- Klinik für Neurologie, Universitätsklinikum, Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
| | - H Vatter
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - W Weber
- Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland
| | - D Hänggi
- Neurochirurgische Klinik/Department of Neurosurgery, Universitätsklinikum Düsseldorf/Düsseldorf University Hospital, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - D Nabavi
- Klinik für Neurologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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9
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Röther J, Busse O, Berlis A, Dörfler A, Groden C, Hamann G, Jansen O, Meixensberger J, Müller O, Regelsberger J, Steinmetz H, Vatter H, Weber W, Hänggi D, Nabavi D. [Interdisciplinary neurovascular networks: state of the art]. Nervenarzt 2020; 91:902-907. [PMID: 32930814 DOI: 10.1007/s00115-020-00991-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In order to treat the complete spectrum of neurovascular diseases at a high level of quality, which goes beyond the purely acute treatment of stroke, the German Stroke Society (DSG) together with the German Societies for Neurosurgery and Neuroradiology developed a certification procedure for neurovascular networks (NVN). Structurally, a NVN consists of a coordinating center with at least three neurovascular network partners with a certified stroke unit. From 2018 to 2020 a total of 15 NVN have so far been audited and certified according to this new standard. OBJECTIVE How efficient are the NVN? Are high standards maintained? MATERIAL AND METHODS The reports of the audits were analyzed. The data were taken from the period 2017-2019. RESULTS The 15 NVN treated a total of 86,510 stroke patients in the years examined and were networked with a total of 107 partner clinics, which were situated an average of 25 km from the coordinating center and transferred a total of 2726 patients. The coordinating centers performed 2463 thrombectomies and treated 2383 patients with nontraumatic intracerebral bleeding. In 712 patients with acute aneurysmatic subarachnoid hemorrhages endovascular treatment was carried out and clipping in 401. The audit was successful in the majority of the NVN. CONCLUSION The certification process of NVN has been successfully established and the audits proved to be a useful instrument for quality control and improvement. The 15 NVN are highly efficient and treat more than one quarter of stroke patients in German stroke units.
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Affiliation(s)
- J Röther
- Kopf- und Neurozentrum, Neurologische Abteilung mit überregionaler Stroke Unit, Neurophysiologie und Neurologischer Intensivmedizin, Asklepios Klinik Hamburg Altona, Asklepios Campus Hamburg der Semmelweis Universität, Paul-Ehrlich-Straße 1, 22763, Hamburg, Deutschland.
| | - O Busse
- Deutsche Schlaganfall-Gesellschaft, Reinhardtstraße 27C, 10117, Berlin, Deutschland
| | - A Berlis
- Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklink Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
| | - A Dörfler
- Neuroradiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6 (Kopfkliniken), 91054, Erlangen, Deutschland
| | - Ch Groden
- Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - G Hamann
- Klinik für Neurologie und Neurologische Rehabilitation, Bezirkskrankenhaus Günzburg der Bezirkskliniken Schwaben, Ludwig-Heilmeyerstr. 2, 89312, Günzburg, Deutschland
| | - O Jansen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Arnold-Heller Str. 3, 24105, Kiel, Deutschland
| | - J Meixensberger
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland
| | - O Müller
- Klinik für Neurochirurgie, Klinikum Dortmund, Münsterstr. 240, 44145, Dortmund, Deutschland
| | - J Regelsberger
- Neurochirurgische Klinik, Universitätsklinikum Hamburg Eppendorf, Martinistr 52, 20251, Hamburg, Deutschland
| | - H Steinmetz
- Klinik für Neurologie, Universitätsklinikum, Goethe-Universität Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Deutschland
| | - H Vatter
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - W Weber
- Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, In der Schornau 23-25, 44892, Bochum, Deutschland
| | - D Hänggi
- Neurochirurgische Klinik / Department of Neurosurgery, Universitätsklinikum Düsseldorf / Düsseldorf University Hospital, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland
| | - D Nabavi
- Klinik für Neurologie, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland
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10
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Dun-Dery F, Beiersmann C, Kuunibe N, Müller O. Knowledge of risks of malaria in pregnancy on use of ITNs among pregnant women in northern Ghana. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.818] [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: 11/13/2022] Open
Abstract
Abstract
Background
Every year malaria in pregnancy causes 10,000 maternal mortalities worldwide, 20% of stillbirths, 11% of all new-born deaths and 900,000 low-birth-weight babies in sub-Saharan Africa. Maternal knowledge of malaria risks in pregnancy plays a significant role in malaria prevention. However, it is unknown if this preventable loss of lives and morbidities are caused by lack of knowledge, lack of prevention tools or both. We measured the pregnancy-related risks of malaria knowledge and bed net availability and use among pregnant women in Ghana.
Methods
We interviewed 770 pregnant women who attended antenatal care in 37 primary care clinics in Ghana from January through May 2019. We integrated this data in a sequential explanatory design with qualitative insights from 6 focus groups with 8 pregnant women each.
Results
697/770 questionnaires were analyzed. 67% have general knowledge on malaria prevention but only 19% knew the specific risks on pregnancy outcomes. ITNs were owned by 89%, but only 75% reported to regularly use them. There was a statistically significant correlation between specific risks of malaria knowledge and ITN use (P<.001, OR = 2.0, CI:1.3-3.0). Other factors associated with ITN use were higher income, owning an ITN, higher parity, formal education, religion, and age. Reasons for non-adherence to ITN use include inappropriate hanging infrastructure, discomfort with using an ITN, and use of other prevention alternatives.
Conclusions
The study demonstrates that maternal knowledge on the risks of malaria in pregnancy significantly influenced their adherence to the use of insecticide-treated bed nets.
Key messages
The use of ITNs as a prevention method for malaria correlates to the knowledge of mothers about risks of malaria in pregnancy. Antenatal care malaria prevention efforts should focus more on teaching the specific risks of malaria in pregnancy.
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Affiliation(s)
- F Dun-Dery
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - C Beiersmann
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - N Kuunibe
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - O Müller
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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11
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Lu G, Nagbanshi M, Goldau N, Mendes Jorge M, Meissner P, Jahn A, Mockenhaupt FP, Müller O. Efficacy and safety of methylene blue in the treatment of malaria: a systematic review. BMC Med 2018; 16:59. [PMID: 29690878 PMCID: PMC5979000 DOI: 10.1186/s12916-018-1045-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [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: 12/20/2017] [Accepted: 03/26/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Methylene blue (MB) was the first synthetic antimalarial to be discovered and was used during the late 19th and early 20th centuries against all types of malaria. MB has been shown to be effective in inhibiting Plasmodium falciparum in culture, in the mouse model and in rhesus monkeys. MB was also shown to have a potent ex vivo activity against drug-resistant isolates of P. falciparum and P. vivax. In preclinical studies, MB acted synergistically with artemisinin derivates and demonstrated a strong effect on gametocyte reduction in P. falciparum. MB has, thus, been considered a potentially useful partner drug for artemisinin-based combination therapy (ACT), particularly when elimination is the final goal. The aim of this study was to review the scientific literature published until early 2017 to summarise existing knowledge on the efficacy and safety of MB in the treatment of malaria. METHODS This systematic review followed PRISMA guidelines. Studies reporting on the efficacy and safety of MB were systematically searched for in relevant electronic databases according to a pre-designed search strategy. The search (without language restrictions) was limited to studies of humans published until February 2017. RESULTS Out of 474 studies retrieved, a total of 22 articles reporting on 21 studies were eligible for analysis. The 21 included studies that reported data on 1504 malaria patients (2/3 were children). Older studies were case series and reports on MB monotherapy while recent studies were mainly controlled trials of combination regimens. MB was consistently shown to be highly effective in all endemic areas and demonstrated a strong effect on P. falciparum gametocyte reduction and synergy with ACT. MB treatment was associated with mild urogenital and gastrointestinal symptoms as well as blue coloration of urine. In G6PD-deficient African individuals, MB caused a slight but clinically non-significant haemoglobin reduction. CONCLUSIONS More studies are needed to define the effects of MB in P. falciparum malaria in areas outside Africa and against P. vivax malaria. Adding MB to ACT could be a valuable approach for the prevention of resistance development and for transmission reduction in control and elimination programs. SYSTEMATIC REVIEW REGISTRATION This study is registered at PROSPERO (registration number CRD42017062349 ).
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Affiliation(s)
- G Lu
- Medical College of Yangzhou University, Yangzhou University, Yangzhou, 225001, China.,Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - M Nagbanshi
- Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - N Goldau
- Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - M Mendes Jorge
- Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - P Meissner
- Department of Paediatric and Adolescent Medicine, Ulm University, Ulm, Germany
| | - A Jahn
- Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - F P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - O Müller
- Institute of Public Health, Medical School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
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12
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Affiliation(s)
- Sabina Rosset
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (S.R., O.M., E.P., P.P.)
| | - Olivier Müller
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (S.R., O.M., E.P., P.P.)
| | - Etienne Pruvot
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (S.R., O.M., E.P., P.P.)
| | - Patrizio Pascale
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (S.R., O.M., E.P., P.P.)
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13
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Yerly P, Adjedj J, Fournier S, Hullin R, Kirsch M, Masci PG, Monney P, Müller O, Regamey J, Schwitter J, Vogt P. [Cardiology update 2017]. Rev Med Suisse 2018; 14:705-711. [PMID: 29589658] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As usual, numerous papers published in 2017 contributed to optimize the management of patients in all clinical cardiologic fields. It is of course impossible to summarize them all in such an article. Subjects and papers were thus selected if they were thought to be particularly important for non-cardiologist physicians, especially general practitioners. The authors would also like to take the opportunity of this article to honor the memory of Pr Daniel Wagner who unfortunately passed away after less than six months at the head of our Cardiology Department. He was well recognized for his generosity as well as his clinical and scientific competence. This article is dedicated to him.
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14
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Kagoné M, Yé M, Nébié E, Sié A, Müller O, Beiersmann C. Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso. BMC Public Health 2018; 18:324. [PMID: 29510684 PMCID: PMC5840732 DOI: 10.1186/s12889-018-5244-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/01/2018] [Indexed: 11/28/2022] Open
Abstract
Background Vaccination has contributed to major reductions in global morbidity and mortality, but there remain significant coverage gaps. Better knowledge on the interplay between population and health systems regarding provision of vaccination information and regarding health staff organization during the immunization sessions appears to be important for improvements of vaccination effectiveness. Methods The study was conducted in the Nouna Health and Demographic Surveillance System (HDSS) area, rural Burkina Faso, from March to April 2014. We employed a combination of in-depth interviews (n = 29) and focus group discussions (n = 4) including children’s mothers, health workers, godmothers, community health workers and traditional healers. A thematic analysis was performed. All material was transcribed, translated and analyzed using the software ATLAS.ti4.2. Results There was better social mobilization in the rural areas as compared to the urban area. Most mothers know the Expanded Program of Immunization (EPI) target diseases, and the importance to immunize their children. However, the great majority of informants reported that mothers don’t know the vaccination schedule. There is awareness that some children are incompletely vaccinated. Mentioned reasons for that were migration, mothers being busy with their work, the practice of not opening vaccine vials unless a critical number of children are present, poor interaction between women and health workers during immunization sessions, potential adverse events associated with vaccination, geographic inaccessibility during rainy season, and lack of information. Conclusions Well organized vaccination programs are a key factor to improve child health and there is a clear need to consider community perceptions on program performance. In Burkina Faso, a number of factors have been identified which need attention by the EPI managers for further improvement of program effectiveness.
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Affiliation(s)
- M Kagoné
- Centre de Recherche en Santé de Nouna, Ministry of Health, PO Box 02, Nouna, Burkina Faso.
| | - M Yé
- Centre de Recherche en Santé de Nouna, Ministry of Health, PO Box 02, Nouna, Burkina Faso
| | - E Nébié
- Centre de Recherche en Santé de Nouna, Ministry of Health, PO Box 02, Nouna, Burkina Faso
| | - A Sié
- Centre de Recherche en Santé de Nouna, Ministry of Health, PO Box 02, Nouna, Burkina Faso
| | - O Müller
- Institute of Public Health, Medical School, Ruprecht-Karls-University, 69120, Heidelberg, Germany
| | - C Beiersmann
- Institute of Public Health, Medical School, Ruprecht-Karls-University, 69120, Heidelberg, Germany
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15
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Franz M, Arif R, Remes A, Zaradzki M, Hecker M, Karck M, Müller O, Wagner A, Kallenbach K. Decoy Oligodeoxynucleotides against the Transcription Factor AP-1 Decrease the Formation of Allograft Vasculopathy. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628070] [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: 10/28/2022]
Affiliation(s)
- M. Franz
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - R. Arif
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - A. Remes
- Division of Cardiovascular Physiology, Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - M. Zaradzki
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - M. Hecker
- Division of Cardiovascular Physiology, Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - M. Karck
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - O. Müller
- Department of Internal Medicine III, University Medical Center Kiel, Kiel, Germany
| | - A. Wagner
- Division of Cardiovascular Physiology, Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - K. Kallenbach
- Department of Cardiac Surgery, INCCI, Luxembourg, Luxembourg
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16
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Molinari-Jobin A, Kéry M, Marboutin E, Marucco F, Zimmermann F, Molinari P, Frick H, Fuxjäger C, Wölfl S, Bled F, Breitenmoser-Würsten C, Kos I, Wölfl M, Černe R, Müller O, Breitenmoser U. Mapping range dynamics from opportunistic data: spatiotemporal modelling of the lynx distribution in the Alps over 21 years. Anim Conserv 2017. [DOI: 10.1111/acv.12369] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - M. Kéry
- Swiss Ornithological Institute; Sempach Switzerland
| | | | - F. Marucco
- Centro Conservazione e Gestione Grandi Carnivori; Cuneo Italy
| | | | | | - H. Frick
- Office of Environment; Vaduz Liechtenstein
| | | | - S. Wölfl
- Lynx Project Bavaria; Lam Germany
| | - F. Bled
- Carnivore Ecology Laboratory; Mississippi State University; Mississippi State MS USA
| | | | - I. Kos
- University of Ljubljana; Ljubljana Slovenia
| | - M. Wölfl
- Bavarian Agency of Environment; Hof Germany
| | - R. Černe
- Slovenia Forest Service; Ljubljana Slovenia
| | - O. Müller
- Office of Environment; Vaduz Liechtenstein
| | - U. Breitenmoser
- Center for Fish and Wildlife Health; University of Berne; Bern Switzerland
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17
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Arroyo D, Gendre G, Schukraft S, Kallinikou Z, Müller O, Baeriswyl G, Stauffer JC, Goy JJ, Togni M, Cook S, Puricel S. Comparison of everolimus- and biolimus-eluting coronary stents with everolimus-eluting bioresorbable vascular scaffolds: Two-year clinical outcomes of the EVERBIO II trial. Int J Cardiol 2017; 243:121-125. [PMID: 28576627 DOI: 10.1016/j.ijcard.2017.05.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/08/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Data from randomized controlled trials have shown that the ABSORB BVS is non-inferior to Cobalt Chromium everolimus-eluting stents at 2years. METHODS & RESULTS The EVERBIO II trial (Comparison of Everolimus- and Biolimus-Eluting Coronary Stents with Everolimus-Eluting Bioresorbable Vascular Scaffold) is a single-center, assessor-blind, randomized controlled trial enrolling 240 patients with an allocation ration of 1:1:1 conducted at University and Hospital Fribourg, Switzerland. The studied devices were an everolimus-eluting persistent polymer stent (EES), a biolimus-eluting stent with bioabsorbable polymer (BES) and a fully bioresorbable vascular scaffold (BVS). Clinical end points collected at 9months, 12months, and 2years, were academic research consortium defined composites, device thrombosis and target-vessel revascularization. Clinical follow-up at 2years was available in 96% (N=77) of patients in the EES group, in 100% (N=80) in the BES and 99% (N=77) in the BVS group. The device-oriented composite end point of cardiac death, target-vessel myocardial infarction and target-lesion revascularization occurred in 13 (16%) patients treated with EES, in 7 (9%) patients treated with BES and in 16 (21%) patients treated with BVS. There was no significant difference when the metallic stents were compared to the BVS (p=0.12). There was one late scaffold thrombosis throughout the trial in the BVS group, and no definite stent thrombosis in either EES or BES treated patients. CONCLUSIONS The current analysis shows no significant differences with regard to clinical outcomes at 2years between BVS and the best-in-class metallic DES. Event rates were numerically higher in BVS-treated patients. However, when BVS were compared to BES alone, the occurrence of device related adverse events was significantly increased.
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Affiliation(s)
- Diego Arroyo
- Hospital & University Fribourg, Fribourg, Switzerland
| | | | | | | | - Olivier Müller
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | | | | | - Mario Togni
- Hospital & University Fribourg, Fribourg, Switzerland
| | - Stéphane Cook
- Hospital & University Fribourg, Fribourg, Switzerland
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18
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Jabbarli R, Müller O. Authors' reply. Eur J Neurol 2016; 23:e42-3. [DOI: 10.1111/ene.13035] [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] [Received: 04/01/2016] [Accepted: 04/04/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. Jabbarli
- Department of Neurosurgery; University Hospital Essen; Essen Germany
| | - O. Müller
- Department of Neurosurgery; University Hospital Essen; Essen Germany
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19
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Jabbarli R, Bohrer AM, Pierscianek D, Müller D, Wrede KH, Dammann P, El Hindy N, Özkan N, Sure U, Müller O. The CHESS score: a simple tool for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage. Eur J Neurol 2016; 23:912-8. [PMID: 26918845 DOI: 10.1111/ene.12962] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [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: 10/04/2015] [Accepted: 12/22/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Acute hydrocephalus is an early and common complication of aneurysmal subarachnoid hemorrhage (SAH). However, considerably fewer patients develop chronic hydrocephalus requiring shunt placement. Our aim was to develop a risk score for early identification of patients with shunt dependency after SAH. METHODS Two hundred and forty-two SAH individuals who were treated in our institution between January 2008 and December 2013 and survived the initial impact were retrospectively analyzed. Clinical parameters within 72 h after the ictus were correlated with shunt dependency. Independent predictors were summarized into a new risk score which was validated in a subsequent SAH cohort treated between January and December 2014. RESULTS Seventy-five patients (31%) underwent shunt placement. Of 23 evaluated variables, only the following five showed independent associations with shunt dependency and were subsequently used to establish the Chronic Hydrocephalus Ensuing from SAH Score (CHESS, 0-8 points): Hunt and Hess grade ≥IV (1 point), location of the ruptured aneurysm in the posterior circulation (1 point), acute hydrocephalus (4 points), the presence of intraventricular hemorrhage (1 point) and early cerebral infarction on follow-up computed tomography scan (1 point). The CHESS showed strong correlation with shunt dependency (P = 0.0007) and could be successfully validated in both internal SAH cohorts tested. Patients scoring ≥6 CHESS points had significantly higher risk of shunt dependency (P < 0.0001) than other patients. CONCLUSION The CHESS may become a valuable diagnostic tool for early estimation of shunt dependency after SAH. Further evaluation and external validation will be required in prospective studies.
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Affiliation(s)
- R Jabbarli
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - A-M Bohrer
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - D Pierscianek
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - D Müller
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - K H Wrede
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - P Dammann
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - N El Hindy
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - N Özkan
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - U Sure
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | - O Müller
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
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20
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Kallinikou Z, Arroyo D, Togni M, Lehman S, Corpataux N, Cook M, Müller O, Baeriswyl G, Stauffer JC, Goy JJ, Puricel SG, Cook S. Vascular response to everolimus- and biolimus-eluting coronary stents versus everolimus-eluting bioresorbable scaffolds--an optical coherence tomography substudy of the EVERBIO II trial. Swiss Med Wkly 2016; 146:w14274. [PMID: 26766027 DOI: 10.4414/smw.2016.14274] [Citation(s) in RCA: 2] [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: 11/18/2022] Open
Abstract
QUESTIONS UNDER STUDY Head-to-head optical coherence tomography (OCT) data comparing metallic stents with bioresorbable vascular scaffolds (BVS) are lacking. This study assessed vascular healing at 9-month follow-up after implantation of everolimus- and biolimus-eluting stents (EES; BES) and everolimus-eluting BVS. METHODS OCT was performed in 74 patients enrolled in the EVERBIO II (NCT01711931) trial (23 with EES: 26 lesions, 7 625 struts; 23 with BES: 26 lesions, 6 140 struts; 28 with BVS: 33 lesions, 10 891 struts). OCT images were acquired using the pullback and nonocclusive flushing technique and analysed offline. RESULTS BVS demonstrated fewer uncovered struts per patient (12 ± 27 [3.8 ± 8.4%] vs 59 ± 55 [21.8 ± 13.7%] in the EES&BES group, p <0.001), and thicker neointimal hyperplasia (BVS 102 ± 44 µm vs EES&BES 66 ± 36 µm, p <0.01). There was no significant difference with regard to malapposed struts (2.1 ± 2.7% in the BVS vs 4.4 ± 8.8% in the EES&BES group, p = 0.41). In a predefined signal intensity scale, quantitative analysis of the "key component" (black) revealed lower intensity in BVS than EES&BES (14 ± 23% vs 13 ± 12%, p = 0.007). Intensity was lower in polylactide-containing stents (BVS&BES) than in EES (15 ± 19% vs 10 ± 10%, p <0.001). CONCLUSIONS BVS has fewer uncovered struts and presents with a thicker neointimal coverage compared with EES&BES. It is not known whether this improved capping correlates with superior vascular healing. Polylactide-containing stents (BVS and BES) demonstrate lower peristrut intensity compared with EES.
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Affiliation(s)
| | - Diego Arroyo
- Hospital and University Fribourg, Fribourg, Switzerland
| | - Mario Togni
- Hospital and University Fribourg, Fribourg, Switzerland
| | - Sonja Lehman
- Hospital and University Fribourg, Fribourg, Switzerland
| | - Noé Corpataux
- Hospital and University Fribourg, Fribourg, Switzerland
| | - Malica Cook
- Hospital and University Fribourg, Fribourg, Switzerland
| | | | | | | | | | | | - Stéphane Cook
- Hospital and University Fribourg, Fribourg, Switzerland
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Pascale P, Regamey J, Iglesias JF, Gabus V, Clair M, Yerly P, Hullin R, Müller O, Eeckhout É, Vogt P. [Cardiology update in 2015]. Rev Med Suisse 2016; 12:17-22. [PMID: 26946696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present review provides a selected choice of clinical trials and therapeutic advances in the field of cardiology in 2015. A new treatment option in heart failure will become available this year in Switzerland. In interventional cardiology, new trials have been published on the duration of dual antiplatelet therapy, the new stents with bioresorbable scaffold and the long-term results of TAVR in patients who are not surgical candidates or at high surgical risk. RegardingAF the BRIDGE trial provides new evidences to guide the management of patients during warfarin interruption for surgery. Recent publications are changing the paradigm of AF treatment by showing a major impact of the management of cardiometabolic risk factors. Finally, refined criteria for ECG interpretation in athletes have been recently proposed to reduce the burden of false-positive screening.
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Müller O, Lützenkirchen-Hecht D, Frahm R. Quick scanning monochromator for millisecond in situ and in operando X-ray absorption spectroscopy. Rev Sci Instrum 2015; 86:093905. [PMID: 26429455 DOI: 10.1063/1.4929866] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The design and capabilities of a novel Quick scanning Extended X-ray Absorption Fine Structure (QEXAFS) monochromator are presented. The oscillatory movement of the crystal stage is realized by means of a unique open-loop driving scheme operating a direct drive torque motor. The entire drive mechanics are installed inside of a goniometer located on the atmospheric side of the vacuum chamber. This design allows remote adjustment of the oscillation frequency and spectral range, giving complete control of QEXAFS measurements. It also features a real step-scanning mode, which operates without a control loop to prevent induced vibrations. Equipped with Si(111) and Si(311) crystals on a single stage, it facilitates an energy range from 4.0 keV to 43 keV. Extended X-ray absorption fine structure spectra up to k = 14.4 Å(-1) have been acquired within 17 ms and X-ray absorption near edge structure spectra covering more than 200 eV within 10 ms. The achieved data quality is excellent as shown by the presented measurements.
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Affiliation(s)
- O Müller
- Bergische Universität Wuppertal, Gaußstraße 20, Wuppertal 42119, Germany
| | | | - R Frahm
- Bergische Universität Wuppertal, Gaußstraße 20, Wuppertal 42119, Germany
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Jüttner B, Wölfel C, Liedtke H, Meyne K, Werr H, Bräuer T, Kemmerer M, Schmeißer G, Piepho T, Müller O, Schöppenthau H. [Diagnosis and treatment of diving accidents. New German guidelines for diving accidents 2014-2017]. Anaesthesist 2015; 64:463-8. [PMID: 26025255 DOI: 10.1007/s00101-015-0033-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 2015 the German Society for Diving and Hyperbaric Medicine (GTÜM) and the Swiss Underwater and Hyperbaric Medical Society (SUHMS) published the updated guidelines on diving accidents 2014-2017. These multidisciplinary guidelines were developed within a structured consensus process by members of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Sports Divers Association (VDST), the Naval Medical Institute (SchiffMedInst), the Social Accident Insurance Institution for the Building Trade (BG BAU), the Association of Hyperbaric Treatment Centers (VDD) and the Society of Occupational and Environmental Medicine (DGAUM). This consensus-based guidelines project (development grade S2k) with a representative group of developers was conducted by the Association of Scientific Medical Societies in Germany. It provides information and instructions according to up to date evidence to all divers and other lay persons for first aid recommendations to physician first responders and emergency physicians as well as paramedics and all physicians at therapeutic hyperbaric chambers for the diagnostics and treatment of diving accidents. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose and the following key action statements: on-site 100% oxygen first aid treatment, still patient positioning and fluid administration are recommended. Hyperbaric oxygen (HBO) recompression remains unchanged the established treatment in severe cases with no therapeutic alternatives. The basic treatment scheme recommended for diving accidents is hyperbaric oxygenation at 280 kPa. For quality management purposes there is a need in the future for a nationwide register of hyperbaric therapy.
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Affiliation(s)
- B Jüttner
- Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland,
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Müller O, Jahn A, Razum O. Poliomyelitis – Herausforderungen in der Endphase des globalen Eradikationsprogramms. Gesundheitswesen 2015; 78:227-9. [DOI: 10.1055/s-0035-1548854] [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: 10/23/2022]
Affiliation(s)
- O. Müller
- Institut für Public Health, Ruprecht-Karls-Universität Heidelberg, Klinikum, Heidelberg
| | - A. Jahn
- Institut für Public Health, Ruprecht-Karls-Universität Heidelberg, Klinikum, Heidelberg
| | - O. Razum
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
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Müller O, Lützenkirchen-Hecht D, Frahm R. Hard disk drive based microsecond X-ray chopper for characterization of ionization chambers and photodiodes. Rev Sci Instrum 2015; 86:035105. [PMID: 25832273 DOI: 10.1063/1.4913900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A fast X-ray chopper capable of producing ms long X-ray pulses with a typical rise time of few μs was realized. It is ideally suited to investigate the temporal response of X-ray detectors with response times of the order of μs to ms, in particular, any kind of ionization chambers and large area photo diodes. The drive mechanism consists of a brushless DC motor and driver electronics from a common hard disk drive, keeping the cost at an absolute minimum. Due to its simple construction and small dimensions, this chopper operates at home lab based X-ray tubes and synchrotron radiation sources as well. The dynamics of the most important detectors used in time resolved X-ray absorption spectroscopy, namely, ionization chambers and Passivated Implanted Planar Silicon photodiodes, were investigated in detail. The results emphasize the applicability of this X-ray chopper.
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Affiliation(s)
- O Müller
- Bergische Universität Wuppertal, Gaußstraße 20, Wuppertal 42119, Germany
| | | | - R Frahm
- Bergische Universität Wuppertal, Gaußstraße 20, Wuppertal 42119, Germany
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Lugrin J, Parapanov R, Rosenblatt-Velin N, Rignault-Clerc S, Feihl F, Waeber B, Müller O, Vergely C, Zeller M, Tardivel A, Schneider P, Pacher P, Liaudet L. Cutting edge: IL-1α is a crucial danger signal triggering acute myocardial inflammation during myocardial infarction. J Immunol 2014; 194:499-503. [PMID: 25505286 DOI: 10.4049/jimmunol.1401948] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Myocardial infarction (MI) induces a sterile inflammatory response that contributes to adverse cardiac remodeling. The initiating mechanisms of this response remain incompletely defined. We found that necrotic cardiomyocytes released a heat-labile proinflammatory signal activating MAPKs and NF-κB in cardiac fibroblasts, with secondary production of cytokines. This response was abolished in Myd88(-/-) fibroblasts but was unaffected in nlrp3-deficient fibroblasts. Despite MyD88 dependency, the response was TLR independent, as explored in TLR reporter cells, pointing to a contribution of the IL-1 pathway. Indeed, necrotic cardiomyocytes released IL-1α, but not IL-1β, and the immune activation of cardiac fibroblasts was abrogated by an IL-1R antagonist and an IL-1α-blocking Ab. Moreover, immune responses triggered by necrotic Il1a(-/-) cardiomyocytes were markedly reduced. In vivo, mice exposed to MI released IL-1α in the plasma, and postischemic inflammation was attenuated in Il1a(-/-) mice. Thus, our findings identify IL-1α as a crucial early danger signal triggering post-MI inflammation.
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Affiliation(s)
- Jérôme Lugrin
- Department of Intensive Care Medicine, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Roumen Parapanov
- Department of Intensive Care Medicine, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Nathalie Rosenblatt-Velin
- Department of Clinical Pathophysiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Stéphanie Rignault-Clerc
- Department of Clinical Pathophysiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - François Feihl
- Department of Clinical Pathophysiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Bernard Waeber
- Department of Clinical Pathophysiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Olivier Müller
- Department of Cardiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland
| | - Catherine Vergely
- Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques, INSERM Unité Mixte de Recherche 866, Facultés de Médecine et Pharmacie, Université de Bourgogne, 21000 Dijon, France
| | - Marianne Zeller
- Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques, INSERM Unité Mixte de Recherche 866, Facultés de Médecine et Pharmacie, Université de Bourgogne, 21000 Dijon, France
| | - Aubry Tardivel
- Department of Biochemistry, University of Lausanne, CH-1066 Epalinges, Switzerland; and
| | - Pascal Schneider
- Department of Biochemistry, University of Lausanne, CH-1066 Epalinges, Switzerland; and
| | - Pal Pacher
- Laboratory of Physiologic Studies, National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892-9413
| | - Lucas Liaudet
- Department of Intensive Care Medicine, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland; Department of Clinical Pathophysiology, University Hospital Medical Center, University of Lausanne, 1011 Lausanne, Switzerland;
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Semmler A, Sacconi S, Bach J, Liebe C, Bürmann J, Kley R, Ferbert A, Anderheiden R, Van den Bergh P, Martin J, Jonghe PD, Neuen-Jacob E, Müller O, Deschauer M, Bergmann M, Schröder J, Vorgerd M, Schulz J, Weis J, Kress W, Claeys K. A.P.3. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.133] [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: 10/24/2022]
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Sure U, El Hindy N, Müller O. Pediatric Pineal Tumours. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1382208] [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: 10/25/2022]
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Schoeps A, Ouédraogo N, Kagoné M, Sié A, Müller O, Becher H. Socio-demographic determinants of timely adherence to BCG, Penta3, measles, and complete vaccination schedule in Burkina Faso. Vaccine 2013; 32:96-102. [PMID: 24183978 DOI: 10.1016/j.vaccine.2013.10.063] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/16/2013] [Accepted: 10/18/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To identify the determinants of timely vaccination among young children in the North-West of Burkina Faso. METHODS This study included 1665 children between 12 and 23 months of age from the Nouna Health and Demographic Surveillance System, born between September 2006 and December 2008. The effect of socio-demographic variables on timely adherence to the complete vaccination schedule was studied in multivariable ordinal logistic regression with 3 distinct endpoints: (i) complete timely adherence, (ii) failure, and (iii) missing vaccination. Three secondary endpoints were timely vaccination with BCG, Penta3, and measles, which were studied with standard multivariable logistic regression. RESULTS Mothers' education, socio-economic status, season of birth, and area of residence were significantly associated with failure of timely adherence to the complete vaccination schedule. Year of birth, ethnicity, and the number of siblings was significantly related to timely vaccination with Penta3 but not with BCG or measles vaccination. Children living in rural areas were more likely to fail timely vaccination with BCG than urban children (OR=1.79, 95%CI=1.24-2.58 (proximity to health facility), OR=3.02, 95%CI=2.18-4.19 (long distance to health facility)). In contrast, when looking at Penta3 and measles vaccination, children living in rural areas were far less likely to have failed timely vaccinations than urban children. Mother's education positively influenced timely adherence to the vaccination schedule (OR=1.42, 95%CI 1.06-1.89). There was no effect of household size or the age of the mother. CONCLUSIONS Additional health facilities and encouragement of women to give birth in these facilities could improve timely vaccination with BCG. Rural children had an advantage over the urban children in timely vaccination, which is probably attributable to outreach vaccination teams amongst other factors. As urban children rely on their mothers' own initiative to get vaccinated, urban mothers should be encouraged more strongly to get their children vaccinated in time.
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Affiliation(s)
- A Schoeps
- University of Heidelberg, Institute of Public Health, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
| | - N Ouédraogo
- University of Heidelberg, Institute of Public Health, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - M Kagoné
- Centre de Recherche en Santé de Nouna (CRSN), BP 02 Nouna, Burkina Faso
| | - A Sié
- Centre de Recherche en Santé de Nouna (CRSN), BP 02 Nouna, Burkina Faso
| | - O Müller
- University of Heidelberg, Institute of Public Health, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - H Becher
- University of Heidelberg, Institute of Public Health, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
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Hillerup S, Puche M, Blessmann M, Müller O, Wilmont A, Pohlenz P, D.Fontaine, Caparso A, Papay F. Sphenopalatine ganglion (SPG) neurostimulator placement for treatment of severe headaches using a trans-oral posterior maxillary approach. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.656] [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: 11/29/2022]
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Ringelstein A, Timchenko O, Goericke SL, Moenninghoff C, Sure U, Müller O, Sandalcioglu IE, Forsting M, Schlamann M. Reangiografie nach perimesencephaler SAB. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346369] [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: 10/26/2022]
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Müller O, Stötzel J, Lützenkirchen-Hecht D, Frahm R. Gridded Ionization Chambers for Time Resolved X-Ray Absorption Spectroscopy. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/425/9/092010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lützenkirchen-Hecht D, Stötzel J, Müller O, Frahm R. Surface science in sub-seconds by a combination of grazing incidence geometry and QEXAFS. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/425/9/092001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Müller O, Donner S, Klinder T, Bartsch I, Krüger A, Heisterkamp A, Rosenhahn B. Compensating motion artifacts of 3D in vivo SD-OCT scans. Med Image Comput Comput Assist Interv 2013; 15:198-205. [PMID: 23285552 DOI: 10.1007/978-3-642-33415-3_25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We propose a probabilistic approach for compensating motion artifacts in 3D in vivo SD-OCT (spectral-domain optical coherence tomography) tomographs. Subject movement causing axial image shifting is a major problem for in vivo imaging. Our technique is applied to analyze the tissue at percutaneous implants recorded with SD-OCT in 3D. The key challenge is to distinguish between motion and the natural 3D spatial structure of the scanned subject. To achieve this, the motion estimation problem is formulated as a conditional random field (CRF). For efficient inference, the CRF is approximated by a Gaussian Markov random field. The method is verified on synthetic datasets and applied on noisy in vivo recordings showing significant reduction of motion artifacts while preserving the tissue geometry.
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Affiliation(s)
- O Müller
- Institut für Informationsverarbeitung, Leibniz Universität Hannover, Germany.
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Apfel J, Reischmann P, Weiden NV, Müller O. 177 A New Fluorescence-based Cell Assay for Visualizing the Wnt Signaling Pathway. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71975-5] [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: 11/25/2022]
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Maderwald S, Thürling M, Küper M, Theysohn N, Müller O, Beck A, Aurich V, Ladd ME, Timmann D. Direct visualization of cerebellar nuclei in patients with focal cerebellar lesions and its application for lesion-symptom mapping. Neuroimage 2012; 63:1421-31. [PMID: 22892334 DOI: 10.1016/j.neuroimage.2012.07.063] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/30/2012] [Accepted: 07/31/2012] [Indexed: 02/07/2023] Open
Abstract
As yet, human cerebellar lesion studies have not taken advantage of direct magnetic resonance imaging (MRI) of the cerebellar nuclei in individual patients. In the present study, susceptibility weighted imaging (SWI) was used to visualize lesions of the dentate nuclei in patients with chronic focal lesions. Fifteen patients with cerebellar lesions either due to stroke or tumor surgery underwent SWI imaging using a 1.5T MRI scanner. Dentate nuclei were seen as hypointensities in all patients. Three of the patients underwent additional SWI imaging at 3T and 7T. Compared to 1.5T, corrugation of the dentate wall was seen with greater precision and the dorsal, iron-poorer part was seen more fully. Lesion-symptom mapping was performed based on the 1.5T MR images. Patients were divided into two groups with and without upper limb ataxia. A region-of-interest-(ROI)-driven normalization technique was used which had initially been developed by Diedrichsen et al. (2011) for functional MRI (fMRI) of the dentate nuclei. Compared to conventional normalization of the cerebellum, overlap of dentate lesions improved and lead to increased sensitivity of lesion-symptom maps. Subtraction analysis revealed that the more dorsal and rostral parts of the dentate nuclei were related to upper limb ataxia. Findings were in good accordance with the dentate hand area shown in recent fMRI studies. These data provide evidence that direct identification of dentate lesions together with the ROI-driven normalization technique allows for improved lesion-symptom mapping at the level of the cerebellar nuclei already at conventional 1.5T MRI field strength.
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Affiliation(s)
- S Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Germany
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Diener HC, Rabe K, Gerwig M, Müller O, Sure U, Gaul C. [Neurostimulation for treatment of headaches]. Nervenarzt 2012; 83:994-1000. [PMID: 22801664 DOI: 10.1007/s00115-012-3571-0] [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] [Indexed: 10/28/2022]
Abstract
Only a small portion of patients with primary headaches are refractory to treatment concerning relief of headache episodes and prophylactic therapy of headaches. New methods of central and peripheral neurostimulation have been developed for these patients during the last few years and experience was mostly gained in small case series. The following overview gives a description of new stimulation methods, such as deep brain stimulation, occipital nerve stimulation, vagal nerve stimulation, neurostimulation of the sphenopalatine ganglion and transcranial magnetic stimulation.
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Affiliation(s)
- H C Diener
- Universitätsklinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Hufelandstr. 55, 45147 Essen, Deutschland.
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Beiersmann C, Bountogo M, Tiendrébeogo J, Louis VR, Gabrysch S, Yé M, Jahn A, Müller O. Malnutrition in young children of rural Burkina Faso: comparison of survey data from 1999 with 2009. Trop Med Int Health 2012; 17:715-21. [PMID: 22519807 DOI: 10.1111/j.1365-3156.2012.02985.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE For measurement of progress towards the Millennium Development Goal (MDG) 1, reliable data on nutrition indicators of specific countries are essential. Malnutrition is also the main determinant for childhood mortality, which is addressed in MDG 4. METHODS In the health and demographic surveillance area of Kossi Province in north-western Burkina Faso, nutritional parameters were compared in two cohorts of young children of the same age range from eight villages. Surveys took place in June and December of the year 1999 and 2009. A multivariate model was used to control for confounding variables. RESULTS For the 1999 study, data were analysed for 179 and 197 children who took part in the June and December survey respectively. In 2009, corresponding data were analysed for 460 and 409 children. Prevalence of underweight was highest in December 1999 (42.6%) and lowest in December 2009 (34.1%). After adjustment for age, sex and village, there was a slight but not always significant improvement in the z-scores of weight-for-age, weight-for-length, length-for-age, and mid-arm circumference over time. CONCLUSIONS The findings from this study confirm the still unacceptable high prevalence of malnutrition in young children of rural sub-Saharan Africa (SSA). Progress in the reduction of malnutrition remains slow on this continent making it rather unlikely that the corresponding MDGs will be achieved. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child health in SSA.
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Affiliation(s)
- C Beiersmann
- Institute of Public Health, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
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Puricel S, Adorjan P, Oberhänsli M, Stauffer JC, Moschovitis A, Vogel R, Goy JJ, Müller O, Eeckhout E, Togni M, Wenaweser P, Meier B, Windecker S, Cook S. Clinical outcomes after PCI for acute coronary syndrome in unprotected left main coronary artery disease: insights from the Swiss Acute Left Main Coronary Vessel Percutaneous Management (SALVage) study. EUROINTERVENTION 2012; 7:697-704. [PMID: 21986328 DOI: 10.4244/eijv7i6a112] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Unprotected left main (ULM) coronary artery disease is encountered in 3%-10% of coronary angiograms and is associated with high mortality. The survival of patients with ULM disease presenting with acute coronary syndromes (ACS) depends on different variables and is lowest in those with cardiogenic shock (CS). The aim of the present study was to estimate the impact of baseline characteristics on the subsequent clinical outcome in patients treated by percutaneous coronary intervention (PCI) of ULM for ACS. METHODS AND RESULTS One hundred and thirty-four patients were retrieved from our database and followed by phone or physician visit. Patients were classified into two groups according to their presentation (CS/STEMI group: patients presenting with CS or ST-elevation myocardial infarction; NSTEMI/UA group: patients with non-STEMI or unstable angina). Data collected were baseline characteristics, procedural information, and clinical outcome. The primary endpoint was all-cause mortality at 6-month follow-up. The secondary end point was a composite of cardiac death, myocardial infarction, and any repeat revascularisation, i.e., major adverse cardiac events (MACE). Kaplan-Meier curves were computed for survival. Logistic regression determined that hypercholesterolaemia (OR 6.22, p=0.03), high pre-procedural TIMI score (OR 3.89, p=0.01), preserved left ventricular ejection fraction (OR 1.07, p=0.01) and LM as culprit lesion (OR 8.57, p=0.01) protected against development of CS. Primary outcome occurred in 44% of patients in the CS/STEMI group compared to 6% in the NSTEMI/UA group (p<0.001). MACE were observed in 30 patients (48%) of the CS/STEMI group and in 12 patients (19%) of the NSTEMI/UA group (p=0.001). CONCLUSIONS Acute coronary syndrome due to critical ULM stenosis is associated with high mortality even after successful PCI. Patients presenting with CS or STEMI are at particular risk.
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Affiliation(s)
- Serban Puricel
- Department of Cardiology, University of Fribourg, Fribourg, Switzerland
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Paßlick C, Müller O, Lützenkirchen-Hecht D, Frahm R, Johnson JA, Schweizer S. Structural properties of fluorozirconate-based glass ceramics doped with multivalent europium. J Appl Phys 2011; 110:113527-1135275. [PMID: 22275772 PMCID: PMC3261053 DOI: 10.1063/1.3662148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 10/14/2011] [Indexed: 05/31/2023]
Abstract
The structure/property relationships of fluorochlorozirconate glass ceramics as a function of divalent and trivalent europium (Eu) co-doping and thermal processing have been investigated; the influence of doping ratio on the formation of barium chloride (BaCl(2)) nanocrystals therein was elucidated. X-ray absorption near-edge structure spectroscopy shows that the post-thermal annealing changes the Eu valence of the as-poured glass slightly, but during the melting process Eu(3+) is more strongly reduced to Eu(2+), in particular, when doped as a chloride instead of fluoride compound. The Eu(2+)-to-Eu(3+) doping ratio also plays a significant role in chemical equilibrium in the melt. X-ray diffraction measurements indicate that a higher Eu(2+) fraction leads to a BaCl(2) phase transition from hexagonal to orthorhombic structure at a lower temperature.
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Schuller RC, Müller O, Känel N, Hösli I, Zimmermann R, Surbek D. Sind Stress- und Schmerzreaktionen von Neugeborenen post partum abhängig vom Geburtsmodus? Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293468] [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: 10/15/2022]
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May M, Fritsche HM, Gilfrich C, Brookman-May S, Burger M, Otto W, Bolenz C, Trojan L, Herrmann E, Michel M, Wülfing C, Tiemann A, Müller S, Ellinger J, Buchner A, Stief C, Tilki D, Wieland W, Höfner T, Hohenfellner M, Haferkamp A, Roigas J, Müller O, Bretschneider-Ehrenberg P, Zacharias M, Gunia S, Bastian P. Einfluss des Alters auf das karzinomspezifische Überleben nach radikaler Zystektomie. Urologe A 2011; 50:821-9. [DOI: 10.1007/s00120-011-2507-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Müller O, Gaul C, Katsarava Z, Sure U, Diener HC, Gasser T. Beidseitige Nervus-occipitalis-Stimulation zur Behandlung des therapierefraktären chronischen Cluster-Kopfschmerzes: eigene Fallserie und Initiierung einer prospektiven Studie. Fortschr Neurol Psychiatr 2010; 78:709-14. [DOI: 10.1055/s-0029-1245599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Eriksen J, Mujinja P, Warsame M, Nsimba S, Kouyaté B, Gustafsson LL, Jahn A, Müller O, Sauerborn R, Tomson G. Effectiveness of a community intervention on malaria in rural Tanzania - a randomised controlled trial. Afr Health Sci 2010; 10:332-340. [PMID: 21416034 PMCID: PMC3052812] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Malaria infections are a major public health problem in Africa and prompt treatment is one way of controlling the disease and saving lives. METHODS This cluster-randomised controlled community intervention conducted in 2003-2005 aimed at improving early malaria case management in under five children. Health workers were trained to train community-based women groups in recognizing malaria symptoms, providing first-line treatment for uncomplicated malaria and referring severe cases. Evaluation was through a pre- (2004) and a post-intervention survey (2005). Anaemia prevalence was the primary outcome. RESULTS 1715 children aged 6-59 months were included in the pre-intervention survey and 2169 in the post-intervention survey. The prevalence of anaemia decreased significantly from 37% [95% CI 34.7-39.3] to 0.5% [95% CI 0.2-0.7] after the intervention (p<0.001); slightly more in the intervention (from 43.9% to 0.8%) than in the control (30.8% to 0.17%) group (p=0.038). Fever and reported fever decreased significantly and the mean body weight of the children increased significantly over the study period in both control and intervention groups. CONCLUSION The decrease in anaemia was significantly associated with the intervention, whereas the fever and body weight trends might be explained by other malaria control activities or seasonal/climate effects in the area. The community intervention was shown to be feasible in the study context.
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Affiliation(s)
- J Eriksen
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden.
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Krug H, Müller O, Bittner U. [Technological intervention in the self? An ethical evaluation of deep brain stimulation relating to patient narratives]. Fortschr Neurol Psychiatr 2010; 78:644-51. [PMID: 21069629 DOI: 10.1055/s-0029-1245753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Technological interventions into the brain raise a number of ethical questions, particularly, questions of personality change and control or manipulation of the human mind. Taking patients undergoing deep brain stimulation as an example, the authors analyse the possible impact of neurotechnologies on human self-perception in individual cases as well as in general. Following the concept of narrative-based medicine and ethics patients' narrations are presented in order to discuss the value of this approach for developing normative considerations as well as for deriving practical consequences regarding the physician-patient-relationship.
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Affiliation(s)
- H Krug
- Klinik und Poliklinik für Neurologie, Charité Universitätsmedizin Berlin.
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Kaiser G, Heuer M, Stanjek M, Schoch B, Müller O, Waydhas C, Mummel P, Radunz S, Wirges U, Lütkes P, Philipp T, Schmid K, Paul A. Organspendeprozess an einem Krankenhaus mit Maximalversorgung. Dtsch Med Wochenschr 2010; 135:2065-70. [DOI: 10.1055/s-0030-1267482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gasser T, Frings M, Gerwig M, Müller O, Diener HC, Sure U. [Deep brain stimulation in neurology - indications and results]. Fortschr Neurol Psychiatr 2010; 78:107-14; quiz 115-17. [PMID: 20146155 DOI: 10.1055/s-0028-1109899] [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] [Indexed: 10/19/2022]
Affiliation(s)
- T Gasser
- Klinik für Neurochirurgie, Universitätsklinikum Essen.
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Lanckohr C, Kasprzynski A, Klein-Hitpass L, Homann HH, Lehnhardt M, Müller O, Kuhnen C, Herter P. Identifikation überexprimierter Gene in myxoid-rundzelligen Liposarkomen. Pathologe 2009; 31:60-6. [DOI: 10.1007/s00292-009-1234-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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