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Schmedding A, Wittekindt B, Schloesser R, Hutter M, Rolle U. Outcome of esophageal atresia in Germany. Dis Esophagus 2021; 34:5912927. [PMID: 32995846 DOI: 10.1093/dote/doaa093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/21/2020] [Revised: 07/28/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Abstract
The aim of this study was to evaluate the outcome of esophageal atresia in Germany in a retrospective observational study of a large cohort. Data from the major health insurance company in Germany, which covers approximately 30% of German patients, were analyzed. All patients born and registered between 2009 and 2013 with a diagnosis of esophageal atresia at first admission to the hospital were included. Mortality was analyzed during the first year of life. We identified 287 patients with esophageal atresia, including 253 with and 34 without tracheoesophageal fistula. Associated anomalies were found in 53.7% of the patients; the most frequent were cardiac anomalies (41.8%), anomalies of the urinary tract (17.4%), and atresia of the colon, rectum, and anus (9.4%). Forty-one patients (14.3%) had a birth weight <1500 g. Seventeen patients (5.9%) died before surgery. Gastrostomy was performed during the index admission in 70 patients (25.9%). The reconstruction of the esophageal passage was performed in 247 patients (93.9%). Forty-eight percent of the patients who underwent an operation required dilatation. The mortality rate in the patients who underwent an operation was 10.4%. These results from Germany correspond to the international results that have been reported. The number of dilatations was in the middle of the range of those reported in the literature; the overall mortality rate was in the upper portion of the range of the international rates. Efforts should be made to establish a clinical registry to measure and improve the quality of care for this and other rare conditions.
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Affiliation(s)
- A Schmedding
- Department of Pediatric Surgery and Pediatric Urology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - B Wittekindt
- Department of Neonatology, University Hospital, Goethe University Frankfurt,Frankfurt am Main, Germany
| | - R Schloesser
- Department of Neonatology, University Hospital, Goethe University Frankfurt,Frankfurt am Main, Germany
| | - M Hutter
- Department of Pediatric Surgery and Pediatric Urology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - U Rolle
- Department of Pediatric Surgery and Pediatric Urology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
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Huenecke S, Fryns E, Wittekindt B, Buxmann H, Königs C, Quaiser A, Fischer D, Bremm M, Klingebiel T, Koehl U, Schloesser R, Bochennek K. Percentiles of Lymphocyte Subsets in Preterm Infants According to Gestational Age Compared to Children and Adolescents. Scand J Immunol 2016; 84:291-298. [DOI: 10.1111/sji.12474] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/17/2016] [Indexed: 12/31/2022]
Affiliation(s)
- S. Huenecke
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - E. Fryns
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - B. Wittekindt
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - H. Buxmann
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - C. Königs
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - A. Quaiser
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - D. Fischer
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - M. Bremm
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - T. Klingebiel
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - U. Koehl
- Institute of Cellular Therapeutics; GMP Development Unit, IFB-TX; Hannover Medical School; Hannover Germany
| | - R. Schloesser
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
| | - K. Bochennek
- Clinic for Pediatric and Adolescent Medicine, University Hospital; Frankfurt Germany
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Toettel EK, Kaempf AK, Peiffer S, Eisele H, Raich M, Eschenburg S, Wittekindt B, Grüßner S, Rolle U, Schloesser R, Louwen F. Das Frankfurter Protokoll zum EXIT-Verfahren bei kongenitalen Kopf-Hals-Tumoren. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388150] [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] Open
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Seher G, Rettwitz-Volk W, Schloesser R, Allendorf A, Huebner P, Schneider M, Loewenich V. Persistierende pulmonale Hypertension des Neugeborenen bei Aneurysma der Vena Galenie. Klin Padiatr 2008. [DOI: 10.1055/s-2007-1025226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ahr A, Faul-Burbes C, Haardt N, Linde R, Haberl A, Bremerich D, Kissler S, Schloesser R, Kaufmann M. [Management of HIV-positive pregnancies -- results from a retrospective study]. ACTA ACUST UNITED AC 2005; 127:242-7. [PMID: 16037906 DOI: 10.1055/s-2005-836480] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The management of HIV-positive pregnancies was investigated in conjunction to pre-, peri and postpartal complications and the HIV transmission rate. PATIENTS AND METHODS Retrospective study of 88 HIV-positive patients who were delivered at the Dept. of Obstetrics and Gynaecology during 1.1.1997-31.12.2001. RESULTS HIV-positive patients showed significantly more prepartal complications, compared to control group. Low CD4-cell count (< or = 200/microl) or high viral load (> 10 000 HIV-copies/ml) was not associated with increased risk for transmission relevant complications. The overall HIV-transmission rate was 3.4 % (3/89 newborns; with ART 2.5 % [2/85], without ART 33.3 % [1/3]). The transmission rate increased with complications during pregnancy (7.7 % [2/26] vs. 1.6 % [1/61]). Newborns delivered < or = 35 (th) week of gestation showed a transmission rate of 5.3 % compared to 2.9 % of newborns delivered after the 35 (th) week of gestation. 98 % of the patients were delivered by cesarean section (primary: n = 71, prior: n = 15), spontaneously: n = 2). 97 % of patients (85/88) were treated with antiretroviral therapy (ART). No differences were found in the postpartal complication rate of HIV-positive to -negative patients. None of the newborns was breast fed. CONCLUSIONS Treatment of this risk-pregnancies in HIV experienced centers significantly reduces the risk of HIV transmission.
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Affiliation(s)
- A Ahr
- Zentrum für Frauenheilkunde der J.W.G.-Universität Frankfurt/M.
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Veldman A, Fischer D, Heller K, Schloesser R, Bauer K. Therapie lebensbedrohlicher Blutungen bei Früh- und Neugeborenen mit rekombinantem aktivierten Faktor VII. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2004-829216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Groll AH, Jaeger G, Allendorf A, Herrmann G, Schloesser R, von Loewenich V. Invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life. Clin Infect Dis 1998; 27:437-52. [PMID: 9770138 DOI: 10.1086/514717] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report a fatal case of invasive pulmonary aspergillosis in a severely ill neonate and review 43 additional cases of invasive aspergillosis reported from 1955 through 1996 that occurred during the first 3 months of life. Eleven of the 44 patients had primary cutaneous aspergillosis, 10 had invasive pulmonary aspergillosis, and 14 had disseminated disease. Most infections were nosocomial in origin. Prematurity (43%); proven chronic granulomatous disease (14%); and a complex of diarrhea, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of the patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received medical and/or surgical treatment, outcome was relatively favorable, with an overall survival rate of 73%. Invasive aspergillosis may occur in neonates and young infants and warrants consideration under certain circumstances. Current therapeutic approaches consist of high-dose amphotericin B and appropriate surgical interventions.
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Affiliation(s)
- A H Groll
- Department of Pediatrics, Johann Wolfgang Goethe University Hospital, Frankfurt/Main, Germany
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Smith GS, Schloesser R, Brodie JD, Dewey SL, Logan J, Vitkun SA, Simkowitz P, Hurley A, Cooper T, Volkow ND, Cancro R. Glutamate modulation of dopamine measured in vivo with positron emission tomography (PET) and 11C-raclopride in normal human subjects. Neuropsychopharmacology 1998; 18:18-25. [PMID: 9408915 DOI: 10.1016/s0893-133x(97)00092-4] [Citation(s) in RCA: 152] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Subanesthetic doses of the noncompetitive N-methyl-D-aspartate (NMDA) antagonist ketamine exacerbate psychosis in schizophrenic patients, and ketamine has significant abuse liability. These observations indicate that a secondary effect of ketamine may be to increase dopamine concentrations. The present study was undertaken using positron emission tomography (PET) and the dopamine (D2) radiotracer 11C-raclopride to determine whether ketamine would decrease D2 receptor availability, indicative of an increase in dopamine concentrations. Two scans were performed in seven male control subjects before and after administration of ketamine (0.5 mg/kg, i.v. infused over 20 min). Ketamine significantly increased cortisol levels and decreased dopamine receptor availability in the striatum (specific binding), but not in the cerebellum (nonspecific binding). In addition, the cerebellar binding subtracted from the striatal binding (to account for changes in nonspecific binding) was significantly decreased after ketamine administration. These results provide in vivo evidence for the ability of ketamine to increase striatal dopamine concentrations, consistent with the role of the NMDA receptor in modulating dopamine function.
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Affiliation(s)
- G S Smith
- Department of Psychiatry, New York University School of Medicine, New York, USA
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Smith GS, Dewey SL, Brodie JD, Logan J, Vitkun SA, Simkowitz P, Schloesser R, Alexoff DA, Hurley A, Cooper T, Volkow ND. Serotonergic modulation of dopamine measured with [11C]raclopride and PET in normal human subjects. Am J Psychiatry 1997; 154:490-6. [PMID: 9090335 DOI: 10.1176/ajp.154.4.490] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study was undertaken to measure serotonergic modulation of dopamine in vivo by using positron emission tomography (PET), a radiotracer for the striatal dopamine D2 receptor ([11C]raclopride), and a pharmacologic challenge of the serotonin system (d,l-fenfluramine). METHOD Two PET studies using [11C]raclopride were performed in 11 normal male subjects before administration of the serotonin-releasing agent and reuptake inhibitor fenfluramine (60 mg p.o.) and 3 hours afterward. A graphical analysis method was used with the [11C]raclopride data to derive the distribution volume of D2 receptors. Plasma levels of fenfluramine, norfenfluramine, homovanillic acid (HVA), cortisol, and prolactin were determined. RESULTS Levels of fenfluramine and prolactin were elevated 2 hours after fenfluramine administration and remained significantly elevated during the second scan, while levels of HVA and cortisol were not altered significantly during the time of scanning. A significant decrease in the specific binding (striatum) and the nonspecific binding subtracted from the specific binding (striatum minus cerebellum) of [11C]raclopride was observed. The rate of metabolism of [11C]raclopride and the nonspecific binding (cerebellum) were not significantly altered by the fenfluramine intervention. CONCLUSIONS The observed decrease in [11C]raclopride binding is consistent with an increase in dopamine concentrations and with the ability of serotonin to stimulate dopamine activity. The ability to measure serotonergic modulation of dopamine in vivo may have implications for the study of etiologic and therapeutic mechanisms in schizophrenia, major depressive disorder, obsessive-compulsive disorder, and substance abuse.
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Affiliation(s)
- G S Smith
- Department of Psychiatry, New York University, School of Medicine, New York, USA
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Schloesser R, Simkowitz P, Bartlett EJ, Wolkin A, Smith GS, Dewey SL, Brodie JD. The study of neurotransmitter interactions using positron emission tomography and functional coupling. Clin Neuropharmacol 1996; 19:371-89. [PMID: 8889281 DOI: 10.1097/00002826-199619050-00001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Functional brain imaging with positron emission tomography (PET) has opened up new avenues for the investigation of possible functional disturbances related to psychiatric disease as well as pharmacodynamic assessment of drug treatment in vivo. Different strategies to study pharmacologic effects on the brain have been developed in recent years. The basic methods are to measure (a) blood flow or glucose metabolism, (b) parameters of specific receptor binding, or (c) neurotransmitter metabolism. Each of these can be performed either in a resting state or after perturbation with a pharmacologic challenge. Our group has developed a general strategy for investigating pharmacologic effects on brain function: (a) determining indirect drug-induced metabolic changes with fluorodeoxyglucose PET and (b) characterizing functional interactions of neurotransmitter systems by assaying drug-induced displacement of specific receptor ligands. These study designs reflect a paradigm shift where functional coupling of brain regions and interaction of different neurotransmitter systems are seen as the basis for a multitransmitter hypothesis of schizophrenia. In this view, any disturbance in the self-regulatory process is reflected in the loss of functional interaction between systems. An overview of recent studies and their possible clinical importance will be presented.
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Affiliation(s)
- R Schloesser
- Department of Psychiatry, New York University Medical Center 10016, USA
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Schlegel S, Steinert H, Bockisch A, Hahn K, Schloesser R, Benkert O. Decreased benzodiazepine receptor binding in panic disorder measured by IOMAZENIL-SPECT. A preliminary report. Eur Arch Psychiatry Clin Neurosci 1994; 244:49-51. [PMID: 7918702 DOI: 10.1007/bf02279812] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Single photon emission tomography (SPECT) imaging of the central benzodiazepine receptor (BZr) became possible with the newly developed ligand 123I-IOMAZENIL. The BZr binding was investigated in ten patients with panic disorder (PP) compared to ten epileptic patients (EP). Panic patients had lower IOMAZENIL uptake rates in the frontal, occipital and temporal cortex than EP indicating the involvement of the BZr complex in panic disorder.
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Affiliation(s)
- S Schlegel
- Department of Psychiatry, University of Mainz, Germany
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Selzer G, Rettwitz-Volk W, Schloesser R, Allendorf A, Huebner P, Schneider M, von Loewenich V. [Persistent pulmonary hypertension in the newborn infant caused by aneurysm of the vein of Galen]. Klin Padiatr 1993; 205:190-3. [PMID: 8350594] [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: 01/30/2023]
Abstract
A male full-term neonate is described in whom cardiac insufficiency developed within 24 hours post partum. Ultrasound revealed an arterio-venous fistula of the vein of Galen. The patient's condition did not allow surgical correction and he died on the 22nd day of life. Persistent pulmonary hypertension was an important accompanying feature. The literature is reviewed with respect to the prognosis and the up to now seldom reported complication of persistent pulmonary hypertension of the newborn (PPHN).
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Affiliation(s)
- G Selzer
- Abteilung Neonatologie, Universität Frankfurt/Main
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