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Gatt M, Willis S, Leuschner S. A meta-analysis of the effectiveness and safety of kinesiology taping in the management of cancer-related lymphoedema. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12510] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 01/05/2023]
Affiliation(s)
- M. Gatt
- Sir Paul Boffa Hospital; Floriana Malta
| | - S. Willis
- Faculty of Health and Wellbeing; Sheffield Hallam University; Sheffield UK
| | - S. Leuschner
- Westpfalz-Klinikum GmbH; Kirchheimbolanden; Germany
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O'Neill S, Leuschner S, McNally SJ, Garden OJ, Wigmore SJ, Harrison EM. Meta-analysis of ischaemic preconditioning for liver resections. Br J Surg 2014; 100:1689-700. [PMID: 24227353 DOI: 10.1002/bjs.9277] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Vascular clamping reduces blood loss during liver resection but leads to ischaemia-reperfusion injury. Ischaemic preconditioning (IP) may reduce this. This study aimed to evaluate IP in liver resection under clamping. METHODS This was a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating IP in adults undergoing liver resection under either continuous clamping (CC) or intermittent clamping (IC). Primary outcomes were mortality, liver failure and morbidity. Secondary outcomes included duration of operation, blood loss, length of hospital stay, length of intensive therapy unit stay, transfusion requirements, prothrombin time, and bilirubin and aminotransferase levels. Weighted mean differences were calculated for continuous data, and pooled odds ratios (ORs) for dichotomous data. Results were produced with a random-effects model with 95 per cent confidence intervals (c.i.). RESULTS A total of 2960 records were identified and 11 RCTs included 669 patients (IP 331, control 338). No significant difference in mortality (6 RCTs; IP 186, control 190; OR 1·36, 95 per cent c.i. 0·13 to 13·68; P = 0·80) or morbidity (6 RCTs; IP 186, control 190; OR 0·58, 0·31 to 1·07; P = 0·08) was found for IP plus CC versus CC. Nor was there a significant difference in mortality (4 RCTs; IP 122, control 121; OR 1·33, 0·24 to 7·32; P = 0·74) or morbidity (4 RCTs; IP 122, control 121; OR 0·87, 0·52 to 1·47; P = 0·61) for IP plus (CC or IC) versus IC. No significant differences were found for secondary outcome measures. CONCLUSION This meta-analysis failed to find a significant benefit of IP in liver resection.
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Affiliation(s)
- S O'Neill
- Medical Research Council Centre for Inflammation Research, Tissue Injury and Repair Group, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent,, Edinburgh EH16 4SA, UK
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Neurohr C, Huppmann P, Leuschner S, von Wulffen W, Meis T, Leuchte H, Ihle F, Zimmermann G, Baezner C, Hatz R, Winter H, Frey L, Ueberfuhr P, Bittmann I, Behr J. Exhaled Nitric Oxide: A Valuable Tool for Early Diagnosis and Phenotyping of Bronchiolitis Obliterans Syndrome. Am J Transplant 2011. [DOI: 10.1111/j.1600-6143.2011.03787.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- C. Neurohr
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - P. Huppmann
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - S. Leuschner
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - W. von Wulffen
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - T. Meis
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - H. Leuchte
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - F. Ihle
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - G. Zimmermann
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - C. Baezner
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - R. Hatz
- Department of Surgery and Thoracic Surgery, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - H. Winter
- Department of Surgery and Thoracic Surgery, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - L. Frey
- Department of Anesthesiology, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - P. Ueberfuhr
- Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
| | - I. Bittmann
- Institute of Pathology, Ludwig‐Maximilians University, Munich, Germany
| | - J. Behr
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig‐Maximilians University, Munich, Germany
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Ihle F, Neurohr C, Huppmann P, Meis T, Baezner C, Leuschner S, Zimmermann G, Wulffen WV, Behr J. Lebensqualität und Leistungsfähigkeit lungentransplantierter Patienten mit und ohne Bronchiolitis Obliterans Syndrom. Pneumologie 2011. [DOI: 10.1055/s-0031-1272091] [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: 10/18/2022]
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Neurohr C, Huppmann P, Leuschner S, von Wulffen W, Meis T, Leuchte H, Ihle F, Zimmermann G, Baezner C, Hatz R, Winter H, Frey L, Ueberfuhr P, Bittmann I, Behr J. Usefulness of exhaled nitric oxide to guide risk stratification for bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2011; 11:129-37. [PMID: 21087415 DOI: 10.1111/j.1600-6143.2010.03327.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of this study was to assess fractional exhaled nitric oxide (FeNO) for the early diagnosis of bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTX). 611 FeNO measurements in 166 consecutive patients were classified depending on BOS stage at the time of assessment and course during minimum follow-up of 3 months: (1) stable non-BOS, (2) unstable non-BOS, (3) stable BOS and (4) unstable BOS. Unstable course was defined as new onset of BOS≥1 or progression of BOS. FeNO before unstable course was significantly increased in comparison to their stable counterparts (non-BOS: 28.9 ± 1.2 ppb, n = 40 vs. 16.4 ± 0.8 ppb, n = 131 and BOS: 32.5 ± 1.3 ppb, n = 35 vs. 15.3 ± 0.8 ppb, n = 26; p = 0.01 each). Average time from FeNO reading to onset of deterioration was 117 ± 9 days in non-BOS and 136 ± 9 days in BOS patients. The positive and negative predictive value of FeNO >20 ppb for BOS was 69.0% and 96.9%, respectively. Serial measurements demonstrated significantly lower mean individual variation in stable recipients as compared to stable patients switching to unstable course (3.2 ± 0.3 ppb vs. 12.7 ± 1.4 ppb, p = 0.02). In particular, the excellent negative predictive value of persistently low FeNO readings for future BOS make FeNO assessments a useful tool for continuous risk stratification after LTX.
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Affiliation(s)
- C Neurohr
- Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Munich, Germany.
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Leuschner S, Neurohr C, Huppmann P, Thum D, Zimmermann G, Baumgartner R, Ihle F, Leuchte H, Behr J. Exhaliertes Stickoxid als prognostischer Marker für das Bronchiolitis Obliterans Syndrom nach Lungentransplantation – eine prospektive Studie. Pneumologie 2009. [DOI: 10.1055/s-0029-1214111] [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: 10/21/2022]
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Huppmann P, Neurohr C, Samweber B, Leuschner S, Zimmermann G, Leuchte H, Baumgartner R, Hatz R, Frey L, Überfuhr P, Bittmann I, Behr J. Neutrophilie in der bronchoalveolären Lavage nach Lungentransplantation – Prognostischer Wert bei stabilen Patienten? Pneumologie 2009. [DOI: 10.1055/s-0029-1202424] [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: 10/21/2022]
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Hofmann-Kiefer KF, Eiser T, Chappell D, Leuschner S, Conzen P, Schwender D. Continuous Interscalene Block for Open Shoulder Surgery. Anesth Analg 2008. [DOI: 10.1213/ane.0b013e31817b67c1] [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: 11/05/2022]
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Hofmann-Kiefer KF, Eiser T, Chappell D, Leuschner S, Conzen P, Schwender D. Valid and Relevant Outcome Measures Are Critical for Objective Hypothesis-Testing. Anesth Analg 2008. [DOI: 10.1213/ane.0b013e31817b65e2] [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: 11/05/2022]
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Huppmann P, Neurohr C, Baumgartner R, Leuchte H, El Nounou M, Zimmermann G, Leuschner S, Überfuhr P, Hatz R, Frey L, Behr J. Verbessertes Langzeitüberleben bei Patienten mit idiopathischer pulmonaler Fibrose durch bilaterale Lungentransplantation. Pneumologie 2008. [DOI: 10.1055/s-2008-1074365] [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: 10/21/2022]
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Hofmann-Kiefer K, Eiser T, Chappell D, Leuschner S, Conzen P, Schwender D. Does patient-controlled continuous interscalene block improve early functional rehabilitation after open shoulder surgery? Anesth Analg 2008; 106:991-6, table of contents. [PMID: 18292451 DOI: 10.1213/ane.0b013e31816151ab] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Early mobilization after shoulder surgery plays a vital role in successful functional rehabilitation. However, postoperative pain often reduces, or even prevents, effective physiotherapy. We investigated the effect of analgesia via patient-controlled interscalene technique on early functional rehabilitation after open shoulder surgery. METHODS Eighty-seven patients were randomly assigned to one of two groups: patient-controlled continuous interscalene block (PCISB) and patient-controlled i.v. (opioid) analgesia (PCA). Interscalene block was performed preoperatively; otherwise analgesic protocols were started in the postanesthesia care unit and were continued for 72 h. Physiotherapy was performed for 60 min a day on day 2 and 3 after surgery according to a standardized protocol. Maximum mobility was defined as the range of motion that could be achieved with pain as the limiting factor. Efficiency of functional rehabilitation was evaluated 1 day before and 3 days after surgery with the help of a multimodal scoring system (Constant-Score) that evaluates pain, daily life activity, strength and range of motion. Maximum intensity of pain was also monitored via Visual Analog Scales for the first 72 h after surgery and during in-hospital physiotherapy. RESULTS Constant-Score rates were significantly improved by the interscalene block. However, no significant differences in mobility and strength sub-scores were observed between the groups. Compared with PCA, PCISB proved to be beneficial concerning pain at rest at 6 h (P < 0.001), 24 h (P = 0.044), and 72 h (P = 0.013) and for pain during physiotherapy at 48 h after surgery (P = 0.016). CONCLUSION Compared with opioid-based PCA, PCISB improved analgesia, but not function, during early rehabilitation of the shoulder joint.
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Affiliation(s)
- Klaus Hofmann-Kiefer
- Clinic of Anesthesiology/Critical Care Medicine and Pain Therapy, Ludwig-Maximilians-University, City of Munich, Germany.
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Von Specht H, Ganz M, Pethe J, Leuschner S, Pytel J. Linear versus non-linear recordings of transiently-evoked otoacoustic emissions--methodological considerations. Scand Audiol Suppl 2001:116-8. [PMID: 11318439 DOI: 10.1080/010503901300007263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A non-linear technique is predominantly used for the recording of transiently-evoked otoacoustic emissions (TEOAEs). The aim of this study was to compare linear and non-linear TEOAE recordings. TEOAEs were recorded in 22 normal hearing subjects to clicks from 90 to 30 dB SPL in 10 dB steps with the ILO88 system using both linear and non-linear recording techniques. The non-linear recording technique reduces stimulus artifacts for early latencies, but total elimination could not be proved. Both artifact reduction and significant differences between the two kinds of TEOAE recordings were reduced for longer latencies and lower stimulus intensities. For longer latencies (>10 ms) there was no significant difference between "linear" and "non-linear" TEOAEs. A higher signal-to-noise ratio was found for "linear" TEOAEs, resulting in better identification and a higher test-retest correlation. The linear recording technique, which includes new methods of artifact cancellation in comparison to the mainly utilized non-linear recording technique, should be used especially in hearing screening.
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Affiliation(s)
- H Von Specht
- Department of Experimental Audiology, Otto-von-Guericke-University Magdeburg, Germany.
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Abstract
In 1986 and 1987 11 children with TEC (transient erythroblastopenia of childhood) were referred to our hospital. Bone marrow aspirations were performed to exclude haematological malignancy. There was a marked reduction of erythropoiesis in 9 cases (1%-8%), two children had already recovered (33% and 44% erythropoiesis). Eight patients exhibited high percentages of stimulated lymphoid cells. The subsequent immunotyping revealed the expression of CALLA (common acute lymphoblastic leukaemia antigen) on these cells but there was no other sign for malignancy. The patients recovered without any specific treatment except transfusions of packed red cells. Eight patients were followed up 11-18 months after initial presentation and were all found to be in good health. A prominent increase of CALLA-positive stimulated lymphoid cells has also been found in other haematological diseases such as neutropenia and immune thrombocytopenia. The expression of CALLA in bone marrow lymphocytes is a general reactive change to various alterations.
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Affiliation(s)
- S Leuschner
- Children's Hospital, Department of General Paediatrics, Kiel, Federal Republic of Germany
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Suttorp M, Schmitz N, Leuschner S, Appelt M, Rister M, Schaub J. Fractionated total body irradiation plus high-dose VP-16 prior to allogeneic bone marrow transplantation in children with poor risk acute leukaemias. Bone Marrow Transplant 1989; 4 Suppl 4:144-8. [PMID: 2697428] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Nineteen children (median age, 13 years; range 4 to 18 years) with acute lymphoblastic leukemia/lymphoma (ALL) (10 patients) or acute nonlymphoblastic leukemia (ANNL) (9 patients) received allogeneic bone marrow transplants (BMT). Marrow was taken from HLA-identical sibling donors (16 patients) (pts), HLA-identical unrelated donor (1 pt), or one-antigen-missmatched sibling donor (1 pt). Preparatory regimen consisted of fractionated total body irradiation and high-dose VP-16 (50-70 mg/kg body weight). At the time of BMT nine of the pts were not in complete remission (CR): seven pts were refractory to aggressive multiagent chemotherapy and two pts were in first relapse. Six pts were in second CR, one pt in third CR; three pts grafted in first CR carried additional risk factors; e.g. induction failure. Ten out of the nineteen pts are alive and free of disease between one and 53 months (median, 28 months) after BMT. The actuarial disease-free survival rate is 37% for pts with ANLL and 54% for pts with ALL. Six pts have died from BMT-related complications. Only three pts (1 pt with ALL, 2 pts with ANLL) have relapsed between day +106 and day +134 after BMT and subsequently died. The four-year actuarial relapse rates of 29% for ANLL and 14% for ALL, respectively, demonstrate that the combination of fractionated total body irradiation and high-dose VP-16 is an effective antileucemic regimen for children with advanced leukemias.
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Affiliation(s)
- M Suttorp
- University Children's Hospital, Kiel, West Germany
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Voigt R, Leuschner S, Bornschein M. [A contribution to the characterization of incompatibilities of drugs with polyethylene glycols and ethoxylated tensides (author's transl)]. Pharmazie 1982; 37:22-5. [PMID: 7071107] [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: 01/23/2023]
Abstract
The authors studied by means of differential and equilibrium dialysis the interactions of 9 drugs reported in the literature as incompatible with polyethylene glycols (PEG) with PEG 1000 and a non-ionogenic ethoxylated tenside, Brij 35. The purpose of this study was to investigate how far methods such as differential and equilibrium dialysis are suitable for detecting and predicting incompatibilities. Interactions were observed with most of the drug-adjuvant mixtures under study. Brij 35, which has been used as a model substance of non-ionogenic ethoxylated tensides, proved to have a greater binding activity than PEG 1000. The measurable interactions indicate that many incompatibilities known to be manifest continue to exist in another medium in the form of masked incompatibilities.
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