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Bretschneider H, Helbig S, Kleber C, de With K, Stiehler M. Mimicry of surgical site infection - Case report. Int J Surg Case Rep 2020; 72:212-214. [PMID: 32544831 PMCID: PMC7298546 DOI: 10.1016/j.ijscr.2020.05.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/06/2020] [Accepted: 05/21/2020] [Indexed: 11/20/2022] Open
Abstract
Calciphylaxis may cause severe soft tissue complications after total joint arthroplasty. Caliphylaxis is a potential differential diagnosis to surgical site infection in patients with chronic kidney disease. Skin biopsy should be taken in case of suspected calciphylaxis to confirm the diagnosis.
Background context Calciphylaxis is a rare complication of secondary hyperparathyroidism caused by calcifications of small blood vessels in the skin and soft tissue. The disease occurs almost exclusively in patients with chronic kidney disease and has an incidence of approximately 50 cases per year in Germany [1]. Purpose We present a case of a 61-year-old woman with calciphylaxis in connection with a primary knee endoprosthesis implantation. Study design Case report. Methods A review of the medical records since the time of initial hospital admission throughout the entire hospitalization until the death of the patient was performed. Results Calciphylaxis caused severe soft tissue complications after total joint arthroplasty. Despite interdisciplinary therapy, including revision and plastic surgery as well as intensive care, the patient died 4 months after primary total knee arthroplasty due to septic multi-organ failure. Conclusion Calciphylaxis may cause severe soft tissue complications after total joint arthroplasty and should be considered as potential differential diagnosis to surgical site infection. This is the first case report on calciphylaxis as direct complication of total joint replacement surgery.
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Affiliation(s)
- H Bretschneider
- University Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus Dresden and Faculty of Medicine of Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - S Helbig
- Division of Infectious Diseases, University Hospital Carl Gustav Carus Dresden and Faculty of Medicine of Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - C Kleber
- University Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus Dresden and Faculty of Medicine of Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - K de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus Dresden and Faculty of Medicine of Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - M Stiehler
- University Centre for Orthopaedics and Trauma Surgery, University Hospital Carl Gustav Carus Dresden and Faculty of Medicine of Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
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Plunkett BJ, Henry-Kirk R, Friend A, Diack R, Helbig S, Mouhu K, Tomes S, Dare AP, Espley RV, Putterill J, Allan AC. Apple B-box factors regulate light-responsive anthocyanin biosynthesis genes. Sci Rep 2019; 9:17762. [PMID: 31780719 PMCID: PMC6882830 DOI: 10.1038/s41598-019-54166-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 10/31/2019] [Indexed: 12/28/2022] Open
Abstract
Environmentally-responsive genes can affect fruit red colour via the activation of MYB transcription factors. The apple B-box (BBX) gene, BBX33/CONSTANS-like 11 (COL11) has been reported to influence apple red-skin colour in a light- and temperature-dependent manner. To further understand the role of apple BBX genes, other members of the BBX family were examined for effects on colour regulation. Expression of 23 BBX genes in apple skin was analysed during fruit development. We investigated the diurnal rhythm of expression of the BBX genes, the anthocyanin biosynthetic genes and a MYB activator, MYB10. Transactivation assays on the MYB10 promoter, showed that BBX proteins 1, 17, 15, 35, 51, and 54 were able to directly function as activators. Using truncated versions of the MYB10 promoter, a key region was identified for activation by BBX1. BBX1 enhanced the activation of MYB10 and MdbHLH3 on the promoter of the anthocyanin biosynthetic gene DFR. In transformed apple lines, over-expression of BBX1 reduced internal ethylene content and altered both cyanidin concentration and associated gene expression. We propose that, along with environmental signals, the control of MYB10 expression by BBXs in 'Royal Gala' fruit involves the integration of the expression of multiple BBXs to regulate fruit colour.
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Affiliation(s)
- Blue J Plunkett
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
| | - Rebecca Henry-Kirk
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
| | - Adam Friend
- PFR, 55 Old Mill Road, RD 3, Motueka, 7198, New Zealand
| | - Robert Diack
- PFR, 55 Old Mill Road, RD 3, Motueka, 7198, New Zealand
| | - Susanne Helbig
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
- BIOTECON Diagnostics GmbH, Hermannswerder 17, 14473, Potsdam, Germany
| | - Katriina Mouhu
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
- Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Sumathi Tomes
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
| | - Andrew P Dare
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
| | - Richard V Espley
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand
| | - Joanna Putterill
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Andrew C Allan
- The New Zealand Institute for Plant and Food Research Limited (PFR), Mt Albert, Private Bag 92169, Auckland, New Zealand.
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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Dieck A, Helbig S, Drake CL, Backhaus J. Validation of the German version of the Ford Insomnia Response to Stress Test. J Sleep Res 2017; 27:e12621. [DOI: 10.1111/jsr.12621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/06/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Arne Dieck
- Department of Psychology; University of Bonn; Bonn Germany
| | - Susanne Helbig
- Department of Psychology; University of Bonn; Bonn Germany
| | | | - Jutta Backhaus
- Department of Psychology; University of Bonn; Bonn Germany
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Helbig S, Backhaus J. "Sex differences in a real academic stressor, cognitive appraisal and the cortisol response". Physiol Behav 2017; 179:67-74. [PMID: 28546084 DOI: 10.1016/j.physbeh.2017.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/03/2017] [Revised: 05/19/2017] [Accepted: 05/19/2017] [Indexed: 11/26/2022]
Abstract
Women and men differ in their physiological and psychological stress response but only a few studies have analyzed this sex difference in a naturalistic setting and focused on cognitive stress appraisal. In the present study, the salivary cortisol concentration of 24 female and 22 male subjects was measured before and several times after an oral academic presentation given by themselves (stress condition) or given by a fellow student (control condition). Feelings of subjective stress and nervousness were assessed simultaneously to the saliva samples and a questionnaire for cognitive stress appraisal was conducted right before the oral presentation. In the stress condition, the presentation led to a significantly higher cortisol increase than in the control condition. Sex differences were shown concerning the subjective stress feelings, which were higher in women, whereas there were no sex differences in cortisol release. Women showed a disadvantageous cognitive appraisal compared to men in both conditions. There was an interaction effect of sex and condition: women reported to feel equally challenged in both conditions whereas men felt significantly more challenged by their own presentation than by the presentations of their fellow students. The result that men's cognitive appraisal was more influenced by an academic stressor than women's and that women felt subjectively more stressed whereas there was no difference concerning the cortisol response is discussed in consideration of evolutional and biological aspects.
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Affiliation(s)
- Susanne Helbig
- Department of Clinical Psychology and Psychotherapy, University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
| | - Jutta Backhaus
- Department of Clinical Psychology and Psychotherapy, University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
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Kranz J, Schmidt S, Lebert C, Schneidewind L, Vahlensieck W, Sester U, Fünfstück R, Helbig S, Hofmann W, Hummers E, Kunze M, Kniehl E, Naber K, Mandraka F, Mündner-Hensen B, Schmiemann G, Wagenlehner FME. Epidemiologie, Diagnostik, Therapie, Prävention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei erwachsenen Patienten. Urologe A 2017; 56:746-758. [DOI: 10.1007/s00120-017-0389-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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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Lebuhn M, Derenkó J, Rademacher A, Helbig S, Munk B, Pechtl A, Stolze Y, Prowe S, Schwarz WH, Schlüter A, Liebl W, Klocke M. DNA and RNA Extraction and Quantitative Real-Time PCR-Based Assays for Biogas Biocenoses in an Interlaboratory Comparison. Bioengineering (Basel) 2016; 3:bioengineering3010007. [PMID: 28952569 PMCID: PMC5597165 DOI: 10.3390/bioengineering3010007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 07/15/2015] [Accepted: 12/24/2015] [Indexed: 01/17/2023] Open
Abstract
Five institutional partners participated in an interlaboratory comparison of nucleic acid extraction, RNA preservation and quantitative Real-Time PCR (qPCR) based assays for biogas biocenoses derived from different grass silage digesting laboratory and pilot scale fermenters. A kit format DNA extraction system based on physical and chemical lysis with excellent extraction efficiency yielded highly reproducible results among the partners and clearly outperformed a traditional CTAB/chloroform/isoamylalcohol based method. Analytical purpose, sample texture, consistency and upstream pretreatment steps determine the modifications that should be applied to achieve maximum efficiency in the trade-off between extract purity and nucleic acid recovery rate. RNA extraction was much more variable, and the destination of the extract determines the method to be used. RNA stabilization with quaternary ammonium salts was an as satisfactory approach as flash freezing in liquid N2. Due to co-eluted impurities, spectrophotometry proved to be of limited value for nucleic acid qualification and quantification in extracts obtained with the kit, and picoGreen® based quantification was more trustworthy. Absorbance at 230 nm can be extremely high in the presence of certain chaotropic guanidine salts, but guanidinium isothiocyanate does not affect (q)PCR. Absolute quantification by qPCR requires application of a reliable internal standard for which correct PCR efficiency and Y-intercept values are important and must be reported.
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Affiliation(s)
- Michael Lebuhn
- Bavarian State Research Center for Agriculture, Department for Quality Assurance and Analytics, Lange Point 6, 85354 Freising, Germany.
| | - Jaqueline Derenkó
- Leibniz Institute for Agricultural Engineering Potsdam-Bornim, Department Bioengineering, Max-Eyth-Allee 100, 14469 Potsdam, Germany.
| | - Antje Rademacher
- Leibniz Institute for Agricultural Engineering Potsdam-Bornim, Department Bioengineering, Max-Eyth-Allee 100, 14469 Potsdam, Germany.
| | - Susanne Helbig
- Beuth University of Applied Sciences, Department of Life Sciences and Technology, Luxemburger Strasse 10, 13353 Berlin, Germany.
| | - Bernhard Munk
- Bavarian State Research Center for Agriculture, Department for Quality Assurance and Analytics, Lange Point 6, 85354 Freising, Germany.
| | - Alexander Pechtl
- Department of Microbiology, Technische Universität München, Emil-Ramann-Str. 4, D-85354 Freising-Weihenstephan, Germany.
| | - Yvonne Stolze
- Institute for Genome Research and Systems Biology, CeBiTec, Bielefeld University, Bielefeld, Germany.
| | - Steffen Prowe
- Beuth University of Applied Sciences, Department of Life Sciences and Technology, Luxemburger Strasse 10, 13353 Berlin, Germany.
| | - Wolfgang H Schwarz
- Department of Microbiology, Technische Universität München, Emil-Ramann-Str. 4, D-85354 Freising-Weihenstephan, Germany.
| | - Andreas Schlüter
- Institute for Genome Research and Systems Biology, CeBiTec, Bielefeld University, Bielefeld, Germany.
| | - Wolfgang Liebl
- Department of Microbiology, Technische Universität München, Emil-Ramann-Str. 4, D-85354 Freising-Weihenstephan, Germany.
| | - Michael Klocke
- Leibniz Institute for Agricultural Engineering Potsdam-Bornim, Department Bioengineering, Max-Eyth-Allee 100, 14469 Potsdam, Germany.
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Rader T, Helbig S, Stöver T, Baumann U. [Hearing preservation: Better hearing with advanced technology]. Laryngorhinootologie 2014; 93:337-49. [PMID: 24782208 DOI: 10.1055/s-0034-1371796] [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: 10/25/2022]
Abstract
Preservation of residual hearing after cochlear implantation allows patients the synergetic use of electric and acoustic stimulation (EAS). The application of specific surgical and therapeutic techniques enables the reduction of inner ear trauma, which leads otherwise to complete hearing loss. Due to simultaneous electric and acoustic stimulation, speech understanding is improved especially in noise. EAS is a well-accepted therapeutic treatment for subjects with profound hearing loss in the higher frequencies and no or mild hearing loss in the low frequencies. Several Manufacturers offer individual soft electrodes specially designed for hearing preservation as well as combined electric-acoustic audio processors.
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Affiliation(s)
- T Rader
- Klinik für HNO-Heilkunde, Audiologische Akustik, Goethe-Universität Frankfurt am Main
| | - S Helbig
- Klinik für HNO-Heilkunde, Audiologische Akustik, Goethe-Universität Frankfurt am Main
| | - T Stöver
- Klinik für HNO-Heilkunde, Audiologische Akustik, Goethe-Universität Frankfurt am Main
| | - U Baumann
- Klinik für HNO-Heilkunde, Audiologische Akustik, Goethe-Universität Frankfurt am Main
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Lange P, Greif M, Vogel A, Thaumann A, Helbig S, Schwarz F, Schmitz C, Becker C, D’Anastasi M, Boekstegers P, Pohl T, Laubender RP, Steinbeck G, Kupatt C. Reduction of pacemaker implantation rates after CoreValve® implantation by moderate predilatation. EUROINTERVENTION 2014; 9:1151-7. [DOI: 10.4244/eijv9i10a195] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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von Ziegler F, Helbig S, Kreissl N, Meiser B, Becker A, Kaczmarek I. Norepinephrine versus dopamine pretreatment of potential heart donors - impact on long-term outcome. Ann Transplant 2013; 18:320-6. [PMID: 23792536 DOI: 10.12659/aot.883960] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Current guidelines advocate administration of inotropic agents to stabilize potential deceased heart-beating donors. A consensus on the specific agent or combination therapy is lacking. We thus initiated a retrospective analysis of patients being transplanted at our center in a matched-pair study design focusing on survival after donor pre-treatment either with norepinephrine or dopamine. MATERIAL AND METHODS 936 patients (759 male; 177 female; mean age: 47.5 ± 15.4 years) were transplanted at our center between 8/1981 and 12/2010. An overall of 22 patient pairs (all male; mean age 55.4 ± 7.5 years; range 23-67 years) were matched according to our strict criteria. During follow-up (5037 ± 1791 days) 11 deaths occurred. Overall survival in both groups was not different (p=0.1438). RESULTS In a sub-population analysis of all patient-pairs that completed 5-year follow-up (n=19), Kaplan-Meier analysis revealed significant superior survival of recipients that received hearts pre-treated with norepinephrine vs. dopamine pre-treatment (p=0.0368). CONCLUSIONS Neither norepinephrine nor dopamine pre-treatment of potential heart donors showed superior overall survival. In a sub-population of long-term survivors norepinephrine pre-treatment was associated with better survival in a rather small cohort of heart transplant recipients. These findings underscore the urgent need of further prospective multicenter randomized trials to recommend a preferable adrenergic therapy.
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Affiliation(s)
- Franz von Ziegler
- Department of Cardiology, Medical Clinic I, Grosshadern Campus, Ludwig-Maximilians-University, Munich, Germany.
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Barcena de Arellano ML, Münch S, Arnold J, Helbig S, Schneider A, Mechsner S. Calcium-binding protein expression in peritoneal endometriosis-associated nerve fibres. Eur J Pain 2013; 17:1425-37. [PMID: 23649874 DOI: 10.1002/j.1532-2149.2013.00323.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent studies demonstrated the potential involvement of nerve fibres in the chronic inflammatory process of endometriosis. We aimed to characterize nerve fibres in the proximal and distal areas of the peritoneal endometriotic lesions in order to understand the chronic inflammatory process in endometriosis. METHODS Peritoneal endometriotic lesions (proximal area) (n = 17), the matching unaffected peritoneum (distal area) and healthy peritoneum of patients without endometriosis (n = 15) were analysed with the neuronal markers PGP 9.5, calbindin, calretinin and parvalbumin. Peritoneal fluids of women with and without endometriosis were used for Western blot analysis and for the neuronal growth assay. The protein expression of neuronal PC-12 cells incubated with peritoneal fluids was analysed. RESULTS The overall nerve fibre density was significantly reduced in the distal area of the lesion when compared with the proximal area or with healthy peritoneum. The density of calbindin-, calretinin- and parvalbumin-positive nerve fibres was significantly increased in the endometriosis group. Calretinin expression was elevated in the peritoneal fluid of women with symptomatic endometriosis when compared with women with asymptomatic endometriosis. Furthermore, PC-12 cells incubated with peritoneal fluid of women with endometriosis showed a higher proliferation rate and a stronger neurite outgrowth than the control group. PC-12 cells incubated in peritoneal fluids of women with endometriosis expressed less calretinin but more calbindin than the control group. CONCLUSIONS Calcium-binding proteins seem to be increased in endometriosis-associated nerve fibres and might play an important role in the chronic inflammatory condition and the pain pathogenesis of endometriosis.
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Greif M, von Ziegler F, Wakili R, Tittus J, Becker C, Helbig S, Laubender RP, Schwarz W, D'Anastasi M, Schenzle J, Leber AW, Becker A. Increased pericardial adipose tissue is correlated with atrial fibrillation and left atrial dilatation. Clin Res Cardiol 2013; 102:555-62. [PMID: 23584714 DOI: 10.1007/s00392-013-0566-1] [Citation(s) in RCA: 35] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/03/2013] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Pericardial adipose tissue (PAT), a visceral fat depot surrounding the heart, serves as an endocrine active organ and is associated with inflammation. There is growing evidence that atrial fibrillation (AF) is linked with inflammation, which in turn can be a promoter of left atrial remodeling. The aim of this study was to evaluate a potential correlation of PAT to AF and left atrial structural remodeling represented by LA size. METHODS PAT was measured in 1,288 patients who underwent coronary artery calcium-scanning for coronary risk stratification. LA size was determined by two independent readers. Patients were subdivided into patients without AF, patients with paroxysmal and persistent AF. RESULTS PAT was independently correlated with AF, persistent AF, and LA size (all p values <0.001). No association could be observed between paroxysmal AF and PAT. These associations persisted after multivariate adjustment for AF risk factors such as age, hypertension, valvular disease, heart failure, and body mass index (AF: OR 1.52, 95 % CI 1.15-2.00, p = 0.003; persistent AF: OR 2.58, 95 % CI 1.69-3.99, p = 0.001; LA size: regression coefficient 0.15 with 95 % CI 0.10-0.20, p < 0.001). CONCLUSION PAT is associated with AF, in particular with persistent AF and LA size. These findings suggest that PAT could be an independent risk factor for the development of AF and for LA remodeling.
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Affiliation(s)
- Martin Greif
- Department of Cardiology, Klinikum Grosshadern, University Hospital of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
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von Ziegler F, Brendel M, Uebleis C, Helbig S, Greif M, Ruemmler J, Becker C, Hacker M, Steinbeck G, Becker A. SPECT myocardial perfusion imaging as an adjunct to coronary calcium score for the detection of hemodynamically significant coronary artery stenosis. BMC Cardiovasc Disord 2012. [PMID: 23206557 PMCID: PMC3527199 DOI: 10.1186/1471-2261-12-116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Coronary artery calcifications (CAC) are markers of coronary atherosclerosis, but do not correlate well with stenosis severity. This study intended to evaluate clinical situations where a combined approach of coronary calcium scoring (CS) and nuclear stress test (SPECT-MPI) is useful for the detection of relevant CAD. Methods Patients with clinical indication for invasive coronary angiography (ICA) were included into our study during 08/2005-09/2008. At first all patients underwent CS procedure as part of the study protocol performed by either using a multidetector computed tomography (CT) scanner or a dual-source CT imager. CAC were automatically defined by dedicated software and the Agatston score was semi-automatically calculated. A stress-rest SPECT-MPI study was performed afterwards and scintigraphic images were evaluated quantitatively. Then all patients underwent ICA. Thereby significant CAD was defined as luminal stenosis ≥75% in quantitative coronary analysis (QCA) in ≥1 epicardial vessel. To compare data lacking Gaussian distribution an unpaired Wilcoxon-Test (Mann–Whitney) was used. Otherwise a Students t-test for unpaired samples was applied. Calculations were considered to be significant at a p-value of <0.05. Results We consecutively included 351 symptomatic patients (mean age: 61.2±12.3 years; range: 18–94 years; male: n=240) with a mean Agatston score of 258.5±512.2 (range: 0–4214). ICA verified exclusion of significant CAD in 66/67 (98.5%) patients without CAC. CAC was detected in remaining 284 patients. In 132/284 patients (46.5%) with CS>0 significant CAD was confirmed by ICA, and excluded in 152/284 (53.5%) patients. Sensitivity for CAD detection by CS alone was calculated as 99.2%, specificity was 30.3%, and negative predictive value was 98.5%. An additional SPECT in patients with CS>0 increased specificity to 80.9% while reducing sensitivity to 87.9%. Diagnostic accuracy was 84.2%. Conclusions In patients without CS=0 significant CAD can be excluded with a high negative predictive value by CS alone. An additional SPECT-MPI in those patients with CS>0 leads to a high diagnostic accuracy for the detection of CAD while reducing the number of patients needing invasive diagnostic procedure.
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Affiliation(s)
- Franz von Ziegler
- Department of Cardiology, University of Munich, Campus Grosshadern, Munich, Germany.
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Helbig S, Augsten R, Mentzel HJ, Strobel J. Case Report: Traumatische Amaurose nach Pfählungsverletzung. Klin Monbl Augenheilkd 2012. [DOI: 10.1055/s-0032-1327153] [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: 10/27/2022]
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von Ziegler F, Rümmler J, Kaczmarek I, Greif M, Schenzle J, Helbig S, Becker C, Meiser B, Becker A. Detection of significant coronary artery stenosis with cardiac dual-source computed tomography angiography in heart transplant recipients. Transpl Int 2012; 25:1065-71. [DOI: 10.1111/j.1432-2277.2012.01536.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
Candiduria is common in hospitalised patients, but the clinical relevance is still unclear. This study was done to further our knowledge on detection of and host responses to candiduria. Urines and clinical data from 136 patients in whom presence of yeast was diagnosed by microscopic urinalysis were collected. Diagnosis by standard urine culture methods on blood and MacConkey agar as well as on fungal culture medium (Sabouraud dextrose agar) was compared. Inflammatory parameters (IL-6 and IL-17, Ig) were quantified in the urine and compared with levels in control patients without candiduria. Standard urine culture methods detected only 37% of Candida spp. in urine. Sensitivity was especially low (23%) for C. glabrata and was independent of fungal burden. Candida specific IgG but not IgA was significantly elevated when compared with control patients (P < 0.0001 and 0.07 respectively). In addition, urine levels of IL-6 and IL-17 were significantly higher in candiduric patients when compared with control patients (P < 0.001). Multivariate analysis documented an independent association between an increased IgG (odds ratio (OR) 136.0, 95% confidence interval (CI) 25.7-719.2; P < 0.0001), an increased IL-17 (OR 17.4, 95% CI 5.3-57.0; P < 0.0001) and an increased IL-6 level (OR 4.9, 95% CI 1.9-12.4; P = 0.001) and candiduria. In summary, our data indicate that clinical studies on candiduria should include fungal urine culture and that inflammatory parameters may be helpful to identify patients with clinically relevant candiduria.
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Affiliation(s)
- S Helbig
- Jacobi Medical Center HHC, Bronx, NY, USA
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Kozak J, Krysztoforski K, Kroll T, Helbig S, Helbig M. Error analysis for determination of accuracy of an ultrasound navigation system for head and neck surgery. ACTA ACUST UNITED AC 2010; 14:69-82. [PMID: 20121587 DOI: 10.3109/10929080903230901] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The use of conventional CT- or MRI-based navigation systems for head and neck surgery is unsatisfactory due to tissue shift. Moreover, changes occurring during surgical procedures cannot be visualized. To overcome these drawbacks, we developed a novel ultrasound-guided navigation system for head and neck surgery. A comprehensive error analysis was undertaken to determine the accuracy of this new system. MATERIALS AND METHODS The evaluation of the system accuracy was essentially based on the method of error definition for well-established fiducial marker registration methods (point-pair matching) as used in, for example, CT- or MRI-based navigation. This method was modified in accordance with the specific requirements of ultrasound-guided navigation. The Fiducial Localization Error (FLE), Fiducial Registration Error (FRE) and Target Registration Error (TRE) were determined. RESULTS In our navigation system, the real error (the TRE actually measured) did not exceed a volume of 1.58 mm(3) with a probability of 0.9. A mean value of 0.8 mm (standard deviation: 0.25 mm) was found for the FRE. The quality of the coordinate tracking system (Polaris localizer) could be defined with an FLE of 0.4 +/- 0.11 mm (mean +/- standard deviation). The quality of the coordinates of the crosshairs of the phantom was determined with a deviation of 0.5 mm (standard deviation: 0.07 mm). CONCLUSION The results demonstrate that our newly developed ultrasound-guided navigation system shows only very small system deviations and therefore provides very accurate data for practical applications.
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Affiliation(s)
- J Kozak
- Aesculap AG, Tuttlingen, Germany.
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Ibrahim HN, Truy E, Helbig S, Jolly C. Combined insertion of intracochlear catheter and electrode array: evaluation of surgical trauma in cadaver temporal bones (a histological study). Cochlear Implants Int 2010; 11 Suppl 1:434-6. [PMID: 21756667 DOI: 10.1179/146701010x12671177204309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- H N Ibrahim
- UMR CNRS 5020, University Claude Bernard Lyon1, France.
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Brockmeier SJ, Peterreins M, Lorens A, Vermeire K, Helbig S, Anderson I, Skarzynski H, Van de Heyning P, Gstoettner W, Kiefer J. Music perception in electric acoustic stimulation users as assessed by the Mu.S.I.C. test. Adv Otorhinolaryngol 2009; 67:70-80. [PMID: 19955723 DOI: 10.1159/000262598] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS This study compared the music perception abilities of 13 electric acoustic stimulation (EAS) users with two control groups: unilateral cochlear implant (CI) users and normal-hearing (NH) listeners. METHODS Groups were matched according to age and musical experience before hearing loss (HL) and tested using the Musical Sounds in Cochlear Implants (Mu.S.I.C.) test. RESULTS No difference was found on rhythm perception, chord discrimination, dissonance rating, and emotion rating subtest performance between groups. Mean frequency discrimination scores were significantly better in EAS participants than in CI participants and not significantly worse than in NH participants. However, the EAS and CI groups scored similarly (significantly worse than NH participants) on both instrument detection and identification. Results for EAS participants were not significantly worse when the hearing aid component was removed. Frequency of listening to music before HL was negatively correlated with EAS participants' frequency discrimination scores, though singing and playing an instrument appeared to have no effect. EAS participants who indicated many reasons for listening to music and who listen to many genres after implantation scored higher on instrument detection and instrument identification. Better results on these two subtests were correlated with EAS participants' better postoperative auditory thresholds at 250 and 500 Hz. CONCLUSIONS Though EAS participants performed better on music perception testing (though not timbre-based tasks) than CI participants, their scores did not reach the level of NH participants. This indicates that acoustic hearing in the low frequencies is helpful for music perception, though not the only important factor.
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Helbig M, Krysztoforski K, Kroll T, Kucharski J, Popek M, Helbig S, Gstoettner W, May A, Kozak J. Navigation-supported and sonographically-controlled fine-needle puncture in soft tissues of the neck. Ultrasound Med Biol 2009; 35:436-442. [PMID: 19056160 DOI: 10.1016/j.ultrasmedbio.2008.09.015] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Revised: 08/13/2008] [Accepted: 09/17/2008] [Indexed: 05/27/2023]
Abstract
In surgery, sonography has been a well-accepted means of orientation for years. The immediate vicinity of many vital structures in the head and neck region calls for a very exact visualization of the surgical instrument in the 2-D ultrasonic picture. We report on the development of a new method for navigation-supported and sonographically-controlled fine-needle puncture in soft tissues of the neck. Our system comprises a navigated ultrasound probe, a navigated fine-puncture needle and a coordinate sensor. A personal computer with specially-developed software assists calibration and surgical application. The applicability test for the system is described. In vitro, a model lymph node of 9 mm in diameter had been hit. It is shown that the target structure can be aimed at very precisely by the navigated puncture needle. An accuracy of 97% and a specificity of 99% could be demonstrated. The development of a very precise and easy-to-handle method for navigation-supported fine-needle puncture in the neck region is presented. The outstanding advantage of this method is that no rigid reference gadget fixed to the patient's body is necessary. That makes this method very suitable for surgery in the neck region. Contrary to other sonographically-supported navigation methods in the head and neck region, preoperative imaging (CT or MRT) is dispensable.
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Affiliation(s)
- M Helbig
- Department of Otolaryngology, Head and Neck Surgery, University of Frankfurt/Main, Frankfurt/Main, Germany.
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Helbig M, Krysztoforski K, Kucharski J, Popek M, Kroll T, Helbig S, May A, Gstoettner W, Kozak J. [Navigation-assisted sonography for soft tissues in the head and neck region]. HNO 2008; 57:1010-5. [PMID: 18846356 DOI: 10.1007/s00106-008-1801-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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
BACKGROUND In soft tissue surgery of the head and neck region tissue shifts limit the usefulness of conventional CT/MRI-based navigation procedures. Furthermore, changes caused by invasive measures cannot be visualized. METHODS A novel navigation device for sonography of soft tissues was developed. This consists of a navigated ultrasound scanner, a navigated surgical instrument, and a personal computer with custom-made software. Its use makes an additional visualization by means of CT or MRI dispensable. RESULTS The system deviation (three-dimensional error) of this newly developed prototype was less than 1 mm. The practical application in a model setup showed good handling properties of the system. Orientation and approach of the surgical instrument to the sonographically visualized target structure were rapid and accurate. CONCLUSION This new navigation system does not require additional CT or MRI images. The navigated ultrasound probe shows tissue changes in real time. This navigation system is especially suitable for invasive procedures in soft tissues.
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Affiliation(s)
- M Helbig
- Zentrum für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main.
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Helbig M, Helbig S, Knecht R, Kahla-Witzsch HA, Gstöttner W. [Quality management: reduced waiting time and enhanced efficiency in a university ear, nose, and throat outpatient department]. HNO 2007; 55:29-35. [PMID: 16622694 DOI: 10.1007/s00106-006-1400-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 11/26/2022]
Abstract
BACKGROUND The introduction of Diagnosis-Related Groups, which standardize payment for each clinical service, entails keeping the inpatient treatment as short as possible. Thus outpatient treatment is gaining in importance. To cope with this change, organizational and structural modifications of clinic routine are necessary. METHODS In the ear, nose, and throat outpatient clinic of Johann Wolfgang Goethe University in Frankfurt, Germany, a hotline was established that allows patients to make appointments and get advice based on quality management guidelines according to DIN EN ISO 9001:2000. The development of this project is described here step by step, from planning to inclusion in the daily clinic routine. RESULTS Patient visits became more effective despite increasing demand. This resulted in high satisfaction of patients and clinic personnel alike. CONCLUSION This model may contribute considerably to coping with the increasing demand for clinic appointments and to optimal use of a clinic's human resources.
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Affiliation(s)
- M Helbig
- Zentrum für HNO-Heilkunde des Universitätsklinikums Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main.
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Helbig M, Kahla-Witzsch HA, Helbig S, Knecht R, Gstöttner W. [Quality assessment according to DIN EN ISO 9001:2000: certification in a university ENT department]. HNO 2007; 54:922-8. [PMID: 17041776 DOI: 10.1007/s00106-006-1467-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/28/2022]
Abstract
BACKGROUND In 2003, our department inaugurated a quality management system. The certification according to DIN EN ISO 9001:2000 as required by the hospital management was achieved in August 2005. The aims were optimization of internal operating schedules and standardization of procedures according to logistic interfaces with external structures. METHODS Since 2000, the implementation of an internal quality management system is required by German law and threatened by penalty in case of non-implementation. Beside a basic audit and optimization of all organizational procedures, all core processes were determined and the approvals checked. These aims involve both the quality of operational procedures, in and outpatient treatment, research, study and teaching and aspects of service such as quickness of scheduling and forwarding of reports as well as economic aspects and efficiency. The department of "quality management", whose main tasks are the professional guidance and the training of the quality management representatives, plays an important role. RESULTS Realization of the new regulations and restructuring resulted in an increase in effectiveness and an improvement in operational procedures. In particular, patients and staff have benefited from the reorganized and modified sequence of operations. CONCLUSION Implementation of a quality management system in different hospital departments is recommended.
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Affiliation(s)
- M Helbig
- Zentrum für Hals-Nasen-Ohren-Heilkunde des Klinikums der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 , Frankfurt/Main, Deutschland.
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Bink A, Helbig S, Zanella F. Kostenreduktion im Gesundheitswesen: Ist eine alleinige CT- oder alleinige MRT-Diagnostik vor Cochlea Implantation verantwortbar? ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940705] [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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Helbig S, Hoyer J. Wartezeit auf Psychotherapie - Probleme und Perspektiven. Psychother Psychosom Med Psychol 2005. [DOI: 10.1055/s-2005-863490] [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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Kriatselis C, Helbig S, Göhl K, Richter P, Höher M, Gottwik M. Seltene Ursache einer Prolongierung der QT-Zeit und reanimationspflichtigen Torsade-de-pointes-Tachykardie. Internist (Berl) 2005; 46:92-6. [PMID: 15645195 DOI: 10.1007/s00108-004-1283-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A 62 year old patient underwent an intraoperative pancreas biopsy because of a pancreas head process. On 13(th) and 20(th) postoperative day a short syncope episode occurred. On that days calcium blood levels were 1,82 and 1,74 mmol/l, respectively. On 13(th) postoperative day QT(c) interval was 565 ms. On 26(th) postoperative day the patient was resuscitated because of torsade de pointes tachycardia. His actual calcium blood level was 1,47 mmol/l and QT(c) interval 627 ms. An extensive diagnostic work-up revealed no evidence of cardiac disease. After calcium substitution QT interval normalised. During a follow-up period of 16 months the patient remained without symptoms.
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Affiliation(s)
- C Kriatselis
- Medizinische Klinik 2-Kardiologie, Klinikum Bayreuth.
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Hähnel A, Weigel B, Hoyer J, Helbig S. Wartezeit für Psychotherapiepatienten – und wie sie zu nutzen ist. Verhaltenstherapie 2004. [DOI: 10.1159/000082839] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kriatselis HD, Goehl K, Richter P, Helbig S, Sindermann J, Gottwik M. Radiofrequency energy modification of the atrioventricular junction in patients with atrial fibrillation: modes of ventricular response under autonomic blockade and long-term effect. Pacing Clin Electrophysiol 2001; 24:1312-20. [PMID: 11584452 DOI: 10.1046/j.1460-9592.2001.01312.x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The short- and long-term effect of radiofrequency (RF) modification of the AV junction on ventricular rate and left ventricular function and the different types of ventricular response during energy application under autonomic nervous blockade were assessed in 28 patients with medically refractory atrial fibrillation. During the successful RF application, ventricular rate slowed progressively (type I response, ten patients) or accelerated at first and then slowed (type II response, 11 patients). Type II response was associated with a more anterior ablation site compared to Type I response. A primary successful outcome was achieved in 21 patients. Inadvertent complete AV block developed in three patients, while in four patients AV nodal ablation was performed after an unsuccessful modification attempt. During 6-month follow-up, the ventricular rate was adequately controlled in only four patients. Among the 16 patients with a recurrence of uncontrolled AF were all 10 patients with type I response and 6 of 11 patients with type II response. One patient died suddenly 10 weeks after the procedure.
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Affiliation(s)
- H D Kriatselis
- Electrophysiology Laboratory, General Hospital of Nuremberg, Nuremberg, Germany.
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Kriatselis N, Helbig S, Göhl K, Richter P, MacCarter D, Gottwik M. Oxygen- and heart rate kinetics during early recovery from exercise: Which sensor is physiologic? Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a63] [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: 11/28/2022] Open
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Helbig S. Online coding using an imaging system. J AHIMA 1996; 67:44-5. [PMID: 10161437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- S Helbig
- Harborview Medical Center, Seattle, WA, USA
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Okamoto C, Helbig S. The future is what you make it. J AHIMA 1995; 66:27-31. [PMID: 10143525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Helbig S, Finlay M. Transcription: a strategic approach to the on-line medical record. J AHIMA 1992; 63:45-8. [PMID: 10119096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Groty J, Helbig S. Health record professionals and prison health care. Interview by Jack A.N. Ellis. Med Rec News 1979; 50:58-62. [PMID: 10244360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Hillman RS, Helbig S, Howes S, Hayes J, Meyer DM, McArthur JR. The effect of an educational program on transfusion practices in a regional blood program. Transfusion 1979; 19:153-7. [PMID: 432926 DOI: 10.1046/j.1537-2995.1979.19279160284.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With the increased complexity of blood component therapy, it is important to be able to modify physician behavior with reliable educational programs. A standardized educational program on the use of red blood cells and whole blood was tested in 22 hospitals in a regional blood program using medical audit and computer monitoring to evaluate effectiveness. Most hospitals were eager to take advantage of the education program but were unwilling to use the audit-education cycle. At the same time, computer monitoring of indivisual hospital ordering and transfusion practices demonstrated an increased utilization of red blood cells in 64 per cent of hospitals with an overall improvement of 8 per cent. The improved use of red blood cells was appreciated within the month of the program and then sustained for six to twelve months at the new level.
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Helbig S. [Skull contusion and concussion: problems of reporting (author's transl)]. Offentl Gesundheitswes 1977; 39:328-30. [PMID: 142224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Garcia D, Helbig S. The health care review coordinator: a new sphere of influence. Med Rec News 1977; 48:66, 68-70. [PMID: 10305623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Helbig S. [Biostatics and carrying capacity of spine]. Med Monatsschr 1974; 28:340-2. [PMID: 4437472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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