1
|
Mehlhorn I, Heichel J, Wohlgemuth W, Skalej M, Izaguirre V, Dießel L, Kisser U, Viestenz A, Wienrich R. [Interdisciplinary management of a combined vascular malformation of the orbit]. Ophthalmologie 2024; 121:68-71. [PMID: 37624390 DOI: 10.1007/s00347-023-01900-x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Ivana Mehlhorn
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.
| | - Jens Heichel
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Walter Wohlgemuth
- Klinik und Poliklinik für Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Martin Skalej
- Klinik und Poliklinik für Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Victor Izaguirre
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Linda Dießel
- Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Ulrich Kisser
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Arne Viestenz
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Ricarda Wienrich
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| |
Collapse
|
2
|
Dutzmann J, Knöpp K, Kefalianakis Z, Daniel JM, Gufler H, Wohlgemuth W, Kahles F, Sedding DG. Effect of intermittent fasting after ST-elevation myocardial infarction on left ventricular function: study protocol of a pilot randomised controlled trial (INTERFAST-MI). BMJ Open 2022; 12:e050067. [PMID: 35393305 PMCID: PMC8990699 DOI: 10.1136/bmjopen-2021-050067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Preclinical studies consistently show robust disease-modifying effects of intermittent fasting in animal models of cardiovascular disease. However, the impact of intermittent fasting on cardiovascular endpoints after myocardial infarction has not been investigated in a clinical trial so far. METHODS AND ANALYSIS The INTERmittent FASTing after Myocardial Infarction (INTERFAST-MI) trial is a monocentric prospective randomised controlled non-confirmatory pilot study including 48 patients with ST-segment elevation myocardial infarction. They will be randomised in a 1:1 ratio to either intermittent fasting (daily time-restricted eating; consuming food for not more than 8 hours/day, fasting for at least 16 hours/day) or to a control group without a particular diet. The follow-up time is 6 months. The prespecified primary outcome is change in left ventricular systolic function at 4 weeks from baseline to estimate effect size required to establishing sample size and power calculation for a future full-scale trial. Secondary outcomes include protocol adherence, recruitment, major adverse cardiac events, revascularisation, changes in left ventricular systolic function at 3 and 6 months, patient weight, blood pressure, and serum markers of inflammation and cardiovascular disease. Enrolment began on 1 November 2020 and is expected to conclude in December 2021. ETHICS AND DISSEMINATION The trial has received ethics approval from the Medical Ethics Committee of the Martin-Luther-University Halle-Wittenberg. Results of the study will be submitted for publication in a peer-reviewed journal and presented at scientific conferences. TRIAL REGISTRATION NUMBER DRKS00021784.
Collapse
Affiliation(s)
- Jochen Dutzmann
- Department of Internal Medicine III, University Hospital Halle, Halle, Germany
| | - Kai Knöpp
- Department of Internal Medicine III, University Hospital Halle, Halle, Germany
| | - Zoe Kefalianakis
- Department of Internal Medicine III, University Hospital Halle, Halle, Germany
| | - Jan-Marcus Daniel
- Department of Internal Medicine III, University Hospital Halle, Halle, Germany
| | - Hubert Gufler
- Department of Radiology, University Hospital Halle, Halle, Germany
| | | | - Florian Kahles
- Department of Internal Medicine I, University Hospital Aachen, Aachen, Germany
| | - Daniel G Sedding
- Department of Internal Medicine III, University Hospital Halle, Halle, Germany
| |
Collapse
|
3
|
Kaur S, Tarraf W, Wu B, Daviglus M, Shah N, Sotres-Alvarez D, Gallo L, Wohlgemuth W, Redline S, Gonzales H, Ramos A. 0423 Older Age Modifies the Association Between Combined Sleep Disordered Breathing and Sleep Duration with Neurocognitive Decline in Hispanic/Latino Adults. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We aimed to determine if age or sex modifies associations between sleep-disordered breathing (SDB), sleep duration and severe phenotypes of combined SDB/sleep duration with 7-year neurocognitive change (NC) in a diverse sample of U.S. Hispanic/Latinos.
Methods
We analyzed data of 5,235 adults 50-80 years of age from SOL-INCA, an ancillary to the Hispanic Community Health Study/Study of Latinos that determines the risk factors for NC. The main outcome was NC after a mean follow-up of 7-years on measures of memory (SEVLT sum and SEVLT recall), language (word fluency), processing speed (DSS) and a cognitive impairment screener. We evaluated the effect of baseline SDB (AHI ≥ 15), sleepiness (Epworth Sleepiness Scale, ESS ≥ 10), self-reported sleep duration (i.e. <6 hours, 6-9 hours, ≥ 9 hours), age and sex on NC. Survey linear regression models with interaction terms were used to examine the relationship between SDB, sleep duration, combinations of SDB and sleep duration phenotypes and NC. Depression, vascular risk, sleep medication, and study site were entered into all models as covariates.
Results
Overall, the mean age was 56.0 years, 54.8% females, 62.2% completed high school, 17.3% had SDB, 6.6% had short sleep,and 14.8% had long sleep. Sleep duration and SDB were not associated with NC. There was a significant interaction between agexSDB+sleep duration on delayed recall (F10,599= 2.40, p=0.01) and processing speed (F10,597= 2.55, p=0.01). Combined SDB + short sleep was associated with decline in processing speed (β=-0.6, 95% CI= [-1.2, -0.1], and combined SDB+long sleep was associated with decline in verbal memory (β=-0.9, 95% CI=[-1.7, -0.2] in adults aged ≥ 65 years. There was no association in participants aged <65 years and no sex differences.
Conclusion
Age, but not sex, modified the association between SDB and sleep duration with decline on processing speed and verbal memory. Sleep interventions tailored for older adults may be useful in slowing or preventing neurocognitive decline.
Support
This work is supported by National Institute on Aging (R01AG048642, RF1AG054548, R01AG061022, and R21AG056952).
Collapse
Affiliation(s)
- S Kaur
- University of Miami Miller School of Medicine, Miami, FL
| | - W Tarraf
- Wayne State University, Detroit, MI
| | - B Wu
- University of California San Diego, San Diego, CA
| | - M Daviglus
- University of Illinois Chicago, Chicago, IL
| | - N Shah
- Mount Sinai Icahn School of Medicine, New York, NY
| | | | - L Gallo
- San Diego State University, San Diego, CA
| | | | - S Redline
- Brigham & Women’s Hospital, Harvard Medical School, Boston, MA
| | - H Gonzales
- University of California San Diego, San Diego, CA
| | - A Ramos
- University of Miami Miller School of Medicine, Miami, FL
| |
Collapse
|
4
|
Wohlgemuth W, Fins A, Tutek J, Gonzalez A, Martinez-Garcia A, Satyanarayana S, Marchetti D, Wallace D. 0551 Longitudinal Measurement Invariance of the Insomnia Severity Index in Veterans with Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The Insomnia Severity Index is a commonly used instrument to assess the presence of insomnia symptoms as well as an outcome measure following an intervention. Longitudinal measurement invariance is a necessary property of an assessment instrument when it is repeated over time. The validity of conclusions regarding change in the construct ‘insomnia severity’ depend on scale equivalence at each measurement timepoint. Assessment of measurement invariance of the ISI in sleep apnea patients has never been performed.
Methods
Veterans with sleep apnea (n=654; AHI=36±28; 93% male; age=52±12; BMI=33±6) completed the ISI on the night of their overnight PSG and again when they picked up their PAP device. Invariance was determined by imposing a series of more restrictive equivalence constraints on a 2-factor model of the ISI. The series of constraints tested for configural, weak, strong and strict invariance. Invariance testing was modeled with exploratory structural equation modeling in Mplus (v. 7.0).
Results
The 2-factor model that emerged from the analysis showed items relating to nighttime symptoms loading on factor 1 and daytime symptoms loading on factor 2. The sleep ‘satisfaction’ item, however, had weak but similar loadings on both factors. The increasingly restrictive constraints imposed on the model revealed no decrement in model fit (RMSEA=.039 to.043; CFI=.987 to .980; TLI=.981-.977; SRMR=.027-.041).
Conclusion
The ISI met strict criteria for longitudinal measurement invariance demonstrating that it is a valid instrument to be used in repeated measures study designs of insomnia in sleep apnea patients. Change over time on the ISI is not due to the changing measurement characteristics of the ISI but to true changes in the ‘insomnia severity’ construct.
Support
None
Collapse
Affiliation(s)
| | - A Fins
- Nova Southeastern University, Ft. Lauderdale, FL
| | - J Tutek
- Miami VA Sleep Center, Miami, FL
| | - A Gonzalez
- Nova Southeastern University, Ft. Lauderdale, FL
| | | | | | | | | |
Collapse
|
5
|
Rigopoulos AG, Ali M, Abate E, Torky AR, Matiakis M, Mammadov M, Melnyk H, Vogt A, de Vecchis R, Bigalke B, Wohlgemuth W, Mavrogeni S, Noutsias M. Advances in the diagnosis and treatment of transthyretin amyloidosis with cardiac involvement. Heart Fail Rev 2020; 24:521-533. [PMID: 30790171 DOI: 10.1007/s10741-019-09776-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Amyloidosis is caused by extracellular deposition of insoluble abnormal fibrils constituted by misfolded proteins, which can modify tissue anatomy and hinder the function of multiple organs including the heart. Amyloidosis that can affect the heart includes mostly systemic amyloidosis (amyloid light chain, AL) and transthyretin amyloidosis (ATTR). The latter can be acquired in elderly patients (ATTRwt), or be inherited in younger individuals (ATTRm). The diagnosis is demanding given the high phenotypic heterogeneity of the disease. Therefore, "red flags," which are suggestive features giving support to diagnostic suspicion, are extremely valuable. However, the lack of broad awareness among clinicians represents a major obstacle for early diagnosis and treatment of ATTR. Furthermore, recent implementation of noninvasive diagnostic techniques has revisited the need for endomyocardial biopsy (EMB). In fact, unlike AL amyloidosis, which requires tissue confirmation and typing for diagnosis, ATTR can now be diagnosed noninvasively with the combination of bone scintigraphy and the absence of a monoclonal protein. Securing the correct diagnosis is pivotal for the newly available therapeutic options targeting both ATTRm and ATTRwt, and are directed to either stabilization of the abnormal protein or the reduction of the production of transthyretin. The purpose of this article is to review the contemporary aspects of diagnosis and management of transthyretin amyloidosis with cardiac involvement, summarizing also the recent therapeutic advances with tafamidis, patisiran, and inotersen.
Collapse
Affiliation(s)
- Angelos G Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Muhammad Ali
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Elena Abate
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Abdel-Rahman Torky
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Marios Matiakis
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Mammad Mammadov
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Hannes Melnyk
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Alexander Vogt
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Renato de Vecchis
- Preventive Cardiology and Rehabilitation Unit, DSB 29, S. Gennaro dei Poveri Hospital, 80136, Naples, Italy
| | - Boris Bigalke
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, D-12200, Berlin, Germany
| | - Walter Wohlgemuth
- Department of Radiology, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, Palaeo Faliro, Athens, Greece
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany.
| |
Collapse
|
6
|
Ramos A, Tarraf W, Wu B, Kaur S, Daviglus M, Shah N, Sostres-Alvarez D, Gallo L, Muñoz E, Wohlgemuth W, Redline S, Gonzalez H. Age and sex interactions between sleep disordered breathing and sleep duration with neurocognitive decline in Sol-Inca, an ancillary to the hispanic community health study/study of latinos. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.877] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
Ali M, Rigopoulos AG, Ali K, Ikonomidis I, Makavos G, Matiakis M, Melnyk H, Abate E, Mammadov M, Prüser JL, de Vecchis R, Wohlgemuth W, Manginas A, Bigalke B, Mavrogeni S, Sedding D, Noutsias M. Advancements in the diagnostic workup, prognostic evaluation, and treatment of takotsubo syndrome. Heart Fail Rev 2019; 25:757-771. [PMID: 31372789 DOI: 10.1007/s10741-019-09843-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Takotsubo syndrome (TTS) is an acute and mostly reversible cardiomyopathy that mimics an acute coronary syndrome with left ventricular (LV) systolic dysfunction without relevant obstructive coronary artery disease. Its prevalence is probably underestimated and reaches 1.2-2% in patients with acute coronary syndrome undergoing coronary catheterization. Although supraphysiological epinephrine levels have been associated with TTS, the detailed pathophysiology is incompletely understood. Chest pain is the most common clinical presentation; however, cardiac decompensation, cardiogenic shock, and sudden cardiac death due to ventricular fibrillation may also be the first clinical manifestations. Patients are mostly postmenopausal women, in whom the condition is commonly associated with emotional triggers; however, men have a higher prevalence of TTS being associated with physical triggers, which has a worse prognosis compared with TTS associated with emotional triggers. As a diagnosis of exclusion, TTS has no single definitive diagnostic test. According to the distribution of LV wall motion abnormalities, various morphological subtypes have been identified. The final diagnosis depends on cardiac imaging with left ventricular angiography during acute heart catheterization, as well as on echocardiography and cardiac magnetic resonance. Most patients recover completely, albeit several factors have been associated with worse prognosis. Management is based on observational data, while randomized multicenter studies are still lacking. This review provides a general overview of TTS and focuses on the hypothesized pathophysiology, and especially on current practices in diagnosis, prognosis, and treatment.
Collapse
Affiliation(s)
- Muhammad Ali
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Angelos G Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Khaldoun Ali
- Department of Thoracic and Cardiovascular Surgery, Klinikum Braunschweig, Brunswick, Germany
| | - Ignatios Ikonomidis
- 2nd Cardiology Department, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, Haidari, GR-12462, Athens, Greece
| | - George Makavos
- 2nd Cardiology Department, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, Haidari, GR-12462, Athens, Greece
| | - Marios Matiakis
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Hannes Melnyk
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Elena Abate
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Mammad Mammadov
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Jan Lukas Prüser
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Renato de Vecchis
- Preventive Cardiology and Rehabilitation Unit, DSB 29 "S. Gennaro dei Poveri Hospital", I-80136, Naples, Italy
| | - Walter Wohlgemuth
- Department of Radiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Athanassios Manginas
- Interventional Cardiology and Cardiology Department, Mediterraneo Hospital, Ilias Street 8-12, Glyfada, GR-16675, Athens, Greece
| | - Boris Bigalke
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, 50 Esperou Street, Palaeo Faliro, GR-17561, Athens, Greece
| | - Daniel Sedding
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany.
| |
Collapse
|
8
|
Abstract
Hereditary hemorrhagic telangiectasia (HHT) describes the presenting manifestations of a disorder that is characterized by pathologic blood vessels. HHT is inherited as an autosomal dominant trait with variable penetrance. The abnormal vascular structures (dysplasias) can affect all the organs in the human body. The link between a physical stimulus and new lesion development has been established for mucosal trauma owing to nasal airflow turbulence, for ultraviolet exposure to the fingers, and for mechanical trauma to the dominant hand. The pressing question then is whether HHT treatment constitutes a stimulus that is sufficient to trigger new lesion development.
Collapse
Affiliation(s)
- Thomas Kühnel
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany.
| | - Kornelia Wirsching
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Walter Wohlgemuth
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Ajay Chavan
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Katja Evert
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | - Veronika Vielsmeier
- University of Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| |
Collapse
|
9
|
Köhler M, Schardey H, Bettels R, Berger H, Wohlgemuth W, Heindel W, Wildgruber M. Median arcuate ligament syndrome – imaging presentation and interdisciplinary management. ROFO-FORTSCHR RONTG 2018; 190:907-914. [DOI: 10.1055/a-0591-5008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Michael Köhler
- Institute for Clinical Radiology, University Hospital Münster, Germany
| | - Hans Schardey
- Department of Surgery, Krankenhaus Agatharied GmbH, Hausham, Germany
| | - Ruth Bettels
- Department for Pediatrics, Westfälische Wilhelms Universität Münster Medizinische Fakultät, Münster, Germany
| | | | - Walter Wohlgemuth
- Department for Radiology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Walter Heindel
- Institute for Clinical Radiology, University Hospital Münster, Germany
| | - Moritz Wildgruber
- Institute for Clinical Radiology, University Hospital Münster, Germany
| |
Collapse
|
10
|
Ranieri M, Wohlgemuth W, Müller-Wille R, Prantl L, Kehrer A, Geis S, Klein S, Lamby P, Schiltz D, Uller W, Aung T, Dolderer JH. Vascular malformations of upper and lower extremity - from radiological interventional therapy to surgical soft tissue reconstruction - an interdisciplinary treatment. Clin Hemorheol Microcirc 2018; 67:355-372. [PMID: 28885203 DOI: 10.3233/ch-179216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This article presents our experience in managing peripheral vascular malformations of upper and lower extremities over a 4-year period in a series of 46 patients of the Department of Plastic Surgery treated in the Interdisciplinary Center of Vascular Anomalies (ICVA) at the University of Regensburg. The patients presented vascular malformations of upper and lower extremity and were selected from our prospective vascular anomalies file archive from 2012 to 2016. During this period in the ICVA at University of Regensburg were performed more than 1400 radiological interventional treatments in patients with vascular malformations.The purpose of this retrospective study was to review combined embolotherapy, sclerotherapy (embolo/sclerotherapy), and surgical procedures (surgical excision and soft tissue reconstruction) to manage vascular malformations. Treatments were principally induced to reduce pain, daily physical limitations, social discomfort and recover tegument continuity after ulceration.The 46 patients were first examined with noninvasive radiological procedures. After diagnosis was posed, embolo/sclerotherapy, surgical procedures and clinically as well as radiological follow-ups were coordinated and established by the multidisciplinary team. All vascular malformations were categorized according to the classification approved at the April 2014 General Assembly of International Society for the Study of Vascular Anomalies (ISSVA) in Melbourne, Australia. Arteriovenous malformations (AVMs) were further classified following the Cho-Do and Schobinger classification.Embolo/sclerotherapy shows to be the most appropriate procedure in vascular malformations treatment. Nevertheless was found that in case of complications or lack of improvement as well as to improve functional or aesthetical results, a following partial or complete surgical excision and immediate soft tissue reconstruction seems to be the gold-standard treatment. In addition, the precise clinical and radiological diagnosis as well as an intensive postoperative patient care have a significant positive influence on the clinical outcome and patient satisfaction while decreasing morbidity and recurrence during early and late follow-up.Vascular malformations require a multidisciplinary approach and individual treatment after complex excision and indispensable reconstruction.
Collapse
Affiliation(s)
- M Ranieri
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - W Wohlgemuth
- Department of Radiology, University Hospital Regensburg, Germany.,Institute of Radiology, University Hospital Halle, Germany
| | - R Müller-Wille
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - L Prantl
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - A Kehrer
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - S Geis
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - S Klein
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - P Lamby
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - D Schiltz
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - W Uller
- Department of Radiology, University Hospital Regensburg, Germany
| | - T Aung
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| | - J H Dolderer
- Center of Plastic, Hand and reconstructive Surgery, University Hospital Regensburg, Germany
| |
Collapse
|
11
|
Ramos A, Weng J, Wallace D, Petrov M, Wohlgemuth W, Sotres-Alvarez D, Loredo J, Reid K, Zee P, Mossavar-Rahmani Y, Patel S. Actigraphic sleep patterns and hypertension in the Hispanic community health study/study of Latinos. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.806] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
12
|
Reina S, Amiel C, Martinez J, Wallace D, Wohlgemuth W. 0529 ADHERENCE TRAJECTORIES DURING THE FIRST SIX WEEKS OF PAP THERAPY DURING THE FIRST 6 WEEKS OF PAP USE DURING THE FIRST 6 WEEKS OF PAP USE. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.528] [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: 11/14/2022] Open
|
13
|
Abbott S, Weng J, Reid K, Daviglus M, Gallo L, Loredo J, Nyenhuis S, Penedo F, Ramos A, Shah N, Sotres-Alvarez D, Wohlgemuth W, Patel S, Zee P. 1016 SLEEP-WAKE TIMING AND STABILITY ARE ASSOCIATED WITH INCREASED BLOOD PRESSURE IN THE SUEÑO ANCILLARY STUDY OF THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS (HCHS/SOL). Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
14
|
Schicho A, Hellerbrand C, Wohlgemuth W, Stroszczynski C, Wiggermann P, Pereira P. Einfluss der Embolisate auf den Anstieg der proangiogenen VEGF-Level im Serum nach TACE. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schicho
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | - C Hellerbrand
- Friedrich-Alexander-Universität Erlangen, Biochemie (Emil-Fischer-Zentrum)
| | - W Wohlgemuth
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | | | - P Wiggermann
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | | |
Collapse
|
15
|
Wildgruber M, Müller-Wille R, Goessmann H, Uller W, Wohlgemuth W. Bestimmung von effektiver Dosis in Fluoroskopie-gesteuerten pädiatrischen abdominalen Interventionen mittels Rando-Alderson Phantomen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Wildgruber
- Universitätsklinikum Münster, Institut für Klinische Radiologie, Münster
| | - R Müller-Wille
- Institut für Rötngendiagnostik, Universitäsklinikum Regensburg, Regensburg
| | - H Goessmann
- Institut für Rötngendiagnostik, Universitätsklinikum Regensburg, Regensburg
| | - W Uller
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg
| | - W Wohlgemuth
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg
| |
Collapse
|
16
|
Maurer K, Lürken L, Verloh N, Stroszczynski C, Pfister K, Wohlgemuth W, Müller-Wille R. Beeinflussung der Nierenfunktion durch das Überstenten von akzessorischen Nierenarterien im Rahmen der endovaskulären Versorgung von Bauchaortenaneurysmen (EVAR). ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K Maurer
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | - L Lürken
- Uniklinikum Regensburg, Radiologie, Regensburg
| | - N Verloh
- Uniklinikum Regensburg, Radiologie, Regensburg
| | | | - K Pfister
- Uniklinikum Regensburg, Gefäßchirurgie, Regensburg
| | | | | |
Collapse
|
17
|
Pfister K, Kasprzak PM, Jung EM, Müller-Wille R, Wohlgemuth W, Kopp R, Schierling W. Contrast-enhanced ultrasound to evaluate organ microvascularization after operative versus endovascular treatment of visceral artery aneurysms. Clin Hemorheol Microcirc 2017; 64:689-698. [PMID: 27802212 DOI: 10.3233/ch-168003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the organ microvascularization after operative versus endovascular treatment of visceral artery aneurysms (VAAs) by contrast-enhanced ultrasound (CEUS) and colour-coded duplex sonography (CCDS). METHOD AND MATERIALS Between April 1995 to January 2016, 168 patients (78 males, 90 females; median age: 62 years) were diagnosed with VAAs at our hospital site. 60/168 patients (36%) fulfilled treatment criteria and had either open (29/60, 48%) or endovascular (31/60, 52%) aneurysm repair. Patients' characteristics and presentations were consecutively reviewed. Technical success and organ microvascularization were determined by CCDS/CEUS and correlated to computed tomography angiography (CTA) or magnetic resonance imaging (MRI). RESULTS 18/60 patients (30%) presented with acute bleeding. 16/18 emergency patients (89%) were treated by endovascular means. After emergency treatment, two patients showed segmental liver malperfusion by CEUS and CTA. One small bowel resection had to be performed.42/60 patients (70%) were electively treated. 27/42 patients (64%) had open and 15/42 (36%) endovascular aneurysm repair. There were no liver or bowel infarctions after elective treatment of hepatic or mesenteric artery aneurysms (n = 13) in CCDS/CEUS and in CTA. Treatment of patients with splenic or renal artery aneurysms led to partial or complete organ loss in 42% (8/19) after operative and in 50% (5/10) after endovascular treatment (p < 0.05). CONCLUSION The endovascular approach is the preferred therapeutic option in emergency to control bleeding. In contrast to hepatic or mesenteric procedures, patients for elective splenic or renal artery aneurysm repair have to be evaluated very carefully because of a high rate of partial or complete organ loss demonstrated by CEUS - either after open or endovascular aneurysm repair.
Collapse
Affiliation(s)
- Karin Pfister
- Division of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Piotr M Kasprzak
- Division of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Ernst M Jung
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - René Müller-Wille
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Walter Wohlgemuth
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - Reinhard Kopp
- Division of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Wilma Schierling
- Division of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| |
Collapse
|
18
|
Wildgruber M, Wohlgemuth W, Köhler M. Letter to the Editor/Leserbrief zu dem Beitrag von C. D. Reimers, M. Wolf, T. Kretschmer und J. Röther „Schwieriger magnetresonanztomografischer Nachweis eines Hämangioms des N. facialis – ein Fallbericht“. ROFO-FORTSCHR RONTG 2017; 189:257-258. [DOI: 10.1055/s-0043-100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Walter Wohlgemuth
- Interdiszplinäres Zentrum für Gefäßanomalien, Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | - Michael Köhler
- Institut für Klinische Radiologie, Universitätsklinikum Münster
| |
Collapse
|
19
|
Wohlgemuth W, Mueller-Wille R, Wildgruber M. Brief an den Herausgeber bezüglich „Mediale Schenkelhalsfraktur bei Klippel-Trenaunay-Syndrom: CT-Angiografie entscheidend für Therapie“ von C. Spink et al. ROFO-FORTSCHR RONTG 2017; 189:259. [DOI: 10.1055/s-0043-101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Walter Wohlgemuth
- Interdiszplinäres Zentrum für Gefäßanomalien, Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | - René Mueller-Wille
- Interdiszplinäres Zentrum für Gefäßanomalien, Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | | |
Collapse
|
20
|
Schicho A, Hellerbrand C, Krüger K, Beyer LP, Wohlgemuth W, Niessen C, Hohenstein E, Stroszczynski C, Pereira PL, Wiggermann P. Impact of Different Embolic Agents for Transarterial Chemoembolization (TACE) Procedures on Systemic Vascular Endothelial Growth Factor (VEGF) Levels. J Clin Transl Hepatol 2016; 4:288-292. [PMID: 28097096 PMCID: PMC5225147 DOI: 10.14218/jcth.2016.00058] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/05/2016] [Accepted: 12/22/2016] [Indexed: 02/07/2023] Open
Abstract
Background and Aims: Intermediate stage hepatocellular carcinoma (HCC) can be treated by transarterial chemoembolization (TACE). However, there appear to be side effects, such as induction of proangiogenic factors, e.g. vascular endothelial growth factor (VEGF), which have been shown to be associated with a poor prognosis. This prospective study was designed to compare serum VEGF level response after TACE with different embolic agents in patients with HCC. Methods: Patients were assigned to one of three different TACE regimens: degradable starch microspheres (DSM) TACE, drug-eluting bead (DEBDOX) TACE or Lipiodol TACE (cTACE). All patients received 50 mg doxorubicin/m2 body surface area (BSA) during TACE. Serum VEGF levels were assessed before TACE treatment, 24 h post-treatment and 4 weeks later. Results: Twenty-two patients with 30 TACE treatments were enrolled. Compared to baseline VEGF levels, a marked increase was observed for 24 h post-TACE (164% of baseline level) and during the 4-week follow-up (170% of baseline level) only for the cTACE arm (p < 0.05). In contrast, the increase of serum VEGF levels were only 114% and 123% for DEBDOX and 121% and 124% for DSM, respectively. Conclusions: Conventional TACE using Lipiodol shows marked increase in blood levels of the proangiogenic factor VEGF, while DEBDOX and DSM TACE induce only a moderate VEGF response.
Collapse
Affiliation(s)
- Andreas Schicho
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
- *Correspondence to: Andreas Schicho, Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg D-93053, Germany. Tel: +49-941-944-7412, Fax: +49-941-944-7469, E-mail:
| | - Claus Hellerbrand
- Friedrich-Alexander University Erlangen-Nürnberg, Institute of Biochemistry (Emil-Fischer Zentrum), Erlangen, Germany
| | - Kristina Krüger
- Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany
| | - Lukas P. Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Walter Wohlgemuth
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Christoph Niessen
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Ernst Hohenstein
- Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany
| | | | - Philippe L. Pereira
- Clinic for Radiology, Minimally-invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn, Germany
| | - Philipp Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
21
|
Wohlgemuth W. Wann interventionelle Therapie, wann besser konservativ? ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581422] [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: 10/22/2022]
|
22
|
Turowski L, Dollinger M, Stroszczynski C, Wohlgemuth W, Müller-Wille R. CT-Angiografie vor EVAR der thorakalen und abdominalen Aorta. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581402] [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: 10/22/2022]
|
23
|
Wildgruber M, Wendorff H, Czubba M, Zimmermann A, Wohlgemuth W, Meier R, Zernecke A. Die Rolle spezifischer Monozytensubpopulationen in der Restenoseentwicklung nach Perkutaner Transluminaler Angioplastie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581489] [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: 10/22/2022]
|
24
|
Wohlgemuth W. Entstehung und die Notwendigkeit der Behandlung von Gefäßmalformationen. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581955] [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: 10/22/2022]
|
25
|
Wohlgemuth W. Materialkunde – Katheter, Mikrokatheter und Embolisate. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581451] [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: 10/22/2022]
|
26
|
Ayx I, Müller-Wille R, Wohlgemuth W, Stroszczynski C, Zorger N. Bronchialarterienembolisation mit Ethylen-Vinylalkohol-Copolymer zur Behandlung akuter Hämoptysen. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581816] [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: 10/22/2022]
|
27
|
|
28
|
Hofmann R, Völler H, Nagels K, Bindl D, Vettorazzi E, Dittmar R, Wohlgemuth W, Neumann T, Störk S, Bruder O, Wegscheider K, Nagel E, Fleck E. First outline and baseline data of a randomized, controlled multicenter trial to evaluate the health economic impact of home telemonitoring in chronic heart failure - CardioBBEAT. Trials 2015; 16:343. [PMID: 26259568 PMCID: PMC4531517 DOI: 10.1186/s13063-015-0886-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 07/24/2015] [Indexed: 12/05/2022] Open
Abstract
Background Evidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Methods Between January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva®). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups’ difference in total cost and in the combined clinical endpoint “days alive and not in hospital nor inpatient care per potential days in study” within the follow-up of 12 months. Results A total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III–IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances. Conclusions CardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic decision-making with regard to home telemonitoring solutions as an option for health care. Overall, it contributes to developing advanced health economic evaluation instruments to be deployed within the specific context of the German Health Care System. Trial registration ClinicalTrials.gov NCT02293252; date of registration: 10 November 2014
Collapse
Affiliation(s)
- Reiner Hofmann
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany.
| | - Heinz Völler
- Rehabilitation Center for Internal Medicine, Klinik am See, Seebad 84, 15562, Rüdersdorf, Germany. .,Center of Rehabilitation Research, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany.
| | - Klaus Nagels
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany.
| | - Dominik Bindl
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany.
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Ronny Dittmar
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany. .,Professional Board of German Surgeons, Luisenstraße 58/59, 10117, Berlin, Germany.
| | - Walter Wohlgemuth
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany. .,Radiology, University Medical Center of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Till Neumann
- Clinic for Cardiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
| | - Stefan Störk
- Comprehensive Heart Failure Center Würzburg and Department of Internal Medicine I, University of Würzburg, Straubmühlweg 2a, 97078, Würzburg, Germany.
| | - Oliver Bruder
- Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth Hospital Essen, Klara-Kopp-Weg 1, 45138, Essen, Germany.
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Eckhard Nagel
- Institute for Healthcare Management and Health Sciences, University of Bayreuth, Prieserstraße 2, 95444, Bayreuth, Germany.
| | - Eckart Fleck
- Department of Medicine/Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | | |
Collapse
|
29
|
Teusch V, Wohlgemuth W, Jung E. CEUS und farbkodierte Perfusionsanalyse für die präinterventionelle Beurteilung von peripheren High-flow- und Slow-flow-Gefäßmalformationen. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551010] [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: 10/23/2022]
|
30
|
Wohlgemuth W. Einseitig oder beidseitig? Wann Stent? Nachsorge. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551056] [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: 10/23/2022]
|
31
|
Wohlgemuth W. Schaumschläger in der Angiografie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551482] [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: 10/23/2022]
|
32
|
Uller W, Wohlgemuth W, Hammer S, Knoppke B, Goessmann H, Loss M, Schlitt H, Stroszczynski C, Zorger N, Heiss P. Percutaneous Treatment of Biliary Complications in Pediatric Patients After Liver Transplantation. ROFO-FORTSCHR RONTG 2014; 186:1127-33. [DOI: 10.1055/s-0034-1366656] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - W. Wohlgemuth
- Department of Radiology, University Medical Center Regensburg
| | - S. Hammer
- Department of Radiology, University Medical Center Regensburg
| | - B. Knoppke
- KUNO University Children’s Hospital Regensburg, University Medical Center Regensburg
| | - H. Goessmann
- Department of Radiology, University Medical Center Regensburg
| | - M. Loss
- Department of Surgery, University Medical Center Regensburg
| | - H. Schlitt
- Department of Surgery, University Medical Center Regensburg
| | | | - N. Zorger
- Department of Radiology, University Medical Center Regensburg
| | - P. Heiss
- Department of Radiology, University Medical Center Regensburg
| |
Collapse
|
33
|
Dornia C, Borgmann T, Heiß P, Wohlgemuth W, Stroszczynski C, Müller-Wille R. Dual-Energy Computertomografie mit Hard-Plaque Imaging zur Detektion von Endoleaks nach endovaskulärer Therapie von Aortenaneurysmen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
34
|
Wohlgemuth W. Therapie der arteriovenösen Malformation (Zertifizierung: Modul B Spezialkurs). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
35
|
Heiß P, Forbrig R, Schnitzbauer M, Müller-Wille R, Gößmann H, Brodoefel H, Wohlgemuth W, Stroszczynski C, Heiß P. Minimal-invasive perkutane Stentrevaskularisierung bei akuter mesenterialer Ischämie: Prädiktoren für Darmnekrose und Tod. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
36
|
|
37
|
Uller W, Müller-Wille R, Loss M, Hammer S, Schleder S, Goessmann H, Wiggermann P, Stroszczynski C, Wohlgemuth W. Percutaneous Management of Postoperative Bile Leaks with an Ethylene Vinyl Alcohol Copolymer (Onyx). ROFO-FORTSCHR RONTG 2013; 185:1182-7. [DOI: 10.1055/s-0033-1350153] [Citation(s) in RCA: 11] [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] [Indexed: 10/26/2022]
Affiliation(s)
- W. Uller
- Department of Radiology, University Medical Center Regensburg
| | - R. Müller-Wille
- Department of Radiology, University Medical Center Regensburg
| | - M. Loss
- Department of Surgery, University Medical Center Regensburg
| | - S. Hammer
- Department of Radiology, University Medical Center Regensburg
| | - S. Schleder
- Department of Radiology, University Medical Center Regensburg
| | - H. Goessmann
- Department of Radiology, University Medical Center Regensburg
| | - P. Wiggermann
- Department of Radiology, University Medical Center Regensburg
| | | | - W. Wohlgemuth
- Department of Radiology, University Medical Center Regensburg
| |
Collapse
|
38
|
Wiggermann P, Brünn K, Müller-Wille R, Uller W, Schreyer AG, Wohlgemuth W, Stroszczynski C, Jung EM. Echtzeit-Visualisierung des Ablationsdefektes während der Radiofrequenzablation von malignen Lebertumoren mithilfe der Ultraschall-gestützten Elastographie: Erste Ergebnisse. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311342] [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: 10/28/2022]
|
39
|
Wohlgemuth W, Uller W, Müller-Wille R, Gößmann H, Wiggermann P, Stroszczynski C. Onyx-Embolisation peripherer high-flow arteriovenöser Malformationen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311185] [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: 10/28/2022]
|
40
|
Gößmann H, Wiggermann P, Meuer F, Uller W, Müller-Wille R, Stroszczynski C, Wohlgemuth W, Schreyer AG. Single Center Studie zum klinischen Verlauf von getunnelten Dialysekathetern (Demers-Katheter). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311264] [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: 10/28/2022]
|
41
|
Uller W, Huber T, Hammer S, Wohlgemuth W, Stroszczynski C, Schreyer AG. Stent-PTA der Vena Cava Inferior nach Lebertransplantation und -resektion. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311145] [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: 10/28/2022]
|
42
|
Engelhardt M, Boos J, Bruijnen H, Wohlgemuth W, Willy C, Tannheimer M, Wölfle K. Critical Limb Ischaemia: Initial Treatment and Predictors of Amputation-free Survival. Eur J Vasc Endovasc Surg 2012; 43:55-61. [DOI: 10.1016/j.ejvs.2011.09.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 09/09/2011] [Indexed: 10/16/2022]
|
43
|
Kirchhof K, Wohlgemuth W, Berlis A. Estimation of the Minimum Dose Required to Measure Ventricular Width in Follow-Up Cranial Computed Tomography (CCT) in Children with Hydrocephalus. ROFO-FORTSCHR RONTG 2010; 182:1118-24. [DOI: 10.1055/s-0029-1245789] [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]
|
44
|
Rottach K, Wohlgemuth W, Sträube A, Leigh R. Der Einfluß von Lidschlägen auf die Genauigkeit und Geschwindigkeit von Sakkaden - Eine Untersuchung mit der magnetischen Search-Coil-Technik. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060123] [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]
|
45
|
Wohlgemuth W, Olbricht W, Klarmann S, Engelhardt M, Freitag M, Wölfle K, Bohndorf K, Kirchhof K. Fragebogen zur gesundheitsbezogenen Lebensqualität von Patienten mit peripherer arterieller Verschlusskrankheit (pAVK) im Stadium kritischer Ischämie (FLeQKI): Psychometrische Bestimmung von Veränderungssensitivität und Praktikabilität (Teil 2). ROFO-FORTSCHR RONTG 2007; 179:1258-63. [DOI: 10.1055/s-2007-963516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
46
|
Wohlgemuth W, Olbricht W, Klarmann S, Engelhardt M, Freitag M, Wölfle K, Bohndorf K, Kirchhoff K. Krankheitsspezifisches Messinstrument zur gesundheitsbezogenen Lebensqualität bei Patienten mit kritischer Ischämie: Bestimmung der Responsiveness und der Praktikabilität. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977186] [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]
|
47
|
Kleffel T, Demharter J, Wohlgemuth W, Schalm J, Bohndorf K, Kirchhof K. [Comparison of contrast-enhanced low mechanical index (Low MI) sonography and unenhanced B-mode sonography for the differentiation between synovitis and joint effusion in patients with rheumatoid arthritis]. ROFO-FORTSCHR RONTG 2005; 177:835-41. [PMID: 15902633 DOI: 10.1055/s-2005-858194] [Citation(s) in RCA: 7] [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: 10/25/2022]
Abstract
PURPOSE To test whether contrast-enhanced low mechanical index (low MI) sonography is superior to non enhanced B-Mode sonography in differentiating synovitis and joint effusion. MATERIAL AND METHODS In a retrospective study, 22 patients with proven rheumatoid arthritis underwent B-Mode sonography and low-MI sonography of 25 symptomatic joints of the upper and lower limbs. For low-MI sonography, 5 ml Sonovue (Bracco Altana Pharma GmbH, Konstanz) were injected as an intravenous bolus followed by 10 ml of 0.9 % saline solution. Magnetic resonance imaging (MRI) was obtained additionally in 3 joints. With non-enhanced sonography, we diagnosed a synovitis in case of an echogenic and a joint effusion in case of an anechoic mass. With contrast-enhanced sonography, we diagnosed a synovitis in case of enhancement and a joint effusion in the absence of enhancement of the intraarticular mass. RESULTS In 13 joints, synovitis and joint effusion were differentiated by both non-enhanced and enhanced sonography. In 12 joints, this differentiation was only possible with contrast-enhanced sonography. In 3 patients diagnosed by sonography as having a synovitis, this diagnosis was proven by MRI. CONCLUSION Contrast-enhanced low-MI sonography is superior to non-enhanced B-Mode sonography in differentiating synovitis and joint effusion.
Collapse
Affiliation(s)
- T Kleffel
- Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
Despite the fact that a large number of women report sleep disturbances associated with peri-menopausal and post-menopausal periods, there is a surprising lack of literature related to this issue. In fact, there has not been enough work in this area to even definitively establish whether there is a sleep disorder that is specifically related to these life-stage changes. Herein we review the available literature which suggests that insomnia may be directly linked to the changes that occur during the peri/post-menopausal periods. This insomnia appears to be due to night sweats caused by the hormonal changes which occur and which lead to an increase in arousals. Persistence of insomnia symptoms after adequate hormone replacement therapy may indicate that behavioral conditioning of the insomnia initially triggered by the night sweats may have occurred. Alternatively, such an insomnia in a peri/post-menopausal woman could be due to unresolved grief related to going through menopause or could reflect an independent sleep disorder, such as periodic movements of sleep, sleep apnea, depression, anxiety, etc. Whereas menopausal changes do not directly lead to an increase in sleep apnea they seemingly contribute to an increased risk for this disorder. In view of these considerations, we provide guidelines for the proper diagnosis and treatment of peri/post-menopausal women with sleep complaints.
Collapse
Affiliation(s)
- A D Krystal
- The Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
| | | | | | | |
Collapse
|
49
|
Abstract
Using the magnetic search coil technique to record eye and lid movements, we investigated the effect of voluntary blinks on horizontal saccades in five normal human subjects. The main goal of the study was to determine whether changes in the dynamics of saccades with blinks could be accounted for by a superposition of the eye movements induced by blinks as subjects fixated a stationary target and saccadic movements made without a blink. First, subjects made voluntary blinks as they fixed on stationary targets located straight ahead or 20 degrees to the right or left. They then made saccades between two continuously visible targets 20 or 40 degrees apart, while either attempting not to blink, or voluntarily blinking, with each saccade. During fixation of a target located straight ahead, blinks induced brief downward and nasalward deflections of eye position. When subjects looked at targets located at right or left 20 degrees, similar initial movements were made by four of the subjects, but the amplitude of the adducted eye was reduced by 65% and was followed by a larger temporalward movement. Blinks caused substantial changes in the dynamic properties of saccades. For 20 degrees saccades made with blinks, peak velocity and peak acceleration were decreased by approximately 20% in all subjects compared with saccades made without blinks. Blinks caused the duration of 20 degrees saccades to increase, on average, by 36%. On the other hand, blinks had only small effects on the gain of saccades. Blinks had little influence on the relative velocities of centrifugal versus centripetal saccades, and abducting versus adducting saccades. Three of five subjects showed a significantly increased incidence of dynamic overshoot in saccades accompanied by blinks, especially for 20 degrees movements. Taken with other evidence, this finding suggests that saccadic omnipause neurons are inhibited by blinks, which have longer duration than the saccades that company them. In conclusion, the changes in dynamic properties of saccades brought about by blinks cannot be accounted for simply by a summation of gaze perturbations produced by blinks during fixation and saccadic eye movements made without blinks. Our findings, especially the appearance of dynamic overshoots, suggest that blinks affect the central programming of saccades. These effects of blinks need to be taken into account during studies of the dynamic properties of saccades.
Collapse
Affiliation(s)
- K G Rottach
- Department of Neurology, Zentralklinikum Augsburg, 86009 Augsburg, Germany
| | | | | | | | | |
Collapse
|
50
|
Geissler B, Fleischmann R, Wagner T, Wohlgemuth W, Lindemann F. [Angiosarcoma of the spleen. Case report and review of the literature]. Langenbecks Arch Chir 1998; 382:226-30. [PMID: 9445970] [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: 02/05/2023]
Abstract
Angiosarcoma of the spleen is a very rare but highly malignant vascular neoplasm. So far only 140 cases have been reported. A 42-year-old patient is presented in which the radiologic imaging misled to the diagnosis of infiltrating echinococcosis. After splenectomy histological and immunohistochemical staining gave proof of metastatic angiosarcoma. The patient died three months later as a consequence of multiple organ dysfunction syndrome. The literature is reviewed in regard to clinical features, diagnosis and therapy.
Collapse
Affiliation(s)
- B Geissler
- Klinik für Allgemein- und Viszeralchirurgie, Zentralklinikum Augsburg
| | | | | | | | | |
Collapse
|