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Schumacher S, Mitzlaff B, Mohrmann C, Fiedler KM, Heep A, Beske F, Hoffmann F, Lange M. Characteristics and special challenges of neonatal emergency transports. Early Hum Dev 2024; 192:106012. [PMID: 38648678 DOI: 10.1016/j.earlhumdev.2024.106012] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND As a rule, newborns do not require special medical care. If unexpected complications occur peripartum or postpartum, support from and transport to specialised neonatal hospitals might be needed. METHODS In a retrospective study, all transport protocols of a supraregional paediatric‑neonatological maximum care hospital in northwestern Germany from 01.10.2018 through 30.09.2021 were analysed. The particular focus was on transports of newborns (<7 days) and the leading symptoms that led to contact. RESULTS A total of 299 patients were included (average age of 15.4 h, 61.6 % males). The average complete transport time was approximately 2 h. Five leading neonatal diseases (respiratory, infectious, asphyxia, cardiac, haematological) were found to represent the causes of >80 % of transfers. Respiratory adaptation disorders are the main reason for transferring a newborn to a centre, whereas asphyxia is the most severe condition. The various symptoms differ in their time of onset, a factor which must be taken into account in practice. Differences were also found between different types of hospitals: while a large proportion of transports were carried out from maternity hospitals (80.6 %), children transported from children's hospitals were generally more severely ill. DISCUSSION Transfers of neonates, especially from maternity hospitals to neonatal intensive care units due to special neonatal diseases, are not rare. In times of increasingly scarce resources, the effective care of sick or at-risk neonates is essential. For low-population regions, this means professional cooperation between maximum care providers and smaller children's hospitals and maternity-only hospitals.
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Affiliation(s)
- S Schumacher
- Department of Pediatrics, Klinikum Leer, Leer, Germany
| | - B Mitzlaff
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Kiel, Germany
| | - C Mohrmann
- Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany
| | - K M Fiedler
- Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany
| | - A Heep
- Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany
| | - F Beske
- Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany
| | - F Hoffmann
- Department of Healthcare Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - M Lange
- Department of Pediatrics, Elisabeth Children's Hospital, University of Oldenburg, Oldenburg, Germany.
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2
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Ren H, Sun Y, Hoffmann F, Vandichel M, Adegoke TE, Liu N, McCarthy C, Gao P, Ryan KM. Resolving Multielement Semiconductor Nanocrystals at the Atomic Level: Complete Deciphering of Domains and Order in Complex Cu αZn βSn γSe δ (CZTSe) Tetrapods. Nano Lett 2024; 24:2125-2130. [PMID: 38341872 DOI: 10.1021/acs.nanolett.3c02810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
Semiconductor nanocrystals (NCs) with high elemental and structural complexity can be engineered to tailor for electronic, photovoltaic, thermoelectric, and battery applications etc. However, this greater complexity causes ambiguity in the atomic structure understanding. This in turn hinders the mechanistic studies of nucleation and growth, the theoretical calculations of functional properties, and the capability to extend functional design across complementary semiconductor nanocrystals. Herein, we successfully deciphered the atomic arrangements of 4 different nanocrystal domains in CuαZnβSnγSeδ (CZTSe) nanocrystals using crucial zone axis analysis on multiple crystals in different orientations. The results show that the essence of crystallographic progression from binary to multielemental semiconductors is actually the change of theoretical periodicity. This transition is caused by decreased symmetry in the crystal instead of previously assumed crystal deformation. We further reveal that these highly complex crystalline entities have highly ordered element arrangements as opposed to the previous understanding that their elemental orderings are random.
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Affiliation(s)
- Huan Ren
- Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland
- Material Science and Engineering, National University of Singapore, 117557, Singapore
| | - Yuanwei Sun
- International Center for Quantum Materials and Electron Microscopy Laboratory, School of Physics, Peking University, Beijing 100871, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Frank Hoffmann
- Department of Chemistry, Institute of Inorganic and Applied Chemistry, University of Hamburg, Hamburg 20148, Germany
| | - Matthias Vandichel
- Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Temilade E Adegoke
- Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Ning Liu
- Department of Physics and Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Conor McCarthy
- Confirm Centre & Bernal Institute, School of Engineering, University of Limerick, Limerick V94 T9PX, Ireland
| | - Peng Gao
- International Center for Quantum Materials and Electron Microscopy Laboratory, School of Physics, Peking University, Beijing 100871, P.R. China
| | - Kevin M Ryan
- Department of Chemical Sciences and Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland
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Geisler T, Keller T, Martus P, Poli K, Serna-Higuita LM, Schreieck J, Gawaz M, Tünnerhoff J, Bombach P, Nägele T, Klose U, Aidery P, Groga-Bada P, Kraft A, Hoffmann F, Hobohm C, Naupold K, Niehaus L, Wolf M, Bäzner H, Liman J, Wachter R, Kimmig H, Jung W, Huber R, Feurer R, Lindner A, Althaus K, Bode FJ, Petzold GC, Nguyen TN, Mac Grory B, Schrag M, Purrucker JC, Zuern CS, Ziemann U, Poli S. Apixaban versus Aspirin for Embolic Stroke of Undetermined Source. NEJM Evid 2024; 3:EVIDoa2300235. [PMID: 38320511 DOI: 10.1056/evidoa2300235] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Apixaban versus Aspirin for Embolic StrokeIn a trial of 352 patients with embolic stroke of undetermined source, 5 mg of apixaban administered twice daily was compared with 100 mg of aspirin administered once daily for the prevention of recurrent ischemic strokes. At 12 months, 13.6% of patients given apixaban had new ischemic lesions on magnetic resonance imaging compared with 16.0% of patients given aspirin, and the rates of clinically relevant bleeding were also comparable.
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Affiliation(s)
- Tobias Geisler
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Timea Keller
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Faculty of Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Khouloud Poli
- Department of Neurology & Stroke, Eberhard Karls University Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Lina Maria Serna-Higuita
- Institute for Clinical Epidemiology and Applied Biometry, Faculty of Medicine, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Juergen Schreieck
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Meinrad Gawaz
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Johannes Tünnerhoff
- Department of Neurology & Stroke, Eberhard Karls University Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Paula Bombach
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Neurology and Interdisciplinary Neuro-Oncology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Thomas Nägele
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Parwez Aidery
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Patrick Groga-Bada
- Department of Cardiology and Angiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Andrea Kraft
- Department of Neurology, Krankenhaus Martha-Maria Halle-Doelau, Halle (Saale), Germany
| | - Frank Hoffmann
- Department of Neurology, Krankenhaus Martha-Maria Halle-Doelau, Halle (Saale), Germany
| | - Carsten Hobohm
- Department of Neurology, Carl-von-Basedow Klinikum Merseburg, Merseburg, Germany
| | - Katrin Naupold
- Department of Neurology, Carl-von-Basedow Klinikum Merseburg, Merseburg, Germany
| | - Ludwig Niehaus
- Department of Neurology, Rems-Murr Kliniken, Winnenden, Germany
| | - Marc Wolf
- Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany
| | - Hansjörg Bäzner
- Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany
| | - Jan Liman
- Department of Neurology, Klinikum Nürnberg, Nürnberg, Germany
- Clinic for Neurology, University Hospital Göttingen, Göttingen, Germany
| | - Rolf Wachter
- Department of Cardiology, University Hospital Leipzig, Leipzig, Germany
- Clinic for Cardiology and Pneumology, University Medicine Göttingen, Göttingen, Germany
- German Center for Cardiovascular Research, Göttingen, Germany
| | - Hubert Kimmig
- Department of Neurology, Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
| | - Werner Jung
- Department of Cardiology, Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
| | - Roman Huber
- Department of Neurology, Klinikum Friedrichshafen, Friedrichshafen, Germany
| | - Regina Feurer
- Department of Neurology, Klinikum Friedrichshafen, Friedrichshafen, Germany
| | - Alfred Lindner
- Department of Neurology, Marienhospital Stuttgart, Stuttgart, Germany
| | | | - Felix J Bode
- Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Gabor C Petzold
- Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Thanh N Nguyen
- Department of Radiology, Boston Medical Center, Boston
- Department of Neurology, Boston Medical Center, Boston
| | - Brian Mac Grory
- Duke Clinical Research Institute, Durham, NC
- Department of Neurology, Duke University School of Medicine, Durham, NC
| | - Matthew Schrag
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN
| | - Jan C Purrucker
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine S Zuern
- Department of Neurology, Klinikum Nürnberg, Nürnberg, Germany
- Department of Cardiology, Universitätsspital Basel, Basel, Switzerland
| | - Ulf Ziemann
- Department of Neurology & Stroke, Eberhard Karls University Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Sven Poli
- Department of Neurology & Stroke, Eberhard Karls University Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen, Tübingen, Germany
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Hoenemann JN, Moestl S, Diedrich A, Mulder E, Frett T, Petrat G, Pustowalow W, Arz M, Schmitz MT, Heusser K, Lee SMC, Jordan J, Tank J, Hoffmann F. Impact of daily artificial gravity on autonomic cardiovascular control following 60-day head-down tilt bed rest. Front Cardiovasc Med 2023; 10:1250727. [PMID: 37953766 PMCID: PMC10634666 DOI: 10.3389/fcvm.2023.1250727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Impaired cardiovascular autonomic control following space flight or immobilization may limit the ability to cope with additional hemodynamic stimuli. Head-down tilt bedrest is an established terrestrial analog for space flight and offers the opportunity to test potential countermeasures for autonomic cardiovascular deconditioning. Previous studies revealed a possible benefit of daily artificial gravity on cardiovascular autonomic control following head-down tilt bedrest, but there is a need for efficiency in a long-term study before an artificial gravity facility would be brought to space. We hypothesized that artificial gravity through short-arm centrifugation attenuates functional adaptions of autonomic function during head-down tilt bed rest. 24 healthy persons (8 women, 33.4 ± 9.3 years, 24.3 ± 2.1 kg/m2) participated in the 60-day head-down tilt bed rest (AGBRESA) study. They were assigned to three groups, 30 min/day continuous, or 6(5 min intermittent short-arm centrifugation, or a control group. We assessed autonomic cardiovascular control in the supine position and in 5 minutes 80° head-up tilt position before and immediately after bed rest. We computed heart rate variability (HRV) in the time (rmssd) and frequency domain, blood pressure variability, and baroreflex sensitivity (BRS). RR interval corrected rmssd was reduced supine (p = 0.0358) and during HUT (p = 0.0161). Heart rate variability in the high-frequency band (hf-RRI; p = 0.0004) and BRS (p < 0.0001) decreased, whereas blood pressure variability in the low-frequency band (lf-SBP, p = 0.0008) increased following bedrest in all groups. We did not detect significant interactions between bedrest and interventions. We conclude that up to daily 30 min of artificial gravity on a short-arm centrifuge with 1Gz at the center of mass do not suffice to prevent changes in autonomic cardiovascular control following 60-day of 6° head-down tilt bed rest. Clinical Trial Registration: https://drks.de/search/en/trial/DRKS00015677, identifier, DRKS00015677.
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Affiliation(s)
- J.-N. Hoenemann
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Cologne, Germany
| | - S. Moestl
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - A. Diedrich
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TN, United States
| | - E. Mulder
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - T. Frett
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - G. Petrat
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - W. Pustowalow
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - M. Arz
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - M.-T. Schmitz
- Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - K. Heusser
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - S. M. C. Lee
- Wyle Laboratories, Life Sciences and Systems Division, Houston, TX, United States
| | - J. Jordan
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Head of Aerospace Medicine, University of Cologne, Germany, Cologne
| | - J. Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - F. Hoffmann
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Cologne, Germany
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5
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Hoenemann JN, Moestl S, van Herwaarden AE, Diedrich A, Mulder E, Frett T, Petrat G, Pustowalow W, Arz M, Heusser K, Lee S, Jordan J, Tank J, Hoffmann F. Effects of daily artificial gravity training on orthostatic tolerance following 60-day strict head-down tilt bedrest. Clin Auton Res 2023; 33:401-410. [PMID: 37347452 PMCID: PMC10439060 DOI: 10.1007/s10286-023-00959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Orthostatic intolerance commonly occurs following immobilization or space flight. We hypothesized that daily artificial gravity training through short-arm centrifugation could help to maintain orthostatic tolerance following head-down tilt bedrest, which is an established terrestrial model for weightlessness. METHODS We studied 24 healthy persons (eight women; age 33.3 ± 9.0 years; BMI 24.3 ± 2.1 kg/m2) who participated in the 60-days head-down tilt bedrest (AGBRESA) study. They were assigned to 30 min/day continuous or 6 × 5 min intermittent short-arm centrifugation with 1Gz at the center of mass or a control group. We performed head-up tilt testing with incremental lower-body negative pressure until presyncope before and after bedrest. We recorded an electrocardiogram, beat-to-beat finger blood pressure, and brachial blood pressure and obtained blood samples from an antecubital venous catheter. Orthostatic tolerance was defined as time to presyncope. We related changes in orthostatic tolerance to changes in plasma volume determined by carbon dioxide rebreathing. RESULTS Compared with baseline measurements, supine and upright heart rate increased in all three groups following head-down tilt bedrest. Compared with baseline measurements, time to presyncope decreased by 323 ± 235 s with continuous centrifugation, by 296 ± 508 s with intermittent centrifugation, and by 801 ± 354 s in the control group (p = 0.0249 between interventions). The change in orthostatic tolerance was not correlated with changes in plasma volume. CONCLUSIONS Daily artificial gravity training on a short-arm centrifuge attenuated the reduction in orthostatic tolerance after 60 days of head-down tilt bedrest.
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Affiliation(s)
- J-N Hoenemann
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Moestl
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - A E van Herwaarden
- Laboratory Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, Netherlands
| | - A Diedrich
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TN, USA
| | - E Mulder
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - T Frett
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - G Petrat
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - W Pustowalow
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - M Arz
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - K Heusser
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
| | - S Lee
- NASA JSC KBR Wyle, Houston, TX, USA
| | - J Jordan
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
- Head of Aerospace Medicine, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
| | - J Tank
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany.
| | - F Hoffmann
- German Aerospace Center - DLR, Institute of Aerospace Medicine, Linder Hoehe, 51147, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Güth J, Jung P, Schiele A, Urban B, Parsch A, Matsche B, Eich C, Becke-Jakob K, Landsleitner B, Russo SG, Bernhard M, Hossfeld B, Olivieri M, Hoffmann F. [Update 2022: interdisciplinary statement on airway management with supraglottic airway devices in pediatric emergency medicine-The laryngeal mask is and remains state of the art : Joint statement of the Institute for Emergency Medicine and Medicine Management (INM), the University Clinic Munich, LMU Munich, Germany, the Working Group for Pediatric Critical Care and Emergency Medicine of the German Interdisciplinary Society for Critical Care and Emergency Medicine (DIVI), the Medical Directors of Emergency Medical Services in Bavaria (ÄLRD), the Scientific Working Group for Pediatric Anesthesia (WAKKA) of the German Society for Anesthesiology and Intensive Care Medicine (DGAI), the Scientific Working Group for Emergency Medicine of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) and the Society of Neonatology and Pediatric Critical Care Medicine (GNPI)]. Anaesthesiologie 2023:10.1007/s00101-023-01284-2. [PMID: 37222766 DOI: 10.1007/s00101-023-01284-2] [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] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Airway management with supraglottic airway devices (SGA) in life-threatening emergencies in children is increasingly being used. Different specifications of laryngeal masks (LM) and the laryngeal tube (LT) are commonly used devices for this purpose. We present a literature review and interdisciplinary consensus statement of different societies on the use of SGA in pediatric emergency medicine. MATERIAL AND METHODS Literature review in the PubMed database and classification of studies according to the criteria of the Oxford Centre for Evidence-based Medicine. Levels and consensus finding within the group of authors. RESULTS The evidence for successful applications of the various types of LM is significantly higher than for LT application. Reported smaller series of successful applications of LT are currently limited to selected research groups and centers. Especially for children below 10 kg body weight there currently exists insufficient evidence for the successful application of the LT and therefore its routine use cannot be recommended. SGAs used for emergencies should have a gastric drainage possibility. DISCUSSION Considering the scientific data and the large clinical experience with the LM in medical routine and emergency situations in children currently only the LM can be recommended for alternative (i.e., non-intubation) emergency airway management in children. If alternative airway management is part of a local emergency strategy, the LM should be provided in all pediatric sizes (1, 1½, 2, 2½, 3) for out of hospital use and in hospital emergency use and all users should regularly be trained in its application.
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Affiliation(s)
- J Güth
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, München, Deutschland
| | - P Jung
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - A Schiele
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - B Urban
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, München, Deutschland
| | - A Parsch
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - B Matsche
- Ärztliche Leitung, Rettungsdienst Bayern (ÄLRD Bayern), München, Deutschland
| | - C Eich
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - K Becke-Jakob
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B Landsleitner
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - S G Russo
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA), Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - M Bernhard
- Wissenschaftlicher Arbeitskreis Notfallmedizin, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B Hossfeld
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - M Olivieri
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - F Hoffmann
- Sektion Pädiatrische Intensiv- und Notfallmedizin, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland.
- Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin (GNPI), Berlin, Deutschland.
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Institut für Notfallmedizin und Medizinmanagement (INM), Ludwig-Maximilians-Universität München, Lindwurmstr. 4, 80337, München, Deutschland.
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Poryvaev AS, Gjuzi E, Yazikova AA, Polyukhov DM, Albrekht YN, Efremov AA, Kudriavykh NA, Yanshole VV, Hoffmann F, Fröba M, Fedin MV. Blatter Radical-Decorated Silica as a Prospective Adsorbent for Selective NO Capture from Air. ACS Appl Mater Interfaces 2023; 15:5191-5197. [PMID: 36652301 DOI: 10.1021/acsami.2c19183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Nitrogen oxides are adverse poisonous gases present in the atmosphere and having detrimental effects on the human health and environment. In this work, we propose a new type of mesoporous materials capable of capturing nitrogen monoxide (NO) from air. The designed material combines the robust Santa Barbara Amorphous-15 silica scaffold and ultrastable Blatter-type radicals acting as NO traps. Using in situ electron paramagnetic resonance spectroscopy, we demonstrate that NO capture from air is selective and reversible at practical conditions, thus making Blatter radical-decorated silica highly promising for environmental applications.
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Affiliation(s)
- Artem S Poryvaev
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
| | - Eva Gjuzi
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Anastasiya A Yazikova
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova Street 2, 630090 Novosibirsk, Russia
| | - Daniil M Polyukhov
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
| | - Yana N Albrekht
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova Street 2, 630090 Novosibirsk, Russia
| | - Aleksandr A Efremov
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova Street 2, 630090 Novosibirsk, Russia
| | | | - Vadim V Yanshole
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
| | - Frank Hoffmann
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Michael Fröba
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Matvey V Fedin
- International Tomography Center SB RAS, Institutskaya Street 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova Street 2, 630090 Novosibirsk, Russia
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8
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Schuster L, Essig F, Daneshkhah N, Herm J, Hellwig S, Endres M, Dirnagl U, Hoffmann F, Michalski D, Pfeilschifter W, Urbanek C, Petzold GC, Rizos T, Kraft A, Haeusler KG. Ability of patients with acute ischemic stroke to recall given information on intravenous thrombolysis: Results of a prospective multicenter study. Eur Stroke J 2023; 8:241-250. [PMID: 37021170 PMCID: PMC10069168 DOI: 10.1177/23969873221143856] [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] [Received: 10/03/2022] [Accepted: 11/20/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction: Intravenous thrombolysis (IVT) is an on label treatment for selected patients with acute ischemic stroke (AIS). As major bleeding or allergic shock may occur, the need to ensure patients’ informed consent for IVT is a matter of debate. Patients and methods: Prospective investigator-initiated multi-center observational study to assess the ability of AIS patients to recall information, provided by a physician during a standardized educational talk (SET) on IVT use. The recall of 20 pre-defined items was assessed in AIS after 60–90 min ( n = 93) or 23–25 h ( n = 40) after SET. About 40 patients with subacute stroke, 40 non-stroke patients, and 23 relatives of AIS patients served as controls, and were surveyed 60–90 min after SET. Results: Within 60–90 min after SET, AIS patients (median age 70 years, 31% female, median NIHSS score on admission 3 points) who were considered capable to provide informed consent recalled 55% (IQR 40%–66.7%) of the provided SET items. In multivariable linear regression analysis recapitulation by AIS patients was associated with their educational level (β = 6.497, p < 0.001), self-reported excitement level (β = 1.879, p = 0.011) and NIHSS score on admission (β = −1.186, p = 0.001). Patients with subacute stroke (70 years, 40% female, median NIHSS = 2) recalled 70% (IQR 55.7%–83.6%), non-stroke patients (75 years, 40% female) 70% (IQR 60%–78.7%), and AIS relatives (58 years, 83% female) 70% (IQR 60%–85%). Compared to subacute stroke patients, AIS patients less often recalled the frequency of IVT-related bleeding (21% vs 43%), allergic shock (15% vs 39%), and bleeding-related morbidity and mortality (44% vs 78%). AIS patients recalled 50% (IQR 42.3%–67.5%) of the provided items 23–25 h after SET. Conclusion: AIS patients eligible for IVT remember about half of all SET-items after 60–90 min or 23–25 h, respectively. The fact that the recapitulation of IVT-associated risks is particularly poor should be given special consideration.
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Affiliation(s)
- Luzie Schuster
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Fabian Essig
- Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Naeimeh Daneshkhah
- Department of Neurology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Juliane Herm
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Diseases (DZHK), Partner Site Berlin, Germany
| | - Simon Hellwig
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Endres
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Diseases (DZHK), Partner Site Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Germany
| | - Ulrich Dirnagl
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
- QUEST Center, Berlin Institute of Health (BIH), Berlin, Germany
| | - Frank Hoffmann
- Department of Neurology, Martha-Maria Hospital, Halle/Saale, Germany
| | | | - Waltraud Pfeilschifter
- Department of Neurology, University of Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Hospital Lüneburg, Lüneburg, Germany
| | - Christian Urbanek
- Department of Neurology, Hospital Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Gabor C Petzold
- Division of Vascular Neurology, Department of Neurology, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Timolaos Rizos
- Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Andrea Kraft
- Department of Neurology, Martha-Maria Hospital, Halle/Saale, Germany
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9
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Diehl C, Sievernich TS, Kruger M, Hoffmann F, Bertram T. Uncertainty-Aware Model-Based Offline Reinforcement Learning for Automated Driving. IEEE Robot Autom Lett 2023. [DOI: 10.1109/lra.2023.3236579] [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: 01/15/2023]
Affiliation(s)
- Christopher Diehl
- Institute of Control Theory and Systems Engineering, TU Dortmund University, Germany
| | | | - Martin Kruger
- Institute of Control Theory and Systems Engineering, TU Dortmund University, Germany
| | - Frank Hoffmann
- Institute of Control Theory and Systems Engineering, TU Dortmund University, Germany
| | - Torsten Bertram
- Institute of Control Theory and Systems Engineering, TU Dortmund University, Germany
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10
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Wieland L, Schwarz T, Engel K, Volkmer I, Krüger A, Tarabuko A, Junghans J, Kornhuber ME, Hoffmann F, Staege MS, Emmer A. Epstein-Barr Virus-Induced Genes and Endogenous Retroviruses in Immortalized B Cells from Patients with Multiple Sclerosis. Cells 2022; 11:cells11223619. [PMID: 36429047 PMCID: PMC9688211 DOI: 10.3390/cells11223619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Abstract
The immune pathogenesis of multiple sclerosis (MS) is thought to be triggered by environmental factors in individuals with an unfavorable genetic predisposition. Epstein-Barr virus (EBV) infection is a major risk factor for subsequent development of MS. Human endogenous retroviruses (HERVs) can be activated by EBV, and might be a missing link between an initial EBV infection and the later onset of MS. In this study, we investigated differential gene expression patterns in EBV-immortalized lymphoblastoid B cell lines (LCL) from MS-affected individuals (MSLCL) and controls by using RNAseq and qRT-PCR. RNAseq data from LCL mapped to the human genome and a virtual virus metagenome were used to identify possible biomarkers for MS or disease-relevant risk factors, e.g., the relapse rate. We observed that lytic EBNA-1 transcripts seemed to be negatively correlated with age leading to an increased expression in LCL from younger PBMC donors. Further, HERV-K (HML-2) GAG was increased upon EBV-triggered immortalization. Besides the well-known transactivation of HERV-K18, our results suggest that another six HERV loci are up-regulated upon stimulation with EBV. We identified differentially expressed genes in MSLCL, e.g., several HERV-K loci, ERVMER61-1 and ERV3-1, as well as genes associated with relapses. In summary, EBV induces genes and HERV in LCL that might be suitable as biomarkers for MS or the relapse risk.
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Affiliation(s)
- Lisa Wieland
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Tommy Schwarz
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Kristina Engel
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Ines Volkmer
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Anna Krüger
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Alexander Tarabuko
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Jutta Junghans
- Department of Neurology, Martha-Maria Hospital Halle-Dölau, 06120 Halle (Saale), Germany
| | - Malte E. Kornhuber
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Frank Hoffmann
- Department of Neurology, Martha-Maria Hospital Halle-Dölau, 06120 Halle (Saale), Germany
| | - Martin S. Staege
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
- Correspondence: ; Tel.: +49-34-5557-7280
| | - Alexander Emmer
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany
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11
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Schneider M, Stephan M, Hoffmann F. Rezidivierende Kopfschmerzattacken mit wechselnden neurologischen Symptomen und Liquorpleozytose. DGNeurologie 2022. [PMCID: PMC9215142 DOI: 10.1007/s42451-022-00447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- M. Schneider
- Klinik für Neurologie, Krankenhaus Martha-Maria Halle-Dölau, Röntgenstr. 1, 06120 Halle (Saale), Deutschland
| | - M. Stephan
- Klinik für Neurologie, Krankenhaus Martha-Maria Halle-Dölau, Röntgenstr. 1, 06120 Halle (Saale), Deutschland
| | - F. Hoffmann
- Klinik für Neurologie, Krankenhaus Martha-Maria Halle-Dölau, Röntgenstr. 1, 06120 Halle (Saale), Deutschland
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12
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Schneider M, Stephan M, Hoffmann F. Rezidivierende Kopfschmerzattacken mit wechselnden neurologischen Symptomen und Liquorpleozytose. DGNeurologie 2022. [PMCID: PMC9204365 DOI: 10.1007/s42451-022-00446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Hoffmann F. The topology of crystalline matter. Physical Sciences Reviews 2022. [DOI: 10.1515/psr-2019-0073] [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: 11/15/2022]
Abstract
Abstract
In this chapter an overview is given in which way framework-like crystalline compounds can be regarded as nets, how a net is derived out of a particular crystal structure, what nets actually are, how they can be appropriately described, what the characteristics of nets are, and how this topological approach helps to categorize framework compounds. Finally the term reticular chemistry is explained and a number of examples are given how the topology-guided approach opens up new possibilities to intentionally develop new framework structures on a rational basis.
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Affiliation(s)
- Frank Hoffmann
- Institute of Inorganic Chemistry, University of Hamburg , Martin-Luther-King-Platz 6, 20146 Hamburg , Germany
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14
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Höfer J, Hoffmann F, Dörks M, Kamp-Becker I, Küpper C, Poustka L, Roepke S, Roessner V, Stroth S, Wolff N, Bachmann C. Health Services Use and Costs in Individuals with Autism Spectrum Disorder in Germany: Results from a Survey in ASD Outpatient Clinics. Eur Psychiatry 2022. [PMCID: PMC9566916 DOI: 10.1192/j.eurpsy.2022.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Autism spectrum disorders (ASD) are associated with high services use, but European data on costs are scarce.
Objectives
Utilisation and annual costs of 385 individuals with ASD (aged 4-67 years; 18.2% females; 37.4% IQ < 85) from German outpatient clinics were assessed.
Methods
Client Service Receipt Inventory
Results
Average annual costs per person were 3287 EUR, with psychiatric inpatient care (19.8%), pharmacotherapy (11.1%), and occupational therapy (11.1%) being the largest cost components. Females incurred higher costs than males (4864 EUR vs. 2936 EUR). In a regression model, female sex (Cost Ratio: 1.65), lower IQ (1.90), and Asperger syndrome (1.54) were associated with higher costs.
Conclusions
In conclusion, ASD-related health costs are comparable to those of schizophrenia, thus underlining its public health relevance. Higher costs in females demand further research.
Disclosure
No significant relationships.
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Callhoff J, Albrecht K, Marschall U, Hoffmann F. POS0162 HOW ACCURATELY CAN WE IDENTIFY RHEUMATOID ARTHRITIS BY ICD-10 CODES? A LINKAGE OF CROSS-SECTIONAL SURVEY DATA WITH CLAIMS DATA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundClaims data from health insurance companies are a valuable source in health services research to provide insights on health care provision for an unselected patient collective. However, the available ICD-10 diagnoses have been collected for billing purposes and their validity is not clear.ObjectivesThe aim of this analysis was to assess the positive predictive values (PPV) of a ICD-10 diagnosis of rheumatoid arthritis (RA) and additional criteria (specific medication, measurement of inflammatory markers, contact to a rheumatologist) in German claims data using patient-reported confirmed diagnosis as reference/gold standard.MethodsWithin the PROCLAIR project (Linking Patient-Reported Outcomes with CLAims data for health services research In Rheumatology), data from a large German statutory health insurance with 6.6 million persons aged 18 to 79 were used. We identified a random sample of persons for which an ICD-10 code for RA (M05/M06) was available in at least two quarters in outpatient care. The sample was stratified for age (18 to 49, 50 to 64, 65 to 79 years), sex and seropositive (M05)/ seronegative RA (M06). Persons were asked to confirm their RA diagnosis (“What does your attending physician call the disease you are suffering from?”) with answer options “chronic polyarthritis”, “rheumatoid arthritis”, “rheumatism of the joints” “other (please specify)”. The answer was used as the gold standard for RA diagnosis. Analyses were weighted to represent the total RA population of the database. Patient-reported information was linked to the claims data given patient consent. PPVs (% of confirmed RA diagnosis) were calculated for ICD-10-diagnosis or additional examination of inflammatory markers (erythrocyte sedimentation rate/C-reactive protein), prescription of specific medication (disease-modifying anti-rheumatic drugs, non-steroidal anti-rheumatic drugs and glucocorticoids) and contact to a rheumatologist, in the respective year.ResultsWe contacted 6,193 persons with a claims diagnosis of RA. Of these 3,184 responding (51%), N=2,535 (81%) confirmed that they had RA. PPVs were 81% for ICD-10 only, 94% in M05 and 76% in M06. When additional criteria were taken into account, PPVs increased to 82% (measure of inflammatory markers), 85% (rheumatologist) and 89% (medication), respectively (Figure 1). However, PPVs ranged from 72% to 76% even if the additional criteria were not fulfilled. PPVs were lowest in men aged 18-49 years and relatively stable among women of all age groups.Figure 1.ConclusionThe ICD-10 codes M05 and (less optimal) M06 have high PPVs and are therefore feasible to identify RA in claims data. The prerequisite of specific medication seems to be the most useful one in identifying RA.AcknowledgementsSupported by the Federal Ministry of Education and Research (grants 01EC1405 and 01EC1902A).Disclosure of InterestsJohanna Callhoff Paid instructor for: Rheumatologische Fortbildungsakademie GmbH, Grant/research support from: Abbvie, AstraZeneca, BMS, GSK, Galapagos, Lilly, Medac, MSD, Pfizer, Sanofi, UCB, Katinka Albrecht: None declared, Ursula Marschall Employee of: Employee of BARMER, Falk Hoffmann: None declared
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Gerstl L, Olivieri M, Heinen F, Bidlingmaier C, Schroeder AS, Reiter K, Hoffmann F, Kurnik K, Liebig T, Trumm CG, Haas NA, Jakob A, Borggraefe I. Notfall-Neuropädiatrie – Der arteriell ischämische Schlaganfall als einer der zeitkritischsten Notfälle bei Kindern und Jugendlichen. Nervenarzt 2022; 93:158-166. [PMID: 35072763 PMCID: PMC8785019 DOI: 10.1007/s00115-021-01252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/21/2022]
Abstract
Der arteriell ischämische Schlaganfall im Kindes- und Jugendalter gehört zu den zeitkritischsten Notfällen in der Pädiatrie. Dennoch wird er häufig mit einer oft prognostisch relevanten Zeitverzögerung diagnostiziert. Gründe dafür liegen neben der geringen Awareness auch in der zuweilen unspezifischen klinischen Präsentation mit einer herausfordernden Breite kritischer Differenzialdiagnosen sowie in der Fläche noch wenig verzahnter Akutversorgungsstrukturen. Gleichwohl zeigen grundsätzlich die beim Erwachsenen etablierten Revaskularisationsstrategien auch beim Kind ihre möglichen, zum Teil spektakulären Erfolge. Es gilt also, diese nach Möglichkeit auch den betroffenen Kindern zur Verfügung zu stellen, auch wenn hier derzeit ein nicht annähernd vergleichbarer Grad an Evidenz erreicht ist. Postakut ist die ätiologische Aufarbeitung durch die größere Bandbreite zu bedenkender Risikofaktoren besonders komplex, muss aber in der Lage sein, das individuelle Risikoprofil mit Sekundärprophylaxe, Rezidivrisiko und Outcome präzise zu identifizieren. Die Langzeitbetreuung im multiprofessionellen, interdisziplinären Team muss die biopsychosozialen Aspekte des Kindes in seiner jeweiligen Entwicklungsphase berücksichtigen und damit eine bestmögliche Integration des Kindes in sein soziales und schulisches, später berufliches Umfeld realisieren.
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Gliwitzky B, Olivieri M, Bathe J, Landsleitner B, Hoffmann F, Hossfeld B, Häske D. Intranasale Analgesie bei Säuglingen und Kleinkindern. Notf Rett Med 2022. [DOI: 10.1007/s10049-021-00958-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Salzberger B, Gastmeier P, Langer F, Welper M, Westhoff M, Pfeifer M, Hoffmann F, Böttiger BW, Marx G, Karagiannidis C. Recommendations for treatment of critically ill patients with COVID-19 : Version 3 S1 guideline. Anaesthesist 2021; 70:19-29. [PMID: 33245382 PMCID: PMC7694585 DOI: 10.1007/s00101-020-00879-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Since December 2019 a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The immense challenges for clinicians and hospitals as well as the strain on many healthcare systems has been unprecedented.The majority of patients present with mild symptoms of coronavirus disease 2019 (COVID-19); however, 5-8% become critically ill and require intensive care treatment. Acute hypoxemic respiratory failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to intensive care unit (ICU) admission. At this point bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS).So far, remdesivir and dexamethasone have shown clinical effectiveness in severe COVID-19 in hospitalized patients. The main goal of supportive treatment is to ascertain adequate oxygenation. Invasive mechanical ventilation and repeated prone positioning are key elements in treating severely hypoxemic COVID-19 patients.Strict adherence to basic infection control measures (including hand hygiene) and correct use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be carried out with utmost precaution and preparation.
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Affiliation(s)
- S Kluge
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Germany.
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany.
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Germany.
- ARDS Netzwerk Deutschland, Berlin, Germany.
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - U Janssens
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Germany
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- ARDS Netzwerk Deutschland, Berlin, Germany
| | - T Welte
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Germany
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Germany
- ARDS Netzwerk Deutschland, Berlin, Germany
| | - S Weber-Carstens
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Germany
- ARDS Netzwerk Deutschland, Berlin, Germany
| | - G Schälte
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Germany
| | - B Salzberger
- Deutsche Gesellschaft für Infektiologie (DGI), Munich, Germany
| | - P Gastmeier
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Germany
| | - F Langer
- Gesellschaft für Thrombose und Hämostaseforschung (GTH), Cologne, Germany
| | - M Welper
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Germany
| | - M Westhoff
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Germany
| | - M Pfeifer
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Germany
| | - F Hoffmann
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Berlin, Germany
| | - B W Böttiger
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- Deutscher Rat für Wiederbelebung (German Resuscitation Council, GRC), Ulm, Germany
| | - G Marx
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Germany
- ARDS Netzwerk Deutschland, Berlin, Germany
| | - C Karagiannidis
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Germany
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Germany
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Germany
- ARDS Netzwerk Deutschland, Berlin, Germany
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Abstract
For decades, headache was not considered a typical symptom of multiple sclerosis (MS) and was construed as a "red flag" for important differential diagnoses such as cerebral vasculitis. Meanwhile, several studies have demonstrated an increased prevalence of headache in MS compared to the general population. This is due to the heterogeneity of headache genesis with frequent occurrence of both primary and secondary headaches in MS. On the one hand, MS and migraine are often comorbid. On the other hand, secondary headaches occur frequently, especially in the course of MS relapses. These are often migraine-like headaches caused by inflammation, which can improve as a result of MS-specific therapy. Headaches are particularly common in the early stages of chronic inflammatory CNS disease, where inflammatory activity is greatest. In addition, headache can also occur as a side effect of disease-modifying drugs (DMDs). Headache can occur with most DMDs and is most frequently described with interferon-beta therapy. The aim of this work is to present the prevalence of headache and describe the heterogeneity of possible causes of headache in MS. In addition, important therapeutic aspects in the treatment of MS patients in general will be presented as well as different approaches to the treatment of headache in MS depending on the etiological classification.
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Affiliation(s)
- Marcel Gebhardt
- Krankenhaus Martha-Maria Halle-Dölau, Klinik für Neurologie, Röntgenstraße 1, 06120 Halle. Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Gehlsheimer Straße 20, 18147, Rostock. Germany
| | | | - Uwe K Zettl
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock. Germany
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Ziemssen T, Hoffmann F, Richter S, Engelmann U, White R. Alemtuzumab in a Large Real-Life Cohort: Interim Baseline Data of the TREAT-MS Study. Front Neurol 2021; 12:620758. [PMID: 34421780 PMCID: PMC8375470 DOI: 10.3389/fneur.2021.620758] [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: 10/23/2020] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
The non-interventional long-Term study foR obsErvAtion of Treatment with alemtuzumab in active relapsing-remitting MS (TREAT-MS) study collects the so far largest real-life cohort regarding utilization, long-term effectiveness, and safety of alemtuzumab, a humanized monoclonal antibody directed against the cell surface glycoprotein CD52, in adult patients with active relapsing-remitting multiple sclerosis (RRMS). An interim analysis of baseline parameters at inclusion of a non-interventional real-world study about alemtuzumab in Germany including previous multiple sclerosis (MS) medication utilization, MS activity, severity, and duration, as well as comorbidities was performed. Of the 883 patients, 71.6% were women. Mean age was 35.7 ± 9.2 years, time since first MS symptoms (=disease duration) is 8.0 ± 6.8 years, and Expanded Disability Status Scale (EDSS) is 2.7 ± 1.8 points (range, 0.0-7.5 points). The number of relapses in the 12 and 24 months prior to inclusion were 1.6 ± 1.2 and 2.2 ± 1.8, respectively. Of the patients, 14.4% were treatment naive, while for the majority, a wide spectrum of MS disease-modifying treatments (DMTs) and treatment sequences were documented. Overall, interferon beta (IFN-beta) was reported most frequently (52.4%), followed by fingolimod (35.2%), natalizumab (34.9%), and glatiramer acetate (28.9%). Patients with longer disease duration and higher EDSS had a higher number of previous DMTs. Compared to the pivotal phase 2/3 studies, RRMS patients starting alemtuzumab treatment had a longer disease duration in real-world conditions. There was variety of different treatment sequences before the final switch to alemtuzumab. In the future, linking these treatment sequences or other baseline characteristics with effectiveness and safety outcomes might be useful to support treatment decisions. Registered at Paul-Ehrlich-Institut under NIS 281.
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Affiliation(s)
- Tjalf Ziemssen
- Department of Neurology, Center of Clinical Neuroscience, Carl Gustav Carus University Hospital, Dresden, Germany
| | - Frank Hoffmann
- Klinik für Neurologie, Krankenhaus Martha-Maria Halle-Doelau, Halle (Saale), Germany
| | - Stephan Richter
- Zentrum für Neurologie und Psychiatrie, MIND, Stuttgart, Germany
| | - Ulrich Engelmann
- Medical Affairs, Sanofi-Aventis Deutschland GmbH, Neu-Isenburg, Germany
| | - Robin White
- Medical Affairs, Sanofi-Aventis Deutschland GmbH, Neu-Isenburg, Germany
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Hoffmann F, Landeg M, Rittberg W, Hinzmann D, Steinbrunner D, Hey F, Heinen F, Kanz KG, Bogner-Flatz V. [Childhood emergencies-worsening healthcare bottlenecks for children in a systematic long-term analysis of the EMS system in a German metropolis]. Med Klin Intensivmed Notfmed 2021; 117:358-366. [PMID: 34156483 DOI: 10.1007/s00063-021-00831-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Children have the right to the best possible medical care. The lack of treatment capacity is rising steadily and increasingly leads to forced centralized allocation of patients by the emergency medical services (EMS) to pediatric emergency departments that are, officially, temporarily "closed". AIM The aim of this study is to present trends in allocation of pediatric emergency patients in greater Munich. MATERIALS AND METHODS Retrospective analysis of hospital admissions of children < 18 years of age collected from 01 January 2015 to 31 December 2019 by means of the web-based IT system IVENA eHealth (manis IT, Frankfurt) used by the emergency medical services. The focus of the evaluation is on patients in category II, who are likely to require inpatient admission. RESULTS During the 5‑year observation period, a total of 44,549 pediatric patients < 18 years of age (90.6% of total admissions) were admitted to a children's hospital by the ambulance service as category II (SKII) in the Munich metropolitan area. These patients showed an increase in the relative frequency of forced allocations from 1.7% (2015) to 9.4% (2019). Parallel to this, there is an increasing frequency of time intervals over the years in which all children's hospitals were temporarily closed due to lack of treatment availability, especially in the winter half-year. CONCLUSION In the examined period from 2015 to 2019, there has been a relevant increase in the number of forced allocations to children's hospitals by the emergency medical services in the Munich area. This observed trend is likely to persist over the coming years, in view of current staff shortages and diminishing hospital capacities.
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Affiliation(s)
- F Hoffmann
- LMU Klinikum, Campus Innenstadt, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Pädiatrische Intensivmedizin - Kindernotfallmedizin, Ludwig-Maximilians-Universität München, Lindwurmstr. 4, 80337, München, Deutschland.
| | - M Landeg
- Klinik für Allgemeine, Unfall und Wiederherstellungschirurgie, Notfallaufnahme Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - W Rittberg
- Klinik für Allgemeine, Unfall und Wiederherstellungschirurgie, Notfallaufnahme Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - D Hinzmann
- Klinik für Anästhesiologie und Intensivmedizin, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland.,Rettungszweckverband München, München, Deutschland
| | | | - F Hey
- LMU Klinikum, Campus Innenstadt, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Pädiatrische Intensivmedizin - Kindernotfallmedizin, Ludwig-Maximilians-Universität München, Lindwurmstr. 4, 80337, München, Deutschland
| | - F Heinen
- LMU Klinikum, Campus Innenstadt, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Pädiatrische Intensivmedizin - Kindernotfallmedizin, Ludwig-Maximilians-Universität München, Lindwurmstr. 4, 80337, München, Deutschland
| | - K-G Kanz
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland.,Regierung von Oberbayern, München, Deutschland
| | - V Bogner-Flatz
- Klinik für Allgemeine, Unfall und Wiederherstellungschirurgie, Notfallaufnahme Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland.,Rettungszweckverband München, München, Deutschland
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22
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Bellmann-Strobl J, Paul F, Wuerfel J, Dörr J, Infante-Duarte C, Heidrich E, Körtgen B, Brandt A, Pfüller C, Radbruch H, Rust R, Siffrin V, Aktas O, Heesen C, Faiss J, Hoffmann F, Lorenz M, Zimmermann B, Groppa S, Wernecke KD, Zipp F. Epigallocatechin Gallate in Relapsing-Remitting Multiple Sclerosis: A Randomized, Placebo-Controlled Trial. Neurol Neuroimmunol Neuroinflamm 2021; 8:e981. [PMID: 33762428 PMCID: PMC8054966 DOI: 10.1212/nxi.0000000000000981] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/07/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess the safety and efficacy of epigallocatechin-3-gallate (EGCG) add-on to glatiramer acetate (GA) in patients with relapsing-remitting multiple sclerosis (RRMS). METHODS We enrolled patients with RRMS (aged 18-60 years, Expanded Disability Status Scale [EDSS] score 0-6.5), receiving stable GA treatment in a multicenter, prospective, double-blind, phase II, randomized controlled trial. Participants received up to 800 mg oral EGCG daily over a period of 18 months. The primary outcome was the proportion of patients without new hyperintense lesions on T2-weighted (T2w) brain MRI within 18 months. Secondary end points included additional MRI and clinical parameters. Immunologic effects of EGCG were investigated in exploratory experiments. RESULTS A total of 122 patients on GA were randomly assigned to EGCG treatment (n = 62) or placebo (n = 60). We could not demonstrate a difference between groups after 18 months for the primary outcome or other radiologic (T2w lesion volume, T1w hypointense lesion number or volume, number of cumulative contrast-enhancing lesions, percent brain volume change), or clinical (EDSS, MS functional composite, and annualized relapse rate) parameter. EGCG treatment did not affect immune response to GA. Pharmacologic analysis revealed wide ranging EGCG plasma levels. The treatment was well tolerated with a similar incidence of mostly mild adverse events similar in both groups. CONCLUSION In RRMS, oral EGCG add-on to GA was not superior to placebo in influencing MRI and clinical disease activity over 18 months. The treatment was safe at a daily dosage up to 800 mg EGCG. It did not influence immune parameters, despite indication of EGCG being bioavailable in patients. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for patients with RRMS, EGCG added to GA did not significantly affect the development of new hyperintense lesions on T2-weighted brain MRI. TRIAL REGISTRATION INFORMATION Clinical trial registration number: NCT00525668.
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Affiliation(s)
- Judith Bellmann-Strobl
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin.
| | - Friedemann Paul
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Jens Wuerfel
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Jan Dörr
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Carmen Infante-Duarte
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Elmira Heidrich
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Benedict Körtgen
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Alexander Brandt
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Caspar Pfüller
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Helena Radbruch
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Rebekka Rust
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Volker Siffrin
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Orhan Aktas
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Christoph Heesen
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Jürgen Faiss
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Frank Hoffmann
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Mario Lorenz
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Benno Zimmermann
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Sergiu Groppa
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Klaus-Dieter Wernecke
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
| | - Frauke Zipp
- From the NeuroCure Clinical Research Center (J.B.-S., F.P., J.D., A.B., V.S.), Charité-Universitätsmedizin Berlin; Medical Image Analysis Center (J.W.), University Basel; Institut for Medical Immunology (C.I.-D., E.H.), Charité-Universitätsmedizin Berlin; Department of Neurology and Neuroimaging Center (B.K.), Johannes Gutenberg University, Mainz; Charité-Universitätsmedizin Berlin (C.P.); NeuroCure Clinical Research Center (H.R., R.R.), Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Institut für Neuroimmunologie und Multiple Sklerose (C.H.), Universitätsklinikum Hamburg-Eppendorf, Hamburg; Klinik für Neurologie (J.F.), Asklepios Klinik Lübben/Teupitz; Department of Neurology (F.H.), Krankenhaus Martha-Maria Halle-Dölau, Halle/Saale; Medizinische Klinik für Kardiologie und Angiologie (M.L.), Campus Mitte, Charité-Universitätsmedizin Berlin; Institute of Nutritional and Food Sciences (B.Z.), University of Bonn; Department of Neurology and Neuroimaging Center (NIC) (S.G., F.Z.), Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University, Mainz; and Charité-Universitätsmedizin Berlin and SOSTANA GmbH (K.-D.W.), Berlin
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23
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Marx G, Hoffmann F, Walcher F. [Overtreatment in intensive care medicine-important topics in a challenging time that need a sophisticated dialog]. Med Klin Intensivmed Notfmed 2021; 116:279-280. [PMID: 33956180 PMCID: PMC8100354 DOI: 10.1007/s00063-021-00822-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 11/21/2022]
Affiliation(s)
- G Marx
- Klinik für Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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24
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Poryvaev AS, Gjuzi E, Polyukhov DM, Hoffmann F, Fröba M, Fedin MV. Blatter-Radical-Grafted Mesoporous Silica as Prospective Nanoplatform for Spin Manipulation at Ambient Conditions. Angew Chem Int Ed Engl 2021; 60:8683-8688. [PMID: 33491265 PMCID: PMC8048659 DOI: 10.1002/anie.202015058] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/11/2021] [Indexed: 12/21/2022]
Abstract
Quantum computing and quantum information processing (QC/QIP) crucially depend on the availability of suitable quantum bits (qubits) and methods of their manipulation. Most qubit candidates known to date are not applicable at ambient conditions. Herein, we propose radical‐grafted mesoporous silica as a versatile and prospective nanoplatform for spin‐based QC/QIP. Extremely stable Blatter‐type organic radicals are used, whose electron spin decoherence time is profoundly long even at room temperature (up to Tm≈2.3 μs), thus allowing efficient spin manipulation by microwave pulses. The mesoporous structure of such composites is nuclear‐spin free and provides additional opportunities of embedding guest molecules into the channels. Robustness and tunability of these materials promotes them as highly promising nanoplatforms for future QC/QIP developments.
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Affiliation(s)
- Artem S. Poryvaev
- International Tomography Center SB RASNovosibirsk630090Russia
- Novosibirsk State UniversityNovosibirsk630090Russia
| | - Eva Gjuzi
- Institute of Inorganic and Applied ChemistryUniversity of HamburgMartin-Luther-King-Platz 620146HamburgGermany
| | | | - Frank Hoffmann
- Institute of Inorganic and Applied ChemistryUniversity of HamburgMartin-Luther-King-Platz 620146HamburgGermany
| | - Michael Fröba
- Institute of Inorganic and Applied ChemistryUniversity of HamburgMartin-Luther-King-Platz 620146HamburgGermany
| | - Matvey V. Fedin
- International Tomography Center SB RASNovosibirsk630090Russia
- Novosibirsk State UniversityNovosibirsk630090Russia
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25
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Poryvaev AS, Gjuzi E, Polyukhov DM, Hoffmann F, Fröba M, Fedin MV. Blatter‐Radical‐Grafted Mesoporous Silica as Prospective Nanoplatform for Spin Manipulation at Ambient Conditions. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202015058] [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: 11/11/2022]
Affiliation(s)
- Artem S. Poryvaev
- International Tomography Center SB RAS Novosibirsk 630090 Russia
- Novosibirsk State University Novosibirsk 630090 Russia
| | - Eva Gjuzi
- Institute of Inorganic and Applied Chemistry University of Hamburg Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | | | - Frank Hoffmann
- Institute of Inorganic and Applied Chemistry University of Hamburg Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | - Michael Fröba
- Institute of Inorganic and Applied Chemistry University of Hamburg Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | - Matvey V. Fedin
- International Tomography Center SB RAS Novosibirsk 630090 Russia
- Novosibirsk State University Novosibirsk 630090 Russia
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26
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Althaus AE, Arendt U, Hoffmann F, Lüske J, Freitag MH, Jobski K, Dörks M. [Epistaxis and anticoagulation therapy: an analysis based on health insurance data from Lower Saxony]. HNO 2021; 69:206-212. [PMID: 32929520 PMCID: PMC8289754 DOI: 10.1007/s00106-020-00940-y] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hintergrund Die Epistaxis ist ein häufiges Symptom in der Arztpraxis und assoziiert mit verschiedenen Komorbiditäten und Medikamenten, insbesondere Antikoagulanzien. Trotz ihrer Alltäglichkeit gibt es nur wenige Daten zur Häufigkeit ihres Auftretens und möglichen Risikofaktoren. Methoden Die Studie untersuchte anhand einer großen Patientenpopulation (AOK Niedersachsen) über 10 Jahre (2007–2016) die Versorgung von Epistaxis in Niedersachsen. Alter bei Diagnose, Begleitmedikation und Komorbiditäten wurden analysiert und die Prävalenz dargestellt. Ergebnisse 162.167 Versicherte der AOK Niedersachen wurden zwischen 2007 und 2016 aufgrund einer Epistaxis in 308.947 Fällen ärztlich vorstellig. Die meisten Patienten wurden ausschließlich ambulant behandelt (96,6 %). Über den Studienzeitraum stieg die Prävalenz um 21 % (Anstieg von 8,7 auf 9,3 pro 1000 Versicherte/Jahr) bei stabiler Prävalenz für stationäre Vorstellungen (0,2 pro 1000 Versicherte/Jahr). Die höchsten Prävalenzen fanden sich bei Personen bis 20 und über 80 Jahre. In 17,5 % aller Epistaxisfälle wurden Antithrombotika erfasst (9,5 % orale Antikoagulanzien). Über den Studienzeitraum konnte eine erhöhte Verschreibung von Antikoagulanzien (7,7 % in 2007 auf 11,8 % in 2016, insbesondere NOAK) dokumentiert werden. Schlussfolgerung Neben der arteriellen Hypertonie, dem männlichen Geschlecht sowie der typischen Altersverteilung bestand auch häufig eine Medikation mit Antikoagulanzien. Über den untersuchten Zeitraum zeigte sich eine Zunahme von Epistaxisfällen bei gleichzeitig ansteigender Verschreibungshäufigkeit von NOAK, nicht jedoch von schweren hospitalisationsbedürftigen Epistaxisfällen. Eine abschließende Beurteilung hinsichtlich eines möglichen kausalen Zusammenhangs muss in weiteren Studien untersucht werden.
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Affiliation(s)
- A E Althaus
- Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland. .,, Theaterwall 43, 26122, Oldenburg, Deutschland.
| | - U Arendt
- Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - F Hoffmann
- Department für Versorgungsforschung, Abteilung Ambulante Versorgung und Pharmakoepidemiologie, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - J Lüske
- Praxis Dr. Lüske, Oldenburg, Deutschland
| | - M H Freitag
- Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - K Jobski
- Department für Versorgungsforschung, Abteilung Ambulante Versorgung und Pharmakoepidemiologie, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - M Dörks
- Department für Versorgungsforschung, Abteilung Ambulante Versorgung und Pharmakoepidemiologie, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
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27
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Abstract
Kommunikationsfehler und systembedingte Probleme wirken sich negativ auf Teamarbeit und gemeinsame Entscheidungsfindung aus und können den Patienten Schaden zufügen. Regelmäßige Nachbesprechungen nach kritischen Ereignissen wiederum wirken sich positiv auf die Teamzusammenarbeit und das Patientenoutcome in der Kindernotfallversorgung aus. Das gemeinsame Reflektieren fördert das Lernen, hilft den Teams, sich zu verbessern, und verhindert, dass sich Fehler in Zukunft wiederholen. Dennoch werden Debriefings im präklinischen und klinischen Alltag noch immer qualitativ unzureichend durchgeführt. Gründe dafür sind mangelnde Zeit, Fehlen von erfahrenen Debriefern und fehlende Unterstützung durch Verantwortungsträger. Debriefings können je nach Bedarf zu verschiedenen Zeitpunkten mit unterschiedlicher Dauer stattfinden. Nachbesprechungen können auch rein virtuell oder als sogenannte Hybridveranstaltung durchgeführt werden. Nachbesprechungen sollten sich auf gemeinsames Lernen und das Erarbeiten zukunftsorientierter Verbesserungen konzentrieren. Nicht nur lebensbedrohliche Ereignisse können Nachbesprechungen auslösen, sondern auch potenziell kritische Situationen, wie routinemäßige Intubationen. Debriefing-Skripte fördern eine Strukturierung und ermöglichen selbst unerfahrenen Moderatoren, alle Aspekte zu bearbeiten. Neben der Diskussion schwieriger Abläufe sollten unbedingt positive Leistungen besprochen werden, um diese zu verstärken und das Lernen am Erfolg zu ermöglichen. Dabei sollten die Beweggründe eines Verhaltens erfragt und nicht nur die nach außen sichtbaren Leistungen bewertet werden. Diese Strategie fördert bedarfsgerechtes Lernen und konzentriert sich auf Lösungen. Hilfreich sind dabei spezielle Fragetechniken, echtes Interesse und eine positive Sicherheitskultur.
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Affiliation(s)
- E Heimberg
- Kinderintensivstation, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Deutschland
| | - J Daub
- Kinderintensivstation, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 1, 72076 Tübingen, Deutschland
| | - J B Schmutz
- Department für Management, Technologie und Ökonomie, ETH Zürich, Zürich, Schweiz
| | - W Eppich
- RCSI Sim: Simulation Education and Research, Royal College of Surgeons of Ireland, Dublin, Irland
| | - F Hoffmann
- Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, LMU München, München, Deutschland
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28
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Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Spinner CD, Malin JJ, Gastmeier P, Langer F, Wepler M, Westhoff M, Pfeifer M, Rabe KF, Hoffmann F, Böttiger BW, Weinmann-Menke J, Kersten A, Berlit P, Haase R, Marx G, Karagiannidis C. [S2k Guideline - Recommendations for Inpatient Therapy of Patients with COVID-19]. Pneumologie 2021; 75:88-112. [PMID: 33450783 DOI: 10.1055/a-1334-1925] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Since December 2019, the novel coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome - Corona Virus-2) has been spreading rapidly in the sense of a global pandemic. This poses significant challenges for clinicians and hospitals and is placing unprecedented strain on the healthcare systems of many countries. The majority of patients with Coronavirus Disease 2019 (COVID-19) present with only mild symptoms such as cough and fever. However, about 6 % require hospitalization. Early clarification of whether inpatient and, if necessary, intensive care treatment is medically appropriate and desired by the patient is of particular importance in the pandemic. Acute hypoxemic respiratory insufficiency with dyspnea and high respiratory rate (> 30/min) usually leads to admission to the intensive care unit. Often, bilateral pulmonary infiltrates/consolidations or even pulmonary emboli are already found on imaging. As the disease progresses, some of these patients develop acute respiratory distress syndrome (ARDS). Mortality reduction of available drug therapy in severe COVID-19 disease has only been demonstrated for dexamethasone in randomized controlled trials. The main goal of supportive therapy is to ensure adequate oxygenation. In this regard, invasive ventilation and repeated prone positioning are important elements in the treatment of severely hypoxemic COVID-19 patients. Strict adherence to basic hygiene, including hand hygiene, and the correct wearing of adequate personal protective equipment are essential when handling patients. Medically necessary actions on patients that could result in aerosol formation should be performed with extreme care and preparation.
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Affiliation(s)
- S Kluge
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN); Berlin.,Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin.,ARDS Netzwerk Deutschland, Berlin
| | - U Janssens
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN); Berlin.,Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,ARDS Netzwerk Deutschland, Berlin
| | - T Welte
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN); Berlin.,Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin.,ARDS Netzwerk Deutschland, Berlin
| | - S Weber-Carstens
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg.,ARDS Netzwerk Deutschland, Berlin
| | - G Schälte
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg
| | - C D Spinner
- Deutsche Gesellschaft für Infektiologie (DGI), Berlin
| | - J J Malin
- Deutsche Gesellschaft für Infektiologie (DGI), Berlin
| | - P Gastmeier
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster
| | - F Langer
- Gesellschaft für Thrombose und Hämostaseforschung (GTH), Köln
| | - M Wepler
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg
| | - M Westhoff
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin
| | - M Pfeifer
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin
| | - K F Rabe
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin
| | - F Hoffmann
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Berlin
| | - B W Böttiger
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutscher Rat für Wiederbelebung (German Resuscitation Council; GRC), Ulm
| | | | - A Kersten
- Deutsche Gesellschaft für Kardiologie (DGK)
| | - P Berlit
- Deutsche Gesellschaft für Neurologie (DGN)
| | - R Haase
- Patientenvertretung (individueller Betroffener)
| | - G Marx
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg.,ARDS Netzwerk Deutschland, Berlin
| | - C Karagiannidis
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN); Berlin.,Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin.,Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin.,ARDS Netzwerk Deutschland, Berlin
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Prasad RRR, Pleass C, Rigg AL, Cordes DB, Lozinska MM, Georgieva VM, Hoffmann F, Slawin AMZ, Wright PA. Isoreticular chemistry of scandium analogues of the multicomponent metal–organic framework MIL-142. CrystEngComm 2021. [DOI: 10.1039/d0ce01593h] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
MIL-142(Sc) is prepared and the limits of the isoreticular substitution of each linker type are explored and characterised by single-crystal XRD.
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Affiliation(s)
- Ram R. R. Prasad
- EaStCHEM School of Chemistry
- University of St Andrews
- St Andrews
- UK
| | - Charlotte Pleass
- EaStCHEM School of Chemistry
- University of St Andrews
- St Andrews
- UK
| | - Amber L. Rigg
- EaStCHEM School of Chemistry
- University of St Andrews
- St Andrews
- UK
| | - David B. Cordes
- EaStCHEM School of Chemistry
- University of St Andrews
- St Andrews
- UK
| | | | | | - Frank Hoffmann
- Institute of Inorganic and Applied Chemistry
- Department of Chemistry
- University of Hamburg
- 20146 Hamburg
- Germany
| | | | - Paul A. Wright
- EaStCHEM School of Chemistry
- University of St Andrews
- St Andrews
- UK
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Kümpfel T, Thiel S, Meinl I, Ciplea AI, Bayas A, Hoffmann F, Hofstadt-van Oy U, Hoshi M, Kluge J, Ringelstein M, Aktas O, Stoppe M, Walter A, Weber MS, Ayzenberg I, Hellwig K. Anti-CD20 therapies and pregnancy in neuroimmunologic disorders: A cohort study from Germany. Neurol Neuroimmunol Neuroinflamm 2020; 8:8/1/e913. [PMID: 33334856 PMCID: PMC7757754 DOI: 10.1212/nxi.0000000000000913] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To report pregnancy outcomes and disease activity (DA) in women with MS, neuromyelitis optica spectrum disorders (NMOSDs), and other neuroimmunologic diseases (ONID) after treatment with rituximab (RTX)/ocrelizumab (OCR) 12 months before or during pregnancy. METHODS Data were collected in the German MS and pregnancy registry and centers from the Neuromyelitis Optica Study Group. Sixty-eight known outcomes of 88 pregnancies from 81 women (64 MS, 10 NMOSD, and 7 ONID) were included and stratified in 3 exposure groups: >6M-group = RTX/OCR >6 but ≤12 months before the last menstrual period (LMP) (n = 8); <6M group = RTX/OCR <6 months before the LMP (n = 47); preg group = RTX/OCR after the LMP (n = 13). RESULTS Pregnancy outcomes were similar between groups, but significantly more preterm births (9.8% vs 45%) occurred after exposure during pregnancy. Overall, 2 major congenital abnormalities (3.3%), both in the preg group, were observed. Three women had severe infections during pregnancy. All women with MS (35) and 12/13 women with NMOSD, RTX/OCR exposure before the LMP and known pregnancy outcomes after gestational week 22 were relapse free during pregnancy. Five of 29 (17.2%) women with relapsing-remitting MS (RRMS) and 1 of 12 (8.3%) with NMOSD and at least 6 months postpartum follow-up experienced a relapse postpartum. Duration of RTX/OCR and early retreatment but not detection of B-cells were possible predictors for postpartum relapses in patients with RRMS/NMOSD. CONCLUSIONS Although RTX/OCR might be an interesting option for women with RRMS/NMOSD who plan to become pregnant to control DA, more data on pregnancy outcomes and rare risks are needed.
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Affiliation(s)
- Tania Kümpfel
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Sandra Thiel
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Ingrid Meinl
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Andrea I Ciplea
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Antonios Bayas
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Frank Hoffmann
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Ulrich Hofstadt-van Oy
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Muna Hoshi
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Jakob Kluge
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Marius Ringelstein
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Orhan Aktas
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Muriel Stoppe
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Annette Walter
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Martin S Weber
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Ilya Ayzenberg
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany
| | - Kerstin Hellwig
- From the Institute of Clinical Neuroimmunology (T.K., I.M.), Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet München, Munich; Department of Neurology (S.T., A.I.C., I.A., K.H.), Katholisches Klinikum, St. Josef Hospital, Ruhr University Bochum; Institute of Clinical Pharmacy and Pharmacotherapy (A.I.C.), Heinrich Heine University Düsseldorf; Department of Neurology (A.B.), University Hospital of Augsburg; Klinik für Neurologie (F.H.), Krankenhaus Martha-Maria Halle-Dölau gGmbH, Halle (Saale); Klinik für Neurologie (U.H.-v.O.), Knappschaftskrankenhaus Dortmund Klinikum Westfalen, Dortmund; Marianne-Strauß-Klinik (M.-M.H.), Berg; Department of Neurology (J.K.), Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen; Department of Neurology (M.R., O.A.), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (M.S.), University of Leipzig; Sektion Neuroimmunologie (A.W.), Klinik für Neurologie, Klinikum Herford; Institute of Neuropathology and Department of Neurology (M.S.W.), University Medical Center, Georg August University Göttingen, Germany.
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Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Salzberger B, Gastmeier P, Langer F, Wepler M, Westhoff M, Pfeifer M, Hoffmann F, Böttiger BW, Marx G, Karagiannidis C. [German recommendations for treatment of critically ill patients with COVID-19-version 3]. Pneumologe (Berl) 2020; 17:406-425. [PMID: 33110402 PMCID: PMC7581953 DOI: 10.1007/s10405-020-00359-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Seit Dezember 2019 verbreitet sich das neuartige Coronavirus SARS-CoV‑2 (Severe Acute Respiratory Syndrome – Corona Virus-2) rasch im Sinne einer weltweiten Pandemie. Dies stellt Kliniker und Krankenhäuser vor große Herausforderungen und belastet die Gesundheitssysteme vieler Länder in einem nie dagewesenen Ausmaß. Die Mehrheit der Patienten zeigt lediglich milde Symptome der sogenannten Coronavirus Disease 2019 (COVID-19). Dennoch benötigen etwa 5–8 % eine intensivmedizinische Behandlung. Die akute hypoxämische respiratorische Insuffizienz mit Dyspnoe und hoher Atemfrequenz (>30/Min) führt in der Regel zur Aufnahme auf die Intensivstation. Oft finden sich dann bereits bilaterale pulmonale Infiltrate/Konsolidierungen oder auch Lungenembolien in der Bildgebung. Im weiteren Verlauf entwickeln viele Patienten ein Acute Respiratory Distress Syndrome (ARDS). Eine klinische Wirksamkeit einer medikamentösen Therapie bei schwerer COVID-Erkrankung (hospitalisierte Patienten) ist bisher für Remdesivir und Dexamethason nachgewiesen. Das Hauptziel der supportiven Therapie ist es eine ausreichende Oxygenierung sicherzustellen. Die invasive Beatmung und wiederholte Bauchlagerung sind dabei wichtige Elemente in der Behandlung von schwer hypoxämischen COVID-19 Patienten. Die strikte Einhaltung der Basishygiene, einschließlich der Händehygiene, sowie das korrekte Tragen von adäquater persönlicher Schutzausrüstung sind im Umgang mit den Patienten unabdingbar. Prozeduren, die zur Aerosolbildung führen könnten, sollten falls nötig, mit äußerster Sorgfalt und Vorbereitung durchgeführt werden.
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Affiliation(s)
- S. Kluge
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Deutschland
| | - U. Janssens
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - T. Welte
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - S. Weber-Carstens
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - G. Schälte
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B. Salzberger
- Deutsche Gesellschaft für Infektiologie (DGI), München, Deutschland
| | - P. Gastmeier
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Deutschland
| | - F. Langer
- Gesellschaft für Thrombose und Hämostaseforschung (GTH), Köln, Deutschland
| | - M. Wepler
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - M. Westhoff
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - M. Pfeifer
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - F. Hoffmann
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Berlin, Deutschland
| | - B. W. Böttiger
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutscher Rat für Wiederbelebung (German Resuscitation Council; GRC), Ulm, Deutschland
| | - G. Marx
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - C. Karagiannidis
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
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Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Salzberger B, Gastmeier P, Langer F, Wepler M, Westhoff M, Pfeifer M, Hoffmann F, Böttiger BW, Marx G, Karagiannidis C. [German recommendations for treatment of critically ill patients with COVID-19-version 3 : S1-guideline]. Anaesthesist 2020; 69:653-664. [PMID: 32833080 PMCID: PMC7444177 DOI: 10.1007/s00101-020-00833-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Seit Dezember 2019 verbreitet sich das neuartige Coronavirus SARS-CoV‑2 (Severe Acute Respiratory Syndrome – Corona Virus-2) rasch im Sinne einer weltweiten Pandemie. Dies stellt Kliniker und Krankenhäuser vor große Herausforderungen und belastet die Gesundheitssysteme vieler Länder in einem nie dagewesenen Ausmaß. Die Mehrheit der Patienten zeigt lediglich milde Symptome der sogenannten Coronavirus Disease 2019 (COVID-19). Dennoch benötigen etwa 5–8 % eine intensivmedizinische Behandlung. Die akute hypoxämische respiratorische Insuffizienz mit Dyspnoe und hoher Atemfrequenz (>30/Min) führt in der Regel zur Aufnahme auf die Intensivstation. Oft finden sich dann bereits bilaterale pulmonale Infiltrate/Konsolidierungen oder auch Lungenembolien in der Bildgebung. Im weiteren Verlauf entwickeln viele Patienten ein Acute Respiratory Distress Syndrome (ARDS). Eine klinische Wirksamkeit einer medikamentösen Therapie bei schwerer COVID-Erkrankung (hospitalisierte Patienten) ist bisher für Remdesivir und Dexamethason nachgewiesen. Das Hauptziel der supportiven Therapie ist es eine ausreichende Oxygenierung sicherzustellen. Die invasive Beatmung und wiederholte Bauchlagerung sind dabei wichtige Elemente in der Behandlung von schwer hypoxämischen COVID-19 Patienten. Die strikte Einhaltung der Basishygiene, einschließlich der Händehygiene, sowie das korrekte Tragen von adäquater persönlicher Schutzausrüstung sind im Umgang mit den Patienten unabdingbar. Prozeduren, die zur Aerosolbildung führen könnten, sollten falls nötig, mit äußerster Sorgfalt und Vorbereitung durchgeführt werden.
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Affiliation(s)
- S Kluge
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland.
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland.
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland.
- ARDS Netzwerk Deutschland, Berlin, Deutschland.
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - U Janssens
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - T Welte
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - S Weber-Carstens
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - G Schälte
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - B Salzberger
- Deutsche Gesellschaft für Infektiologie (DGI), München, Deutschland
| | - P Gastmeier
- Deutsche Gesellschaft für Hygiene und Mikrobiologie (DGHM), Münster, Deutschland
| | - F Langer
- Gesellschaft für Thrombose und Hämostaseforschung (GTH), Köln, Deutschland
| | - M Wepler
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
| | - M Westhoff
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - M Pfeifer
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
| | - F Hoffmann
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Berlin, Deutschland
| | - B W Böttiger
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutscher Rat für Wiederbelebung (German Resuscitation Council; GRC), Ulm, Deutschland
| | - G Marx
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
| | - C Karagiannidis
- Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), Berlin, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), Berlin, Deutschland
- ARDS Netzwerk Deutschland, Berlin, Deutschland
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Hoffmann F, Böttiger BW, Eich C. [Best possible balance between risk to those providing help and the benefit for the patients]. Notf Rett Med 2020; 23:462-464. [PMID: 32863757 PMCID: PMC7445804 DOI: 10.1007/s10049-020-00769-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- F. Hoffmann
- Campus Innenstadt, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Interdisziplinäre Kinderintensivstation – Kindernotfallmedizin, LMU Klinikum, Lindwurmstr. 4, 80337 München, Deutschland
| | - B. W. Böttiger
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR), Köln, Deutschland
| | - C. Eich
- Abteilung Anästhesie, Kinderintensiv- und Notfallmedizin, Kinder- und Jugendkrankenhaus AUF DER BULT, Hannover, Deutschland
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Frahm M, Drathen T, Gronbach LM, Voss A, Lorenz F, Bresien J, Villinger A, Hoffmann F, Brasholz M. Visible‐Light Cascade Photooxygenation of Tetrahydrocarbazoles and Cyclohepta[
b
]indoles: Access to
C
,
N
‐Diacyliminium Ions. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202007549] [Citation(s) in RCA: 4] [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: 12/12/2022]
Affiliation(s)
- Mario Frahm
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Thorsten Drathen
- Department of Chemistry University of Hamburg Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | - Lisa Marie Gronbach
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Alice Voss
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Felix Lorenz
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Jonas Bresien
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Alexander Villinger
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
| | - Frank Hoffmann
- Department of Chemistry University of Hamburg Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | - Malte Brasholz
- Institute of Chemistry University of Rostock Albert-Einstein-Str. 3A 18059 Rostock Germany
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Frahm M, von Drathen T, Gronbach LM, Voss A, Lorenz F, Bresien J, Villinger A, Hoffmann F, Brasholz M. Visible-Light Cascade Photooxygenation of Tetrahydrocarbazoles and Cyclohepta[b]indoles: Access to C,N-Diacyliminium Ions. Angew Chem Int Ed Engl 2020; 59:12450-12454. [PMID: 32501642 PMCID: PMC7384090 DOI: 10.1002/anie.202007549] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 11/11/2022]
Abstract
Tetrahydrocarbazoles and perhydrocyclohepta[b]indoles undergo a catalytic cascade singlet oxygenation in alkaline medium, which leads to chiral tricyclic perhydropyrido- and perhydroazepino[1,2-a]indoles in a single operation. These photooxygenation products are new synthetic equivalents of uncommon C,N-diacyliminium ions and can be functionalized with the aid of phosphoric acid organocatalysis.
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Affiliation(s)
- Mario Frahm
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Thorsten von Drathen
- Department of ChemistryUniversity of HamburgMartin-Luther-King-Platz 620146HamburgGermany
| | - Lisa Marie Gronbach
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Alice Voss
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Felix Lorenz
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Jonas Bresien
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Alexander Villinger
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
| | - Frank Hoffmann
- Department of ChemistryUniversity of HamburgMartin-Luther-King-Platz 620146HamburgGermany
| | - Malte Brasholz
- Institute of ChemistryUniversity of RostockAlbert-Einstein-Str. 3A18059RostockGermany
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Van de Voorde P, Biarent D, Bingham B, Brissaud O, De Lucas N, Djakow J, Hoffmann F, Lauritsen T, Martinez AM, Turner NM, Maconochie I, Monsieurs KG. Basismaßnahmen und erweiterte Maßnahmen zur Wiederbelebung von Kindern. Notf Rett Med 2020; 23:251-256. [PMID: 32536801 PMCID: PMC7284676 DOI: 10.1007/s10049-020-00721-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- P. Van de Voorde
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - D. Biarent
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - B. Bingham
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - O. Brissaud
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - N. De Lucas
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - J. Djakow
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - F. Hoffmann
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - T. Lauritsen
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - A. M. Martinez
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - N. M. Turner
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - I. Maconochie
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
| | - K. G. Monsieurs
- European Resuscitation Council VZW, Emile Vanderveldelaan 35, 2845 Niel, Belgien
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Dörr J, Bäcker-Koduah P, Wernecke KD, Becker E, Hoffmann F, Faiss J, Brockmeier B, Hoffmann O, Anvari K, Wuerfel J, Piper SK, Bellmann-Strobl J, Brandt AU, Paul F. High-dose vitamin D supplementation in multiple sclerosis - results from the randomized EVIDIMS (efficacy of vitamin D supplementation in multiple sclerosis) trial. Mult Scler J Exp Transl Clin 2020; 6:2055217320903474. [PMID: 32047645 PMCID: PMC6984434 DOI: 10.1177/2055217320903474] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 11/22/2022] Open
Abstract
Background Epidemiological, preclinical, and non-interventional studies link vitamin D (VD) serum levels and disease activity in multiple sclerosis (MS). It is unclear whether high-dose VD supplementation can be used as an intervention to reduce disease activity. Objectives The study aimed to compare the effects of every other day high- (20,400 IU) versus low-dose (400 IU) cholecalciferol supplementation on clinical and imaging markers of disease activity in patients with relapsing–remitting MS or clinically isolated syndrome. Methods The EVIDIMS (efficacy of vitamin D supplementation in multiple sclerosis) trial was a multicentre randomized/stratified actively controlled explorative phase 2a pilot trial with a double-blind intervention period of 18 months, add on to interferon-β1b. Results Fifty-three patients were randomized, and 41 patients completed the study. Cholecalciferol supplementation was well tolerated and safe in both arms. After 18 months, clinical (relapse rates, disability progression) and radiographical (T2-weighted lesion development, contrast-enhancing lesion development, brain atrophy) did not differ between both treatment arms. Post-study power calculations suggested that the sample size was too low to prove the hypothesis. Conclusions The results neither support nor disprove a therapeutic benefit of high-dose VD supplementation but provide a basis for sound sample size estimations in future confirmatory studies. www.clinicaltrials.gov/NCT01440062
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Affiliation(s)
- Jan Dörr
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | - Priscilla Bäcker-Koduah
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | | | - Elke Becker
- Neurologisches Facharztzentrum Berlin, Germany
| | - Frank Hoffmann
- Department of Neurology, Krankenhaus Martha-Maria Halle-Doelau, Germany
| | - Jürgen Faiss
- Department of Neurology, Asklepios Kliniken Teupitz and Lübben, Germany
| | | | - Olaf Hoffmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | | | - Jens Wuerfel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | - Sophie K Piper
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Germany
| | - Judith Bellmann-Strobl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | - Alexander U Brandt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
| | - Friedemann Paul
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center, Germany
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Schendera E, Unkel LN, Huyen Quyen PP, Salkewitz G, Hoffmann F, Villinger A, Brasholz M. Visible-Light-Mediated Aerobic Tandem Dehydrogenative Povarov/Aromatization Reaction: Synthesis of Isocryptolepines. Chemistry 2020; 26:269-274. [PMID: 31553081 PMCID: PMC6973160 DOI: 10.1002/chem.201903921] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Indexed: 01/25/2023]
Abstract
A metal‐free, photoinduced aerobic tandem amine dehydrogenation/Povarov cyclization/aromatization reaction between N‐aryl glycine esters and indoles leads to tetracyclic 11H‐indolo[3,2‐c]quinolines under mild conditions and with high yields. The reaction can be performed by using molecular iodine along with visible light, or by combining an organic photoredox catalyst with a halide anion. Mechanistic studies reveal that product formation occurs through a combination of radical‐mediated oxidation steps with an iminium ion or N‐haloiminium ion [4+2]‐cycloaddition, and the N‐heterocyclic products constitute new analogues of the antiplasmodial natural alkaloid isocryptolepine.
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Affiliation(s)
- Eva Schendera
- Institute of Chemistry, Organic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
| | - Lisa-Natascha Unkel
- Institute of Chemistry, Organic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
| | - Phung Phan Huyen Quyen
- Institute of Chemistry, Organic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
| | - Gwen Salkewitz
- Institute of Chemistry, Organic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
| | - Frank Hoffmann
- Department of Chemistry, Institute of Inorganic Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146, Hamburg, Germany
| | - Alexander Villinger
- Institute of Chemistry, Inorganic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
| | - Malte Brasholz
- Institute of Chemistry, Organic Chemistry, University of Rostock, Albert-Einstein-Strasse 3A, 18059, Rostock, Germany
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Demirakca S, Hoffmann F. Respiratorische Notfälle und Atemwegsmanagement bei Kindern. Notf Rett Med 2019. [DOI: 10.1007/s10049-019-00655-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Haibel H, Redeker I, Zink A, Callhoff J, Marschall U, Hoffmann F, Sieper J, Poddubnyy D. [Health care and disease burden in persons with axial spondyloarthritis in Germany]. Z Rheumatol 2019; 78:865-874. [PMID: 31172266 DOI: 10.1007/s00393-019-0650-7] [Citation(s) in RCA: 9] [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: 12/21/2022]
Abstract
BACKGROUND Only very few data are available on the comprehensive care in patients with axial spondylarthritis (axSpA), one of the most frequent inflammatory rheumatic disease. OBJECTIVE Description of the comprehensive care and common prescription patterns of medications and other therapies in patients with axSpA depending on the type of medical care by rheumatologists or nonrheumatologists. METHODS A cross-sectional analysis was performed based on claims data of the BARMER health insurance company (in 2015) and a questionnaire, which was sent to a representative sample of patients with axSpA (International Classification of Diseases, 10th revision, German modification, ICD-10-GM, code M45) aged 18-79 years. A stratified sample of 5000 patients was used. The patients received a postal questionnaire including questions regarding the disease, health-related and psychological parameters and socioeconomic factors. Claims data consisted of demographic factors, medicinal and nonmedicinal treatment and the extra-articular manifestations inflammatory bowel disease, psoriasis and uveitis. RESULTS A total of 1741 patients (mean age 55.9 years, female 46.4%, 86.2% Human Leucocyte Antigen[HLA]-B27 positive) confirmed the diagnosis and answered the questionnaire. The mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 4.5 and the mean Bath Ankylosing Spondylitis Functional Index (BASFI) 4.1. Of the patients 46% were treated by rheumatologists. There was a substantial difference between patients in rheumatological care and those who were not in rheumatological care regarding prescriptions for drug treatment of axSpA (91.8% versus 66.4%). This difference was especially prominent for prescriptions of biologic disease-modifying antirheumatic drugs: 34.1% of patients in rheumatological care versus 3.1% of patients treated by nonrheumatologists (p < 0.0001), despite similar disease activity in both groups. CONCLUSION The data show that the majority of patients diagnosed with axSpA did not receive regular care from rheumatologists. This seemed to be associated with insufficient medicinal care at least in some of these patients.
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Affiliation(s)
- H Haibel
- Abteilung für Rheumatologie, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
| | - I Redeker
- Abteilung für Rheumatologie, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.,Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - A Zink
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - J Callhoff
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Berlin, Deutschland
| | - U Marschall
- Forschungsbereichsleitung BARMER Institut für Gesundheitssystemforschung, Wuppertal, Deutschland
| | - F Hoffmann
- Abteilung für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - J Sieper
- Abteilung für Rheumatologie, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland
| | - D Poddubnyy
- Abteilung für Rheumatologie, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland
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Bantel C, Hoffmann F, Jobski K. Pain And The Use Of Gabapentinoids In German Nursing Home Residents - Results From An Analysis Based On Statutory Health Insurance Data. J Pain Res 2019; 12:3175-3184. [PMID: 31819602 PMCID: PMC6878919 DOI: 10.2147/jpr.s221579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/03/2019] [Indexed: 11/23/2022] Open
Abstract
Background Gabapentinoids (gabapentin and pregabalin) are psychoactive medications that are increasingly used for different conditions. Since there is evidence that psychotropic drugs, in general, are often inappropriately prescribed in elderly patients, we aimed to determine frequency and indications of gabapentinoid prescribing for nursing home residents. Methods We analyzed data from a large German statutory health insurance database. Included were records from people ≥65 years-of-age, who were admitted to a nursing home between January 2010 and December 2014. We determined the number and proportion of common indications for on- and off-label prescriptions, the most frequent co-medications, and the characteristics of patients and prescribers. Results Of 127,277 residents, 9539 (7.5%) received gabapentinoids and 4852 initiated treatment (4.0%; with 66.3% pregabalin). Median age of gabapentinoid initiators was 84 years (78.5% females). In these users, on-label prescribing was found in 57.4%, predominantly for neuropathic pain. Other painful conditions were also chief causes (84.7%) for off-label prescribing. Gabapentinoids were mainly started by general practitioners (64.5%) while pain specialists contributed <2%. Forty-six percent of users received additional opioids and in 27.5% gabapentinoids were prescribed only once. Conclusion Gabapentinoids were frequently used in nursing home residents. Regular co-prescribing with opioids and psychotropic drugs might indicate employment to improve pain or assist treatment of conditions that are frequently associated with disruptive behavior such as dementia. However, more research is needed to better understand decision-making regarding gabapentinoid prescribing, especially in view of aggressive marketing, uncertain analgesic effects, problematic side effects, and uncritical use in the elderly.
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Affiliation(s)
- C Bantel
- Department of Anesthesiology, Critical Care, Emergency and Pain Medicine, Universität Oldenburg, Klinikum Oldenburg, Oldenburg, Germany.,Department of Surgery & Cancer, Anaesthetics Section, Imperial College London, London, UK
| | - F Hoffmann
- Department of Health Services Research, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - K Jobski
- Department of Health Services Research, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
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43
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Albrecht K, Luque Ramos A, Callhoff J, Hoffmann F, Minden K, Zink A. [Outpatient care and disease burden of rheumatoid arthritis : Results of a linkage of claims data and a survey of insured persons]. Z Rheumatol 2019; 77:102-112. [PMID: 28324149 DOI: 10.1007/s00393-017-0294-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 11/24/2022]
Abstract
BACKGROUND Healthcare of patients with rheumatoid arthritis (RA) in Germany has mainly been evaluated in the past in RA cohorts from specialized arthritis centers. This study investigated rheumatological care on a population basis, using claims data from a nationwide statutory health insurance fund (BARMER GEK) in combination with patient-reported outcomes from a questionnaire survey of insured persons with RA. METHODS Data from insurants aged 18-79 years with M05 (seropositive RA) or M06 (other RA, ICD-10) diagnoses were analyzed concerning diagnostics, medication and prescribing physician. A 31-item questionnaire covering patient reported diagnosis, healthcare utilization and burden of illness was sent to a stratified random sample of 6193 insured persons. Data from the respondents regarding rheumatological care and disease status were evaluated. RESULTS In 2013 and 2014, a total of 96,921 adults with M05 or M06 diagnosis were insured. The questionnaire was answered by 51% of the sample and of these 81% confirmed the RA diagnosis. RA had been diagnosed by a rheumatologist in 59% of the cases, 70% reported moderate to severe pain and 46% had functional disability. Between at least 40% (claims data) and up to 68% (respondents) were in specialized rheumatological care. Treatment with disease-modifying antirheumatic drugs (DMARDs) was 61% (claims data) and 63% (respondents) in persons in rheumatological care but only 18% outside rheumatological care. CONCLUSION The results indicate that specialized rheumatological care is required to provide adequate treatment for patients with RA in Germany. Patients with higher age and patients with M06 diagnosis had less drug prescriptions and were less frequently treated by rheumatologists.
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Affiliation(s)
- K Albrecht
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - A Luque Ramos
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - J Callhoff
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - F Hoffmann
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - K Minden
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.,Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - A Zink
- Programmbereich Epidemiologie, Deutsches Rheumaforschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.,Charité Universitätsmedizin Berlin, Berlin, Deutschland
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44
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Callhoff J, Albrecht K, Hoffmann F, Poddubnyy D, Günther KP, Zink A. Reality of care for musculoskeletal diseases at the population level. Z Rheumatol 2019; 78:73-79. [DOI: 10.1007/s00393-019-0669-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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45
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Poryvaev AS, Polyukhov DM, Gjuzi E, Hoffmann F, Fröba M, Fedin MV. Radical-Doped Metal–Organic Framework: Route to Nanoscale Defects and Magnetostructural Functionalities. Inorg Chem 2019; 58:8471-8479. [DOI: 10.1021/acs.inorgchem.9b00696] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Artem S. Poryvaev
- International Tomography Center SB RAS, Institutskaya str. 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova str. 2, Novosibirsk, 630090, Russia
| | - Daniil M. Polyukhov
- International Tomography Center SB RAS, Institutskaya str. 3a, Novosibirsk, 630090, Russia
- N.N. Vorozhtsov Institute of Organic Chemistry SB RAS, Novosibirsk, 630090, Russia
| | - Eva Gjuzi
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Frank Hoffmann
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Michael Fröba
- Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King-Platz 6, 20146 Hamburg, Germany
| | - Matvey V. Fedin
- International Tomography Center SB RAS, Institutskaya str. 3a, Novosibirsk, 630090, Russia
- Novosibirsk State University, Pirogova str. 2, Novosibirsk, 630090, Russia
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46
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Fischer M, Köhler W, Faiss JH, Hoffmann F, Kunkel A, Sailer M, Schwab M, Zettl UK, Bublak P. A smart peek: Processing of rapid visual displays is disturbed in newly diagnosed, cognitively intact MS patients and refers to cognitive performance and disease progression in late stages. J Neurol Sci 2019; 401:118-124. [DOI: 10.1016/j.jns.2019.04.031] [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] [Received: 09/26/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 10/27/2022]
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47
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Unkel L, Malcherek S, Schendera E, Hoffmann F, Rehbein J, Brasholz M. Photoorganocatalytic Aerobic Oxidative Amine Dehydrogenation/Super Acid‐Mediated Pictet‐Spengler Cyclization: Synthesis of
cis
‐1,3‐Diaryl Tetrahydroisoquinolines. Adv Synth Catal 2019. [DOI: 10.1002/adsc.201900165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Lisa‐Natascha Unkel
- University of RostockInstitute of Chemistry Albert-Einstein-Str. 3 A 18059 Rostock Germany
| | - Simon Malcherek
- University of RegensburgInstitute of Organic Chemistry Universitätsstr. 31 93053 Regensburg Germany
| | - Eva Schendera
- University of RostockInstitute of Chemistry Albert-Einstein-Str. 3 A 18059 Rostock Germany
| | - Frank Hoffmann
- University of Hamburg, Department of ChemistryInstitute of Inorganic Chemistry Martin-Luther-King-Platz 6 20146 Hamburg Germany
| | - Julia Rehbein
- University of RegensburgInstitute of Organic Chemistry Universitätsstr. 31 93053 Regensburg Germany
| | - Malte Brasholz
- University of RostockInstitute of Chemistry Albert-Einstein-Str. 3 A 18059 Rostock Germany
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48
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Heimböckel R, Hoffmann F, Fröba M. Insights into the influence of the pore size and surface area of activated carbons on the energy storage of electric double layer capacitors with a new potentially universally applicable capacitor model. Phys Chem Chem Phys 2019; 21:3122-3133. [PMID: 30675602 DOI: 10.1039/c8cp06443a] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The electric double layer formation of supercapacitors is governed by ion electrosorption at the electrode surface. Large surface areas are beneficial for the energy storage process, typically achieved by carbon electrode materials. It is a matter of debate whether pores provide the same contribution to the capacitance regardless of the size, or if subnanometer pores lead to an anomalous increase of capacitance. In our work, we developed a new model for normalized capacitance depending on pore sizes, using a combination of a sandwich type capacitor for micropores and double-cylinder capacitor model for larger pores. Modification factors for each capacitance value were calculated using the nonlinear generalized reduced gradient method to obtain a modified electric sandwich double-cylinder capacitor (ESDCC) model. The model was validated by comparing the measured capacitance values of a set of prepared activated carbons in organic electrolytes with simulated values according to the modified ESDCC model, using combined physisorption data of carbon dioxide and nitrogen. We concluded a non-constant capacitive contribution, with pores having the size of bare cations contributing to the capacitance to a larger extent and mesopores with the size of three solvated ions providing an unusual low contribution to the overall capacitance.
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Affiliation(s)
- Ruben Heimböckel
- Department of Chemistry, Institute of Inorganic and Applied Chemistry, University of Hamburg, Martin-Luther-King Platz 6, D-20146 Hamburg, Germany.
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Stork L, Brück W, von Gottberg P, Pulkowski U, Kirsten F, Glatzel M, Rauer S, Scheibe F, Radbruch H, Hammer E, Stürner KH, Kaulen B, Heesen C, Hoffmann F, Brock S, Pawlitzki M, Bopp T, Metz I. Severe meningo-/encephalitis after daclizumab therapy for multiple sclerosis. Mult Scler 2019; 25:1618-1632. [DOI: 10.1177/1352458518819098] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Daclizumab is a monoclonal antibody that binds the high-affinity interleukin-2 receptor and was approved for the treatment of relapsing multiple sclerosis. Due to severe inflammatory brain disorders, the approval was suspended in March 2018. Objective and Methods: This retrospective cohort study summarizes clinical, laboratory, radiological, and histological findings of seven patients who developed meningo-/encephalitis after daclizumab therapy. Results: Patients presented with encephalitis and/or meningitis and suffered from systemic symptoms such as fever (5/7), exanthema (5/7), or gastrointestinal symptoms (4/7). Secondary autoimmune diseases developed. Blood analysis revealed an increase in eosinophils (5/7). Six patients fulfilled the diagnostic criteria for a drug reaction with eosinophilia and systemic symptoms (DRESS). Magnetic resonance imaging (MRI) showed multiple contrast-enhancing lesions, and enhancement of the ependyma (6/7), meninges (5/7), cranial or spinal nerves (2/7), and a vasculitic pattern (3/7). Histology revealed a pronounced inflammatory infiltrate consisting of lymphocytes, plasma cells and eosinophils, and densely infiltrated vessels. Most patients showed an insufficient therapeutic response and a high disability at last follow-up (median Expanded Disability Status Scale (EDSS) 8). Two patients died. Conclusion: Meningoencephalitis and DRESS may occur with daclizumab therapy. This potential lethal side effect is characterized by a dysregulated immune response. Our findings underline the importance of postmarketing drug surveillance.
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Affiliation(s)
- Lidia Stork
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
| | - Phillip von Gottberg
- Institute of Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Florian Kirsten
- Department of Neurology, Imland Hospital, Rendsburg, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Sebastian Rauer
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
| | - Franziska Scheibe
- Department of Neurology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Helena Radbruch
- Institute of Neuropathology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Eckhard Hammer
- Department of Neurology, Marienkrankenhaus, Hamburg, Germany
| | - Klarissa H Stürner
- Department of Neurology, University Hospital Schleswig—Holstein, Kiel, Germany
| | - Barbara Kaulen
- Department of Neurology, University Hospital Hamburg Eppendorf, Hamburg, Germany; Institute of Neuroimmunology and Multiple Sclerosis, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Department of Neurology, University Hospital Hamburg Eppendorf, Hamburg, Germany; Institute of Neuroimmunology and Multiple Sclerosis, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Frank Hoffmann
- Department of Neurology, Martha-Maria Hospital, Halle, Germany
| | - Sebastian Brock
- Department of Neurology, Martha-Maria Hospital, Halle, Germany
| | - Marc Pawlitzki
- Department of Neurology, University Medical Center, Otto von Guericke University, Magdeburg, Germany
| | - Tobias Bopp
- Institute for Immunology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Imke Metz
- Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany
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Stein T, Hoffmann F, Fröba M. A new set of metal–organic frameworks synthesised from diisophthalate-based, 2′-phosphorus-substituted m-terphenyl linker molecules. Dalton Trans 2019; 48:15127-15135. [DOI: 10.1039/c9dt03044a] [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: 11/21/2022]
Abstract
Four metal–organic frameworks employing the m-terphenyl diisophthalate linker molecule with 2′ substitution by P(v)-based functional groups of the central aryl have been synthesised.
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Affiliation(s)
- Timo Stein
- Institut für Anorganische und Angewandte Chemie
- Universität Hamburg
- 20146 Hamburg
- Germany
| | - Frank Hoffmann
- Institut für Anorganische und Angewandte Chemie
- Universität Hamburg
- 20146 Hamburg
- Germany
| | - Michael Fröba
- Institut für Anorganische und Angewandte Chemie
- Universität Hamburg
- 20146 Hamburg
- Germany
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