51
|
Kribs A, Härtel C, Kattner E, Vochem M, Küster H, Möller J, Müller D, Segerer H, Wieg C, Gebauer C, Nikischin W, Wense AVD, Herting E, Roth B, Göpel W. Surfactant without intubation in preterm infants with respiratory distress: first multi-center data. KLINISCHE PADIATRIE 2010; 222:13-7. [PMID: 20084586 DOI: 10.1055/s-0029-1241867] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recently in a report of a single center a method has been described to apply surfactant via a thin endotracheal catheter to very low birth weight infants spontaneously breathing with nasal continuous positive airway pressure. We now analyzed available multicenter data. PATIENTS AND METHODS In a multicenter study investigating genetic risk factors, clinical and outcome data and data of antenatal and postnatal treatment of infants with a birth weight below 1,500 g were prospectively recorded. The measures of infants treated with the new method of surfactant application were compared to those of infants who received standard care. The analysis was restricted to infants with a gestational age below 31 weeks (n=1,541). RESULTS 319 infants were treated with the new method and 1,222 with standard care. The need for mechanical ventilation during the first 72 h (29% vs. 53%, p<0.001), the rate of bronchopulmonary dysplasia defined as oxygen at 36 weeks of postmenstrual age (10.9 % vs. 17.5%, p=0.004) and the rate of death or bronchopulmonary dysplasia were significantly lower in the treatment group than in the standard care group. Surfactant, theophyllin, caffeine and doxapram were significantly more often and analgetics, catecholamines and dexamethasone were significantly less frequently used in the treatment group. CONCLUSIONS A new method of surfactant application was associated with a lower prevalence of mechanical ventilation and better pulmonary outcome. A prospective controlled trial is required to determine whether this approach is superior to standard care.
Collapse
|
52
|
Kanariou M, Dracou C, Spanou K, Möller J, Rösen-Wolff A, Schuster V, Roesler J. Twenty year follow up of a patient with a new de-novo NLRP3 mutation (S595G) and CINCA syndrome. KLINISCHE PADIATRIE 2009; 221:379-81. [PMID: 19890791 DOI: 10.1055/s-0029-1239572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report on a 22-year-old girl with a history of recurrent febrile episodes, chronic arthritis, urticarial rash, and neurological symptoms including right hemiparesis, internal hydrocephalus, mental retardation, progressive deafness, and visual impairment. Treatment starting at age 20 months, including different combinations of immunosuppressive and antiinflammatory drugs such as corticosteroids and anti-TNFalpha antibody, was unsuccessful. Four years ago, we found a heterozygous S595G mutation in the NLRP3 gene of this patient. This prompted us to introduce anakinra, which resulted in considerable improvement of the patient's complaints.
Collapse
|
53
|
Möller J, Zieres G. Zur Transparenz der Qualität von Pflegeeinrichtungen. GESUNDHEITSÖKONOMIE & QUALITÄTSMANAGEMENT 2009. [DOI: 10.1055/s-0028-1109638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
54
|
Schmidt C, Möller J, Malchow B, Meyer J, Schmidt K, Küchler T. [Patient satisfaction--a potential cornerstone of hospital management]. Dtsch Med Wochenschr 2009; 134:1151-6. [PMID: 19603379 DOI: 10.1055/s-0029-1222582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hospitals consider themselves to be exposed to intense competition for patient admissions. Yet their competitive performance is only rarely assessed in terms of patient satisfaction. METHODS Following agreed guidelines, formulated on the basis of interdisciplinary research, the University Clinical Centre (2,500 beds, 10,000 employees) of Schleswig Holstein, Germany's most northerly Bundesland, developed and distributed standardized questionnaires on patient satisfaction and collected them after completion. RESULTS 18,711 completed questionnaires were collected from a population of 71,000 treated patients (rate of return: 26%; males 50,6%; females 49,4%). Two-thirds of admissions were elective whereas the remainder were emergencies. The quarterly evaluation revealed quality of food and cleanliness as the main areas of complaint. Patients' dissatisfactions was the greater the longer the stay in hospital. Other differences between patients on statutory or private health insurance, respectively, were voiced regarding "respectful treatment" and "professional ability" (especially by private patients). Furthermore, patient satisfaction related to the duration of doctors' rotation (i.e. how long they were on duty), satisfaction being greater the longer the period of rotation. CONCLUSION The study has provided information on patient satisfaction as a measure of effective hospital management.
Collapse
|
55
|
Trojan J, Getzmann S, Möller J, Kleinböhl D, Hölzl R. Tactile-auditory saltation: spatiotemporal integration across sensory modalities. Neurosci Lett 2009; 460:156-60. [PMID: 19477228 DOI: 10.1016/j.neulet.2009.05.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 02/13/2009] [Accepted: 05/20/2009] [Indexed: 11/26/2022]
Abstract
The perceptual phenomena of sensory saltation involve the systematic displacement of a target stimulus (the attractee) towards a subsequent stimulus (the attractant), which occurs closely in time and space. Here, we demonstrate the existence of cross-modal tactile-auditory saltation. Tactile stimuli were delivered to the forehead and spatially congruent stereoscopic auditory stimuli were presented via headphones to a total of 20 participants. After a reference stimulus at one of five spatial positions, the attractee was presented at a fixed position, followed by the attractant at a different fixed position with a delay of 81, 121, or 181 ms. Participants rated whether the attractee was perceived left or right of the reference in 2 uni-modal and 2 cross-modal (different reference/attractee vs. attractant mode) configurations. Saltation was present in all uni- and cross-modal configurations at an attractee-attractant delay of 81 ms. At delays of 81 ms the overall displacements were stronger than at delays of 121 ms, and tactile attractants generally induced stronger displacements than auditory attractants. The results indicated the existence of cross-modal tactile-auditory saltation, suggesting the application of the saltation phenomenon as a powerful approach for examining multi-modal sensory representations in future studies.
Collapse
|
56
|
Jäger T, Szabo K, Griebe M, Bäzner H, Möller J, Hennerici MG. Selective disruption of hippocampus-mediated recognition memory processes after episodes of transient global amnesia. Neuropsychologia 2009; 47:70-6. [PMID: 18789957 DOI: 10.1016/j.neuropsychologia.2008.08.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 07/27/2008] [Accepted: 08/15/2008] [Indexed: 11/19/2022]
|
57
|
Schmidt C, Reibe F, Sellschopp C, Möller J, Bauer M, Kremer B. [Risk scores and outcomes after cholecystectomy: a comparison between a university hospital and a short-stay clinic--a prospective observational study]. Zentralbl Chir 2008; 133:498-503. [PMID: 18924051 DOI: 10.1055/s-2008-1076886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study was designed to compare the risks of morbidity and mortality of patients in a surgical department of an academic medical centre and a short-stay clinic. Furthermore, economic and patient-related parameters were assessed. METHODS A number of 50 respectively 33 consecutive patients scheduled for a cholecystectomy were included in this prospective study. Data were collected well-assorted against the POSSUM score, the duration of the operation, complications and the length of stay as well as quality of life and patient satisfaction. RESULTS No differences among patients of the two hospitals became apparent as they were referenced against the POSSUM score, nor were any discrepancies in expected respectively ex-post complications upon cholecystectomy observed. The continuance of the operative procedure was found to be significantly lengthened in the university hospital as compared with the non-academic clinic (120.1 +/- 34.3 min vs. 65.6 +/- 16.3 min; p < 0.001). The difference in durability splits up in 1.2 days pre-operatively versus 2.4 days post-operatively. In return, the post-operative pain therapy was esteemed much better in the university hospital. CONCLUSION The POSSUM score is a reliable tool to assess morbidity and mortality in surgical patients. The scores were found to be equal for patients in a university hospital and those in a short-stay clinic. Complications likewisely were equally low in both hospitals. The longer duration of the operation and the higher length of stay revealed structural benefits of the smaller unit. Advantages of the academic centre were found in the standards for pain therapy. The present study is taken both as a reference and as a basis for a fundamental process-redesign to the benefit of involved parties e. g. patients, relatives, staff in the university hospital.
Collapse
|
58
|
Ihmann K, Anhalt D, Steinmann S, Mayer P, Möller J. Neonataler Diabetes mit Mutation im KCNJ11 Gen, eine seltene Diagnose (Fallbeispiel). Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
59
|
Anhalt D, Möller J, Frenzel J, Lüttges J. Koinzidenz eines plazentaren Chorangioms mit fetalem Verschluss von foramen ovale und ductus arteriosus – komplizierter neonataler Verlauf mit pulm. Hypertonus und Multiorganversagen. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
60
|
Abstract
The German hospital market is in a state of transition due to the introduction of diagnosis-related groups (DRGs) and a constant change of the reimbursement, demographic, economical and technical framework. To date mainly public hospitals were bought by private hospital chains, but this trend has currently reached university hospitals. During recent months a consolidation within the market of private hospitals took place, while new market players such as foreign hospital chains, US universities and private equity firms emerged on the scene. The target of the privatisation process, however, turns more and more to larger hospitals. Central key values remain the cluster formation and centralisation of key competences such as food supply, purchasing and pharmacy. Within a network of clinics the representation of different care components (basic, regular and maximum care provider) and care levels (low, normal, intermediate and intensive care) remain important elements of efficient hospital management. Today, successful hospital operation is based on the successful competition for patients and even more for qualified staff. In this aspect, university hospitals could play a decisive role, because of their combination of maximum acute care provision and educational mandate. No such network has yet been formed due to the different interests of the owners, however, given the new market situation this alternative concept could become more attractive.
Collapse
|
61
|
Spiegler J, Härtel C, Gebauer C, Wieg C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, von der Wense A, Herting E, Göpel W. Der 4G/5G-Polymorphismus des Plasminogen-Aktivator-Inhibitor-1-Gens bei Frühgeborenen mit einem Geburtsgewicht unter 1500 Gramm. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
62
|
Schumacher M, Spiegler J, Wieg C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, von der Wense A, Herting E, Göpel W. Wie wichtig sind Diuretika bei VLBW-Frühgeborenen? Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
63
|
Göpel W, Kribs A, Spiegler J, Härtel C, Gebauer C, Wieg C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Vochem M, von der Wense A, Roth B, Herting E. Surfactantgabe ohne Intubation: Multizentrische Daten zu Intubationsraten, Surfactantverbrauch und Begleitmedikation. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
64
|
Kribs A, Göpel W, Frankenbusch K, Gebauer C, Wieg C, Kattner E, Küster H, Möller J, Nikischin W, Roth B, von der Wense A, Herting E, Segerer H, Vochem M, Müller D. Surfactantgabe ohne Intubation: Multizentrische Daten zu bronchopulmonaler Dysplasie, Hirnblutungen, Frühgeborenenretinopathie und Tod. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
65
|
Möller J, Schunert G, Reiss I. Einflussgrößen auf die Urin-Endothelinausscheidung bei Frühgeborenen mit Atemnotsyndrom und Asphyxie. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
66
|
Spiegler J, Härtel C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, Wieg C, von der Wense A, Herting E, Göpel W. Klinische Verläufe monozygoter und gleichgeschlechtlicher dizygoter VLBW-Frühgeborener. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
67
|
Göpel W, Härtel C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, Wieg C, von der Wense A, Herting E. Aktuelle Mortalitätsraten und Outcomedaten extrem unreifer Frühgeborener. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
68
|
Struwe E, Beckmann MW, Blessing H, Dötsch J, Drexel L, Frenzel J, Goecke T, Hauck B, Kirschbaum M, Meurer B, Möller J, Plank C, Scheler C, Schild RL, Schleussner E, Stuppy A, Weidinger M, Winzer H. Die FIPS-Studie (Fetale Programmierung–Intrauterine Wachstumsrestriktion–Plazentare Marker–Studie). Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
69
|
Spiegler J, Härtel C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, Wieg C, von der Wense A, Herting E, Göpel W. Klinische Verläufe monozygoter und gleichgeschlechtlicher dizygoter VLBW-Frühgeborener. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
70
|
Göpel W, Härtel C, Kattner E, Küster H, Möller J, Müller D, Nikischin W, Segerer H, Roth B, Vochem M, Wieg C, von der Wense A, Herting E. Aktuelle Mortalitätsraten und Outcomedaten extrem unreifer Frühgeborener. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
71
|
Kriegeskotte C, Möller J, Lipinsky D, Wittig A, Sauerwein W, Haier J, Arlinghaus HF. Imaging of atomic and molecular species in tissue with laser-SNMS for pharmaceutical studies. SURF INTERFACE ANAL 2006. [DOI: 10.1002/sia.2159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
72
|
Göpel W, Härtel C, Ahrens P, König I, Kattner E, Kuhls E, Küster H, Möller J, Müller D, Roth B, Segerer H, Wieg C, Herting E. Interleukin-6-174-genotype, sepsis and cerebral injury in very low birth weight infants. Genes Immun 2005; 7:65-8. [PMID: 16208404 DOI: 10.1038/sj.gene.6364264] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We investigated the association between the interleukin 6 (IL-6)-174-genotype and unfavorable outcomes in preterm infants since it has been reported that the IL-6-174GG-genotype is associated with increased susceptibility to sepsis, and the IL-6-174CC-genotype is more common in preterm infants with severe intraventricular hemorrhage (IVH). We studied 1206 preterm infants with a birth weight below 1500 g. In contrast to previously published data, the frequency of IVH grade IV, periventricular leukomalacia, ventricular-peritoneal-shunting or death was not different between infants with different IL-6-genotypes: IL-6-174GG (n = 430) 8%, IL-6-174GC (n = 605) 9% and IL-6-174CC (n = 167) 12% (P = 0.2 for IL-6-174CC vs GG + GC). Furthermore, we were not able to confirm previously reported association between sepsis and the IL-6-174GG-genotype. Blood-culture-proven sepsis occurred in 19% of IL-6-174GG-carriers (n = 157), 26% of IL-6-174GC-carriers (n = 193) and 27% of infants carrying the IL-6-174CC-genotype (n = 67). We were not able to confirm previously reported associations between sepsis, cerebral injury and the IL-6-174-genotype in VLBW-infants.
Collapse
|
73
|
Groene O, Möller J, Jorgensen SJ, Fugleholm AM, Moeller L, Schmidt W, Brandt E. Standards zur Gesundheitsförderung im Krankenhaus - Entwicklung und Testergebnisse aus neun europäischen Ländern. GESUNDHEITSÖKONOMIE & QUALITÄTSMANAGEMENT 2005. [DOI: 10.1055/s-2005-857907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
74
|
Laflamme L, Engström K, Möller J, Alldahl M, Hallqvist J. Bullying in the school environment: an injury risk factor? Acta Psychiatr Scand Suppl 2005:20-5. [PMID: 12072121 DOI: 10.1034/j.1600-0447.106.s412.5.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe a research project assessing the role of bullying at school as an injury trigger and the modification effect of the socio-economic environment of the victims. Preliminary results are also presented. METHOD A case-crossover and a case-referent design were combined. The study base consisted of all children aged 10-15 years residing in the Stockholm county in 2000-02. Cases were recruited at the county's children hospital and interviewed shortly after the injury, using a specially designed questionnaire. RESULTS Preliminary analyses (261 interviews) reveal that about two injured children out of 10 reported having been bullied during the school term. Also, one out of 10 had been bullied shortly enough before the injury for bullying to be considered as a trigger. The circumstances of occurrence of those injuries varied. CONCLUSION Bullying, apart from being frequent in the school environment, is quite likely to act as an injury trigger.
Collapse
|
75
|
Härtel C, Ahrens P, Hünseler C, Kattner E, Kuhls E, Küster H, Möller J, Segerer H, Müller D, Wieg C, Herting E, Göpel W. Interleukin-6–174-Genotyp und Sepsisrisiko bei VLBW-Frühgeborenen. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-871339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|