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Richter C, Möhlenbruch MA, Vollherbst DF, Taschner CA, Elsheikh S, Klisch J, Lobsien D, Bester M, Ramdani N, Kaiser DPO, Gerber JC, Schob S, Gazis A, Smirnov P, Scherlach C, Hoffmann KT, Gawlitza M. Non-ischemic cerebral enhancing (NICE) lesions after flow diversion for intracranial aneurysms: a multicenter study. J Neurointerv Surg 2024:jnis-2023-021176. [PMID: 38184369 DOI: 10.1136/jnis-2023-021176] [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: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Non-ischemic cerebral enhancing (NICE) lesions have been reported as a rare complication of various neuroendovascular procedures, but information on their incidence after flow diversion is scant. It is unclear if specific devices or novel coating technologies may impact their occurrence. METHODS We conducted a multicenter study on the incidence of NICE lesions after flow diverter (FD) implantation for cerebral aneurysm treatment. RESULTS Eight centers identified 15 patients and provided detailed data. The clinical presentation ranged from asymptomatic to hemiplegia and cognitive impairment. The mean time to diagnosis after treatment was 65.1±101.5 days. Five centers disclosed information on all of their 1201 FD procedures during the inclusion period (2015-2022), during which 12 patients were diagnosed with NICE lesions in these institutions-that is, an incidence of 1%. FD coatings did not increase the incidence (6/591 patients (1%) treated with surface-modified FD vs 6/610 patients (1%) treated with bare FD; P=1.00). Significantly increased rates of 3.7% (6 cases in 161 procedures; P<0.01) and 3.3% (5 cases in 153 procedures; P<0.01) were found with stents of two specific product lines. The use of one product line was associated with a significantly lower incidence (0 cases in 499 procedures (0%); P<0.01). CONCLUSIONS Novel stent coatings are not associated with an increased incidence of NICE lesions. The incidence rate of 1% suggests that these lesions may occur more often after flow diversion than after other endovascular treatments. We found a concerning accumulation of NICE lesion cases when FDs from two product families were used.
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Affiliation(s)
- Cindy Richter
- Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany
| | - Markus A Möhlenbruch
- Department of Interventional Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Dominik F Vollherbst
- Department of Interventional Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Christian A Taschner
- Department of Neuroradiology, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Samer Elsheikh
- Department of Neuroradiology, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Joachim Klisch
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, HELIOS Hospital Erfurt, Erfurt, Germany
| | - Donald Lobsien
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, HELIOS Hospital Erfurt, Erfurt, Germany
| | - Maxim Bester
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nora Ramdani
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel P O Kaiser
- Institute of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Johannes C Gerber
- Institute of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stefan Schob
- Department of Radiology and Neuroradiology, University Hospital Halle, Halle, Germany
| | - Angelos Gazis
- Department of Radiology and Neuroradiology, St Georg Hospital, Leipzig, Germany
| | - Paulina Smirnov
- Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany
| | - Cordula Scherlach
- Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany
| | | | - Matthias Gawlitza
- Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany
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Gazis A, Loukas C. C3DTRANS: A DEEP LEARNING APPROACH FOR SURGICAL GESTURE RECOGNITION. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)03070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Schober R, Eisenlöffel C, Gazis A, Busche-Zistl S, Zurek M. Extensive Postnatal Brainstem Calcification in a Premature Infant. J Neuropathol Exp Neurol 2022; 81:850-852. [PMID: 35984323 DOI: 10.1093/jnen/nlac064] [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: 11/14/2022] Open
Affiliation(s)
- Ralf Schober
- Department of Pathology, St. Georg Teaching Hospital, University of Leipzig, Leipzig, Germany
| | - Christian Eisenlöffel
- Department of Pathology, St. Georg Teaching Hospital, University of Leipzig, Leipzig, Germany
| | - Angelos Gazis
- Department of Neuroradiology, St. Georg Teaching Hospital, University of Leipzig, Leipzig, Germany
| | - Silke Busche-Zistl
- Department of Neonatology, St. Georg Teaching Hospital, University of Leipzig, Leipzig, Germany
| | - Marlen Zurek
- Department of Neonatology, St. Georg Teaching Hospital, University of Leipzig, Leipzig, Germany
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Lurz M, Gazis A, Hanschke S, Weimann A, Schäfer AO. Value of high-field magnetic resonance imaging for diagnosis and classification of acute colonic diverticulitis. Int J Colorectal Dis 2022; 37:201-207. [PMID: 34633499 DOI: 10.1007/s00384-021-04045-y] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Due to limited and outdated literature, the role of magnetic resonance imaging (MRI) in the diagnostic work-up of acute colonic diverticulitis (ACD) is still under debate. The purpose of this study was to compare the performance of modern high-field MRI and multidetector computed tomography (MDCT) in the diagnosis and classification of ACD. METHODS In our prospective study 24 emergency patients with the clinical diagnosis of ACD received MDCT and high-field MRI. Imaging features of ACD were assessed and categorized according to the classification of diverticular disease (CDD) by three independent readers. Results were matched with the final clinical report. RESULTS MRI with a specialized examination protocol clearly depicted all relevant findings of ACD. Statistical analysis resulted in an almost perfect strength of agreement between CT and MRI across all readers for the final CDD category (κ = 0.94) and the stage-related image features (κ = 0.98). Moderate agreement was seen for the detection of micro-abscesses (κ = 0.78), with a slight advantage for MRI. CONCLUSION Modern high-field MRI is fully comparable to MDCT in the assessment of ACD and has the potential to serve as a first-line imaging tool.
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Affiliation(s)
- Markus Lurz
- Department of Radiology, Klinikum St. Georg Leipzig, Leipzig, Germany.
| | - Angelos Gazis
- Department of Radiology, Klinikum St. Georg Leipzig, Leipzig, Germany
| | - Stefanie Hanschke
- Department of Emergency Medicine, Klinikum St. Georg Leipzig, Leipzig, Germany
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, Klinikum St. Georg Leipzig, Leipzig, Germany
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Wybranski C, Siedek F, Damm R, Gazis A, Wenzel O, Haneder S, Persigehl T, Steinhauser S, Pech M, Fischbach F, Fischbach K. Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis. PLoS One 2020; 15:e0230024. [PMID: 32196535 PMCID: PMC7083299 DOI: 10.1371/journal.pone.0230024] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The objective of this study is to evaluate if intensified pre-scan patient preparation (IPPP) that comprises custom-made educational material on dynamic phase imaging and supervised pre-imaging breath-hold training in addition to standard informative conversation with verbal explanation of breath-hold commands (standard pre-scan patient preparation–SPPP) might reduce the incidence of gadoxetate disodium (Gd-EOB-DTPA)-related transient severe respiratory motion (TSM) and severity of respiratory motion (RM) during dynamic phase liver MRI. Material and methods In this bi-institutional study 100 and 110 patients who received Gd-EOB-DTPA for dynamic phase liver MRI were allocated to either IPPP or SPPP at site A and B. The control group comprised 202 patients who received gadoterate meglumine (Gd-DOTA) of which each 101 patients were allocated to IPPP or SPPP at site B. RM artefacts were scored retrospectively in dynamic phase images (1: none– 5: extensive) by five and two blinded readers at site A and B, respectively, and in the hepatobiliary phase of the Gd-EOB-DTPA-enhanced scans by two blinded readers at either site. Results The incidence of TSM was 15% at site A and 22.7% at site B (p = 0.157). IPPP did not reduce the incidence of TSM in comparison to SPPP: 16.7% vs. 21.6% (p = 0.366). This finding was consistent at site A: 12% vs. 18% (p = 0.401) and site B: 20.6% vs. 25% (p = 0.590). The TSM incidence in patients with IPPP and SPPP did not differ significantly between both sites (p = 0.227; p = 0.390). IPPP did not significantly mitigate RM in comparison to SPPP in any of the Gd-EOB-DTPA-enhanced dynamic phases and the hepatobiliary phase in patients without TSM (all p≥0.072). In the Gd-DOTA control group on the other hand, IPPP significantly mitigated RM in all dynamic phases in comparison to SPPP (all p≤0.031). Conclusions We conclude that Gd-EOB-DTPA-related TSM cannot be mitigated by education and training and that Gd-EOB-DTPA-related breath-hold difficulty does not only affect the subgroup of patients with TSM or exclusively the arterial phase as previously proposed.
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Affiliation(s)
- Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- * E-mail:
| | - Robert Damm
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Angelos Gazis
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Ortrud Wenzel
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Susanne Steinhauser
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
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Damm R, Mohnike K, Gazis A, Rogits B, Seidensticker M, Ricke J, Pech M. Improvement of Contrast Media Enhancement in CTA Evaluating Pulmonary Embolism by Utilizing 'Delayed' Bolus Tracking in the Descending Aorta. Pol J Radiol 2016; 81:422-7. [PMID: 27668026 PMCID: PMC5022633 DOI: 10.12659/pjr.897456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/31/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND As standard bolus triggering in the pulmonary trunk sometimes fails to achieve sufficient enhancement in the pulmonary arteries, the study investigates an alternative, 'delayed' position of the tracking ROI in the descending aorta. MATERIAL/METHODS Retrospective analysis of 143 patients suspected of pulmonary embolism investigated with 3 different scanners (16 to 80 rows) in clinical routine. Bolus triggering with 120 hounsfield units (HU) was performed using the pulmonary trunk (n=70) or descending aorta (n=73) after application of 70 to 120 mL of contrast agent, Iomeprol 300. Student's t-test was applied to compare vascular enhancement. Additional factors were analysed by a regression analysis. RESULTS Positioning of the tracking ROI in the descending aorta achieved a significantly higher contrast enhancement in the pulmonary trunk with a mean increase of 63 HU (p<0.001). CONCLUSIONS In CTA, delayed acquisition by using the descending aorta for bolus triggering can improve the enhancement of the pulmonary trunk to investigate a pulmonary embolism. Furthermore, the scan protocol simultaneously allows to rule out aortic pathologies as an alternative cause for a similar clinical condition.
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Affiliation(s)
- Robert Damm
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Konrad Mohnike
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Angelos Gazis
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Bela Rogits
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Max Seidensticker
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Jens Ricke
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
| | - Maciej Pech
- Department for Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
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Damm R, Mohnike K, Gazis A, Seidensticker M, Rogits B, Ricke J, Pech M. Verbesserung der Kontrastierung in der CTA der Lungenarterien durch „verzögerndes“ Bolus tracking in der Aorta descendens. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fischbach F, Gazis A, Wybranski C, Pech M, Ricke J, Fischbach K. „Near real-time“ MR-gestützte periradikuläre Therapie: ein optimierter Freihand-Ansatz am offenen 1.0 Tesla Scanner. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373068] [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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Milnik A, Gazis A, Tammer I, Bartels C. Immunocompetent young man with cerebral abscess and cortical venous infarction mimicking cerebritis caused by Gemella morbillorum. BMJ Case Rep 2013; 2013:bcr-2012-007252. [PMID: 23355562 DOI: 10.1136/bcr-2012-007252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Gemella morbillorum is an anaerobic gram-positive diplococcus and in most cases a harmless commensal, which occasionally causes infections in the central nervous system. We report on an immunocompetent young man with focal neurological symptoms and cephalgia caused by a cerebral abscess. Although successful treatment was done with neurosurgical intervention and antibiotic therapy, he suffered from a venous infarction 5 weeks after first diagnosis, which mimicked cerebritis as an early stage of relapsing abscess. Imaging and investigation of cerebrospinal fluid was necessary for sufficient differential diagnosis and antibiotic therapy could be stopped after altogether 8 weeks of treatment. In summary, G morbillorum causes not only biphasic infections, but also can be accompanied by infarction in the central nervous system despite sufficient antibiotic therapy.
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Affiliation(s)
- Annette Milnik
- Department of Neurology, University Medical Center Magdeburg A.ö.R, Magdeburg, Germany.
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Weekes MP, Reddi BAJ, Wharton S, Gazis A. Hyponatraemia associated with cardiac tamponade and chronic fluid excess. BMJ Case Rep 2010; 2010:2010/jul09_1/bcr0720092113. [PMID: 22752560 DOI: 10.1136/bcr.07.2009.2113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We describe a complex case of hyponatraemia with two aetiologies. A 49-year-old man who drank 6 litres of dilute alcohol per day presented confused and oedematous with a serum sodium of 95 mmol/litre. Urine sodium was <10 mmol/litre and urine osmolality 440 mOsmol/kg. Chest x-ray demonstrated a globular heart. ECG showed saddle-shaped ST elevation. ECHO demonstrated a large pericardial effusion causing marked tamponade. Following pericardiocentesis there was a marked diuresis; serum sodium returned to normal after 2 weeks. A full recovery ensued. Cardiac tamponade is associated with antidiuresis via release of antidiuretic hormone (ADH). Tamponade is also associated with antinatriuresis. Antidiuresis and antinatriuresis usually balance in cardiac tamponade; excessive fluid intake may have caused an imbalance in this case.
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Affiliation(s)
- M P Weekes
- Department of Infectious Diseases, University of Cambridge Clinical School, UK.
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Abstract
BACKGROUND Maternal diabetes increases the risk of pre-eclampsia and abnormalities of fetal growth. We studied the additional impact of maternal vascular disease on these risks. METHODS The first viable (> 23 weeks) pregnancies of 138 women with Type 1 diabetes mellitus (Type 1 DM), delivered between 1994 and 2003 at the Queen's Medical Centre, Nottingham, UK were studied. Women were divided into groups with and without vascular disease (retinopathy and/or nephropathy and/or pre-existing hypertension). Primary outcomes were pre-eclampsia and fetal customized birthweight percentile (cbp) (adjusted for maternal weight, height, parity, ethnicity, gestational age and gender). Secondary outcomes were perinatal outcome (miscarriage, intrauterine or neonatal death), preterm birth, birth asphyxia, neonatal hypoglycaemia and delivery mode. RESULTS Women with vascular disease were more likely to develop pre-eclampsia (OR 3.5; CI 1.28-9.53) and deliver infants with lower cbp (median 89.0, range 0-100 vs. 98.0, range 0-100; P < or = 0.005). Infants were less likely to be macrosomic (OR 0.46; CI 0.224-0.928) but more likely to have intrauterine growth restriction (IUGR; OR 6.0; CI 1.54-23.33). Women with vascular disease had higher Caesarean section rates (90 vs. 56%, P < or = 0.001). CONCLUSIONS/INTERPRETATION Women with Type 1 DM and vascular disease are at greater risk of pre-eclampsia and pathological fetal growth. This should influence counselling and merit increased pregnancy surveillance.
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Affiliation(s)
- C Howarth
- Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK
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Abstract
BACKGROUND The risk of chronic liver disease is higher in diabetics, and serum alanine transaminase (ALT) is a sensitive predictor of mortality from liver disease. AIM To estimate the prevalence of elevated ALT in type 1 and type 2 diabetes, and identify possible risk factors. METHODS We identified all patients (n = 2077) attending review between September 2002 and August 2003. We excluded those with no ALT measurement (n = 73); those whose alcohol consumption was >14 units/week (women) (n = 276) or >21 units/week (men) (n = 324); and those with a diagnosis of Maturity Onset Diabetes of the Young, secondary diabetes, gestational diabetes or uncertain type of diabetes (n = 51). We calculated the prevalences of elevated ALT in both type 1 and type 2 diabetes patients, and compared the demographic, microvascular risk factors and current drug use between each group using multivariate logistic regression. RESULTS Of 1353 patients included, 836 (61.9%) had type 2 diabetes. Elevated ALT was found in 9.5% (95%CI 7.1-12.3%) of patients with type 1 diabetes, and 12.1% (95%CI 9.9-14.5%) of those with type 2 diabetes. The risk of elevated ALT in patients with type 2 diabetes increased with increasing body mass index (p(trend) = 0.04), and was lower in those taking insulin (OR 0.38, 95%CI 0.22-0.65). DISCUSSION The prevalence of elevated ALT is 3-4 times higher in patients with either type 1 or type 2 diabetes than in the general population. Further studies investigating the aetiology and mechanisms of this elevation may suggest appropriate early interventions.
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Affiliation(s)
- J West
- Division of Epidemiology & Public Health, University of Nottingham Medical School, Nottingham, UK
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Lehnert T, Gazis A, Wetter A, Zangos S, Thalhammer A, Balzer JO, Bechstein WO, Vogl TJ. In vivo Leberregneration nach Intervention: Vergleich der transarteriellen Chemotherapie (TACE) vs. chirurgischer Resektion mittels CT-Volumetrie und Bestimmung des Regenerations-Faktors HGF. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lehnert T, Gazis A, Zangos S, Eichler K, Thalhammer A, Mack M, Balzer JO, Vogl TJ. Ergebnisse einer Langzeitstudie – Qualitative und quantitative Evaluierung der in vivo Leberregeneration nach Intervention. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lehnert T, Gazis A, Wetter A, Hammerstingl R, Eichler K, Mack M, Bechstein WO, Vogl TJ. Hepatocyte growth factor (HGF) – Quantitative Evaluation des Zytokins HGF vor Intervention: Ergebnisse einer Langzeitstudie über die prognostische Aussagekraft für die Leberregeneration. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lehnert T, Gazis A, Kakabadze M, Wetter A, Bourquain H, Bechstein WO, Mack M, Vogl TJ. Human growth factor (HGF) - Quantitative Evaluation des Zytokins HGF vor Intervention: Prognostische Aussagekraft für die Leberregeneration. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867630] [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: 10/19/2022]
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Lehnert T, Gazis A, Kakabadze M, Hammerstingl R, Mack M, Bechstein WO, Bourquain H, Vogl TJ. CT-Evaluation der In-vivo-Leberregeneration nach MR-laserinduzierter Thermotherapie (LITT) von malignen Lebertumoren im Vergleich zur Leberresektion. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868290] [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: 10/19/2022]
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Lehnert T, Gazis A, Kakabadze M, Mack M, Bechstein WO, Bourquain H, Hammerstingl R, Vogl TJ. In-vivo-Leberregneration nach Intervention: Vergleich der transarteriellen Chemotherapie (TACE) vs. chirurgischer Resektion mittels CT-Volumetrie und Bestimmung der Regenerationsfaktoren TNF-alpha und. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867631] [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: 10/19/2022]
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Abstract
OBJECTIVE To determine the mortality of a population of patients diagnosed with Charcot neuropathic osteoarthropathy managed by a single specialist unit and to compare the results with a control population. METHODS We have undertaken a retrospective analysis of all cases of Charcot foot on the comprehensive database which has been maintained at the specialist diabetic foot clinic at the City Hospital, Nottingham since 1982. Survival and the incidence of amputation (major and minor) was compared with a control population referred with uncomplicated neuropathic ulceration. Controls were individually matched for gender, age (+/-2 years), disease type, disease duration (+/-2 years) and year of referral (+/-3 years). RESULTS Forty-seven cases (21 female, 26 male) of Charcot foot were identified, of whom 18 (38.3%) had Type 1 diabetes. Mean age and disease duration at presentation were 59.2 +/- 13.4 (sd) and 16.2 +/- 11.2 years, compared with 59.7 +/- 12.6 and 16.3 +/- 11.2 years, respectively, in the controls. Twenty-one (44.7%) of those with Charcot had died, after a mean interval of 3.7 +/- 2.8 years. This compared with 16 (34.0%) after a mean 3.1 +/- 2.7 years in the control group. Mean duration of follow-up in the survivors was 4.7 +/- 4.9 years (Charcot) and 5.3 +/- 3.9 years (controls). A total of 11 (23.4%) Charcot patients had had a major amputation on the side of the index lesion, compared with five (10.6%) controls. There was no difference between the two groups (P > 0.05, Chi-square). CONCLUSIONS The mortality in this group of patients with Charcot foot was higher than expected. Nevertheless, there was no difference between those with Charcot and those with uncomplicated neuropathic ulceration. It is possible that it is neuropathy, rather than Charcot osteoarthropathy, which is independently associated with increased mortality in diabetes. The mechanism underlying any such association is not known. There is a need for a formal, prospective, multicentre study to investigate the life expectancy and cardiovascular risk of those with Charcot osteoarthropathy.
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Affiliation(s)
- A Gazis
- Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, City Hospital, Nottingham NG5 1PB, UK
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Lehnert T, Gazis A, Kakabadze M, Zangos S, Bechstein WO, Bourquain H, Vogl TJ. In vivo Leberregeneration nach Intervention: Vergleich der transarteriellen Chemotherapie vs. chirurgische Resektion mittels CT-Volumetrie und Bestimmung der Regenerations-Faktoren TNF-alpha und HGF. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-828026] [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: 10/19/2022]
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Lehnert T, Gazis A, Wetter A, Bechstein WO, Bourquain H, Vogl TJ. CT-Evaluation der in vivo Leberregeneration nach MR-laserinduzierter Thermotherapie von malignen Lebertumoren im Vergleich zur Leberresektion. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-828080] [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: 10/19/2022]
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Molyneux A, Gazis A, Packham C. Attachments in public health for physicians. J R Coll Physicians Lond 2000; 34:555-6. [PMID: 11191973 PMCID: PMC9665445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Hospital-based specialist registrars in Nottingham are offered six month secondments in public health medicine. These attachments give clinicians valuable skills in public health and an opportunity to influence the development of local health service provision. Other skills gained are an understanding of the balance between health promotion and disease treatment; the management of limited resources; an appreciation of the effects of social deprivation; the chairing and preparing of committee meetings; and contact tracing of communicable diseases. We strongly recommend the experience gained from working in a lively public health department.
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Affiliation(s)
- A Molyneux
- Department of Respiratory Medicine, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB.
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Abstract
AIMS Vascular endothelial dysfunction, an early marker of atherosclerosis, has been demonstrated in Type 2 diabetes mellitus (DM). Vitamin E preserves endothelial function in animal models of diabetes and reduces cardiovascular risk. We examined endothelial function and the effect of vitamin E supplements in uncomplicated Type 2 DM. METHODS Forty-eight subjects with Type 2 DM and 21 controls had endothelial function assessed using forearm venous occlusion plethysmography with endothelium-independent (sodium nitroprusside) and dependent (acetylcholine, bradykinin) vasodilators. Those with diabetes received 1600 i.u. daily oral alpha-tocopherol or placebo, double-blind for 8 weeks, and had endothelial function reassessed. RESULTS The diabetic group had higher HbA1c (6.9+/-1.4 vs 4.8+/-0.6%; P<0.01) and systolic (145+/-15 vs. 130+/-16 mm Hg; P<0.01) but not diastolic blood pressure (79+/-8 vs. 76+/-9 mm Hg; P = 0.15). There was blunted vasodilation to acetylcholine (15 microg/min; P<0.01) in subjects with diabetes. Vasodilation to sodium nitroprusside and bradykinin was similar (all P>0.1). Alpha-tocopherol did not affect vasodilation to nitroprusside (P>0.1), acetylcholine (P>0.1) or bradykinin (P>0.1). CONCLUSIONS There may be receptor-specific endothelial dysfunction in subjects with uncomplicated Type 2 DM. This is not improved by treatment with alpha-tocopherol.
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Affiliation(s)
- A Gazis
- Department of Therapeutics and Diabetes, University Hospital, Nottingham, UK
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Affiliation(s)
- A Gazis
- Department of Diabetes, Endocrinology and Nutrition, Queen's Medical Centre, University Hospital, Nottingham, UK
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Abstract
European guidelines recommend annual screening for microalbuminuria in patients with Type 1 (insulin-dependent) diabetes mellitus (IDDM) of greater than 5 years' duration and in those with Type 2 (non-insulin-dependent) diabetes mellitus (NIDDM) from diagnosis. To determine the current provision of screening for microalbuminuria we performed a postal survey of all diabetologists in the United Kingdom. Of 556 questionnaires sent, 326 (59%) were returned (246 adult, 57 paediatric, 3 adolescent clinics) and of these 306 (55%) were suitable for analysis. Screening programmes have been established by 210 (69%) diabetologists: 70 of these in the last 2 years. 46 more plan to screen patients with IDDM within 2 years. 155 (92%) of 169 adult programmes perform annual screening in IDDM, 74% according to European guidelines (39% in NIDDM). Other clinics use age, type of diabetes or criteria such as blood pressure to target screening. An albumin/creatinine ratio (52%) on an early morning urine (56%) or random (29%) urine sample is most commonly requested. Financial constraint was the principal reason given in 32 (33%) of 96 clinics that do not currently screen. Other reasons included implementation of other developments with a higher priority (24%) and doubts about the medical value of screening (46%). Assuming respondents are representative of current UK practice, we conclude that microalbuminuria screening is available to patients in many clinics, but is neither universal nor always performed according to European guidelines.
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Affiliation(s)
- A Gazis
- Department of Diabetes, Endocrinology, and Nutrition, University Hospital, Nottingham, UK
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Turner P, Edwards R, Weston V, Gazis A, Ispahani P, Greenwood D. Simultaneous resistance to metronidazole, co-amoxiclav, and imipenem in clinical isolate of Bacteroides fragilis. Lancet 1995; 345:1275-7. [PMID: 7746059 DOI: 10.1016/s0140-6736(95)90927-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A blood-culture isolate of Bacteroides fragilis, taken from a woman after elective laparotomy, was resistant to metronidazole and had reduced susceptibility to imipenem and co-amoxiclav. After treatment with imipenem, pus drained from the pleural cavity yielded an identical isolate that had become highly resistant to imipenem and co-amoxiclav. Emergence of full resistance to the beta-lactam antibiotics was accompanied by a tenfold rise in the specific activity of a metallo-beta-lactamase. Clinicians need to be alert to simultaneous resistance to metronidazole, co-amoxiclav, and imipenem and development of high-level resistance to imipenem in B fragilis during treatment with this agent.
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Affiliation(s)
- P Turner
- Nottingham Public Health Laboratory, UK
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Bouros D, Gazis A, Blatsios V, Melissinos C. Leiomyoma of the trachea. Eur J Respir Dis 1987; 71:206-9. [PMID: 3315729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- D Bouros
- Department of Pulmonary Diseases, 401 Army General Hospital, Athens, Greece
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