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Unger T, de Sousa Ribeiro R, Mokni M, Weikert T, Pohl J, Schwarz A, Held J, Sauerzopf L, Kühnis B, Gavagnin E, Luft A, Gassert R, Lambercy O, Awai Easthope C, Schönhammer J. Upper limb movement quality measures: comparing IMUs and optical motion capture in stroke patients performing a drinking task. Front Digit Health 2024; 6:1359776. [PMID: 38606036 PMCID: PMC11006959 DOI: 10.3389/fdgth.2024.1359776] [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: 12/21/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Clinical assessment of upper limb sensorimotor function post-stroke is often constrained by low sensitivity and limited information on movement quality. To address this gap, recent studies proposed a standardized instrumented drinking task, as a representative daily activity combining different components of functional arm use. Although kinematic movement quality measures for this task are well-established, and optical motion capture (OMC) has proven effective in their measurement, its clinical application remains limited. Inertial Measurement Units (IMUs) emerge as a promising low-cost and user-friendly alternative, yet their validity and clinical relevance compared to the gold standard OMC need investigation. Method In this study, we conducted a measurement system comparison between IMUs and OMC, analyzing 15 established movement quality measures in 15 mild and moderate stroke patients performing the drinking task, using five IMUs placed on each wrist, upper arm, and trunk. Results Our findings revealed strong agreement between the systems, with 12 out of 15 measures demonstrating clinical applicability, evidenced by Limits of Agreement (LoA) below the Minimum Clinically Important Differences (MCID) for each measure. Discussion These results are promising, suggesting the clinical applicability of IMUs in quantifying movement quality for mildly and moderately impaired stroke patients performing the drinking task.
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Affiliation(s)
- T. Unger
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | | | - M. Mokni
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - T. Weikert
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - J. Pohl
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - A. Schwarz
- Department of Neurology, UCLA, Los Angeles, CA, United States
- California Rehabilitation Institute, Los Angeles, CA, United States
| | - J.P.O. Held
- Ambulante Reha Triemli Zurich, Zurich, Switzerland
| | - L. Sauerzopf
- ZHAW School of Health Sciences, Institute of Occupational Therapy, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - B. Kühnis
- ZHAW School of Management and Law, Institute of Business Information Technology, Winterthur, Switzerland
| | - E. Gavagnin
- ZHAW School of Management and Law, Institute of Business Information Technology, Winterthur, Switzerland
- ZHAW School of Engineering, Centre for Artificial Intelligence, Winterthur, Switzerland
| | - A.R. Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology and Clinical Neuroscience Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - R. Gassert
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | - O. Lambercy
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | | | - J.G. Schönhammer
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology and Clinical Neuroscience Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Isaksson S, Schwarz A, Rusner M, Nordström S, Källman U. Monitoring Preventable Adverse Events and Near Misses: Number and Type Identified Differ Depending on Method Used. J Patient Saf 2022; 18:325-330. [PMID: 35617591 PMCID: PMC9162067 DOI: 10.1097/pts.0000000000000921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to investigate how many preventable adverse events (PAEs) and near misses are identified through the methods structured record review, Web-based incident reporting (IR), and daily safety briefings, and to distinguish the type of events identified by each method. METHODS One year of retrospective data from 2017 were collected from one patient cohort in a 422-bed acute care hospital. Preventable adverse events and near misses were collected from the hospital's existing resources and presented descriptively as number per 1000 patient-days. RESULTS The structured record review identified 19.9 PAEs; the IR system, 3.4 PAEs; and daily safety briefings, 5.4 PAEs per 1000 patient-days. The most common PAEs identified by the record review method were drug-related PAEs, pressure ulcers, and hospital-acquired infections. The most common PAEs identified by the IR system and daily safety briefings were fall injury and pressure ulcers, followed by skin/superficial vessel injuries for the IR system and hospital-acquired infections for the daily safety briefings. Incident reporting and daily safety briefings identified 7.8 and 31.9 near misses per 1000 patient-days, respectively. The most common near misses were related to how care is organized. CONCLUSIONS The different methods identified different amounts and types of PAEs and near misses. The study supports that health care organizations should adopt multiple methods to get a comprehensive review of the number and type of events occurring in their setting. Daily safety briefings seem to be a particularly suitable method for assessing an organization's inherent security and may foster a nonpunitive culture.
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Affiliation(s)
- Stina Isaksson
- From the Department of Research, Education and Innovation, South Älvsborg Hospital, Region Västra Götaland, Borås
| | - Anneli Schwarz
- From the Department of Research, Education and Innovation, South Älvsborg Hospital, Region Västra Götaland, Borås
| | - Marie Rusner
- From the Department of Research, Education and Innovation, South Älvsborg Hospital, Region Västra Götaland, Borås
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg
| | - Sophia Nordström
- Department of Medicine, South Älvsborg Hospital, Region Västra Götaland, Borås, Sweden
| | - Ulrika Källman
- From the Department of Research, Education and Innovation, South Älvsborg Hospital, Region Västra Götaland, Borås
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg
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Wiljén A, Chaplin JE, Crine V, Jobe W, Johnson E, Karlsson K, Lindroth T, Schwarz A, Stenmarker M, Thunberg G, Öhlén J, Nilsson S. The Development of an mHealth Tool for Children With Long-term Illness to Enable Person-Centered Communication: User-Centered Design Approach. JMIR Pediatr Parent 2022; 5:e30364. [PMID: 35258466 PMCID: PMC8941441 DOI: 10.2196/30364] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/19/2021] [Accepted: 11/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Children with long-term illnesses frequently experience symptoms that could negatively affect their daily lives. These symptoms are often underreported in health care. Despite a large number of mobile health (mHealth) tools, few are based on a theoretical framework or supported by scientific knowledge. Incorporating universal design when developing a product can promote accessibility and facilitate person-centered communication. OBJECTIVE The aim of this study is to identify the symptom-reporting needs of children with cancer and congenital heart defects that could be satisfied by using a mobile app. Another aim is to evaluate how the child might interact with the app by considering universal design principles and to identify parents' views and health care professionals' expectations and requirements for an mHealth tool. METHODS User-centered design is an iterative process that focuses on an understanding of the users. The adapted user-centered design process includes 2 phases with 4 stages. Phase 1 involved interviews with 7 children with long-term illnesses, 8 parents, and 19 health care professionals to determine their needs and wishes for support; a workshop with 19 researchers to deepen our understanding of the needs; and a workshop with developers to establish a preliminary tool to further investigate needs and behaviors. Phase 2 involved interviews with 10 children with long-term illnesses, 9 parents, and 21 health care professionals to evaluate the mock-up (prototype) of the mHealth tool. Data were synthesized using the interpretive description technique. RESULTS A total of 4 aspects of needs emerged from the synthesis of the data, as follows: different perspectives on provided and perceived support; the need for an easy-to-use, non-clinic-based tool to self-report symptoms and to facilitate communication; the need for safety by being in control and reaching the child's voice; and a way of mapping the illness journey to facilitate recall and improve diagnostics. The children with long-term illnesses expressed a need to not only communicate about pain but also communicate about anxiety, fatigue, fear, and nausea. CONCLUSIONS The findings of this study indicated that the PicPecc (Pictorial Support in Person-Centered Care for Children) app is a potential solution for providing communicative support to children with long-term illnesses dealing with multiple symptoms and conditions. The interview data also highlighted symptoms that are at risk of being overlooked if they are not included in the mobile app. Further studies are needed to include usability testing and evaluation in hospitals and home care settings.
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Affiliation(s)
- Angelica Wiljén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
| | - John Eric Chaplin
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vanessa Crine
- University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - William Jobe
- Department of Informatics, School of Business, Economics and IT, University West, Trollhättan, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.,Department of Inclusive Education, University of South Africa, Pretoria, South Africa
| | - Katarina Karlsson
- Department of Health Sciences, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Tomas Lindroth
- Department of Applied Information Technology, University of Gothenburg, Gothenburg, Sweden
| | - Anneli Schwarz
- Department of Research, Education and Innovation, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
| | - Margaretha Stenmarker
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Region Jönköping County, Jönköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Gunilla Thunberg
- University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Dart Centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kieslich M, Parwani A, Weber-Bärenbrinker S, Opgen-Rhein B, Schwarz A, Berger F, Will J. Successful Epicardial Mapping and Ablation of Ventricular Tachycardia after Failed Medical Therapy and Conventional Endocardial Ablation Therapy in a 10-Year-Old Girl with Severe Biventricular Arrhythmogenic Cardiomyopathy. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Kieslich
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - A. Parwani
- Cardiology Charité University, Berlin, Deutschland
| | | | - B. Opgen-Rhein
- Pediatric Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Deutschland
| | - A. Schwarz
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - F. Berger
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Will
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Schwarz A, Timme N, Kieslich M, Opgen-Rhein B, Weber-Bärenbrinker S, Berger F, Will J. Nonsustained Ventricular Tachycardia in Adolescents after mRNA-SARS-CoV-2 Vaccine: Report of Two Cases. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Schwarz
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - N. Timme
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - M. Kieslich
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | | | | | - F. Berger
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
| | - J. Will
- CharitéUniversitätsmedizin Berlin, Berlin, Deutschland
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Abstract
OBJECTIVES The Green Cross (GC) method is a visual method for health service staff to recognize risks and preventable adverse events (PAEs) on a daily basis. The aim was to compare patient safety culture and the number of reported PAEs in units using the GC method with units that do not. METHODS This study has a retrospective cross-sectional design in the setting of psychiatric and somatic care departments in a Swedish hospital. In total, 1476 staff members from 62 different units participate in the study. RESULTS Units who had implemented the GC method scored higher than non-GC units in overall quality. The dimensions Feedback and communication about error, Nonpunitive response to errors, Organizational learning-continuous improvement, Handoffs and transitions between units and shifts, and Teamwork within units scored significantly higher in GC units. More risks were reported in the incident reporting system in GC units than in non-GC units, but the number of PAEs was similar. Units with nursing staff who used the GC method scored higher on patient safety culture than those who did not use the method. This difference was not seen in physician units. CONCLUSIONS The implementation of the GC method has a positive impact on patient safety culture and PAE reporting. However, the method does not seem to have the same impact in physician units as in units with nursing staff, which calls for further investigation.
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Affiliation(s)
- Ulrika Källman
- From the Departments of Research
- Development, Region Västra Götaland, South Älvsborg Hospital
| | - Marie Rusner
- From the Departments of Research
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bonaterra GA, Struck N, Zuegel S, Schwarz A, Mey L, Schwarzbach H, Strelau J, Kinscherf R. Characterization of atherosclerotic plaques in blood vessels with low oxygenated blood and blood pressure (Pulmonary trunk): role of growth differentiation factor-15 (GDF-15). BMC Cardiovasc Disord 2021; 21:601. [PMID: 34920697 PMCID: PMC8684150 DOI: 10.1186/s12872-021-02420-9] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growth differentiation factor (GDF)-15 is linked to inflammation, cancer, and atherosclerosis. GDF-15 is expressed in most tissues but is extremely induced under pathological conditions. Elevated serum levels are suggested as a risk factor and a marker for cardiovascular diseases. However, the cellular sources and the effects of GDF-15 on the cardiovascular system have not been completely elucidated including progression, and morphology of atherosclerotic plaques. Thus, this work aimed to characterize the influence of GDF-15 deficiency on the morphology of atherosclerotic plaques in blood vessels with low-oxygen blood and low blood pressure as the pulmonary trunk (PT), in hypercholesterolemic ApoE-/- mice. METHODS GDF-15-/- ApoE-/- mice were generated by crossbreeding of ApoE-/-- and GDF-15-/- mice. After feeding a cholesterol-enriched diet (CED) for 20 weeks, samples of the brachiocephalic trunk (BT) and PT were dissected and lumen stenosis (LS) was measured. Furthermore, changes in the cellularity of the PT, amounts of apoptosis-, autophagy-, inflammation- and proliferation-relevant proteins were immunohisto-morphometrically analyzed. Additionally, we examined an atherosclerotic plaque in a human post mortem sample of the pulmonary artery. RESULTS After CED the body weight of GDF-15-/-ApoE-/- was 22.9% higher than ApoE-/-. Double knockout mice showed also an 35.3% increase of plasma triglyceride levels, whereas plasma cholesterol was similar in both genotypes. LS in the BT and PT of GDF-15-/-ApoE-/- mice was significantly reduced by 19.0% and by 6.7% compared to ApoE-/-. Comparing LS in PT and BT of the same genotype revealed a significant 38.8% (ApoE-/-) or 26.4% (GDF-15-/-ApoE-/-) lower LS in the PT. Immunohistomorphometry of atherosclerotic lesions in PT of GDF-15-/-ApoE-/- revealed significantly increased levels (39.8% and 7.3%) of CD68 + macrophages (MΦ) and α-actin + smooth muscle cells than in ApoE-/-. The density of TUNEL + , apoptotic cells was significantly (32.9%) higher in plaques of PT of GDF-15-/-ApoE-/- than in ApoE-/-. Analysis of atherosclerotic lesion of a human pulmonary artery showed sm-α-actin, CD68+, TUNEL+, Ki67+, and APG5L/ATG+ cells as observed in PT. COX-2+ and IL-6+ immunoreactivities were predominantly located in endothelial cells and subendothelial space. In BT and PT of GDF15-/-ApoE-/- mice the necrotic area was 10% and 6.5% lower than in ApoE-/-. In BT and PT of GDF15-/-ApoE-/- we found 40% and 57% less unstable plaques than ApoE-/- mice. CONCLUSIONS Atherosclerotic lesions occur in both, BT and PT, however, the size is smaller in PT, possibly due to the effect of the low-oxygen blood and/or lower blood pressure. GDF-15 is involved in atherosclerotic processes in BT and PT, although different mechanisms (e.g. apoptosis) in these two vessels seem to exist.
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Affiliation(s)
- G A Bonaterra
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany.
| | - N Struck
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - S Zuegel
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - A Schwarz
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - L Mey
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - H Schwarzbach
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - J Strelau
- Department of Functional Neuroanatomy, University of Heidelberg, 69120, Heidelberg, Germany
| | - R Kinscherf
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
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Anarte-Lazo E, Carvalho GF, Schwarz A, Luedtke K, Falla D. Differentiating migraine, cervicogenic headache and asymptomatic individuals based on physical examination findings: a systematic review and meta-analysis. BMC Musculoskelet Disord 2021; 22:755. [PMID: 34479514 PMCID: PMC8417979 DOI: 10.1186/s12891-021-04595-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine and cervicogenic headache (CGH) are common headache disorders, although the large overlap of symptoms between them makes differential diagnosis challenging. To strengthen differential diagnosis, physical testing has been used to examine for the presence of musculoskeletal impairments in both conditions. This review aimed to systematically evaluate differences in physical examination findings between people with migraine, CGH and asymptomatic individuals. METHODS The databases MEDLINE, PubMed, CINAHL, Web of Science, Scopus, EMBASE were searched from inception until January 2020. Risk of bias was assessed with the Downs and Black Scale for non-randomized controlled trials, and with the Quality Assessment of Diagnostic Accuracy Studies tool for diagnostic accuracy studies. When possible, meta-analyses with random effect models was performed. RESULTS From 19,682 articles, 62 studies were included in this review and 41 were included in the meta-analyses. The results revealed: a) decreased range of motion [°] (ROM) on the flexion-rotation test (FRT) (17.67, 95%CI:13.69,21.65) and reduced neck flexion strength [N] (23.81, 95%CI:8.78,38.85) in CGH compared to migraine; b) compared to controls, migraineurs exhibit reduced flexion ROM [°] (- 2.85, 95%CI:-5.12,-0.58), lateral flexion ROM [°] (- 2.17, 95% CI:-3.75,-0.59) and FRT [°] (- 8.96, 95%CI:-13.22,-4.69), reduced cervical lordosis angle [°] (- 0.89, 95%CI:-1.72,-0.07), reduced pressure pain thresholds over the cranio-cervical region [kg/cm2], reduced neck extension strength [N] (- 11.13, 95%CI:-16.66,-5.6) and increased activity [%] of the trapezius (6.18, 95%CI:2.65,9.71) and anterior scalene muscles (2.87, 95%CI:0.81,4.94) during performance of the cranio-cervical flexion test; c) compared to controls, CGH patients exhibit decreased neck flexion (- 33.70, 95%CI:-47.23,-20.16) and extension (- 55.78, 95%CI:-77.56,-34.00) strength [N]. CONCLUSION The FRT and neck flexion strength could support the differential diagnosis of CGH from migraine. Several physical tests were found to differentiate both headache types from asymptomatic individuals. Nevertheless, additional high-quality studies are required to corroborate these findings. STUDY REGISTRATION Following indications of Prisma-P guidelines, this protocol was registered in PROSPERO on 21/05/2019 with the number CRD42019135269 . All amendments performed during the review were registered in PROSPERO, indicating the date and what and why was changed.
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Affiliation(s)
- E Anarte-Lazo
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - G F Carvalho
- Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Institute of Health Sciences, University of Luebeck, Luebeck, Germany
| | - A Schwarz
- Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Institute of Health Sciences, University of Luebeck, Luebeck, Germany
| | - K Luedtke
- Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Institute of Health Sciences, University of Luebeck, Luebeck, Germany
| | - D Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), College of Life and Environmental Sciences, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Schwarz A, Pollmann S, Bonaterra G, Kinscherf R. PACAP antagonizes oxldl-induced lipid-/triglyceride accumulation and VPAC1-expression in human M2-MΦ. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Almer G, Brunner M, Schwarz A, Diwoky C, Lechleitner M, Sommer G, Kolb D, Wolinski H, Oswald W, Opriessnig P, Hörl G, Groselj-Strele A, Höfler G, Rechberger G, Frank S, Holzapfel G, Kratky D, Mangge H, Tehlivets O. Elevated homocysteine induces atherosclerosis-related changes in aortic rabbit walls in the absence of hypercholesterolemia. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nilsson S, Wiljén A, Bergquist J, Chaplin J, Johnson E, Karlsson K, Lindroth T, Schwarz A, Stenmarker M, Thunberg G, Esplana L, Frid E, Haglind M, Höök A, Wille J, Öhlen J. Evaluating pictorial support in person-centred care for children (PicPecc): a protocol for a crossover design study. BMJ Open 2021; 11:e042726. [PMID: 33947726 PMCID: PMC8098982 DOI: 10.1136/bmjopen-2020-042726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION This study protocol outlines the evaluation of the pictorial support in person-centred care for children (PicPecc). PicPecc is a digital tool used by children aged 5-17 years to self-report symptoms of acute lymphoblastic leukaemia, who undergo high-dose methotrexate treatments. The design of the digital platform follows the principles of universal design using pictorial support to provide accessibility for all children regardless of communication or language challenges and thus facilitating international comparison. METHODS AND ANALYSIS Both effect and process evaluations will be conducted. A crossover design will be used to measure the effect/outcome, and a mixed-methods design will be used to measure the process/implementation. The primary outcome in the effect evaluation will be self-reported distress. Secondary outcomes will be stress levels monitored via neuropeptides, neurosteroids and peripheral steroids indicated in plasma blood samples; frequency of in-app estimation of high levels of distress by the children; children's use of analgesic medicine and person centeredness evaluated via the questionnaire Visual CARE Measure. For the process evaluation, qualitative interviews will be carried out with children with cancer, their legal guardians and case-related healthcare professionals. These interviews will address experiences with PicPecc in terms of feasibility and frequency of use from the child's perspective and value to the caseworker. Interview transcripts will be analysed using an interpretive description methodology. ETHICS AND DISSEMINATION Ethical approval was obtained from the Swedish Ethical Review Authority (reference 2019-02392; 2020-02601; 2020-06226). Children, legal guardians, healthcare professionals, policymaking and research stakeholders will be involved in all stages of the research process according to Medical Research Council's guidelines. Research findings will be presented at international cancer and paediatric conferences and published in scientific journals. TRIAL REGISTRATION ClinicalTrials.gov; NCT04433650.
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Affiliation(s)
- Stefan Nilsson
- University of Gothenburg Centre for Person-Centred Care, and Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Angelica Wiljén
- Department of Paediatrics, Södra Älvsborg Hospital, Region Västra Götaland, Borås, Sweden
| | - Jonas Bergquist
- Department of Chemistry - Biomedical Centre, Analytical Chemistry and Neurochemistry, Uppsala University, Uppsala, Sweden
| | - John Chaplin
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Katarina Karlsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Tomas Lindroth
- Division of Informatics, University of Gothenburg, Gothenburg, Sweden
| | - Anneli Schwarz
- Department of Paediatrics, Södra Älvsborg Hospital, Region Västra Götaland, Borås, Sweden
| | - Margaretha Stenmarker
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics, Region Jönköping County, Jönköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Gunilla Thunberg
- DART centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Linda Esplana
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Eva Frid
- Department of Paediatric Oncology and Haematology, Skåne University Hospital, Lund, Sweden
| | - Malin Haglind
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Angelica Höök
- Department of Anaesthesia and Intensive Care, Linköping University Hospital, Linköping, Sweden
| | - Joakim Wille
- Department of Paediatric Oncology and Haematology, Skåne University Hospital, Lund, Sweden
| | - Joakim Öhlen
- University of Gothenburg Centre for Person-Centred Care, and Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Palliative Centre, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Schwarz A, Isaksson S, Källman U, Rusner M. Enabling patient safety awareness using the Green Cross method: A qualitative description of users' experience. J Clin Nurs 2021; 30:830-839. [PMID: 33372328 PMCID: PMC8048610 DOI: 10.1111/jocn.15626] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
AIM The Green Cross method was developed to support healthcare staff in daily patient safety work. The aim of this study was to describe users' experiences of the method when working with patient safety and their views on the core elements. BACKGROUND Patient safety systems need to be user-friendly to facilitate learning from adverse events. The Green Cross method is described as a simple visual method to recognise risks and preventable adverse events (PAEs) in real time. There are no previous studies describing users' experiences of the Green Cross method. DESIGN A qualitative descriptive design. METHODS 32 healthcare workers and managers from different specialties in a Swedish hospital were interviewed, from May-September 2018 about their experiences of the Green Cross method; either individually or as part of a group. The interviews were analysed using thematic analysis. The study follows the COREQ guidelines for qualitative data. RESULTS Participants associated the Green Cross method with patient safety, but no core elements of the method were identified. Instead, the opportunity to be engaged in patient safety work in a systematic way was underlined by all study participants. Highlighted key areas were the simplicity and the systematic framework of the method along with a need of distinct leadership. The daily meetings promoted trust and dialogue and developed the patient safety mindset. Daily meetings, together with the visualisation of the cross, were emphasised as important by users who otherwise had limited knowledge of the entire method. CONCLUSION This study offers valuable information that can help deepen the understanding of how the method specifically supports patient safety work. RELEVANCE TO CLINICAL PRACTICE Healthcare workers are expected to report patient safety issues. This study presents user-friendly aspects of the method as well as limitations, relevant for present and future users.
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Affiliation(s)
- Anneli Schwarz
- Department of Research, Education and InnovationRegion Västra GötalandSouth Älvsborg HospitalBoråsSweden
| | - Stina Isaksson
- Department of Research, Education and InnovationRegion Västra GötalandSouth Älvsborg HospitalBoråsSweden
| | - Ulrika Källman
- Department of Research, Education and InnovationRegion Västra GötalandSouth Älvsborg HospitalBoråsSweden
- Department of DevelopmentRegion Västra GötalandSouth Älvsborg HospitalBoråsSweden
| | - Marie Rusner
- Department of Research, Education and InnovationRegion Västra GötalandSouth Älvsborg HospitalBoråsSweden
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Rohse P, Butlewski J, Klein F, Wagner T, Friesen C, Schwarz A, Wiesendanger R, Sengstock K, Becker C. A cavity optomechanical locking scheme based on the optical spring effect. Rev Sci Instrum 2020; 91:103102. [PMID: 33138582 DOI: 10.1063/5.0010255] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/12/2020] [Indexed: 06/11/2023]
Abstract
We present a novel locking scheme for active length-stabilization and frequency detuning of a cavity optomechanical device based on the optical spring effect. The error signal is generated by utilizing the position measurement of a thermally driven intra-cavity nanomechanical device and employing its detuning-dependent frequency shift caused by the dispersive coupling to the cavity field. The scheme neither requires external modulation of the laser or the cavity nor does it demand for additional error signal readout, rendering its technical implementation rather simple for a large variety of existing optomechanical devices. Specifically, for large-linewidth microcavities or in situations where other locking schemes appear unfavorable conceptually or are hard to realize technically, the optical spring lock represents a potential alternative for stabilizing the cavity length. We explain the functional principle of the lock and characterize its performance in terms of bandwidth and gain profile.
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Affiliation(s)
- P Rohse
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - J Butlewski
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - F Klein
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - T Wagner
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - C Friesen
- INF (Institut für Nanostruktur- und Festkörperphysik), Universität Hamburg, Jungiusstraße 9, 20355 Hamburg, Germany
| | - A Schwarz
- INF (Institut für Nanostruktur- und Festkörperphysik), Universität Hamburg, Jungiusstraße 9, 20355 Hamburg, Germany
| | - R Wiesendanger
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - K Sengstock
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - C Becker
- ZOQ (Zentrum für Optische Quantentechnologien), Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
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Montenbruck M, Kelle S, Esch S, Andre F, Schwarz A, Korosoglou G, Steen H. 4304Fast-SENC quantifies segmental right ventricular intramyocardial strain to assess subclinical RV dysfunction prior to changes in RV ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0149] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Right ventricular ejection fraction (RVEF) identifies reduced right-side cardiac function in symptomatic patients. However, alternative metrics are needed to detect subclinical RV dysfunction before cardiac remodeling results in systemic damage. Fast-SENC intramyocardial strain (fSENC) is a unique cardiac magnetic resonance imaging (CMR) modality that measures intramyocardial RV contraction in 1 heartbeat per image plane. This prospective registry compares fSENC and RVEF based on ACC/AHA Heart Failure Stage.
Methods
A single center, prospective registry of MRI scans acquired with a 1.5T scanner were evaluated for conventional CMR diagnostics including RVEF. In addition, fSENC scans were acquired and processed with the MyoStrain software to quantify intramyocardial RV strain. Two short axis scans (basal & midventricular) were used to calculate strain in 6 longitudinal RV segments while two long axis scans (3-chamber & 4-chamber) were used to calculate 5 circumferential RV segments.
CMR and fSENC metrics were compared based on progression of heart failure in which the ACC/AHA Heart Failure stage was determined by CMR findings including LGE in cases in which contrast was injected. HF Stages B and C were separated into different degrees of structural heart disease with “−” representing lower levels and “+” higher levels to provide better delineation of progression of heart dysfunction leading to heart failure.
Results
A total of 977 scans in 779 patients were included in the study. Patients had an average (± stdev) age of 55 (17) yrs and BMI of 26 (5) kg/m2; 48% had arterial hypertension, 12% diabetes mellitus, 33% moderate or severe valvular heart disease, 25% cancer, 7% atrial fibrillation, and 24% coronary artery disease.
Figure 1 shows the relationship between % normal RV myocardium (RV fSENC <−17%) and CMR RVEF in the y-axis versus modified ACC/AHA Heart Failure Stage in the x-axis respectively.
Figure 1
Conclusion
Segmental fSENC detects subclinical RV dysfunction well before changes in RVEF. The ability to directly measure intramyocardial RV strain allows quantification various subclinical right heart diseases, the impact and monitoring of pharmacological therapiesand device interventions on RV function.
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Affiliation(s)
- M Montenbruck
- Marienhospital, Cardiology/Cardiac Imaging, Hamburg, Germany
| | - S Kelle
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - S Esch
- Marien Hospital, Hamburg, Germany
| | - F Andre
- University Hospital of Heidelberg, Heidelberg, Germany
| | - A Schwarz
- Marienhospital, Cardiology/Cardiac Imaging, Hamburg, Germany
| | - G Korosoglou
- Academic Teaching Hospital Weinheim, Department of Internal Medicine/Cardiology and Vascular Medicine, Hamburg, Germany
| | - H Steen
- Marienhospital, Cardiology/Cardiac Imaging, Hamburg, Germany
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Steen H, Montenbruck M, Esch S, Schwarz A, Kelle S, Wuelfing P, Andre F, Korosoglou G. P411Accuracy of cardiotoxicity detection with fast strain-encoded CMR vs echocardiography. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Steen
- Marien Hospital, Hamburg, Germany
| | | | - S Esch
- Marien Hospital, Hamburg, Germany
| | | | - S Kelle
- Charite University Hospital, Berlin, Germany
| | - P Wuelfing
- Mammazentrum am Krankenhaus Jerusalem, Hamburg, Germany
| | - F Andre
- University Hospital of Heidelberg, Heidelberg, Germany
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Steen H, Montenbruck M, Esch S, Schwarz A, Kelle S, Wuelfing P, Andre F, Korosoglou K. P140Fast-SENC quantifies right ventricular intramyocardial strain to assess subclinical RV dysfunction. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Steen
- Marien hospital, Faculty of University hospital, Hamburg, Germany
| | | | - S Esch
- Marien Hospital, Hamburg, Germany
| | | | - S Kelle
- Charite University Hospital, Berlin, Germany
| | - P Wuelfing
- Mammazentrum am Krankenhaus Jerusalem, Hamburg, Germany
| | - F Andre
- University Hospital of Heidelberg, Heidelberg, Germany
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Schwarz T, Schwarz A. 014 Psoriatic regulatory T cells are impaired in their suppressive activity and respond differently to IL-33. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Fiss I, Bettag C, Schatlo B, von Eckardstein K, Tsogkas I, Schwarz A, von der Brelie C, Rohde V. Prophylactic enlargement of the thecal sac volume by spinal expansion duroplasty in patients with unresectable malignant intramedullary tumors and metastases prior to radiotherapy. Neurosurg Rev 2018; 43:273-279. [PMID: 30426355 DOI: 10.1007/s10143-018-1051-0] [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] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/14/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
Unresectable malignant intramedullary tumors and metastases usually require radiotherapy which intensifies spinal cord edema and might result in neurological decline. Spinal expansion duroplasty before radiotherapy enlarges the intrathecal volume and might thus prevent neurological deficits. The study aims to evaluate the clinical course of patients undergoing expansion duroplasty. This retrospective analysis (2007-2016) included all patients with unresectable intramedullary tumors who underwent spinal expansion duroplasty. To assess the degree of preoperative cord enlargement, we calculated the "diameter ratio": diameter of the spinal cord below and above the tumor / diameter of the tumor × 2. The presence of perimedullary cerebrospinal fluid (CSF) at the affected levels was analyzed on the preoperative magnetic resonance imaging (MRI). We recorded the occurrence of neurological deficits, wound breakdown, and CSF fistula. We screened 985 patients, 11 of which were included. Eight patients had an intramedullary metastasis, three patients a spinal malignant glioma. A diameter ratio ≤ 0.8 representing a significant preoperative intramedullary enlargement was seen in 10 cases (90.9%). Postoperative imaging was available in 9 patients, demonstrating successful decompression in 8 of the 9 patients (88.9%). The postoperative course was uneventful in 9 patients (81.8%). Mean overall survival was 13.4 (SD 16.2) months. Spinal expansion duroplasty prior to radiotherapy is a previously undescribed concept. Despite neoadjuvant radiation, no wound breakdown or CSF fistula occurred. In unresectable intramedullary tumors and metastases, spinal expansion duroplasty seems to be a safe procedure with the potential to prevent neurological decline due to radiation-induced cord swelling.
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Affiliation(s)
- Ingo Fiss
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany.
| | - C Bettag
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - B Schatlo
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - K von Eckardstein
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - I Tsogkas
- Department of Neuroradiology, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - A Schwarz
- Department of Neuroradiology, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - C von der Brelie
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany
| | - V Rohde
- Department of Neurosurgery, Medical Center, Georg August University of Göttingen, Göttingen, Germany
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Pérez N, Schwarz A, de Bruijn J. Evaluation of fine organic mixtures for treatment of acid mine drainage in sulfidogenic reactors. Water Sci Technol 2018; 78:1715-1725. [PMID: 30500795 DOI: 10.2166/wst.2018.452] [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: 06/09/2023]
Abstract
The performance of passive biochemical reactors in acid mine drainage (AMD) treatment could be enhanced by using fine organic substrates in new reactor designs, such as diffusive exchange reactors. This work evaluated the effect of fine cellulosic components in organic mixtures and of enrichment with inoculum, on sulfate and metals removal in discontinuous cultures for three types of synthetic AMD. The cellulosic substrates evaluated were sawdust, microcrystalline cellulose, and forestry cellulose fibers, supplemented with cow manure and leaf compost. Using microcrystalline cellulose and forestry cellulose fibers with the less concentrated AMD, high sulfate reduction rates (73 mg/L-d and 58.2 mg/L-d, respectively) were achieved. Correspondingly, iron concentrations were reduced by 69% and 86.6%. Based on their higher sulfate reducing capacity, cellulose fibers obtained as fiber boards from a local kraft pulp mill were selected for treating a synthetic AMD with a high copper concentration (273 mg/L) and pH 4.94. In batch culture, low sulfate reducing activity (13.10 mg/L-d) was only observed at the highest substrate/AMD ratio (0.5:10) tested. Results show that the use of forestry cellulose fibers in reactive mixtures supplemented with inoculum could be an alternative for optimization of diffusive exchange reactors for AMD treatment.
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Affiliation(s)
- N Pérez
- Centro de Recursos Hídricos para la agricultura y Minería (CRHIAM), Universidad de Concepción, Barrio Universitario sn, Concepción, Chile E-mail: ; Departamento de Acuicultura, Universidad Católica del Norte, Facultad de Ciencias del Mar, Larrondo 1281, P.O. Box 117, Coquimbo, Chile and Escuela de Prevención de Riesgos y Medio Ambiente, Facultad de Ciencias del Mar, Universidad Católica del Norte
| | - A Schwarz
- Centro de Recursos Hídricos para la agricultura y Minería (CRHIAM), Universidad de Concepción, Barrio Universitario sn, Concepción, Chile E-mail: ; Departamento de Ingeniería Civil, Universidad de Concepción, Barrio Universitario sn, Concepción, Chile
| | - J de Bruijn
- Facultad de Ingeniería Agrícola, Universidad de Concepción, Avenida Vicente Méndez 595, Chillán, Chile
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Hug PJ, Cap VH, Honegger J, Schüpbach-Regula G, Schwarz A, Bettschart-Wolfensberger R. Optimization of analgesia for piglet castration under isoflurane anaesthesia with parenteral butorphanol, meloxicam or intratesticular lidocaine. SCHWEIZ ARCH TIERH 2018; 160:461-467. [PMID: 29989553 DOI: 10.17236/sat00169] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This blinded prospective study investigated analgesic effects of intramuscular (IM) butorphanol, meloxicam or intratesticular (IT) lidocaine for castration of 7-14 days old piglets under isoflurane anaesthesia. 66 piglets were randomly injected with: meloxicam IM (0.4 mg/kg; group M), butorphanol IM (0.2 mg/kg; group B), or both (group BM) 20 minutes prior to castration, or lidocaine IT (4 mg/kg (group ML4) or 8 mg/kg (group ML8)) together with meloxicam IM (0.4 mg/kg) under anaesthesia with 1.8% end-tidal isoflurane. Heart rate, respiratory rate, mean arterial blood pressure and end-tidal carbon dioxide were recorded. Anaesthesia quality was scored and postoperative behaviour assessed. As butorphanol caused unacceptable side effects, its use was stopped. Group M showed worse anaesthesia quality than ML4 and ML8 (higher incidence of movements: 11/17, 3/18 and 4/17, respectively). There were no significant differences between groups regarding parameters measured during castration. Postoperative behaviour did not differ between groups. For castration of 7-14 days old piglets under isoflurane anaesthesia, IT lidocaine provides an additional side effect free analgesia.
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Affiliation(s)
- P J Hug
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich
| | - V H Cap
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich
| | - J Honegger
- Department for Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich
| | - G Schüpbach-Regula
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern
| | - A Schwarz
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich
| | - R Bettschart-Wolfensberger
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich
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Rigamonti S, Bettschart-Wolfensberger R, Schwarz A, Nussbaumer I. [Evaluation of a field-suitable injection anesthesia protocol for the castration of 8 to 14 days old piglets]. SCHWEIZ ARCH TIERH 2018; 160:469-474. [PMID: 29989554 DOI: 10.17236/sat00170] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The aim of this study was to find an intramuscularly (IM) injectable anaesthetic combination for 8 to 14-days old piglets, that guarantees a calm induction and sufficient quality of anaesthesia without excitations with a maximum of two hours long lasting recovery. In preliminary dose finding trials, different combinations of -ketamine, azaperone and romifidine were compared. A constant dose of 0.2 mg/kg of butorphanol was added to each combination and all piglets received 0.4 mg/kg meloxicam. Subsequently a dosage algorithm for the main trial was developed. In case of insufficient analgesia, lidocaine 2% (0.25 ml) was injected intratesticular. If two piglets showed an insufficient anaesthetic induction phase, depth of anaesthesia or recovery, the next dosage in the algorithm was tried. With the combination of 3 mg/kg azaperone, 0.2 mg/kg romifidine, 15 mg/kg ketamine and 0.2 mg/kg butorphanol the requirement of a smooth anaesthesia induction, sufficient anaesthesia and a recovery without excitation was fulfilled but the recovery lasted more than 120 minutes.
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Affiliation(s)
| | - R Bettschart-Wolfensberger
- Departement für klinische Diagnostik und Services, Abteilung Anästhesiologie, Vetsuisse-Fakultät, Universität Zürich
| | - A Schwarz
- Departement für klinische Diagnostik und Services, Abteilung Anästhesiologie, Vetsuisse-Fakultät, Universität Zürich
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Schwarz A, Strieth D, Ulber R, Muffler K. Auswirkung von heterotropher und mixotropher Kultivierung auf die EPS-Produktion terrestrischer Cyanobakterien. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855312] [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: 11/12/2022]
Affiliation(s)
- A. Schwarz
- Technische Hochschule Bingen; Fachbereich 1 - Life Sciences & Engineering; Berlinstraße 109 55411 Bingen am Rhein Deutschland
| | - D. Strieth
- Technische Universität Kaiserslautern; Lehrgebiet Bioverfahrenstechnik; Gottlieb-Daimler-Straße 49 67663 Kaiserslautern Deutschland
| | - R. Ulber
- Technische Universität Kaiserslautern; Lehrgebiet Bioverfahrenstechnik; Gottlieb-Daimler-Straße 49 67663 Kaiserslautern Deutschland
| | - K. Muffler
- Technische Hochschule Bingen; Fachbereich 1 - Life Sciences & Engineering; Berlinstraße 109 55411 Bingen am Rhein Deutschland
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Muri B, Schmierer P, Schwarz A, Sigrist N. Hyperfibrinolysis diagnosed with rotational thromboelastometry and treated with tranexamic acid in a dog with acute traumatic coagulopathy. SCHWEIZ ARCH TIERH 2018; 160:227-233. [PMID: 29615381 DOI: 10.17236/sat00155] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/06/2022]
Abstract
INTRODUCTION A 4-year old male Australian Cattle Dog involved in a road traffic accident was presented with severe polytrauma to the Small Animal Clinic, University of Zurich. He was presented in hemorrhagic shock, with an initial lactate of 10.3mmol/l and ongoing bleeding from multiple injury sites. Acute traumatic coagulopathy diagnosed with ROTEM within one hour after accident showed marked hypocoagulation and hyperfibrinolysis. Treatment with a total dose of 40mg/kg of tranexamic acid intravenously resulted in successful elimination of hyperfibrinolysis in the following, serially measured ROTEM tracings.
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Affiliation(s)
- B Muri
- Department for Small Animals, Vetsuisse Faculty, University of Zurich
| | - P Schmierer
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich
| | - A Schwarz
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich
| | - N Sigrist
- Department for Small Animals, Vetsuisse Faculty, University of Zurich
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Schwarz A, Bruhs A, Schwarz T. 016 Deficiency of the G protein-coupled receptor HCA2 alters the phenotype and function of dendritic cells. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.020] [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: 10/17/2022]
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Schwarz T, Bruhs A, Schwarz A. 014 The arylhydrocarbon receptor agonist 4-n-nonylphenol switches non-regulatory T cells into a regulatory phenotype. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- J.L. Vanherweghem
- Dept. of Nephrology, Erasme Hospital, University of Brussels, Brussels, Belgium
| | - W. Drukker
- Dept. of Nephrology, St. Lucas Hospital, Amsterdam, The Netherlands
| | - A. Schwarz
- Universitäts Kliniken Steglitz, Freie Universität Berlin, Berlin, FRG
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Berberich R, Kuhlmann L, Zabori S, Schwarz A, Steinsträßer A. Bindung des monoklonalen Antikörpers BW 250/183 an menschliche Granulozyten. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungFür den szintigraphischen Nachweis entzündlicher Herde wird seit einiger Zeit die spezifische Bindung geeigneter monoklonaler Antikörper an menschliche Granulozyten ausgenutzt. Mit dem Antikörper BW 250/183 wurde versucht, die hierbei zugrundeliegende Bindungskinetik aufzuklären. Als wichtigste Voraussetzung für eine spezifische Zellbindung konnte gezeigt werden, daß der Markierungsvorgang die Immunreaktivität nicht beeinflußt. Bindungsstudien ergaben für den Antikörper eine Affinitätskonstante von 2 × 109l/mol. Üblicherweise werden pro Patient 0,25-1,0 mg des 99mTc-markierten Antikörpers eingesetzt. Nach intravenöser Applikation stellte sich bei den beschriebenen Untersuchungen rasch ein Gleichgewichtszustand im Blut ein, bei dem etwa 1/4 der Aktivität in zellgebundener Form vorlag. Der übrige Aktivitätsanteil fand sich in Form des markierten IgG im Plasma und konnte so direkt mit den Granulozyten, die bereits im Entzündungsherd kumuliert waren, reagieren. Auch eine drastische Reduktion der applizierten Antikörpermenge änderte an diesem Gleichgewichtszustand nichts, das Massenwirkungsgesetz scheint hier nicht unmittelbar anwendbar zu sein. Interferenzen mit Plasmabestandteilen können als Ursache für dieses Verhalten ausgeschlossen werden. Appliziert man statt der Antikörper Granulozyten, die in vitro mit dem Antikörper markiert wurden und bei denen der nicht gebundene Antikörperanteil durch Waschschritte entfernt wurde, so stellt sich bereits innerhalb der ersten 10 min ebenfalls dasselbe Bindungsgleichgewicht im Plasma ein. Interessanterweise verlängerte sich die intravasale Verweildauer der Aktivität hierbei deutlich.
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Elbracht T, Jeschke A, Weseloh G, Swoboda B, Kuwert T, Schwarz A. Bone scintigraphy and clinical outcome in rheumatoid gonarthritis. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryAim: For evaluation of the effect of radiosynoviorthesis (RSO) on the early and delayed uptake of 99mTc-biphosphonates and its relation to clinical outcome we studied these variables before and after radiosynoviorthesis performed on 41 knees affected by rheumatoid arthritis. Method: Thirty-seven patients with rheumatoid gonarthritis were treated by intraarticular injection with 185 MBq yttrium-90 citrate. In four of them both knees were treated so that 41 therapies were evaluated. On the average 35 days before and 120 days after radiosynoviorthesis, the early and delayed uptake of 99mTc-diphosphonate (DPD) was measured with a planar gamma camera. Early and late DPD uptake was quantified as a ratio between count values derived from rectangular ROIs placed on the knee treated and on the ipsilateral thigh. The severity of clinical symptoms was assessed on two 3-point rating scales averaged. Results: 30 of the 41 cases favorably responded to radiosynovior-thesis. There was a significant correlation between clinical outcome and pretherapeutic early DPD uptake (EDU) (p <0.05), but not between outcome and pretherapeutic late DPD uptake (DDU). In the whole group, EDU decreased in approximately 76% of cases after therapy (p <0.05), DDU in 54% (p >0.05). In 25 of the 30 responders EDU decreased; EDU increased or remained constant in five of the eleven non-responders. The correlation between outcome and the difference in EDU was significant (r = 0.344; p <0.05). There was no such significant relationship between the difference between pre- and posttherapeutic DDU and clinical course. Conclusion: Three-phase bone scintigraphy may contribute to predict and assess the success of radiosynovior-thesis in rheumatoid arthritis of the knee joint.
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Schnetzler C, Hagen R, Schwarz A, Kircher P, Nuss K. Klinische Anwendung der Computertomographie beim Rind. Tierarztl Prax Ausg G Grosstiere Nutztiere 2018. [DOI: 10.1055/s-0038-1623076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
ZusammenfassungDie Computertomographie liefert mithilfe von Röntgenstrahlen Schnittbilder von Körperregionen. Diese zeigen eine überlagerungsfreie, zweidimensionale Darstellung aller gewünschten Ebenen und ermöglichen auch eine dreidimensionale Rekonstruktion interessierender Körperregionen. Berichte über die Computertomographie beim Rind finden sich nur vereinzelt. Hohe Kosten, medikamentöse Restriktionen und die notwendige Allgemeinanästhesie limitieren die Anwendungen. Indikationen beim Rind sind vor allem Erkrankungen des Kopfes – wie Zahnerkrankungen oder Otitis media – sowie neurologische Erkrankungen, weniger oft Erkrankungen der Wirbelsäule und Gliedmaßen. Bei wertvollen Rindern, bei denen eine operative Therapie geplant ist, kann die Computertomographie Befunde liefern, die für die Durchführung des Eingriffs entscheidend sind. Die computertomographischen Befunde können andererseits auch dazu beitragen, eine ungünstige Prognose zu erkennen und so unnötige Operationen zu vermeiden.
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Schramm E, Schwarz A, Alber H, Alber G. Effects of the multi-compound complex in Corticosal® in 177 horses with PPID in a retrospective veterinary questionnaire analysis in Germany. PFERDEHEILKUNDE 2018. [DOI: 10.21836/pem20180605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bruhs A, Schwarz T, Schwarz A. 325 The short chain fatty acid sodium butyrate attenuates imiquimod-induced psoriasis-like skin inflammation. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hohenberger GM, Schwarz A, Hohenberger F, Niernberger T, Krassnig R, Hörlesberger N, Weiglein AH, Matzi V. Evaluation of Monaldi's approach with regard to needle decompression of the tension pneumothorax-A cadaver study. Injury 2017; 48:1888-1894. [PMID: 28602180 DOI: 10.1016/j.injury.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/08/2017] [Revised: 05/12/2017] [Accepted: 06/01/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although needle decompression of tension pneumothorax through the second intercostal space in the midclavicular line (Monaldi's approach) is a life-saving procedure, severe complications have been reported after its implementation. We evaluated the procedure by comparing how it was performed on cadavers by study participants with different training levels. METHODS Six participants including one thoracic surgeon performed bilateral thoracic drainage after Monaldi on 82 torsos. After the thoraces were opened, the distances from the internal thoracic artery (A), the site of the puncture (B) and the midclavicular line (C) were measured bilaterally with reference to the median of the sternum. Further, it was determined whether the participants had correctly identified the second intercostal space. The differences between B-A and C-B were analysed. RESULTS The needle was placed in the second intercostal space in 136 hemithoraces (83%). The thoracic surgeon showed a hit rate of 0% laceration of adjacent vessels. All the other participants had hit rates between 10% and 15%. The interval B-A ranged from 2.88 to 5.06cm in right and from 3.00 to 5.00cm in left hemithoraces. The distance C-B lay between 1.03cm and 1.87cm (right side), and 0.84cm and 2.02cm (left side). CONCLUSION In our collective, the main problem was failure to assess correctly the lateral extension of the clavicle. If this fact is emphasized during training, Monaldi's approach is a safe method for needle decompression of pneumothorax.
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Affiliation(s)
- G M Hohenberger
- Medical University of Graz, Department of Orthopedics and Trauma Surgery, Austria.
| | | | | | - T Niernberger
- State Hospital Hochsteiermark/Leoben, Department for Surgery, Austria
| | - R Krassnig
- Medical University of Graz, Department of Orthopedics and Trauma Surgery, Austria
| | | | | | - V Matzi
- State Hospital Hochsteiermark/Leoben, Department for Surgery, Austria
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Hohenberger GM, Maier MJ, Dolcet C, Weiglein AH, Schwarz A, Matzi V. Sensory nerve supply of the distal radio-ulnar joint with regard to wrist denervation. J Hand Surg Eur Vol 2017; 42:586-591. [PMID: 27852665 DOI: 10.1177/1753193416677699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The objective of this study was to determine the precise departure points of the articular branches innervating the distal radio-ulnar joint from the anterior and posterior interosseous nerves. The study sample consisted of 116 upper limbs from adult human cadavers. The articular branches were prepared under the dissection microscope to take measurements using the radial styloid process as point of reference. The articular branch departed from the anterior interosseous nerve at a mean distance of 2.9 cm proximal to the styloid for a radius length of 20.5 cm, and 3.7 cm for a radius length of 26.5 cm, respectively. For the posterior interosseous nerve, the departure point was at a mean distance of 3.1 cm (radius length of 20.5 cm) and at 4.0 cm (radius length of 26.5 cm). Apart from a single branch from the posterior interosseous nerve, all articular branches were located distal to the proximal border of the pronator quadratus. Results indicate that wrist denervation from the volar approach, if performed at the proximal border of the pronator quadratus, or from the dorsal approach at a distance of 4.8 cm (for a radius length of 20.5 cm) or 6.2 cm (for a radius length of 26.5 cm) proximal to the radial styloid process, will eliminate the nerve supply to the distal radio-ulnar joint in the majority of cases.
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Affiliation(s)
- G M Hohenberger
- 1 Department of Trauma Surgery, Medical University of Graz, Graz, Austria
| | - M J Maier
- 2 Institute for Statistics and Mathematics, Vienna University of Economics and Business, Vienna, Austria
| | - C Dolcet
- 3 Institute of Anatomy, Medical University of Graz, Graz, Austria
| | - A H Weiglein
- 3 Institute of Anatomy, Medical University of Graz, Graz, Austria
| | - A Schwarz
- 4 AUVA Trauma Hospital Graz, Graz, Austria
| | - V Matzi
- 4 AUVA Trauma Hospital Graz, Graz, Austria
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Müller-Putz GR, Schwarz A, Pereira J, Ofner P. From classic motor imagery to complex movement intention decoding: The noninvasive Graz-BCI approach. Prog Brain Res 2017; 228:39-70. [PMID: 27590965 DOI: 10.1016/bs.pbr.2016.04.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In this chapter, we give an overview of the Graz-BCI research, from the classic motor imagery detection to complex movement intentions decoding. We start by describing the classic motor imagery approach, its application in tetraplegic end users, and the significant improvements achieved using coadaptive brain-computer interfaces (BCIs). These strategies have the drawback of not mirroring the way one plans a movement. To achieve a more natural control-and to reduce the training time-the movements decoded by the BCI need to be closely related to the user's intention. Within this natural control, we focus on the kinematic level, where movement direction and hand position or velocity can be decoded from noninvasive recordings. First, we review movement execution decoding studies, where we describe the decoding algorithms, their performance, and associated features. Second, we describe the major findings in movement imagination decoding, where we emphasize the importance of estimating the sources of the discriminative features. Third, we introduce movement target decoding, which could allow the determination of the target without knowing the exact movement-by-movement details. Aside from the kinematic level, we also address the goal level, which contains relevant information on the upcoming action. Focusing on hand-object interaction and action context dependency, we discuss the possible impact of some recent neurophysiological findings in the future of BCI control. Ideally, the goal and the kinematic decoding would allow an appropriate matching of the BCI to the end users' needs, overcoming the limitations of the classic motor imagery approach.
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Affiliation(s)
- G R Müller-Putz
- Graz University of Technology, Institute of Neural Engineering, Graz, Austria.
| | - A Schwarz
- Graz University of Technology, Institute of Neural Engineering, Graz, Austria
| | - J Pereira
- Graz University of Technology, Institute of Neural Engineering, Graz, Austria
| | - P Ofner
- Graz University of Technology, Institute of Neural Engineering, Graz, Austria
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Schwarz T, Krejner A, Mrowietz U, Bruhs A, Schwarz A. 578 Expression of the G protein-coupled receptors GPR109A and GPR43 is downregulated in psoriatic skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gebhardt V, Mueller-Hansen L, Schwarz A, Bussen D, Weiss C, Schmittner MD. Chloroprocaine 10 mg/ml for low-dose spinal anaesthesia in perianal surgery - a randomised dose finding study. Acta Anaesthesiol Scand 2017; 61:241-249. [PMID: 27892594 DOI: 10.1111/aas.12839] [Citation(s) in RCA: 12] [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] [Received: 06/23/2016] [Revised: 10/20/2016] [Accepted: 11/01/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Low-dose spinal anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery. Regarding its short duration of action and its trend to hyperbaric characteristics, plain chloroprocaine 10 mg/ml seems to be ideal to perform low-dose spinal anaesthesia. The aim of this trial was to determine the optimal dosage of chloroprocaine for this indication. METHODS Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally. Patients had to sit upright for at least 10 min after injection. We measured the expansion of sensory and motor block and the times until voiding, walking without assistance and home discharge. RESULTS The expansion of the sensory (P ≤ 0.0059) and the motor block (P ≤ 0.0086) gained with increasing doses. At a dose of 30 mg the incidence of a profound, clinically relevant motor block was significantly higher compared to 10 and 20 mg (P ≤ 0.0004). In the 10 mg group two patients suffered from nociceptive pain due to an incomplete block and five patients announced discomfort during procedure. Doses of 10 and 20 mg led to a significantly earlier discharge compared to 30 mg (P = 0.0003; P = 0.0406). CONCLUSION Plain chloroprocaine 10 mg/ml can successfully be used for low-dose spinal anaesthesia in perianal outpatient surgery. Regarding the unfavourable motor block and later discharge-times in the 30 mg group on the one hand and the block-failures in the 10 mg group on the other, 20 mg can be recommended as the optimal dose.
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Affiliation(s)
- V. Gebhardt
- Department of Anaesthesiology and Surgical Intensive Care Medicine; University Medical Centre Mannheim; Mannheim Germany
| | - L. Mueller-Hansen
- Department of Anaesthesiology and Surgical Intensive Care Medicine; University Medical Centre Mannheim; Mannheim Germany
| | - A. Schwarz
- Department of Anaesthesiology and Surgical Intensive Care Medicine; University Medical Centre Mannheim; Mannheim Germany
| | - D. Bussen
- Centre of Colo-proctology; Mannheim Germany
| | - C. Weiss
- Department of Medical Statistics; University Medical Centre Mannheim; Mannheim Germany
| | - M. D. Schmittner
- Department of Anaesthesiology and Surgical Intensive Care Medicine; University Medical Centre Mannheim; Mannheim Germany
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Zhong H, Fläschner G, Schwarz A, Wiesendanger R, Christoph P, Wagner T, Bick A, Staarmann C, Abeln B, Sengstock K, Becker C. A millikelvin all-fiber cavity optomechanical apparatus for merging with ultra-cold atoms in a hybrid quantum system. Rev Sci Instrum 2017; 88:023115. [PMID: 28249514 DOI: 10.1063/1.4976497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We describe the construction of an apparatus designed to realize a hybrid quantum system comprised of a cryogenically cooled mechanical oscillator and ultra-cold 87Rb atoms coupled via light. The outstanding feature of our instrument is an in situ adjustable asymmetric all-fiber membrane-in-the-middle cavity located inside an ultra-high vacuum dilution refrigerator based cryostat. We show that Bose-Einstein condensates of N=2×106 atoms can be produced in less than 20 s and demonstrate a single photon optomechanical coupling strength of g0=2π×9 kHz employing a high-stress Si3N4 membrane with a mechanical quality factor Qm>107 at a cavity setup temperature of TMiM = 480 mK.
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Affiliation(s)
- H Zhong
- Institut für Angewandte Physik, Universität Hamburg, Jungiusstrasse 9-11, 20355 Hamburg, Germany
| | - G Fläschner
- Institut für Angewandte Physik, Universität Hamburg, Jungiusstrasse 9-11, 20355 Hamburg, Germany
| | - A Schwarz
- Institut für Angewandte Physik, Universität Hamburg, Jungiusstrasse 9-11, 20355 Hamburg, Germany
| | - R Wiesendanger
- Institut für Angewandte Physik, Universität Hamburg, Jungiusstrasse 9-11, 20355 Hamburg, Germany
| | - P Christoph
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - T Wagner
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - A Bick
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - C Staarmann
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - B Abeln
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - K Sengstock
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
| | - C Becker
- ZOQ-Zentrum für Optische Quantentechnologien, Universität Hamburg, Luruper Chaussee 149, 22761 Hamburg, Germany
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Abstract
The objective of this study is to evaluate the treatment of high-strength acid mine drainage (AMD) from copper mining by nanofiltration (NF) and reverse osmosis (RO) at pilot scale. The performances of two commercial spiral-wound membranes - NF99 and RO98pHt, both from Alfa Laval - were compared. The effects of pressure and feed flow on ion rejection and permeate flux were evaluated. The results showed high ion removal under optimum pressure conditions, which reached 92% for the NF99 membrane and 98% for the RO98pHt membrane. Sulfate removal reached 97% and 99% for NF99 and RO98pHt, respectively. In the case of copper, aluminum, iron and manganese, the removal percentage surpassed 95% in both membranes. Although concentration polarization limited NF performance at higher pressures, permeate fluxes observed in NF were five times greater than those obtained by RO, with only slightly lower divalent ion rejection rates, making it a promising option for the treatment of AMD.
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Affiliation(s)
- K Ambiado
- Department of Chemical Engineering, Universidad de Concepción, P.O. Box 160-C, Concepción, Chile
| | - C Bustos
- Department of Civil Engineering, Universidad de Concepción, P.O. Box 160-C, Concepción, Chile E-mail:
| | - A Schwarz
- Department of Civil Engineering, Universidad de Concepción, P.O. Box 160-C, Concepción, Chile E-mail:
| | - R Bórquez
- Department of Chemical Engineering, Universidad de Concepción, P.O. Box 160-C, Concepción, Chile
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Trey T, Sharif A, Schwarz A, Fiatarone Singh M, Lavee J. Transplant Medicine in China: Need for Transparency and International Scrutiny Remains. Am J Transplant 2016; 16:3115-3120. [PMID: 27532896 PMCID: PMC5096240 DOI: 10.1111/ajt.14014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 01/25/2023]
Abstract
Previous publications have described unethical organ procurement procedures in the People's Republic of China. International awareness and condemnation contributed to the announcement abolishing the procurement of organs from executed prisoners starting from January 2015. Eighteen months after the announcement, and aligned with the upcoming International Congress of the Transplantation Society in Hong Kong, this paper revisits the topic and discusses whether the declared reform has indeed been implemented. China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience, nor has the government initiated any legislative amendments. Recent reports have discussed an implausible discrepancy of officially reported steady annual transplant numbers and a steep expansion of the transplant infrastructure in China. This paper expresses the viewpoint that, in the current context, it is not possible to verify the veracity of the announced changes, and it thus remains premature to include China as an ethical partner in the international transplant community. Until we have independent and objective evidence of a complete cessation of unethical organ procurement from prisoners, the medical community has a professional responsibility to maintain the academic embargo on Chinese transplant professionals.
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Affiliation(s)
- T. Trey
- Doctors Against Forced Organ HarvestingWashingtonDC
| | - A. Sharif
- Doctors Against Forced Organ HarvestingWashingtonDC,Department of Nephrology and TransplantationQueen Elizabeth HospitalBirminghamUnited Kingdom
| | - A. Schwarz
- Independent China researcherMunichGermany
| | - M. Fiatarone Singh
- Doctors Against Forced Organ HarvestingWashingtonDC,Exercise, Health and PerformanceFaculty of Health Sciences and Sydney Medical SchoolUniversity of SydneySydneyAustralia
| | - J. Lavee
- Doctors Against Forced Organ HarvestingWashingtonDC,Heart Transplantation UnitDepartment of Cardiac SurgerySheba Medical Center and the Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
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Affiliation(s)
- A Sharif
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK. .,Doctors Against Forced Organ Harvesting, Washington, DC.
| | - T Trey
- Doctors Against Forced Organ Harvesting, Washington, DC
| | - A Schwarz
- Independent China scholar, Munich, Germany
| | - M Fiatarone Singh
- Doctors Against Forced Organ Harvesting, Washington, DC.,Exercise, Health and Rehabilitation, Faculty of Health Sciences and Sydney Medical School, University of Sydney, Sydney, Australia
| | - J Lavee
- Doctors Against Forced Organ Harvesting, Washington, DC.,Heart Transplantation Unit, Department of Cardiac Surgery, Sheba Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hohenberger G, Schwarz A, Hohenberger F, Krassnig R, Hörlesberger N, Weiglein A, Matzi V. Monaldipunktion – Wird die Punktionsstelle von Medizinern richtig lokalisiert? Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bruhs A, Schwarz T, Schwarz A. 247 Disruption of the epidermal barrier induces regulatory T cells in an IL-33 dependent fashion. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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von Allwörden H, Ruschmeier K, Köhler A, Eelbo T, Schwarz A, Wiesendanger R. Set-up of a high-resolution 300 mK atomic force microscope in an ultra-high vacuum compatible (3)He/10 T cryostat. Rev Sci Instrum 2016; 87:073702. [PMID: 27475560 DOI: 10.1063/1.4955448] [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] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 06/26/2016] [Indexed: 06/06/2023]
Abstract
The design of an atomic force microscope with an all-fiber interferometric detection scheme capable of atomic resolution at about 500 mK is presented. The microscope body is connected to a small pumped (3)He reservoir with a base temperature of about 300 mK. The bakeable insert with the cooling stage can be moved from its measurement position inside the bore of a superconducting 10 T magnet into an ultra-high vacuum chamber, where the tip and sample can be exchanged in situ. Moreover, single atoms or molecules can be evaporated onto a cold substrate located inside the microscope. Two side chambers are equipped with standard surface preparation and surface analysis tools. The performance of the microscope at low temperatures is demonstrated by resolving single Co atoms on Mn/W(110) and by showing atomic resolution on NaCl(001).
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Affiliation(s)
- H von Allwörden
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
| | - K Ruschmeier
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
| | - A Köhler
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
| | - T Eelbo
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
| | - A Schwarz
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
| | - R Wiesendanger
- Department of Physics, University of Hamburg, Jungiusstrasse 11, 20355 Hamburg, Germany
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Schwarz T, Bruhs A, Schwarz A. 452 Short chain fatty acids induce regulatory T cells by switching antigen-presenting cells from a stimulatory to a regulatory phenotype. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kucki M, Rupper P, Sarrieu C, Melucci M, Treossi E, Schwarz A, León V, Kraegeloh A, Flahaut E, Vázquez E, Palermo V, Wick P. Interaction of graphene-related materials with human intestinal cells: an in vitro approach. Nanoscale 2016; 8:8749-60. [PMID: 27064646 DOI: 10.1039/c6nr00319b] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Graphene-related materials (GRM) inherit unique combinations of physicochemical properties which offer a high potential for technological as well as biomedical applications. It is not clear which physicochemical properties are the most relevant factors influencing the behavior of GRM in complex biological environments. In this study we have focused on the interaction of GRM, especially graphene oxide (GO), and Caco-2 cells in vitro. We mimiked stomach transition by acid-treatment of two representative GRM followed by analysis of their physicochemical properties. No significant changes in the material properties or cell viability of exposed Caco-2 cells in respect to untreated GRM could be detected. Furthermore, we explored the interaction of four different GO and Caco-2 cells to identify relevant physicochemical properties for the establishment of a material property-biological response relationship. Despite close interaction with the cell surface and the formation of reactive oxygen species (ROS), no acute toxicity was found for any of the applied GO (concentration range 0-80 μg ml(-1)) after 24 h and 48 h exposure. Graphene nanoplatelet aggregates led to low acute toxicity at high concentrations, indicating that aggregation, the number of layers or the C/O ratio have a more pronounced effect on the cell viability than the lateral size alone.
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Affiliation(s)
- M Kucki
- Laboratory for Particles-Biology Interactions, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014 St. Gallen, Switzerland.
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Cornberg M, Schlevogt B, Rademacher J, Schwarz A, Sandherr M, Maschmeyer G. [Specific infections in organ transplantation]. Internist (Berl) 2016; 57:38-48. [PMID: 26782282 DOI: 10.1007/s00108-015-3807-8] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article is concerned with the important topic of infections associated with organ transplantation and includes a discussion on four subtopics. The first section describes the current options in the prevention and therapy of viral hepatitis in association with liver transplantation. Infections with hepatitis B, C, D (delta) and E are discussed with special emphasis on the interferon-free treatment of hepatitis C with the new antiviral drugs.The second section deals with Pseudomonas aeruginosa (PA) infections following lung transplantation (LuTx), which is one of the most frequently detected pathogens in the airway after LuTx. Patients with cystic fibrosis are particularly affected. This is important because studies have shown a clear correlation between chronic PA infections after LuTx and development of chronic transplant failure. Even if the data are still sparse, recommendations on prevention and therapeutic strategies are given. The theme of the third section is the high importance of viral infections after kidney transplantation. In addition to acquired infections, the transplanted organ as well as the recipient can be the source of the infection. The better the transplanted organ is tolerated under moderate immunosuppression, the less common and severe virus infections are. The focus of this section is on three common pathogens: cytomegalovirus, polyomavirus BK and hepatitis viruses.The final section deals with Aspergillus infections following transplantation of various organs. In this context Aspergillus spp. are one of the most commonly occurring fungal diseases. The epidemiology, risk factors, diagnostics, prophylaxis and therapy of invasive aspergillosis are presented.
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Affiliation(s)
- M Cornberg
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30623, Hannover, Deutschland.
| | - B Schlevogt
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30623, Hannover, Deutschland
| | - J Rademacher
- Klinik für Pneumologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - A Schwarz
- Klinik für Nieren- und Hochdruckerkrankungen, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - M Sandherr
- Gemeinschaftspraxis für Hämatologie und Onkologie, Röntgenstr. 4, 82362, Weilheim, Deutschland.
| | - G Maschmeyer
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Ernst von Bergmann, Potsdam, Deutschland
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Erdbrügger U, Scheffner I, Mengel M, Schwarz A, Haller H, Gwinner W. Long-term impact of CMV infection on allografts and on patient survival in renal transplant patients with protocol biopsies. Am J Physiol Renal Physiol 2015; 309:F925-32. [DOI: 10.1152/ajprenal.00317.2015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/08/2015] [Indexed: 12/13/2022] Open
Abstract
Cytomegalovirus (CMV) infection is a frequent complication of early posttransplantation. This study examines its impact on chronic allograft changes, long-term graft loss, and patient survival. We studied 594 patients who had protocol biopsies at 6 wk, and 3 and 6 mo posttransplantation. Chronic allograft changes were evaluated according to the updated Banff classification [interstitial fibrosis/tubular atrophy (IF/TA), vascular and glomerular lesions]. Follow-up data were available for up to 10 yr. CMV infection was diagnosed in 153 of 594 patients (26%) in the first year after transplantation, mostly within the first 3 mo. Graft survival was reduced in patients with CMV ( P = 0.03) as well as the combined allograft/patient survival ( P = 0.008). Prevalence of IF/TA at 6 wk after transplantation was already threefold higher in patients who experienced CMV infection later on compared with patients without CMV ( P = 0.005). In multivariate analyses, CMV viremia or disease was not a significant factor for graft loss or death. In conclusion, patients with CMV infection posttransplantation show more chronic allograft changes early on, even before CMV infection, and development of IF/TA is not more prevalent in patients with CMV. Our data do not support a significant role of CMV in patient and graft outcomes.
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Affiliation(s)
- U. Erdbrügger
- Division of Nephrology and Hypertension, University of Virginia Health System, Charlottesville, Virginia
| | - I. Scheffner
- Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; and
| | - M. Mengel
- Department of Laboratory Medicine and Pathology, University of Edmonton, Edmonton, Ontario, Canada
| | - A. Schwarz
- Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; and
| | - H. Haller
- Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; and
| | - W. Gwinner
- Division of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; and
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Schwarz A, Pick C, Harrach R, Stein G, Bendella H, Ozsoy O, Ozsoy U, Schoenau E, Jaminet P, Sarikcioglu L, Dunlop S, Angelov D. Reactions of the rat musculoskeletal system to compressive spinal cord injury (SCI) and whole body vibration (WBV) therapy. J Musculoskelet Neuronal Interact 2015; 15:123-36. [PMID: 26032204 PMCID: PMC5133715] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Traumatic spinal cord injury (SCI) causes a loss of locomotor function with associated compromise of the musculo-skeletal system. Whole body vibration (WBV) is a potential therapy following SCI, but little is known about its effects on the musculo-skeletal system. Here, we examined locomotor recovery and the musculo-skeletal system after thoracic (T7-9) compression SCI in adult rats. Daily WBV was started at 1, 7, 14 and 28 days after injury (WBV1-WBV28 respectively) and continued over a 12-week post-injury period. Intact rats, rats with SCI but no WBV (sham-treated) and a group that received passive flexion and extension (PFE) of their hind limbs served as controls. Compared to sham-treated rats, neither WBV nor PFE improved motor function. Only WBV14 and PFE improved body support. In line with earlier studies we failed to detect signs of soleus muscle atrophy (weight, cross sectional diameter, total amount of fibers, mean fiber diameter) or bone loss in the femur (length, weight, bone mineral density). One possible explanation is that, despite of injury extent, the preservation of some axons in the white matter, in combination with quadripedal locomotion, may provide sufficient trophic and neuronal support for the musculoskeletal system.
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Affiliation(s)
- A. Schwarz
- Department of Anatomy I, University of Cologne, Germany
| | - C. Pick
- Department of Anatomy I, University of Cologne, Germany
| | - R. Harrach
- Department of Anatomy I, University of Cologne, Germany
| | - G. Stein
- Department of Orthopedics and Trauma Surgery, University of Cologne, Germany
| | - H. Bendella
- Department of Neurosurgery, Hospital Merheim, University of Witten-Herdecke, Cologne, Germany
| | - O. Ozsoy
- Department of Physiology, Akdeniz University of Antalya, Turkey
| | - U. Ozsoy
- Department of Anatomy, Akdeniz University of Antalya, Turkey
| | - E. Schoenau
- Children’s Hospital, University of Cologne, Germany
| | - P. Jaminet
- Department of Hand-, Plastic-, and Reconstructive Surgery with Burn Unit, BG-Trauma Centre, University of Tuebingen, Germany
| | - L. Sarikcioglu
- Department of Anatomy, Akdeniz University of Antalya, Turkey
| | - S. Dunlop
- School of Animal Biology, The University of Western Australia, Australia
| | - D.N. Angelov
- Department of Anatomy I, University of Cologne, Germany,Corresponding author: Prof. Dr. Doychin N. Angelov, M.D., Ph.D., Institut 1 für Anatomie der Universität zu Köln, Joseph-Stelzmann-Strasse 9, D-50924 Köln, Germany E-mail:
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Scherzinger C, Balaceanu A, Hofmann C, Schwarz A, Leonhard K, Pich A, Richtering W. Cononsolvency of mono- and di-alkyl N-substituted poly(acrylamide)s and poly(vinyl caprolactam). POLYMER 2015. [DOI: 10.1016/j.polymer.2015.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gent TC, Schwarz A, Hatz LA, Gozalo-Marcilla M, Schauvliege S, Frank Gasthuys F, Bettschart-Wolfensberger R. Evaluation of accuracy of invasive and non-invasive blood pressure monitoring in relation to carotid artery pressure in anaesthetised ponies. PFERDEHEILKUNDE 2015. [DOI: 10.21836/pem20150105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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