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Ding J, Du T, Thomsen EH, Andresen D, Fischer MR, Møller AK, Petersen AR, Pedersen AK, Jensen LR, Wang S, Smedskjaer MM. Metal-Organic Framework Glass as a Functional Filler Enables Enhanced Performance of Solid-State Polymer Electrolytes for Lithium Metal Batteries. Adv Sci (Weinh) 2024; 11:e2306698. [PMID: 38145970 PMCID: PMC10933666 DOI: 10.1002/advs.202306698] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/11/2023] [Indexed: 12/27/2023]
Abstract
Polymers are promising candidates as solid-state electrolytes due to their performance and processability, but fillers play a critical role in adjusting the polymer network structure and electrochemical, thermal, and mechanical properties. Most fillers studied so far are anisotropic, limiting the possibility of homogeneous ion transport. Here, applying metal-organic framework (MOF) glass as an isotropic functional filler, solid-state polyethylene oxide (PEO) electrolytes are prepared. Calorimetric and diffusion kinetics tests show that the MOF glass addition reduces the glass transition temperature of the polymer phase, improving the mobility of the polymer chains, and thereby facilitating lithium (Li) ion transport. By also incorporating the lithium salt and ionic liquid (IL), Li-Li symmetric cell tests of the PEO-lithium salt-MOF glass-IL electrolyte reveal low overpotential, indicating low interfacial impedance. Simulations show that the isotropic structure of the MOF glass facilitates the wettability of the IL by enhancing interfacial interactions, leading to a less confined IL structure that promotes Li-ion mobility. Finally, the obtained electrolyte is used to construct Li-lithium iron phosphate full batteries that feature high cycle stability and rate capability. This work therefore demonstrates how an isotropic functional filler can be used to enhance the electrochemical performance of solid-state polymer electrolytes.
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Affiliation(s)
- Junwei Ding
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | - Tao Du
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | - Emil H. Thomsen
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | - David Andresen
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | - Mathias R. Fischer
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | - Anders K. Møller
- Department of Chemistry and BioscienceAalborg UniversityAalborg9220Denmark
| | | | | | - Lars R. Jensen
- Department of Materials and ProductionAalborg UniversityAalborg9220Denmark
| | - Shiwen Wang
- College of New EnergyZhengzhou University of Light IndustryZhengzhou450002China
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2
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Gulholm T, Kim MG, Lennard K, Mirdad F, Overton K, Martinello M, Maley MW, Konecny P, Andresen D, Post JJ. Clinical variation in the early assessment and management of suspected community-acquired meningitis: a multicentre retrospective study. Intern Med J 2023; 53:2298-2306. [PMID: 36951401 DOI: 10.1111/imj.16076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/14/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Bacterial meningitis is a medical emergency and timely management has been shown to improve outcomes. The aim of this study was to compare the early assessment and management of adults with suspected community-onset meningitis between hospitals and identify opportunities for clinical practice improvement. METHODS This retrospective cohort study was conducted at three principal referral hospitals in Sydney, Australia. Adult patients with suspected meningitis undergoing cerebrospinal fluid sampling between 1 July 2018 and 31 June 2019 were included. Relevant clinical and laboratory data were extracted from the medical record. Differences between sites were analysed and factors associated with time to antimicrobial therapy were assessed by Cox regression. RESULTS In 260 patients, the median time from triage to antibiotic administration was 332 min with a difference of up to 147 min between hospitals. Median time from triage to lumbar puncture (LP) was 366 min with an inter-hospital difference of up to 198 min. Seventy per cent of patients had neuroimaging prior to LP, and this group had a significantly longer median time to antibiotic administration (367 vs 231 min; P = 0.001). Guideline concordant antibiotics were administered in 84% of patients, with only 39% of those administered adjunctive corticosteroids. Seven (3%) patients had confirmed bacterial meningitis. Modifiable factors associated with earlier antimicrobial administration included infectious diseases involvement (adjusted hazard ratio [aHR], 1.50 [95% confidence interval (CI), 1.01-2.24]) and computed tomography (CT) scanning (aHR, 0.67 [95% CI, 0.46-0.98]). CONCLUSION Opportunities for improvement include reducing the time to LP and antibiotic administration, improving coadministration of corticosteroids and avoiding potentially unnecessary CT scanning.
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Affiliation(s)
- Trine Gulholm
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Myong Gyu Kim
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Kate Lennard
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Feras Mirdad
- Department of Microbiology and Infectious Diseases, NSW Health Pathology and South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Kristen Overton
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Marianne Martinello
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
- Kirby Institute, UNSW Sydney, Kensington, New South Wales, Australia
| | - Michael W Maley
- Department of Microbiology and Infectious Diseases, NSW Health Pathology and South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Pamela Konecny
- Department of Infectious Diseases and Immunology, St George Hospital, Kogarah, New South Wales, Australia
| | - David Andresen
- Departments of Infectious Diseases and Microbiology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
- St Vincent's Hospital Clinical School, University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Jeffrey J Post
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Sydney, Kensington, New South Wales, Australia
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3
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Kim MG, Gulholm T, Lennard K, Mirdad F, Overton K, Maley M, Konecny P, Andresen D, Post JJ. The impact of cerebrospinal fluid viral polymerase chain reaction testing on the management of adults with viral meningitis: A multi-center retrospective study. J Med Virol 2023; 95:e28198. [PMID: 36207770 PMCID: PMC10092443 DOI: 10.1002/jmv.28198] [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: 06/01/2022] [Revised: 09/03/2022] [Accepted: 10/04/2022] [Indexed: 01/11/2023]
Abstract
The aim of this study was to evaluate the role of viral polymerase chain reaction (PCR) testing in patients with aseptic meningitis and identify opportunities for improvement in clinical management. All cerebrospinal fluid samples collected in 1 year from four teaching hospitals in Sydney, Australia, were reviewed. Patients with aseptic meningitis were selected, and clinical and diagnostic features, hospital length of stay (LOS), and treatment were analyzed. Identifying a cause by viral PCR did not reduce hospital LOS (median 3 days) or antibiotic use (median 2 days), but the turnaround time of the PCR test correlated with LOS (Rs = 0.3822, p = 0.0003). Forty-one percent of patients received intravenous acyclovir treatment, which was more frequent in patients admitted under neurologists than infectious diseases physicians (56% vs. 24%; p = 0.013). The majority of patients did not have investigations for alternative causes of aseptic meningitis such as human immunodeficiency virus and syphilis if the viral PCR panel was negative. The benefit of PCR testing in aseptic meningitis in adults in reducing LOS and antibiotic use is unclear. The reasons for unnecessary aciclovir use in meningitis syndromes require further assessment.
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Affiliation(s)
- Myong Gyu Kim
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia.,Clinical School of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Trine Gulholm
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia.,Clinical School of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Kate Lennard
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Feras Mirdad
- Department of Microbiology and Infectious Diseases, NSW Health Pathology and South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Kristen Overton
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia.,Clinical School of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Michael Maley
- Department of Microbiology and Infectious Diseases, NSW Health Pathology and South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Pamela Konecny
- Clinical School of Medicine, UNSW Sydney, Kensington, New South Wales, Australia.,Department of Infectious Diseases and Immunology, St. George Hospital, Kogarah, New South Wales, Australia
| | - David Andresen
- Departments of Infectious Diseases and Microbiology, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia.,St. Vincent's Hospital Clinical School of medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Jeffrey John Post
- Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia.,Clinical School of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
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4
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Li J, Lau C, Anderson N, Burrows F, Mirdad F, Carlos L, Pitman AJ, Muthiah K, Darley DR, Andresen D, Macdonald P, Marriott D, Dharan NJ. Multispecies Outbreak of Nocardia Infections in Heart Transplant Recipients and Association with Climate Conditions, Australia. Emerg Infect Dis 2022; 28:2155-2164. [PMID: 36287030 PMCID: PMC9622252 DOI: 10.3201/eid2811.220262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Extreme weather conditions, coupled with greater susceptibility to opportunistic infection, could explain this outbreak. A multispecies outbreak of Nocardia occurred among heart transplant recipients (HTR), but not lung transplant recipients (LTR), in Sydney, New South Wales, Australia, during 2018–2019. We performed a retrospective review of 23 HTR and LTR who had Nocardia spp. infections during June 2015–March 2021, compared risk factors for Nocardia infection, and evaluated climate conditions before, during, and after the period of the 2018–2019 outbreak. Compared with LTR, HTR had a shorter median time from transplant to Nocardia diagnosis, higher prevalence of diabetes, greater use of induction immunosuppression with basiliximab, and increased rates of cellular rejection before Nocardia diagnosis. During the outbreak, Sydney experienced the lowest monthly precipitation and driest surface levels compared with time periods directly before and after the outbreak. Increased immunosuppression of HTR compared with LTR, coupled with extreme weather conditions during 2018–2019, may explain this outbreak of Nocardia infections in HTR.
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5
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McNeill J, Chew H, Andresen D, Muller D, Granger E, Wang LW. Coronary artery embolism and culture-negative endocarditis post Bentall's procedure. J Surg Case Rep 2021; 2021:rjab438. [PMID: 34631009 PMCID: PMC8496241 DOI: 10.1093/jscr/rjab438] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 11/14/2022] Open
Abstract
Infective endocarditis is an important cause of morbidity and mortality, which classically presents with fevers and nonspecific symptoms. Afebrile infective endocarditis with negative blood cultures makes diagnosis more challenging and delays in treatment can occur increasing the likelihood of complications. The presence of prosthetic heart valves places patients at an increased risk of infective endocarditis and the case described below highlights the importance of considering this diagnosis even if classic clinical features such as fever and raised inflammatory markers are not present, as well as discussing an unusual complication of infective endocarditis; coronary artery embolism leading to myocardial infarction.
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Affiliation(s)
- Jared McNeill
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - Hong Chew
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - David Andresen
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, NSW, Australia
| | - David Muller
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Emily Granger
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, NSW, Australia
| | - Louis W Wang
- Department of Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
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Schleberger R, Metzner A, Kuck KH, Andresen D, Willems S, Hoffmann E, Deneke T, Eckardt L, Brachmann J, Hochadel M, Senges J, Rillig A. Antiarrhythmic drug therapy after catheter ablation for atrial fibrillation has no impact on recurrences, cardiovascular events and mortality – insights from the German Ablation Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0357] [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
Background
Data on the optimal treatment strategy for antiarrhythmic drug therapy (AAD) after atrial fibrillation (AF) catheter ablation are inconsistent. While AAD potentially stabilizes sinus rhythm, it also increases the patients' treatment burden.
Methods
Patients from the prospective German Ablation Registry (n=3275) discharged with or without AAD after AF catheter ablation were compared regarding long-term success, cardiovascular events and patient reported outcome.
Results
In patients with paroxysmal AF (n=2138) recurrence and rehospitalization rates did not differ when discharged with (n=1051) or without (n=1087) AAD (recurrence: adjusted odds ratio (OR) 1.13, 95% confidence interval (CI) [0.95–1.35]; rehospitalization: OR 1.08, 95% CI [0.90–1.30]). The reablation rate was higher and reduced treatment satisfaction was reported more often in those discharged with AAD (reablation: OR 1.30, 95% CI [1.05–1.61]; reduced treatment satisfaction: OR 1.76, 95% CI [1.20–2.58]).
Similar rates of recurrences, rehospitalisations, reablations and treatment satisfaction were found in patients with persistent AF (n=1137) discharged with (n=641) or without (n=496) AAD (recurrence: OR 1.22, 95% CI [0.95–1.56]; rehospitalization: OR 1.16, 95% CI [0.90–1.50]; reablation: OR 1.21, 95% CI [0.91–1.61]; treatment satisfaction: OR 1.24, 95% CI [0.74–2.08]).
The incidence of cardiovascular events and mortality did not differ at follow-up in paroxysmal and persistent AF patients discharged with or without AAD.
Conclusion
The rates of recurrences, cardiovascular events and mortality did not differ between patients discharged with or without AAD after AF catheter ablation. However, AAD should be considered carefully in patients with paroxysmal AF, in whom it was associated with a higher reablation rate and reduced treatment satisfaction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Schleberger
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - A Metzner
- University Heart & Vascular Center Hamburg, Hamburg, Germany
| | | | | | - S Willems
- Asklepios Clinic St. Georg, Hamburg, Germany
| | | | - T Deneke
- Heart Center Bad Neustadt, Bad Neustadt a. d. Saale, Germany
| | - L Eckardt
- Muenster University Hospital, Muenster, Germany
| | | | - M Hochadel
- Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany
| | - J Senges
- Stiftung Institut fuer Herzinfarktforschung, Ludwigshafen, Germany
| | - A Rillig
- University Heart & Vascular Center Hamburg, Hamburg, Germany
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7
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Lau C, Marriott D, Schultz HB, Gould M, Andresen D, Wicha SG, Alffenaar JW, Penm J, Reuter SE. Assessment of cefepime toxicodynamics: comprehensive examination of pharmacokinetic/pharmacodynamic targets for cefepime-induced neurotoxicity and evaluation of current dosing guidelines. Int J Antimicrob Agents 2021; 58:106443. [PMID: 34551358 DOI: 10.1016/j.ijantimicag.2021.106443] [Citation(s) in RCA: 3] [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] [Received: 06/09/2021] [Revised: 08/19/2021] [Accepted: 09/12/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cefepime-induced neurotoxicity (CIN) is an increasingly reported adverse event; however, the toxicity threshold remains unclear. This study was conducted to provide a comprehensive examination of the most appropriate threshold for CIN, and evaluate the ability of current dosing regimens to attain therapeutic targets. METHODS Data of the incidence of CIN and cefepime plasma concentrations were collected retrospectively from patients administered cefepime. Population pharmacokinetic modelling was used to determine daily cefepime trough concentration (Cmin), maximum serum concentration and area under the concentration-time curve. The ability of each pharmacokinetic parameter to predict CIN was evaluated using receiver operating characteristic (ROC) curves, from which optimal toxicity thresholds were determined. Pharmacokinetic simulation was used to evaluate the ability of cefepime dosing guidelines to meet established efficacy targets, whilst maintaining exposure below the determined CIN threshold. RESULTS In total, 102 cefepime courses were evaluated, with CIN reported in 10. ROC analyses showed that all cefepime pharmacokinetic parameters were strongly predictive of CIN. Cmin of 49 mg/L was identified as the optimal toxicity target, based on its predictive ability (0.88, 95% confidence interval 0.758-0.999, P<0.001) and ease of clinical use. Assessment of cefepime dosing regimens predicted that only 29% of simulated patients achieve therapeutic targets, with patients with impaired renal function more likely to exhibit subtherapeutic concentrations (89%), and patients with normal renal function likely to have potentially toxic exposure (64%). CONCLUSIONS The findings from this study provide evidence that cefepime exposure is highly predictive of CIN, with Cmin of 49 mg/L being the most appropriate toxicity threshold. Further research is required to optimize cefepime dosing in the context of this therapeutic target.
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Affiliation(s)
- Cindy Lau
- Department of Pharmacy, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia.
| | - Deborah Marriott
- Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia; School of Medicine, University of New South Wales, NSW, Australia
| | - Hayley B Schultz
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Michael Gould
- School of Medicine, University of Notre Dame Australia, NSW, Australia; Department of Intensive Care, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - David Andresen
- Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia; School of Medicine, University of Notre Dame Australia, NSW, Australia
| | - Sebastian G Wicha
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Hamburg, Hamburg, Germany
| | - Jan-Willem Alffenaar
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; Westmead Hospital, Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan Penm
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia; Department of Pharmacy, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Stephanie E Reuter
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, SA, Australia
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8
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Lau C, Marriott D, Gould M, Andresen D, Reuter SE, Penm J. A retrospective study to determine the cefepime-induced neurotoxicity threshold in hospitalized patients. J Antimicrob Chemother 2021; 75:718-725. [PMID: 31711216 DOI: 10.1093/jac/dkz476] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/04/2019] [Accepted: 10/05/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Cefepime-induced neurotoxicity (CIN) has been demonstrated to be associated with cefepime plasma concentrations; however, the toxicity threshold remains unclear. The primary objective of this study was to identify the cefepime plasma trough concentration at which neurotoxicity occurs. Secondary objectives were to determine the incidence of CIN at a large tertiary institution and to identify patient factors associated with the development of CIN. METHODS A retrospective review of all adult patients administered cefepime between October 2017 and May 2018 in a tertiary hospital was conducted to determine total incidence of CIN. A receiver operating characteristic (ROC) curve was constructed to review the sensitivity and specificity of using various cefepime trough plasma concentrations to predict the development of neurotoxicity. Cefepime plasma concentrations were measured using ultra-HPLC. A regression was conducted to identify patient factors associated with CIN. RESULTS In total, 206 patients were administered 259 courses of cefepime, with an overall CIN incidence of 6% (16/259 courses). A total of 64 courses had a cefepime trough concentration measured (24.7%). A cefepime trough concentration of 36 mg/L provided the best differentiation between patients who experienced neurotoxicity and those who did not. No other patient covariates were identified to be significantly associated with neurotoxicity occurring. CONCLUSIONS A cefepime trough plasma concentration ≥36 mg/L appears to be the most sensitive and specific cut-off to predict CIN occurring. No patient factors were associated with the development of CIN when accounting for cefepime trough plasma concentrations.
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Affiliation(s)
- Cindy Lau
- Department of Pharmacy, St Vincent's Hospital, Sydney, NSW, Australia.,The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia
| | - Deborah Marriott
- Department of Infectious Diseases and Clinical Microbiology, St Vincent's Hospital, Sydney, NSW, Australia.,School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Michael Gould
- School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia
| | - David Andresen
- Department of Infectious Diseases and Clinical Microbiology, St Vincent's Hospital, Sydney, NSW, Australia.,School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia
| | - Stephanie E Reuter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jonathan Penm
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia
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9
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Marriott D, Beresford R, Mirdad F, Stark D, Glanville A, Chapman S, Harkness J, Dore GJ, Andresen D, Matthews GV. Concomitant Marked Decline in Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Respiratory Viruses Among Symptomatic Patients Following Public Health Interventions in Australia: Data from St Vincent's Hospital and Associated Screening Clinics, Sydney, NSW. Clin Infect Dis 2021; 72:e649-e651. [PMID: 32841316 PMCID: PMC7499558 DOI: 10.1093/cid/ciaa1256] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 05/24/2020] [Accepted: 08/21/2020] [Indexed: 01/10/2023] Open
Abstract
Our Australian hospital tested almost 22,000 symptomatic people over 11 weeks for SARS-CoV-2 in a multiplex PCR assay. Following travel bans and physical distancing, SARS-CoV-2 and other respiratory viruses diagnoses fell dramatically. Increasing rhinovirus diagnoses as social control measures were relaxed may indirectly indicate an elevated risk of COVID-19 resurgence
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Affiliation(s)
- Deborah Marriott
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | | | - Feras Mirdad
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Damien Stark
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Allan Glanville
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Scott Chapman
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Jock Harkness
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Gregory J Dore
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia.,Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | - David Andresen
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia
| | - Gail V Matthews
- Department of Infectious Diseases, St Vincent's Hospital, Sydney, Australia.,Kirby Institute, University of New South Wales Sydney, Sydney, Australia
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10
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Darley DR, Dore GJ, Cysique L, Wilhelm KA, Andresen D, Tonga K, Stone E, Byrne A, Plit M, Masters J, Tang H, Brew B, Cunningham P, Kelleher A, Matthews GV. Persistent symptoms up to four months after community and hospital-managed SARS-CoV-2 infection. Med J Aust 2021; 214:279-280. [PMID: 33657671 PMCID: PMC8014234 DOI: 10.5694/mja2.50963] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 11/22/2022]
Affiliation(s)
- David R Darley
- St Vincent's Hospital, Sydney, NSW.,St Vincent's Clinical School, University of New South Wales, Sydney, NSW
| | - Gregory J Dore
- St Vincent's Hospital, Sydney, NSW.,Kirby Institute, University of New South Wales, Sydney, NSW
| | - Lucette Cysique
- Institute for Applied Medical Research, St Vincent's Hospital, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Kay A Wilhelm
- St Vincent's Hospital, Sydney, NSW.,The University of Notre Dame Australia, Sydney, NSW
| | - David Andresen
- St Vincent's Hospital, Sydney, NSW.,The University of Notre Dame Australia, Sydney, NSW.,The University of Sydney, Sydney, NSW
| | - Katrina Tonga
- St Vincent's Hospital, Sydney, NSW.,St Vincent's Clinical School, University of New South Wales, Sydney, NSW.,The University of Sydney, Sydney, NSW
| | - Emily Stone
- St Vincent's Hospital, Sydney, NSW.,St Vincent's Clinical School, University of New South Wales, Sydney, NSW
| | - Anthony Byrne
- St Vincent's Hospital, Sydney, NSW.,St Vincent's Clinical School, University of New South Wales, Sydney, NSW
| | - Marshall Plit
- St Vincent's Hospital, Sydney, NSW.,St Vincent's Clinical School, University of New South Wales, Sydney, NSW
| | - Jeffrey Masters
- Institute for Applied Medical Research, St Vincent's Hospital, Sydney, NSW
| | - Helen Tang
- Institute for Applied Medical Research, St Vincent's Hospital, Sydney, NSW
| | - Bruce Brew
- St Vincent's Hospital, Sydney, NSW.,Institute for Applied Medical Research, St Vincent's Hospital, Sydney, NSW
| | - Philip Cunningham
- Institute for Applied Medical Research, St Vincent's Hospital, Sydney, NSW
| | - Anthony Kelleher
- St Vincent's Hospital, Sydney, NSW.,Kirby Institute, University of New South Wales, Sydney, NSW
| | - Gail V Matthews
- St Vincent's Hospital, Sydney, NSW.,Kirby Institute, University of New South Wales, Sydney, NSW
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11
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Haifer C, Kelly CR, Paramsothy S, Andresen D, Papanicolas LE, McKew GL, Borody TJ, Kamm M, Costello SP, Andrews JM, Begun J, Chan HT, Connor S, Ghaly S, Johnson PD, Lemberg DA, Paramsothy R, Redmond A, Sheorey H, van der Poorten D, Leong RW. Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice. Gut 2020; 69:801-810. [PMID: 32047093 DOI: 10.1136/gutjnl-2019-320260] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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: 11/12/2019] [Revised: 12/17/2019] [Accepted: 12/27/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Faecal microbiota transplantation (FMT) has proved to be an extremely effective treatment for recurrent Clostridioides difficile infection, and there is interest in its potential application in other gastrointestinal and systemic diseases. However, the recent death and episode of septicaemia following FMT highlights the need for further appraisal and guidelines on donor evaluation, production standards, treatment facilities and acceptable clinical indications. DESIGN For these consensus statements, a 24-member multidisciplinary working group voted online and then convened in-person, using a modified Delphi approach to formulate and refine a series of recommendations based on best evidence and expert opinion. Invitations to participate were directed to Australian experts, with an international delegate assisting the development. The following issues regarding the use of FMT in clinical practice were addressed: donor selection and screening, clinical indications, requirements of FMT centres and future directions. Evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. RESULTS Consensus was reached on 27 statements to provide guidance on best practice in FMT. These include: (1) minimum standards for donor screening with recommended clinical selection criteria, blood and stool testing; (2) accepted routes of administration; (3) clinical indications; (4) minimum standards for FMT production and requirements for treatment facilities acknowledging distinction between single-site centres (eg, hospital-based) and stool banks; and (5) recommendations on future research and product development. CONCLUSIONS These FMT consensus statements provide comprehensive recommendations around the production and use of FMT in clinical practice with relevance to clinicians, researchers and policy makers.
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Affiliation(s)
- Craig Haifer
- The University of Sydney, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Colleen R Kelly
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sudarshan Paramsothy
- The University of Sydney, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - David Andresen
- The University of Sydney, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Lito E Papanicolas
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Genevieve L McKew
- The University of Sydney, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Thomas J Borody
- Centre for Digestive Diseases, Sydney, New South Wales, Australia
| | - Michael Kamm
- St Vincent's Hospital, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Samuel P Costello
- The Queen Elizabeth Hospital, Woodville, South Australia, Australia
- BiomeBank, Adelaide, South Australia, Australia
| | - Jane M Andrews
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- The University of Adelaide, Adelaide, South Australia, Australia
| | - Jakob Begun
- The University of Queensland, Brisbane, Queensland, Australia
- Mater Hospital Brisbane, Brisbane, Queensland, Australia
| | | | - Susan Connor
- Liverpool Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Simon Ghaly
- St Vincent's Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Dr Johnson
- The University of Melbourne, Melbourne, Victoria, Australia
- Austin Hospital, Melbourne, Victoria, Australia
| | - Daniel A Lemberg
- University of New South Wales, Sydney, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | | | - Andrew Redmond
- The University of Queensland, Brisbane, Queensland, Australia
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | | | - David van der Poorten
- The University of Sydney, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
| | - Rupert W Leong
- The University of Sydney, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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12
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Frommeyer G, Reinke F, Andresen D, Klemann T, Spitzer SG, Jehle J, Brachmann J, Stellbrink C, Hochadel M, Senges J, Eckardt L. P988Implantable cardioverter defibrillators in patients with electrical heart disease and hypertrophic cardiomyopathy - data from the German device Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0581] [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: 11/14/2022] Open
Abstract
Abstract
Background
Implantable cardioverter- defibrillator (ICD) therapy is established for prevention of sudden cardiac death (SCD) in different entities. However, data from large patient cohorts on patients with electrical heart disease of hypertrophic cardiomyopathy (HCM) is rare. Therefore, we investigated these patients by analysing registry data from a multi-center “real-life” registry.
Methods
The German Device Registry (DEVICE) is a nationwide, prospective registry with one-year follow-up investigating 5450 patients receiving device implantations in 50 German centres. The present analysis of DEVICE focussed on patients with electrical heart disease or HCM who received an ICD for primary or secondary prevention.
Results
174 patients with HCM and 112 patients with electrical heart disease were compared with 5164 other ICD patients. Median follow-up was 17.0 months. Patients in the control group were significantly older. Of note, overall mortality after one year was 1.8% in HCM patients, 6.6% in patients with electrical heart disease and 7.3% in the control group. Patients in the control group presented significantly more severe comorbidities. In contrast to HCM patients and the control group where primary prevention was the major indication for ICD implantation 77.5% of patients with electrical heart disease received an ICD for secondary prevention. The number of surgical revisions was higher in patients with electrical heart disease.
Conclusion
Data from the present registry display a surprisingly high mortality in patients with electrical heart disease equivalent to the control group. A high proportion of patients who received an ICD for secondary prevention may be regarded as a major determinant for these results while severe comorbidities such as diabetes, hypertension and renal failure are major determinants for mortality in the control cohort.
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Affiliation(s)
- G Frommeyer
- University Medical Center, Clinic for Cardiology II - Electrophysiology, Münster, Germany
| | - F Reinke
- University Medical Center, Clinic for Cardiology II - Electrophysiology, Münster, Germany
| | - D Andresen
- Department of Cardiology, Kardiologie am Hubertus-Krankenhaus, Berlin, Germany
| | - T Klemann
- Hear Center Ludwigshafen, Ludwigshafen, Germany
| | - S G Spitzer
- Praxisklinik Herz und Gefaesse, Dresden, Germany
| | - J Jehle
- Department of Cardiology, Klinikum Straubing, Straubing, Germany, Straubing, Germany
| | | | | | - M Hochadel
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - J Senges
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - L Eckardt
- University Medical Center, Clinic for Cardiology II - Electrophysiology, Münster, Germany
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Droth K, El-Armouche A, Andresen D, Bestehorn KP. 2406Role of implantation access on complication rates in pacemaker implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0159] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
The implantation access (IA) either via vena cephalica (VC) or vena subclavia (VS) is the usual procedure in pacemaker implantation (PI). Valid data on head-to head comparisons between access via CV and VS regarding serious complications are missing.
Purpose
We analyzed potential associations between the type of implantation access and complication rates in a real world data set with 69.957 cases.
Methods
The 2013 dataset of the German Federal Council, containing information about all 1st pacemaker implantations for Germanywas analyzed. First two cohorts of patients treated via CV or CS access were compared for all relevant variables through descriptive statistics. Secondly all patient-clusters with exactly the same risk-/condition-vector were identified based on the following variables: age, sex, ASA classification (ASA 1–ASA 5), leading symptom, indication for implantation, etiology, ejection fraction (EF), estimated need of stimulation, and all possible 1:1 exact matchings were compared.
Results
Out of the total cohort of 69,957 patients (mean age 76.2 years, 43.3% females, VC access 36%, VS access 64%) 19,643 pairs with identical profile of all factors contained in the database could be identified. These pairs of all 1:1 matchings had following profile: age 77.07 years, ASA 1 to 4 6.3%, 2 45.0%, 46.9%, 4 1.7%, leading symptoms (dizziness 51.9%, singular cardiac syncope 10.3%, recurring syncope 28,7%), pacemaker indication (AV-Block II/III 11.6%/26.3%, sick sinus syndrome 39,8%, bradycardia in atrial fibrillation 20.0%), unknown etiology 90.3%, estimated need of stimulation (permanent (>90%) 20.9%, frequent (5–90%) 70.2%, rare (<5%) 8.9%), EF (≤35%: 0.4%: 35, 50%: 9.1%, >50%: 79.9%, unknown: 10.5%).
Intra- and post-procedural complication [C] rates different between VC and VS are: at least one C: 2.6% (VC), 3.0% (VS) p=0.018; surgical C with need for intervention (haematothorax, pericardial effusion, pouch hematoma): 0.5% (VC), 1.0% (VS) p=0.005; asystole: 0.1% (VC), 0.2% (VS) p=0.047; pneumothorax: 0.1% (VC), 0.7% (VC) p<0.001; dislocated atrial lead: 0.8% (VC), 0.6% (VS) p=0.027. Intra-hospital mortality was 1.0% (VC), 1.1% (VS) p=0.521.
Conclusion
Our analysis of a large-scale database shows that in patients with first pacemaker implantation the overall rate of complications is relatively low. But even after adjustment for available risk factors there are differences between the access routes: whereas VS access route is associated with statistically significant higher risk of overall complications, i.e. surgical complications, asystole, pneumothorax the VC access has a greater risk of dislocated atrial lead. In view of the two times higher rate of implantations via VS (64 vs. 36%) the clinical implications should be considered when choosing the access route and the VC access should be preferred.
Acknowledgement/Funding
None
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Affiliation(s)
- K Droth
- Dresden University of Technology, Institute of Clinical Pharmacology, Dresden, Germany
| | - A El-Armouche
- Dresden University of Technology, Institute of Clinical Pharmacology, Dresden, Germany
| | - D Andresen
- Charite - Campus Mitte (CCM), Cardiology, Berlin, Germany
| | - K P Bestehorn
- Dresden University of Technology, Institute of Clinical Pharmacology, Dresden, Germany
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Cameron Smail R, O'Neill JH, Andresen D. Brainstem encephalitis caused by Coxsackie A16 virus in a rituximab-immunosuppressed patient. BMJ Case Rep 2019; 12:12/8/e230177. [PMID: 31451462 DOI: 10.1136/bcr-2019-230177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rituximab and other B cell depleting agents are increasingly used for haematological, immunological and neurological diseases. In a small minority, immunosuppression leads to increased virulence of normally mild infections. Brainstem encephalitis has been described occurring after infection from enteroviruses, more commonly in the paediatric population, but also in immunosuppressed adults. In this paper, we describe an enteroviral brainstem encephalitis in a rituximab-immunosuppressed patient. The enterovirus identified was Coxsackie A16, which has never yet been reported to cause brainstem encephalitis in an adult.
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Affiliation(s)
| | - John H O'Neill
- Neurology, Saint Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
| | - David Andresen
- Neurology, Saint Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
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15
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Bart N, Emmanuel S, Andresen D, Muthiah K, Hayward C. Baseline LVAD Flow is an Important Risk for Hemoresponse to Blood Stream Infection in LVAD Patients with Fixed Cardiac Output. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.578] [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] Open
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16
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Jilek C, Brachmann J, Lewalter TH, Kuck KH, Andresen D, Willems SG, Spitzer SG, Straube F, Schumacher B, Eckardt L, Danilovic D, Thomas D, Hochadel M, Senges J. 366No support for additional left atrial substrate modification among patients with persistent atrial fibrillation at first PVI procedure - results from German Ablation registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.366] [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: 11/12/2022] Open
Affiliation(s)
- C Jilek
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - J Brachmann
- Coburg Hospital, Department of Cardiology, Angiology, and Pneumology, Second Medical Clinic, Coburg, Germany
| | - T H Lewalter
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - D Andresen
- Vivantes Klinik Am Urban, Department of Cardiology and Internal Medicine, Berlin, Germany
| | - S G Willems
- University Heart Center Hamburg, Department of Electrophysiology, Hamburg, Germany
| | - S G Spitzer
- Praxisklinik Herz und Gefäße, Dresden, Germany
| | - F Straube
- Municipal Hospital of Munich, Heart Center Munich-Bogenhausen, Munich, Germany
| | - B Schumacher
- Westpfalz Hospital, Department of Cardiology, Pneumology, Angiology and Intensive Care, Kaiserslautern, Germany
| | - L Eckardt
- University Medical Center, Division of Electrophysiology, Department of Cardiology and Angiology, Münster, Germany
| | - D Danilovic
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - D Thomas
- University of Heidelberg, Department of Cardiology, Heidelberg, Germany
| | - M Hochadel
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - J Senges
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
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17
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Scholz KH, Andresen D, Böttiger BW, Busch HJ, Fischer M, Frey N, Kelm M, Kill C, Schieffer B, Storm C, Thiele H, Gräsner JT. [Quality indicators and structural requirements for Cardiac Arrest Centers-German Resuscitation Council (GRC)]. Anaesthesist 2018; 66:360-362. [PMID: 28474242 DOI: 10.1007/s00101-017-0311-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K H Scholz
- Medizinische Klinik I, Kardiologie und Intensivmedizin, St. Bernward Krankenhaus Hildesheim, Hildesheim, Deutschland
| | - D Andresen
- Evangelisches Krankenhaus Hubertus, Berlin, Deutschland.,Medizinische Klinik und Poliklinik, Schwerpunkt Kardiologie, Angiologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - B W Böttiger
- Klinik für Anästhesiologie und Operative Intensivmedizin, Uniklinik Köln (AöR), Kerpener Straße 62, 50937, Köln, Deutschland.
| | - H J Busch
- Universitäts-Notfallzentrum (UNZ) Freiburg, Universitätsklinik Freiburg, Freiburg, Deutschland
| | - M Fischer
- Klinik für Anästhesiologie, Operative Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinik am Eichert, ALB FILS KLINIKEN GmbH, Göppingen, Deutschland
| | - N Frey
- Klinik für Innere Medizin III, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - M Kelm
- Division of Cardiology, Pulmology and Vascular Medicine, University Hospital Düsseldorf/Medical Faculty University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - C Kill
- Zentrum für Notfallmedizin, Universitätsklinikum Marburg, Marburg, Deutschland
| | - B Schieffer
- Klinik für Innere Medizin, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum Giessen und Marburg GmbH, Marburg, Deutschland
| | - C Storm
- Klinik für Nephrologie und Internistische Intensivmedizin, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - H Thiele
- Medizinische Klinik II, Universitäres Herzzentrum Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - J T Gräsner
- Institut für Rettungs- und Notfallmedizin, Kiel, Deutschland
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18
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Jilek C, Brachmann J, Lewalter T, Kuck KH, Andresen D, Willems S, Spitzer SG, Straube F, Schumacher B, Eckardt L, Danilovic D, Thomas D, Hochadel M, Senges J. 1012No support for additional left atrial substrate modification among patients with persistent atrial fibrillation at first PVI procedure- Results from German Ablation registry. Europace 2018. [DOI: 10.1093/europace/euy015.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Jilek
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - J Brachmann
- Coburg Hospital, Department of Cardiology, Angiology, and Pneumology, Second Medical Clinic, Coburg, Germany
| | - T Lewalter
- Peter-Osypka-Heart Centre, Hospital for Internal Medicine Munich South, Munich, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - D Andresen
- Vivantes Klinikum Am Urban, Department of Cardiology and Internal Medicine, Berlin, Germany
| | - S Willems
- University Heart Center Hamburg, Department of Electrophysiology, Hamburg, Germany
| | - S G Spitzer
- Praxisklinik Herz und Gefäße, Dresden, Germany
| | - F Straube
- Munich Municipal Hospital Group, Heart Center Munich- Bogenhausen, Munich, Germany
| | - B Schumacher
- Westpfalz Hospital, Department of Cardiology, Pneumology, Angiology and Intensive Care, Kaiserslautern, Germany
| | - L Eckardt
- University Medical Center, Division of Electrophysiology, Department of Cardiology and Angiology, Münster, Germany
| | - D Danilovic
- Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
| | - D Thomas
- University of Heidelberg, Department of Cardiology, Heidelberg, Germany
| | - M Hochadel
- Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
| | - J Senges
- Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany
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19
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Stechemesser B, Seeberger U, Müller S, Andresen D, Baer U, Schulz SL. Are graduated compression stockings still essential for VTE prophylaxis in general surgical patients? Phlebologie 2018. [DOI: 10.1055/s-0037-1622214] [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: 10/17/2022]
Abstract
Summary
Background: Current guidelines for the prevention of venous thromboembolism in surgical patients continue to recommend the use of graduated compression stockings in addition to low molecular weight heparins (LMWH). Nearly all the studies documenting a prophylactic benefit from these stockings were carried out before the introduction of LMWH. Patients, methods: We studied the rate of symptomatic venous thromboembolism (VTE) occurring in patients of a general surgery department during two consecutive time periods of 24 months with different prophylaxis regimen. During the first 24 months (Group A), preventive measures consisted of LMWH and graduated compression stockings. During the second 24 months (Group B) only LMWH was used. Results: In Group A there were 3181 patient with a total of 3050 operations. In Group B there were 2986 patients with a total of 2911 operations. 82.5% of the patients in Group A and 84.0% in Group B received VTE prophylaxis (stockings and LMWH in A, LMWH only in B). Symptoms suggesting venous thromboembolism occured in 44 patients in Group A and in 47 in Group B. Examinations of these patients revealed a VTE in 7 A and 5 B patients. Conclusions: The incidence of symptomatic venous thromboembolism in patients of a general surgery department was kept low with a simple, but strictly applied preventative protocol of LMWH. Graduated compression stockings did not yield additional benefits in our patients.
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Sultan A, Lüker J, Andresen D, Kuck KH, Hoffmann E, Brachmann J, Hochadel M, Willems S, Eckardt L, Lewalter T, Senges J, Steven D. Predictors of Atrial Fibrillation Recurrence after Catheter Ablation: Data from the German Ablation Registry. Sci Rep 2017; 7:16678. [PMID: 29192223 PMCID: PMC5709464 DOI: 10.1038/s41598-017-16938-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022] Open
Abstract
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence. Furthermore, comorbidities such as valvular heart disease and renal failure as well as an early AF relapse were also predictors of AF recurrence during 1-y-FU. However, despite an AF recurrence rate of 45.9%, the majority of these pts (72.4%) reported a significant alleviation of clinical symptoms. In conclusion in pts with initially successful CA for AF female sex, AF type, in-hospital AF relapse and comorbidities such as renal failure and valvular heart disease are independent predictors for AF recurrence during 1-y-FU. However, the majority of pts deemed their interventions as successful with significant reduction of symptoms irrespective of AF.
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Affiliation(s)
- A Sultan
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany.
| | - J Lüker
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany
| | | | - K H Kuck
- Asklepios Hosp. St. Georg Hamburg, Hamburg, Germany
| | | | | | | | - S Willems
- University Heart Center Hamburg, Dept. of Electrophysiology, Hamburg, Germany
| | - L Eckardt
- University Hosp. Münster, Dept. of Electrophysiology, Münster, Germany
| | - T Lewalter
- Dept. of Medicine-Cardiology, P. Osypka Heart Center Munich, Munich, Germany
| | - J Senges
- IHF Ludwigshafen, Ludwigshafen, Germany
| | - D Steven
- University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany
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Moser J, Hoffmann B, Andresen D, Kuck KH, Brachmann J, Eckardt L, Hoffmann E, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P786Factors associated with acute pacemaker implantation after carvo- tricuspidal isthmus ablation - results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p786] [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: 11/12/2022] Open
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck KH, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P2672Which factors are associated with acute pacemaker implantation after ablation of atrial fibrillation? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2672] [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: 11/12/2022] Open
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23
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck K, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P783Influencing factors of in-hospital pacemaker implantation after ablation of AV-nodal reentry- and AV-reentry tachycardia: results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p783] [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: 11/13/2022] Open
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Lauschke J, Busch M, Haverkamp W, Bulava A, Schneider R, Andresen D, Nägele H, Israel C, Hindricks G, Bänsch D. New implantable cardiac monitor with three-lead ECG and active noise detection. Herz 2016; 42:585-592. [DOI: 10.1007/s00059-016-4492-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 09/27/2016] [Accepted: 10/04/2016] [Indexed: 01/14/2023]
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McMullan BJ, Andresen D, Blyth CC, Avent ML, Bowen AC, Britton PN, Clark JE, Cooper CM, Curtis N, Goeman E, Hazelton B, Haeusler GM, Khatami A, Newcombe JP, Osowicki J, Palasanthiran P, Starr M, Lai T, Nourse C, Francis JR, Isaacs D, Bryant PA. Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. Lancet Infect Dis 2016; 16:e139-52. [PMID: 27321363 DOI: 10.1016/s1473-3099(16)30024-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 03/04/2016] [Accepted: 03/29/2016] [Indexed: 12/22/2022]
Abstract
Few studies are available to inform duration of intravenous antibiotics for children and when it is safe and appropriate to switch to oral antibiotics. We have systematically reviewed antibiotic duration and timing of intravenous to oral switch for 36 paediatric infectious diseases and developed evidence-graded recommendations on the basis of the review, guidelines, and expert consensus. We searched databases and obtained information from references identified and relevant guidelines. All eligible studies were assessed for quality. 4090 articles were identified and 170 studies were included. Evidence relating antibiotic duration to outcomes in children for some infections was supported by meta-analyses or randomised controlled trials; in other infections data were from retrospective series only. Criteria for intravenous to oral switch commonly included defervescence and clinical improvement with or without improvement in laboratory markers. Evidence suggests that intravenous to oral switch can occur earlier than previously recommended for some infections. We have synthesised recommendations for antibiotic duration and intravenous to oral switch to support clinical decision making and prospective research.
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Affiliation(s)
- Brendan J McMullan
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, NSW, Australia
| | - David Andresen
- Department of Infectious Diseases, Immunology, and HIV Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia; Sydney Medical School, University of Sydney, NSW, Australia
| | - Christopher C Blyth
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Subiaco, WA, Australia; School of Paediatrics and Child Health, University of Western Australia, WA, Australia; PathWest Laboratory Medicine, WA, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, WA, Australia
| | - Minyon L Avent
- The University of Queensland, UQ Centre for Clinical Research and School of Public Health, Herston, QLD, Australia
| | - Asha C Bowen
- Department of Infectious Diseases, Princess Margaret Hospital for Children, Subiaco, WA, Australia; School of Paediatrics and Child Health, University of Western Australia, WA, Australia; Menzies School of Health Research, Darwin, NT, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, WA, Australia
| | - Philip N Britton
- Department of Infectious Diseases & Microbiology, Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Julia E Clark
- Infection Management and Prevention Service, Lady Cilento Children's Hospital, South Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Celia M Cooper
- Department of Microbiology and Infectious Diseases, SA Pathology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Emma Goeman
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Briony Hazelton
- Sydney Medical School, University of Sydney, NSW, Australia; Department of Infectious Diseases, Princess Margaret Hospital for Children, Subiaco, WA, Australia
| | - Gabrielle M Haeusler
- Department of Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Infection and Immunity, Monash Children's Hospital, Clayton, VIC, Australia
| | - Ameneh Khatami
- Department of Infectious Diseases & Microbiology, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - James P Newcombe
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Joshua Osowicki
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Pamela Palasanthiran
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, NSW, Australia
| | - Mike Starr
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Tony Lai
- Department of Pharmacy, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Clare Nourse
- Infection Management and Prevention Service, Lady Cilento Children's Hospital, South Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Joshua R Francis
- Department of Paediatrics, Royal Darwin Hospital, Darwin, NT, Australia
| | - David Isaacs
- Department of Infectious Diseases & Microbiology, Children's Hospital at Westmead, Westmead, NSW, Australia; Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Penelope A Bryant
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
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Jensen TO, Stelzer-Braid S, Willenborg C, Cheung C, Andresen D, Rawlinson W, Clezy K. Outbreak of respiratory syncytial virus (RSV) infection in immunocompromised adults on a hematology ward. J Med Virol 2016; 88:1827-31. [PMID: 26990584 DOI: 10.1002/jmv.24521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 11/07/2022]
Abstract
We describe an outbreak of respiratory syncytial virus (RSV) infection on a hematology ward without allogeneic stem cell transplant patients. Twelve patients and one staff member infected with RSV were identified from the laboratory database. Five patients had lower respiratory tract infection, seven had upper respiratory tract infection, one was asymptomatic, and there were two (15.4%) deaths. Most patients had overlapping periods of potential infectiousness on the ward. Sequencing was possible on eight specimens and five of these had identical sequences. Results were consistent with transmission occurring both on the ward and by introduction of RSV from the community. J. Med. Virol. 88:1827-1831, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Tomas Ostergaard Jensen
- Department of Infectious Diseases, St. Vincent's Hospital, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Australia
| | - Sacha Stelzer-Braid
- School of Medical Sciences, University of New South Wales, Australia.,Division of Serology and Virology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, Australia
| | - Christiana Willenborg
- Division of Serology and Virology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, Australia
| | - Carol Cheung
- Department of Haematology, Prince of Wales Hospital, Sydney, Australia
| | - David Andresen
- Department of Infectious Diseases, St. Vincent's Hospital, Sydney, Australia
| | - William Rawlinson
- School of Medical Sciences, University of New South Wales, Australia.,Division of Serology and Virology, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, Australia.,School of Biotechnology and Biomolecular Sciences, University of New South Wales, Australia
| | - Kate Clezy
- Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia
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27
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Mubarak N, Sandaradura I, Isaia L, O'Sullivan M, Zhou F, Marriott D, Iredell JR, Harkness J, Andresen D. Non-susceptibility to ceftaroline in healthcare-associated multiresistant MRSA in Eastern Australia. J Antimicrob Chemother 2015; 70:2413-4. [PMID: 25977400 DOI: 10.1093/jac/dkv124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Affiliation(s)
- Nasmiya Mubarak
- Department of Microbiology, St Vincent's Hospital, Darlinghurst, Sydney, Australia
| | - Indy Sandaradura
- Department of Microbiology, St Vincent's Hospital, Darlinghurst, Sydney, Australia School of Biological Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Lupeoletalalelei Isaia
- Centre for Infectious Diseases and Microbiology, Institute for Clinical Pathology and Medical Research, Westmead, Sydney, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Matthew O'Sullivan
- Centre for Infectious Diseases and Microbiology, Institute for Clinical Pathology and Medical Research, Westmead, Sydney, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Fei Zhou
- Centre for Infectious Diseases and Microbiology, Institute for Clinical Pathology and Medical Research, Westmead, Sydney, Australia
| | - Deborah Marriott
- Department of Microbiology, St Vincent's Hospital, Darlinghurst, Sydney, Australia School of Biological Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia Department of HIV, Immunology and Infectious Diseases, St Vincent's Hospital, Darlinghurst, Sydney, Australia
| | - Jon R Iredell
- Centre for Infectious Diseases and Microbiology, Institute for Clinical Pathology and Medical Research, Westmead, Sydney, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia Sydney Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia
| | - John Harkness
- Department of Microbiology, St Vincent's Hospital, Darlinghurst, Sydney, Australia School of Biological Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David Andresen
- Department of HIV, Immunology and Infectious Diseases, St Vincent's Hospital, Darlinghurst, Sydney, Australia Sydney Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia
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28
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Moser J, Kuck KH, Andresen D, Spitzer SG, Hoffmann E, Schumacher B, Eckardt L, Brachmann J, Lewalter T, Hochadel M, Senges J, Willems S, Hoffmann BA. [Anticoagulation in high thromboembolic risk after catheter ablation for atrial fibrillation: results from the German Ablation Registry]. Dtsch Med Wochenschr 2014; 139:1923-8. [PMID: 25225860 DOI: 10.1055/s-0034-1387316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Catheter ablation (CA) for atrial fibrillation (AF) is an effective therapeutic option for the treatment of symptomatic drug-refractory AF. According to current guidelines, the prevention of stroke and embolism is the most important therapeutic goal in AF and the recommendations for anticoagulation (OAC) after successful CA are based upon the CHA2DS2-VASc-Score 3. The aim of this study was to evaluate the use of OAC in patients with a high risk for thromboembolic events 1 year after CA and to identify predictor variables for discontinuation of OAC. METHODS Between January 2007 and January 2010 13092 patients were enrolled in the study. A total of 52 German electrophysiological centers agreed to participate in this prospective multicenter registry. 41 centers included patients undergoing CA for AF. Analysis included patients who were discharged with OAC after CA and had a CHA2DS2-VASc-Score ≥ 2. A centralized 1 year follow-up (FU) was conducted via telephone. RESULTS 1300 patients fulfilled the inclusion criteria. One year after CA 51.8 % of these patients were on OAC. Factors significantly associated with discontinuation of OAC included no AF recurrence in FU (adjusted odds ratio (OR): 2.14, [95 % confidence interval (CI): 1.73-2.66], P < 0.001) and paroxysmal AF (OR: 1.53 [95 % CI: 1.29-1.81], P < 0.001). Factors associated with continuation of OAK were patient age (OR per 10 years: 0.79 [95 % CI: 0.68-0.91], P = 0.002), valvular heart disease (OR: 0.67 [95 % CI: 0.48-0.92], P = 0.013), an implanted pacemaker, defibrillator or a cardiac resynchronization therapy system (OR: 0.55 [95 % CI: 0.41-0.74], P < 0.001) and neurological events in hospital or during FU (OR: 0.40 [95 % CI: 0.18-0.88], P < 0.022). CONCLUSION Almost half of the patients with an indication for OAC are not adequately anticoagulated one year after CA for AF. Paroxysmal AF or freedom from AF is significantly associated with discontinuation of OAC.
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Affiliation(s)
- J Moser
- Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf
| | - K H Kuck
- Abteilung für Kardiologie, Asklepios Klinik St. Georg, Hamburg
| | - D Andresen
- Klinik für Innere Medizin - Kardiologie, Vivantes Klinikum Am Urban, Berlin
| | | | - E Hoffmann
- Klinik für Kardiologie und Intensivmedizin , Städtische Kliniken München, Klinikum Bogenhausen, München
| | - B Schumacher
- Medizinische Klinik II, Westpfalz-Klinikum, Kaiserslautern
| | - L Eckardt
- Abteilung Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Münster
| | - J Brachmann
- II. Medizinische Klinik, Regiomed Klinik, Coburg
| | - T Lewalter
- Klinik für Kardiologie und internistische Intensivmedizin, Isar Herz Zentrum, Isar Kliniken GmbH, München
| | - M Hochadel
- Institut für Herzinfarktforschung, Ludwigshafen
| | - J Senges
- Institut für Herzinfarktforschung, Ludwigshafen
| | - S Willems
- Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf
| | - B A Hoffmann
- Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf
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29
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Fletcher S, Caprarelli G, Merif J, Andresen D, Hal SV, Stark D, Ellis J. Epidemiology and geographical distribution of enteric protozoan infections in sydney, australia. J Public Health Res 2014; 3:298. [PMID: 25343139 PMCID: PMC4207027 DOI: 10.4081/jphr.2014.298] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/05/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. DESIGN AND METHODS Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007 - December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. RESULTS Frequently detected protozoa were Blastocystis spp. (57%), Giardia intestinalis (27%) and Dientamoeba fragilis (12%). The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of Blastocystis (53.1%) are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. CONCLUSIONS These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural areas is needed. Significance for public healthThis research is significant since it provides the most recent epidemiological update on the common enteric protozoa affecting Australians. It reveals that enteric protozoa cause considerable disease burden in high risk city dwellers, and provides the evidence base for development of targeted interventions for their prevention and control in high risk populations. The prevalence of enteric protozoa in this metropolitan setting underscores that microorganisms do not respect borders and that a collaborative approach is needed to contain the global spread of infectious diseases. Incorporating spatial analysis is valuable in providing a compelling picture of the geographical distribution of these often neglected diseases. Local and State Public Health departments can use this information to support further inves-
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Affiliation(s)
- Stephanie Fletcher
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
| | - Graziella Caprarelli
- Division of IT, Engineering and the Environment, University of South Australia, Adelaide
| | - Juan Merif
- Microbiology Department, South Eastern Area Laboratory Service (SEALS), Prince of Wales Hospital, Rand wick
| | - David Andresen
- Department of Microbiology, Children’s Hospital Westmead, Darlinghurst, Australia
| | - Sebastian Van Hal
- Department of Microbiology, Liverpool Hospital, Darlinghurst, Australia
| | - Damien Stark
- Division of Microbiology, St. Vincent’s Hospital, Darlinghurst, Australia
| | - John Ellis
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
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Messelken M, Fischer M, Wnent J, Seewald S, Gräsner JT, Andresen D, Frey N, Helm M, Jantzen T, Lechleuthner A, Kanz KG. Ohne Daten kein messbarer Fortschritt. Notf Rett Med 2014. [DOI: 10.1007/s10049-014-1885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Kill C, Frey N, Scholz J, Scholz K, Andresen D, Busch H, Lunz D, Prückner S, Skorning M, von Kaufmann F, Fischer M, Kreimeier U, Lemke H, Strauss J. Die spezialisierte Krankenhausbehandlung nach erfolgreicher Wiederbelebung ist überlebenswichtig. Notf Rett Med 2014. [DOI: 10.1007/s10049-014-1889-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Liao AY, Andresen D, Martin HC, Harvey JG, Holland AJ. The infection risk of plastic wrap as an acute burns dressing. Burns 2014; 40:443-5. [DOI: 10.1016/j.burns.2013.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 11/28/2022]
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Abstract
The therapy of patients with syncope is oriented to the underlying pathophysiological mechanisms. Patients with reflex syncope require careful education regarding recognition of warning signs and the avoidance of trigger factors. Treatment with beta blockers is nowadays obsolete. Even other drugs have failed to show any benefit. Pacemaker therapy should only be considered if syncope attacks are frequent and if there is a correlation between symptoms and the electrocardiogram (ECG). Because autonomic failure in patients with orthostatic hypotension is often drug-induced, reduction of the dosage or the complete elimination is the treatment of choice in these patients. A higher than normal salt and fluid intake as well as general measures to avoid delayed venous backflow, e.g. elastic stockings, may also be helpful. A change in blood pressure medication can be decisive for therapy success, especially in elderly patients with arterial hypertension. Pacemaker and defibrillator therapy is the treatment of choice in patients with bradycardia and tachycardia arrhythmias, respectively. Although these measures are simple but effective, in individual cases it is still difficult to find clinical proof that arrhythmic disorders are the causal factors for the syncope. However, also in these patients cardiac pacing should be based on a symptom ECG correlation. The recently conducted market release of the injectable miniaturized ECG recorder will alleviate the diagnostic process. The limits of this approach, however, become obvious when there is the suspicion of a life-threatening rhythm disorder, because the only difference between syncope and sudden cardiac death is that in one case the patient wakes up again.
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Affiliation(s)
- D Andresen
- Klinik für Kardiologie, Intensivmedizin und Allgemeine Innere Medizin, Vivantes Klinikum Am Urban, Dieffenbachstr. 1, 10967, Berlin, Deutschland,
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Arbelo E, Brugada J, Hindricks G, Maggioni AP, Tavazzi L, Vardas P, Laroche C, Anselme F, Inama G, Jais P, Kalarus Z, Kautzner J, Lewalter T, Mairesse GH, Perez-Villacastin J, Riahi S, Taborsky M, Theodorakis G, Trines SA, Brugada J, Arbelo E, Hindriks G, Maggioni AP, Morgan J, Tavazzi L, Vardas P, Alonso A, Ferrari R, Komajda M, Tavazzi L, Wood D, Vardas P, Brugada J, Mairesse G, Taborsky M, Kautzner J, Lewalter T, Riahi S, Jais P, Anselme F, Theodorakis G, Inama G, Trines S, Kalarus Z, Villacastin JP, Maggioni AP, Manini M, Gracia G, Laroche C, Missiamenou V, Taylor C, Konte M, Fiorucci E, Lefrancq EF, Glémot M, McNeill PA, Bois T, Heidbüchel H, Nuyens D, Boland J, Dinraths V, Herzet JM, Hoffer E, Malmendier D, Massoz M, Pourbaix S, Ballant E, Blommaert D, Deceuninck O, Dormal F, Xhaet O, De Potter T, Geelen P, Derycker K, Duytschaever M, Tavernier R, Vandekerckhove Y, Vankats D, Bulava A, Hanis J, Sitek D, Blahova M, Cihak R, Hanyasova L, Jansova H, Peichl P, Tanzerova M, Wichterle D, Duda J, Haman L, Parizek P, Coling L, Neuzil P, Petru J, Sediva L, Skoda J, Chovancik J, Fiala M, Neuwirth R, Karlsdottir A, Pehrson S, Gerdes C, Jensen H, Lukac P, Nielsen JC, Hansen J, Johannessen A, Hansen PS, Pedersen A, Heath F, Hjortshoj S, Thogersen A, Da Costa A, Martel I, Romeyer-Bouchard C, Sadki N, Schmid A, Haissaguerre M, Hocini M, Knecht S, Sacher F, Ait Said M, Cauchemez B, Ledoux F, Thomas O, Cebron JP, Decarsin N, Gras D, Hervouet S, Durand C, Durand-Dubief A, Poty H, Babuty D, Pierre B, Albenque JP, Boveda S, Combes N, Mas R, Hermida JS, Kubala M, Godin B, Savouré A, Soublin Y, Defaye P, Jacon P, Brigadeau F, Corbut S, Flament-Balzola F, Kacet S, Klug D, Lacroix D, Copie X, Gilles L, Hocine Z, Paziaud O, Piot O, Crocq C, Kaballu G, Le Moal V, Lotton P, Mabo P, Pavin D, Andronache M, De Chillou C, Magnin-Poull I, Deharo JC, Durand C, Franceschi F, Peyrouse E, Prevot S, Etchegoin M, Extramiana F, Leenhardt A, Messali A, Heine T, Schneider A, Winter N, Brachmann J, Ritscher G, Schertel-Gruenler B, Simon H, Sinha AM, Turschner O, Wystrach A, Stemberg M, Kuck KH, Metzner A, Tilz R, Wissner E, Heitmann K, Willems S, Andresen D, Mueller S, Volkmer M, Schmidt B, Kostopoulou A, Livanis E, Voudris V, Efremidis M, Letsas K, Tsikrikas S, Christoforatou E, Ioannidis P, Katsivas A, Kourouklis S, Andrikopoulos G, Rassias I, Tzeis S, Dakos G, Paraskevaidis S, Stavropoulos G, Theofilogiannakos E, Vassilikos V, Bongiorni M, Zucchelli G, Raviele A, Themistoclakis S, Pratola C, Tritto M, Della Bella P, Mazzone P, Moltrasio M, Tondo C, Calo L, De Luca L, Guarracini F, Lioy E, Dozza L, Frigoli E, Giannelli L, Pappone C, Saviano M, Schiavina G, Vicedomini G, De Ponti R, Doni LA, Marazzi R, Salerno-Uriarte J, Tamborini C, Anselmino M, Ferraris F, Gaita F, Bertaglia E, Brandolino G, Zoppo F, De Groot N, Janse P, Jordaens L, Pison L, Roos C, Van Gelder I, Manusama R, Meijer A, Van der Voort P, Trines S, Compier MG, Kazmierczak J, Kornacewicz-Jach Z, Wielusinski M, Baran J, Kulakowski P, Dzidowski M, Fuglewicz A, Nowak K, Pruszkowska-Skrzep P, Wozniak A, Nowak S, Trusz-Gluza M, Almendral J, Atienza F, Castellanos E, De Diego C, Ortiz M, Moreno Planas J, Perez Castellano N, Benezet J, Farre Muncharaz J, Rubio Campal J, Hernandez Madrid A, Matia R, Arana E, Pedrote A, Cozar R, Peinado R, Valverde I, Arbelo E, Berruezo A, Calvo N, Guiu E, Husseini S, Mont Girbau L. The Atrial Fibrillation Ablation Pilot Study: an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association. Eur Heart J 2014; 35:1466-78. [DOI: 10.1093/eurheartj/ehu001] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [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: 11/14/2022] Open
Affiliation(s)
- Elena Arbelo
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | - Josep Brugada
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | | | - Aldo P. Maggioni
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Cotignola, Italy
| | - Panos Vardas
- Department of Cardiology, Heraklion University Hospital, Crete, Greece
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Frédéric Anselme
- Service De Cardiologie, Hôpital Charles Nicolle, Rouen Cedex, France
| | | | - Pierre Jais
- Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France
| | - Zbigniew Kalarus
- Department of Cardiology, Silesian Academy of Medicine, Zabrze, Poland
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | | | | | - Sam Riahi
- AF Study Group, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Milos Taborsky
- Internal Cardiology Department, Faculty Hospital Olomouc, Olomouc, Czech Republic
| | | | - Serge A. Trines
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
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Schmidt M, Dorwarth U, Andresen D, Brachmann J, Kuck KH, Kuniss M, Willems S, Senges J, Lewalter T, Hoffmann E. RF versus cryoballoon in atrial fibrillation ablation: outcome data from the German ablation registry I. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Deneke T, Lewalter T, Andresen D, Becker R, Brachmann J, Eckadt L, Hoffmann E, Kuck KH, Willems S, Senges J. Ablation of sustained ventricular tachycardia in patients with and without structural heart disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4928] [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: 11/13/2022] Open
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Zeymer U, Gitt A, Hochadel M, Lauer B, Kaul N, Andresen D, Zahn R. Pretreatment with prasugrel is safe and associated with an improvement outcome in patients with NSTE-ACS. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4866] [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: 11/13/2022] Open
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Fletcher S, Van Hal S, Andresen D, McLaws ML, Stark D, Harkness J, Ellis J. Gastrointestinal pathogen distribution in symptomatic children in Sydney, Australia. J Epidemiol Glob Health 2013; 3:11-21. [PMID: 23856534 PMCID: PMC7320378 DOI: 10.1016/j.jegh.2012.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/28/2012] [Accepted: 11/30/2012] [Indexed: 12/14/2022] Open
Abstract
There is limited information on the causes of paediatric diarrhoea in Sydney. This cross-sectional study used clinical and microbiological data to describe the clinical features and pathogens associated with gastrointestinal illnesses for children presenting to two major public hospitals in Sydney with diarrhoea, for the period January 2007-December 2010. Of 825 children who tested positive for an enteric pathogen, 430 medical records were reviewed. Adenovirus, norovirus and rotavirus were identified in 20.8%, 20.3% and 21.6% of reviewed cases, respectively. Younger children were more likely to have adenovirus and norovirus compared with rotavirus (P=0.001). More viruses were detected in winter than in the other three seasons (P=0.001). Rotavirus presented a distinct seasonal pattern with the lowest rates occurring in the warm months and peaking in the cooler months. Adenovirus showed a less consistent monthly trend, and norovirus detection increased in the cooler months (P=0.008). A decline in the number of rotavirus cases was observed after mid-2008. The majority of childhood diarrhoeal illnesses leading to hospital presentations in Sydney are caused by enteric viruses with most infections following clear seasonal patterns. However, a sustained decrease in the incidence of rotavirus infections has been observed over the study period.
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Affiliation(s)
- Stephanie Fletcher
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney, P.O. Box 123, Broadway, NSW, Australia
| | - Sebastian Van Hal
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney, P.O. Box 123, Broadway, NSW, Australia
- Department of Microbiology, Liverpool Hospital, Locked Bag 7103, Liverpool NSW 1871, Australia
| | - David Andresen
- Department of Microbiology, Children’s Hospital at Westmead, NSW, University of Sydney, Australia
| | - Mary-Louise McLaws
- School of Public Health and Community Medicine, UNSW Medicine, The University of New South Wales, Sydney, NSW, Australia
| | - Damien Stark
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney, P.O. Box 123, Broadway, NSW, Australia
- Division of Microbiology, SydPath, St. Vincent’s Hospital, Sydney, NSW, Australia
| | - John Harkness
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney, P.O. Box 123, Broadway, NSW, Australia
- Division of Microbiology, SydPath, St. Vincent’s Hospital, Sydney, NSW, Australia
| | - John Ellis
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney, P.O. Box 123, Broadway, NSW, Australia
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Stellbrink C, Andresen D, Böcker D, Lewalter T. [Implantable cardioverter defibrillator]. Herzschrittmacherther Elektrophysiol 2013; 24:75-78. [PMID: 23608953 DOI: 10.1007/s00399-013-0265-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article aims to give an overview over important articles in the field of implantable cardioverter defibrillator (ICD) therapy in 2012. Important publications concern analyses on therapy efficacy and safety of the subcutaneous ICD, gender-specific differences in the complication rate and prognosis after ICD implantation, the necessity of intraoperative testing of the defibrillation threshold and the impact of preventive measures to reduce ICD therapies on prognosis after device implantation. The relevance of the study findings for daily clinical practice is briefly discussed.
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Affiliation(s)
- C Stellbrink
- Klinik für Kardiologie und Internistische Intensivmedizin, Klinikum Bielefeld, Teutoburger Strasse 50, Bielefeld, Germany.
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Liljeqvist TGH, Andresen D, Zuo Y, Weston C. Bug breakfast in the Bulletin: antimicrobial resistance: moving forward to the past. N S W Public Health Bull 2012; 23:37. [PMID: 22487333 DOI: 10.1071/nb11043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tore G H Liljeqvist
- NSW Public Health Officer Training Program, NSW Ministry of Health, Australia
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Jamal A, O'Grady G, Harnett E, Dalton D, Andresen D. Republished: Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach. Postgrad Med J 2012; 88:353-8. [DOI: 10.1136/pgmj-2011-000056rep] [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: 11/04/2022]
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Jamal A, O'Grady G, Harnett E, Dalton D, Andresen D. Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach. BMJ Qual Saf 2012; 21:171-6. [DOI: 10.1136/bmjqs-2011-000056] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bogale N, Priori S, Gitt A, Alings M, Linde C, Dickstein K, Dickstein K, Priori S, Auricchio A, Bogale N, Brugada J, Cleland JG, Derumeaux G, Gitt A, Gras D, Komajda M, Linde C, Morgan J, van Veldhuisen DJ, Fruhwald F, Strohmer B, Goethals M, Vijgen J, Trochu JN, Gras D, Kindermann M, Stellbrink C, McDonnald K, Keane D, Ben Gal T, Glikson M, Metra M, Gasparini M, Maass A, Jordaens L, Alings M, Larsen AI, Faerestrand S, Delgado J, Mont L, Persson H, Gadler F, Rocca HPBL, Osswald S, Squire I, Morgan J, Brant J, Gadler F, Linde C, Andresen D, Butter C, Gonska B, Jung W, Kuck KH, Senges J, Stellbrink C. The European cardiac resynchronization therapy survey: patient selection and implantation practice vary according to centre volume. Europace 2011; 13:1445-53. [DOI: 10.1093/europace/eur173] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tam CS, O'Reilly M, Andresen D, Lingaratnam S, Kelly A, Burbury K, Turnidge J, Slavin MA, Worth LJ, Dawson L, Thursky KA. Use of empiric antimicrobial therapy in neutropenic fever. Australian Consensus Guidelines 2011 Steering Committee. Intern Med J 2011; 41:90-101. [PMID: 21272173 DOI: 10.1111/j.1445-5994.2010.02340.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Administration of empiric antimicrobial therapy is standard practice in the management of neutropenic fever, but there remains considerable debate about the selection of an optimal regimen. In view of emerging evidence regarding efficacy and toxicity differences between empiric treatment regimens, and strong evidence of heterogeneity in clinical practice, the current guidelines were developed to provide Australian clinicians with comprehensive guidance for selecting an appropriate empiric strategy in the setting of neutropenic fever. Beta-lactam monotherapy is presented as the treatment of choice for all clinically stable patients while early treatment with combination antibiotic therapy is considered for patients at higher risk. Due consideration is given to the appropriate use of glycopeptides in this setting. Several clinical caveats, accounting for institution- and patient-specific risk factors, are provided to help guide the judicious use of the agents described. Detailed recommendations are also provided regarding time to first dose, timing of blood cultures, selection of a first-line antibiotic regimen, subsequent modification of antibiotic choice and cessation of therapy.
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Affiliation(s)
- C S Tam
- St Vincent's Hospital, Melbourne, Victoria, Australia
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Ino H, Sprenger C, Breithardt G, Haeusler KG, Meinertz T, Ravens U, Steinbeck G, Tebbe U, Oeff M, Pisters R, Nieuwlaat R, Prins MH, Le Heuzey JY, Maggioni AP, Camm AJ, Crijns HJGM, Torp-Pedersen C, Crijns HJ, Page RL, Connolly SJ, Hohnloser SH, Sehra R, Krummen D, Briggs C, Rappel WJ, Narayan S, Simon HU, Horack M, Senges J, Hoffmann E, Willems S, Spitzer S, Kuck KH, Brachmann J, Revishvili A, Matsonashvili G, Labartkava E, Dzhordzhikiya T, Serguladze S, Shmul A, Kvasha B, Lima CEB, Martinelli M, Alkmim-Teixeira R, Nishioka SAD, Siqueira S, Jesus LD, Wajngarten M, Costa R, Ferrero P, De Filippo P, Ferrari P, Brambilla R, Cantu F, Pachon J, Pachon M E, J Lobo T, Pachon JC, Pachon MZ, Santillana P T, Jatene AD, Sinha AM, Senges J, Kuck KH, Andresen D, Hoffmann E, Schumacher B, Tebbenjohanns J, Brachmann J, Castrejon Castrejon S, Perez-Silva A, Doiny D, Estrada A, Ortega M, Lopez-Sendon JL, Merino JL, Jais P, Sacher F, Derval N, Jadidi A, Maury P, Nault I, Hocini M, Haissaguerre M, Pokushalov E, Romanov A, Artemenko S, Shabanov V, Turov A. Flash Presentations I. Europace 2011. [DOI: 10.1093/europace/eur227] [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: 11/13/2022] Open
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Tada H, Yamasaki H, Sekiguchi Y, Igarashi M, Kuroki K, Machino T, Yoshida K, Aonuma K, Heinzel FR, Forstner H, Lercher P, Bisping E, Rotman B, Fruhwald FM, Pieske BM, Dabrowski R, Kowalik I, Borowiec A, Smolis-Bak E, Trybuch A, Sosnowski C, Szwed H, Baturova MA, Lindgren A, Shubik YV, Olsson B, Platonov PG, Van Den Broek KC, Denollet J, Widdershoven J, Kupper N, Allam R, Allam RAGAB, Galal WAGDY, El-Damnhoury HAYAM, Mortada AYMAN, Jimenez-Candil J, Martin A, Hernandez J, Martin F, Gallego M, Martin-Luengo C, Quintanilla JG, Moreno Planas J, Molina-Morua R, Archondo T, Garcia-Torrent MJ, Perez-Castellano N, Macaya C, Perez-Villacastin J, Saiz J, Tobon C, Rodriguez JF, Hornero F, Ferrero JM, Ito K, Date T, Kawai M, Hioki M, Narui R, Matsuo S, Yoshimura M, Yamane T, Tabatabaei N, Lin G, Powell BD, Smairat R, Glockner JF, Brady PA, Fichtner S, Czudnochowsky U, Estner H, Reents T, Jilek C, Ammar S, Hessling G, Deisenhofer I, Shah DC, Kautzner J, Saoudi N, Herrera C, Jais P, Hindricks G, Neuzil P, Kuck KH, Wong KCK, Jones M, Qureshi N, Muthumala A, Betts TR, Bashir Y, Rajappan K, Vogtmann T, Wagner M, Schurig J, Hein P, Hamm B, Baumann G, Lembcke A, Saad B, Piwowarska W, Nessler J, Edvardsson N, Rieger G, Garutti C, Linker N, Jorge C, Silva Marques J, Veiga A, Cruz J, Slater C, Correia MJ, Sousa J, Miltenberger-Miltenyi G, Nunes Diogo A, Matic D, Mrdovic I, Stankovic G, Asanin M, Antonijevic N, Matic M, Oliveira LA, Kocev N, Vasiljevic Z, Ramirez-Marrero MA, Perez-Villardon B, Delgado-Prieto JL, Jimenez-Navarro M, De Teresa-Galvan E, De Mora-Martin M, Pietrucha AZ, Bzukala I, Elias R, Sztefko K, Wnuk M, Malek A, Piwowarska W, Nessler J, Szili-Torok T, Bauernfeind T, De Groot N, Shalganov T, Schalij M, Camiletti A, Jordaens L, Rivas N, Casaldaliga J, Roca I, Pijuan A, Perez-Rodon J, Dos L, Garcia-Dorado D, Moya A, Baruteau AE, Moura D, Behaghel A, Chatel S, Mabo P, Schott JJ, Daubert JC, Le Marec H, Probst V, Zorio Grima E, Navarro-Manchon J, Molina P, Maldonado P, Igual B, Cano O, Bermejo M, Giner J, Salvador A, Bourgonje VJA, Vos MA, Ozdemir S, Doisne N, Van Der Heyden MAG, Camanho LE, Van Veen AAB, Sipido K, Antoons G, Altieri PI, Escobales N, Crespo M, Banchs HL, Sciarra L, Bloise R, Allocca G, Bulava A, Marras E, Lioy E, Delise P, Priori S, Calo' L, Hanis J, Sitek D, Novotny A, Chik WB, Lim TW, Choon HK, See VA, Mccall R, Thomas L, Ross DL, Thomas SP, Chen J, De Bortoli A, Rossvoll O, Hoff PI, Solheim E, Sun LZ, Schuster P, Ohm OJ, Ardashev AV, Zhelyakov E, Rybachenko MS, Konev AV, Belenkov YUN, Gunawardene M, Chun KRJ, Schulte-Hahn B, Windhorst V, Kulikoglu M, Nowak B, Schmidt B, Albina GA, Rivera RS, Scazzuso F, Laino RL, Giniger GA, Arbelo E, Calvo N, Tamborero D, Andreu D, Borras R, Berruezo A, Brugada J, Mont L, Stefan L, Eisenberger M, Celentano E, Peytchev P, Bodea O, Geelen P, De Potter T, Oliveira MM, Silva N, Cunha PS, Feliciano J, Lousinha A, Toste A, Santos S, Ferreira RC, Matsuda H, Harada T, Soejima K, Ishikawa Y, Mizukoshi K, Sasaki T, Mizuno K, Miyake F, Adragao PP, Cavaco D, Miranda R, Santos M, Morgado F, Reis Santos K, Candeias R, Marcelino S, Zoppo F, Grandolino G, Zerbo F, Bertaglia E, Schlueter SM, Grebe O, Vester EG, Miracle Blanco AL, Arenal Maiz A, Atienza Fernandez F, Datino Romaniega T, Gonzalez Torrecilla E, Eidelman G, Hernandez Hernandez J, Fernandez Aviles F, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Richter B, Gwechenberger M, Socas A, Zorn G, Albinni S, Marx M, Wojta J, Goessinger H, Deneke T, Balta O, Paesler M, Buenz K, Anders H, Horlitz M, Muegge A, Shin DI, Natsuyama K, Yamaguchi KM, Nishida YN, De Bortoli A, Ohm OJ, Hoff PI, Solheim E, Schuster P, Sun LZ, Chen J, Kosiuk J, Bode K, Arya A, Piorkowski C, Gaspar T, Sommer P, Hindricks G, Bollmann A, Wichterle D, Peichl P, Simek J, Havranek S, Bulkova V, Cihak R, Kautzner J, Jurado Roman A, Salguero Bodes R, Lopez Gil M, Fontenla Cerezuela A, De Riva Silva M, Arribas Ynsaurriaga F, Fernandez Herranz AI, De Dios Perez S, Revishvili AS, Dishekov M, Tembotova Z, Barsamyan S, Vaccari D, Alvarenga C, Jesus I, Layher J, Takahashi A, Singh N, Siot P, Elkaim JP, Savelieva I, Mcclelland L, Lovegrove A, Jones S, Camm J, Folino AF, Breda R, Calzavara P, Comisso J, Borghetti F, Iliceto S, Buja G, Mlynarski R, Mlynarska A, Sosnowski M, Wilczek J, Mabo P, Carrault G, Bordachar P, Makdissi A, Duchemin L, Alonso C, Neri G, Masaro G, Vittadello S, Vaccari D, Gardin A, Barbetta A, Di Gregorio F, Sciaraffia E, Ginks MR, Gustafsson JS, Hollmark MC, Rinaldi CA, Blomstrom Lundqvist C, Brusich S, Tomasic D, Ferek-Petric B, Mavric Z, Kutarski A, Malecka B, Kolodzinska A, Grabowski M, Dovellini EV, Giurlani L, Cerisano G, Carrabba N, Valenti R, Antoniucci D, Kolodzinska A, Kutarski A, Grabowski M, Malecka B, Opolski G, Tomassoni G, Baker J, Corbisiero R, Martin D, Niazi I, Sheppard R, Sperzel J, Gutleben K, Petru J, Sediva L, Skoda J, Neuzil P, Mazzone P, Ciconte G, Vergara P, Marzi A, Paglino G, Sora N, Gulletta S, Della Bella P, Kutarski A, Pietura R, Czajkowski M, Cabanelas N, Martins VP, Alves M, Valente FX, Marta L, Francisco A, Silva R, Ferreira Da Silva G, Huo Y, Holmqvist F, Carlson J, Arya A, Wetzel U, Hindricks G, Bollmann A, Platonov P, Nof E, Abu Shama R, Kuperstein R, Feinberg MS, Eldar M, Glikson M, Luria D, Kubus P, Materna O, Gebauer RA, Matejka T, Gebauer R, Tlaskal T, Janousek J, Muessigbrodt A, Arya A, Wetzel U, Hindricks G, Richter S, Stockburger M, Boveda S, Defaye P, Stancak Branislav P, Kaliska G, Rolando M, Moreno J, Ohlow MAG, Lauer B, Buchter B, Schreiber M, Geller JC, Val-Mejias JE, Ouali S, Azzez S, Kacem S, Ben Salem H, Hammas S, Neffeti E, Remedi F, Boughzela E, Miyazaki H, Miyanaga S, Shibayama K, Tokuda M, Narui R, Kudo T, Yamane T, Yoshimura M, Coppola B, Shehada REN, Costandi P, Healey J, Hohnloser SH, Gold MR, Capucci A, Van Gelder IC, Carlson M, Lau CP, Connolly SJ, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Thibault B, Dubuc M, Karst E, Ryu K, Paiement P, Farazi T, Puetz V, Berndt C, Buchholz J, Dorszewski A, Mornos C, Cozma D, Ionac A, Petrescu L, Mornos A, Pescariu S, Puetz V, Berndt C, Buchholz J, Dorszewski A, Benser M, Roscoe G, De Jong S, Roberts G, Boileau P, Rec A, Ryu K, Folman C, Morttada A, Abd El Kader M, Samir R, Roushdy R, Khaled S, Abo El Maaty M, Van Gelder B, Houthuizen P, Bracke FA, Osca Asensi J, Tejada D, Sanchez JM, Munoz B, Cano O, Rodriguez M, Sancho-Tello MJ, Olague J, Hou W, Rosenberg S, Koh S, Poore J, Snell J, Yang M, Nirav D, Bornzin G, Deering T, Dan D, Wickliffe AC, Cazeau S, Karimzadeh K, Mukerji S, Loghin C, Kantharia B, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Betts TR, Jones MA, Wong KCK, Qureshi N, Rajappan K, Bashir Y, Lamba J, Simpson CS, Redfearn DP, Michael KA, Fitzpatrick M, Baranchuk A, Heinke M, Ismer B, Kuehnert H, Surber R, Haltenberger AM, Prochnau D, Figulla HR, Delarche N, Bizeau O, Couderc P, Chapelet A, Amara W, Lazarus A, Kubus P, Krupickova S, Gebauer RA, Janousek J, Van Deursen CJM, Strik M, Vernooy K, Van Hunnik A, Kuiper M, Crijns HJGM, Prinzen FW, Islam N, Gras D, Abraham W, Calo L, Birgersdotter-Green U, Clyne C, Herre J, Sheppard R, Abraham W, Gras D, Birgersdotter-Green U, Calo L, Clyne C, Klein N, Herre J, Sheppard R, Kowalski O, Lenarczyk R, Pruszkowska P, Sokal A, Kukulski T, Zielinska T, Pluta S, Kalarus Z, Schwab JO, Gasparini M, Anselme F, Clementy J, Santini M, Martinez Ferrer J, Burrone V, Santi E, Nevzorov R, Porter A, Kusniec J, Golovchiner G, Ben-Gal T, Strasberg B, Haim M, Rordorf R, Savastano S, Sanzo A, Vicentini A, Petracci B, De Amici M, Striuli L, Landolina M, Tolosana JM, Martin AM, Hernandez-Madrid A, Macias A, Fernandez-Lozano I, Osca J, Quesada A, Mont L, Igarashi M, Tada H, Yamasaki H, Sekiguchi Y, Kuroki K, Yoshida K, Noguchi Y, Aonuma K, Shahrzad S, Karim Soleiman N, Tavoosi A, Taban S, Emkanjoo Z, Fukunaga M, Goya M, Hiroshima K, Ohe M, Hayashi K, Iwabuchi M, Nosaka H, Nobuyoshi M, Doiny D, Perez-Silva A, Castrejon Castrejon S, Estrada A, Ortega M, Lopez-Sendon JL, Merino JL, Garcia Fernandez FJ, Gallardo R, Pachon M, Almendral J, Gonzalez Torrecilla E, Martin J, Yahya D, Al-Mogheer B, Gouda S, Eweis E, El Ramly M, Abdelwahab A, Kassenberg W, Wittkampf FHM, Hof IE, Heijden JH, Neven KGEJ, Meine M, Hauer RNW, Loh P, Baratto F, Bignami E, Pappalardo F, Maccabelli G, Nicolotti D, Zangrillo A, Della Bella P, Hayashi K, Goya M, Hiroshima K, Nagashima M, An Y, Fukunaga M, Okreglicki A, Russouw C, Tilz R, Yoshiga Y, Mathew S, Fuernkranz A, Rillig A, Wissner E, Kuck KH, Ouyang F, De Sisti A, Tonet J, Gueffaf F, Amara W, Touil F, Aouate P, Hidden-Lucet F, Doiny D, Castrejon Castrejon S, Estrada A, Ortega M, Perez-Silva A, Lopez-Sendon JL, Merino JL, Makimoto H, Satomi K, Yamada Y, Okamura H, Noda T, Shimizu W, Aihara N, Kamakura S, Estrada A, Perez Silva A, Doiny D, Castrejon S, Gonzalez Vasserot M, Merino JL, Tilz R, Senges J, Brachmann J, Andresen D, Hoffmann E, Schumacher B, Willems S, Kuck KH, Reents T, Deisenhofer I, Ammar S, Springer B, Fichtner S, Jilek C, Kolb C, Hessling G, Akca F, Bauernfeind T, De Groot NMS, Schwagten B, Witsenburg M, Jordaens L, Szili-Torok T, Hata Y, Nakagami R, Watanabe T, Sato A, Watanabe H, Kabutoya T, Mituhashi T, Theuns DAMJ, Smith T, Pedersen SS, Dabiri-Abkenari L, Jordaens L, Prull MW, Unverricht S, Bittlinsky A, Wirdemann H, Sasko B, Wirdeier S, Trappe HJ, Zorio Grima E, Rueda J, Medina P, Jaijo T, Sevilla T, Osca J, Arnau MA, Salvador A, Starrenburg AH, Kraaier K, Pedersen SS, Scholten MF, Van Der Palen J, De Haan S, Commandeur J, De Boer K, Beek AM, Van Rossum AC, Allaart CP, Berne P, Porres JM, Fernandez-Lozano I, Arnaiz JA, Mont L, Berruezo A, Brugada R, Brugada J, Man S, Maan AC, Thijssen J, Van Der Wall EE, Schalij MJ, Burattini L, Burattini R, Swenne CA, Bonny A, Hidden-Lucet F, Ditah I, Larrazet F, Frank R, Fontaine G, Van Den Broek 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Scazzuso F, Albina G, Klein A, Laino R, Sammartino V, Giniger A, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Muggenthaler M, Raju H, Papadakis M, Chandra N, Bastiaenen R, Behr ER, Sharma S, Samniah N, Radezishvsky Y, Omari H, Rosenschein U, Perez Riera AR, Ferreira M, Hopman WM, Mcintyre WF, Baranchuk AR, Wongcharoen W, Keanprasit K, Phrommintikul A, Chaiwarith R, Yagishita A, Hachiya H, Nakamura T, Tanaka Y, Higuchi K, Kawabata M, Hirao K, Isobe M, Havranek S, Simek J, Wichterle D, Stoickov V, Ilic S, Deljanin Ilic M, Aagaard P, Sahlen A, Bergfeldt L, Braunschweig F, Sousa A, Lebreiro A, Sousa C, Oliveira S, Correia AS, Rangel I, Freitas J, Maciel MJ, Asensio Lafuente E, Aguilera AAC, Corral MACC, Mendoza KLMC, Nava PEND, Rendon ALRC, Villegas LVC, Castillo LCM, Schaerf R, Develle R, Brembilla-Perrot B, Oliver C, Zinzius PY, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Borbola J, Abraham P, Foldesi CS, Kardos A, Miranda R, Almeida S, Santos MB, Cavaco D, Quaresma R, Morgado FB, Adragao P, Fatemi M, Didier R, Le Gal G, Etienne Y, Jobic Y, Gilard M, Boschat J, Mansourati J, Zubaid M, Rashed W, Alsheikh-Ali A, Almahmeed W, Shehab A, Sulaiman K, Asaad N, Amin H, Boersma LVA, Swaans M, Post M, Rensing B, Jarverud K, Broome M, Noren K, Svensson T, Hjelm S, Hollmark M, Bjorling A, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Maeda K, Takagi M, Suzuki K, Tatsumi H, Yoshiyama M, Simeonidou E, Michalakeas C, Kastellanos S, Varounis C, Nikolopoulou A, Koniari C, Anastasiou-Nana M, Furukawa T, Maggi R, Bertolone C, Fontana D, Brignole M, Pietrucha AZ, Wnuk M, Bzukala I, Mroczek-Czernecka D, Konduracka E, Kruszelnicka O. Poster Session 4. Europace 2011. [DOI: 10.1093/europace/eur231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Andresen D. [Editorial]. Herzschrittmacherther Elektrophysiol 2010; 21:95. [PMID: 20517613 DOI: 10.1007/s00399-010-0086-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ewertsen NC, Steinbeck G, Senges J, Andresen D. [ICD therapy for primary prevention. The patient in the early post-infarct phase]. Herzschrittmacherther Elektrophysiol 2010; 21:109-111. [PMID: 20552317 DOI: 10.1007/s00399-010-0077-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
There is high mortality during the first few weeks after an acute myocardial infarction. However, according to the guidelines, the prophylactic implantation of an ICD, given the corresponding risk constellation, is recommended not earlier than 1 month after acute myocardial infarction. This article analyzes available data and highlights that the recently published IRIS study supports current clinical practise.
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Affiliation(s)
- N C Ewertsen
- Vivantes Klinikum am Urban, Klinik für Innere Medizin, Kardiologie und konservative Intensivmedizin, Dieffenbachstr. 1, 10697, Berlin, Deutschland.
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Abstract
AIMS Because of the paucity of previous data, we report the organisms causing infection in children with injuries from lawnmowers and farm machinery. METHODS Retrospective study of children admitted to the Children's Hospital at Westmead for lawnmower and farm machinery-related injuries from 1998 to 2007. RESULTS Twenty-four patients were admitted for lawnmower-related injuries. They had a bimodal age distribution, with peaks at 2-4 years and 14 years. Twenty-one (87.5%) were boys. Positive wound cultures were obtained in 16.7% and included Gram-positive and Gram-negative organisms. Eight patients were admitted for farm machinery-related injuries. Two patients (25%) returned positive wound cultures with multiple organisms including bacteria, fungi and mycobacteria and were diagnosed with osteomyelitis caused by Stenotrophomonas maltophilia and Scedosporium prolificans, respectively. CONCLUSION The rate of infection in our small series of children with lawnmower and farm machinery-related injuries was comparable to previous reports. We found a wide range of causative organisms, often inherently antibiotic resistant, and we add a case of invasive fungal infection to previous case reports. Because of the wide range of organisms, empirical antibiotic therapy is difficult and our data emphasise the need for cultures to direct ongoing therapy.
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Affiliation(s)
- Ben Harkness
- Medical Student, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
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