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Crettenand F, Assayed-Leonardi N, Rohrer F, Martinez Carrique S, Roth B. Reply to Beilstein, C.M.; Wuethrich, P.Y. Comment on "Crettenand et al. Is Continuous Wound Infiltration a Better Option for Postoperative Pain Management after Open Nephrectomy Compared to Thoracic Epidural Analgesia? J. Clin. Med. 2023, 12, 2974". J Clin Med 2023; 12:5918. [PMID: 37762859 PMCID: PMC10531563 DOI: 10.3390/jcm12185918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
We appreciate your comprehensive comment [...].
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Affiliation(s)
- François Crettenand
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Nady Assayed-Leonardi
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Felix Rohrer
- Department of Anesthesiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Silvia Martinez Carrique
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Beat Roth
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Crettenand F, Assayed-Leonardi N, Rohrer F, Martinez Carrique S, Roth B. Is Continuous Wound Infiltration a Better Option for Postoperative Pain Management after Open Nephrectomy Compared to Thoracic Epidural Analgesia? J Clin Med 2023; 12:jcm12082974. [PMID: 37109313 PMCID: PMC10143069 DOI: 10.3390/jcm12082974] [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: 03/02/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Despite increasingly advanced minimally invasive percutaneous ablation techniques, surgery remains the only evidence-based therapy in curative intent for larger (>3-4 cm) renal tumors. Although minimally invasive surgery using (robotic-assisted) laparoscopic or retroperitoneoscopic approaches has gained popularity, open nephrectomy (ON) is still performed in 25% of cases, especially in tumors with central localization (partial ON) or large tumors with/without cava thrombus (total ON). As postoperative pain is one of the drawbacks of ON, our study aims to assess recovery and post-operative pain management using continuous wound infiltration (CWI) compared to thoracic epidural analgesia (TEA). METHODS Since 2012, all patients undergoing ON at our tertiary cancer center at CHUV have been included in our prospective ERAS® (enhanced recovery after surgery) registry that is centrally stored in ERAS® Interactive Audit System (EIAS) secured server. This study represents an analysis of all patients operated on with partial or total ON at our center between 2012 and 2022. An additional analysis was performed for the estimations of the total cost of CWI and TEA, based on the diagnosis-related group method. RESULTS 92 patients were included and analyzed in this analysis (n = 64 (70%) with CWI; n = 28 (30%) with TEA). Adequate oral pain control was earlier achieved in the CWI group compared to the TEA group (median 3 vs. 4 days; p = 0.001), whereas immediate postoperative pain relief was better in the TEA group (p = 0.002). Consequently, opioid use was higher in the CWI group (p = 0.004). Still, reported nausea was lower in the CWI group (p = 0.002). Median time to bowel recovery was similar in both groups (p = 0.03). A shorter LOS (0.5 days) was observed in patients managed with CWI, although this was not statistically significant (p = 0.06). The use of CWI has reduced total hospital costs by nearly 40%. CONCLUSIONS TEA has better results in terms of postoperative pain management compared to CWI following ON. However, CWI is better tolerated, and causes less nausea and earlier recovery, which leads to a shorter length of stay. Given its simplicity and cost-effectiveness, CWI should be encouraged for ON.
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Affiliation(s)
- François Crettenand
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Nady Assayed-Leonardi
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Felix Rohrer
- Department of Anesthesiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Silvia Martinez Carrique
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Beat Roth
- Department of Urology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Rohrer F, Farokhnia A, Nötzli H, Haubitz F, Hermann T, Gahl B, Limacher A, Brügger J. Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements. Int J Environ Res Public Health 2022; 19:ijerph19074325. [PMID: 35410007 PMCID: PMC8998626 DOI: 10.3390/ijerph19074325] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
The aging population and the associated demand for orthopedic surgeries are increasing health costs. Although the Diagnostic Related Groups (DRG) system was introduced to offer incentives for hospitals, concerns remain that reimbursements for older and frail patients do not cover all hospital expenses. We investigated further: (1) Does age influence net financial results in orthopedic surgery? (2) Are there patient or surgical factors that influence results? This retrospective, monocentric study compares costs and reimbursements for orthopedic patients in a tertiary care hospital in Switzerland between 2015 and 2017. The data of 1230 patients were analyzed. Overall, the net results for the hospital were positive, despite 19.5% of patients being treated at a loss. We did not find any correlation between age and profitability (p = 0.61). Patient-related factors associated with financial losses were female sex (p < 0.001) and diabetes (p = 0.013). Patients free of serious comorbidities (p = 0.012) or with a higher cost weight (p < 0.001) were more often profitable. A longer length of stay was associated with higher losses (p < 0.001). This is the first study to address the Swiss DRG reimbursement system in a broad orthopedic population, while also analyzing specific patient and surgical factors. Overall, the reimbursement system is fair, but could better account for certain interventions.
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Affiliation(s)
- Felix Rohrer
- Centre Hospitalier Universitaire Vaudois, CHUV, 1011 Lausanne, Switzerland
- Department of Internal Medicine, Sonnenhofspital, 3006 Bern, Switzerland;
- Correspondence: ; Tel.: +41-78-890-13-32
| | - Aresh Farokhnia
- Clinic for Immunology, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Hubert Nötzli
- Orthopädie Sonnenhof, 3006 Bern, Switzerland;
- Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | | | - Tanja Hermann
- Stiftung Lindenhof, Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, 3010 Bern, Switzerland;
| | - Brigitta Gahl
- Clinical Trial Unit, University of Bern, 3012 Bern, Switzerland; (B.G.); (A.L.)
| | - Andreas Limacher
- Clinical Trial Unit, University of Bern, 3012 Bern, Switzerland; (B.G.); (A.L.)
| | - Jan Brügger
- Department of Internal Medicine, Sonnenhofspital, 3006 Bern, Switzerland;
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
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Rohrer F, Haddenbruch D, Noetzli H, Gahl B, Limacher A, Hermann T, Bruegger J. Readmissions after elective orthopedic surgery in a comprehensive co-management care system-a retrospective analysis. Perioper Med (Lond) 2021; 10:47. [PMID: 34906233 PMCID: PMC8672479 DOI: 10.1186/s13741-021-00218-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022] Open
Abstract
Background No surgical intervention is without risk. Readmissions and reoperations after elective orthopedic surgery are common and are also stressful for the patient. It has been shown that a comprehensive ortho-medical co-management model decreases readmission rates in older patients suffering from hip fracture; but it is still unclear if this also applies to elective orthopedic surgery. The aim of the current study was to determine the proportion of unplanned readmissions or returns to operating room (for any reason) across a broad elective orthopedic population within 90 days after elective surgery. All cases took place in a tertiary care center using co-management care and were also assessed for risk factors leading to readmission or unplanned return to operating room (UROR). Methods In this observational study, 1295 patients undergoing elective orthopedic surgery between 2015 and 2017 at a tertiary care center in Switzerland were investigated. The proportion of reoperations and readmissions within 90 days was measured, and possible risk factors for reoperation or readmission were identified using logistic regression. Results In our cohort, 3.2% (42 of 1295 patients) had an UROR or readmission. Sixteen patients were readmitted without requiring further surgery—nine of which due to medical and seven to surgical reasons. Patient-related factors associated with UROR and readmission were older age (67 vs. 60 years; p = 0.014), and American Society of Anesthesiologists physical status (ASA PS) score ≥ 3 (43% vs. 18%; p < 0.001). Surgery-related factors were: implantation of foreign material (62% vs. 33%; p < 0.001), duration of operation (76 min. vs. 60 min; p < 0.001), and spine surgery (57% vs. 17%; p < 0.001). Notably, only spine surgery was also found to be independent risk factor. Conclusion Rates of UROR during initial hospitalization and readmission were lower in the current study than described in the literature. However, several comorbidities and surgery-related risk factors were found to be associated with these events. Although no surgery is without risk, known threats should be reduced and every effort undertaken to minimize complications in high-risk populations. Further prospective controlled research is needed to investigate the potential benefits of a co-management model in elective orthopedic surgery.
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Affiliation(s)
- Felix Rohrer
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland. .,Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland.
| | | | - Hubert Noetzli
- University of Bern, 3012, Bern, Switzerland.,Orthopaedie Sonnenhof, 3006, Bern, Switzerland
| | - Brigitta Gahl
- Clinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland
| | - Andreas Limacher
- Clinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland
| | - Tanja Hermann
- Stiftung Lindenhof, Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, 3010, Bern, Switzerland
| | - Jan Bruegger
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland.,University of Zurich, 8006, Zurich, Switzerland
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Rohrer F, Albrecht E. Efficacy of intra-operative administration of iron isomaltoside for preventing postoperative anaemia after total knee arthroplasty. Eur J Anaesthesiol 2021; 38:1209-1210. [PMID: 34617927 DOI: 10.1097/eja.0000000000001553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Felix Rohrer
- From the Department of Anaesthesia, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland (FR, EA)
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Rohrer F, Maurer A, Noetzli H, Gahl B, Limacher A, Hermann T, Bruegger J. Prolonged antibiotic prophylaxis use in elective orthopaedic surgery - a cross-sectional analysis. BMC Musculoskelet Disord 2021; 22:420. [PMID: 33957917 PMCID: PMC8101240 DOI: 10.1186/s12891-021-04290-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/22/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose Surgical antibiotic prophylaxis (SAP) prevents surgical site infections (SSI). In orthopaedic surgery, the use of prolonged SAP (PSAP) has been reported in daily routine, despite guidelines advising against it. Therefore, we asked: What is the proportion of PSAP use, defined as administration of SAP ≥24 h after elective orthopaedic surgery? Are there patient- and surgery-related predictors of PSAP use? Methods This cross-sectional analysis investigated 1292 patients who underwent elective orthopaedic surgery including total joint arthroplasties at one Swiss centre between 2015 and 2017. Patient comorbidities, surgical characteristics and occurrence of SSI at 90 days in PSAP group were compared to the SAP group (< 24 h post-operative). Results PSAP use was 12% (155 of 1292). Patient-related factors associated with PSAP compared to the SAP group included older age (63 vs. 58y; p < 0.001), higher BMI (29 vs. 27 kg/m2; p < 0.001), ASA classification ≥3 (31% vs. 17%; p < 0.001) and lung disease (17% vs. 9%; p = 0.002). Surgery-related factors associated with PSAP were use of prosthetics (62% vs. 45%; p < 0.001), surgery of the knee (65% vs. 25%; p < 0.001), longer surgery duration (87 vs. 68 min; p < 0.001) and presence of drains (90% vs. 65%; p < 0.001). All four SSI occurred in the SAP group (0 vs. 4; p = 1.0). Surgeons administered PSAP with varying frequencies; proportions ranged from 0 to 33%. Conclusion PSAP use and SSI proportions were lower than reported in the literature. Several patient- and surgery-related factors associated with PSAP use were identified and some were potentially modifiable. Also, experienced surgeons seemed to implement differing approaches regarding the duration of SAP administration.
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Affiliation(s)
- Felix Rohrer
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland. .,Centre Hospitalier Universitaire Vaudois, CHUV, 1011, Lausanne, Switzerland.
| | - Anita Maurer
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland.,University of Bern, 3012, Bern, Switzerland
| | - Hubert Noetzli
- University of Bern, 3012, Bern, Switzerland.,Orthopaedie Sonnenhof, 3006, Bern, Switzerland
| | - Brigitta Gahl
- Clinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland
| | - Andreas Limacher
- Clinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland
| | - Tanja Hermann
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland.,Stiftung Lindenhof, Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, 3010, Bern, Switzerland
| | - Jan Bruegger
- Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland.,University of Zurich, 8006, Zurich, Switzerland
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Rohrer F, Wendt M, Noetzli H, Risch L, Bodmer T, Cottagnoud P, Hermann T, Limacher A, Gahl B, Bruegger J. Preoperative decolonization and periprosthetic joint infections-A randomized controlled trial with 2-year follow-up. J Orthop Res 2021; 39:333-338. [PMID: 33258495 DOI: 10.1002/jor.24916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 02/04/2023]
Abstract
Preoperative decolonization, especially of Staphylococcus aureus carriers, has been proposed to reduce periprosthetic joint infections (PJI), but the evidence-based consensus is still lacking and data on long-term outcomes is scarce. In a previous randomized, single-blinded trial, decolonization produced no significant reduction of surgical site infections in overall elective orthopedic surgery at 3-month follow-up. A 2-year follow-up was then performed to specifically detect the impact of decolonization on delayed-onset PJI (3-24 months after surgery). Between November 2015 and September 2017, 613 of 1318 recruited patients underwent prosthetic surgery. Individuals were allocated into either the S. aureus carrier group (34%, 207 of 613 patients) or the noncarrier group (406 of 613 patients), according to nasal swab screening results. Both groups were then randomized into intervention and control arms. In the S. aureus group, the intervention consisted of daily chlorhexidine showers and application of mupirocin nasal ointment twice a day for 5 days before surgery. In noncarriers, only chlorhexidine showers were prescribed. Sample size calculation was based on the initial trial for overall and not for the prosthetic surgery group. No PJI was found at 2 years in either the carrier or in the noncarrier group. Therefore, no definite conclusion about the efficacy of preoperative decolonization to reduce PJI can be drawn. PJI proportions in this study were lower than described in the literature (mostly around 0.3%). Despite the insufficient sample size, this trial is the largest randomized trial on decolonization with a long-term follow-up, and results may be helpful for future meta-analyses.
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Affiliation(s)
- Felix Rohrer
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland
| | - Malte Wendt
- Department of Dermatology, Hautärzte Hamburg, Hamburg, Germany
| | - Hubert Noetzli
- Faculty of Medicine, University of Bern, Bern, Switzerland.,Orthopaedic Department, Sonnenhofspital, Bern, Switzerland
| | - Lorenz Risch
- Faculty of Medicine, University of Bern, Bern, Switzerland.,Department of Microbiology, Labormedizinisches Zentrum Dr Risch, Koeniz, Switzerland
| | - Thomas Bodmer
- Department of Microbiology, Labormedizinisches Zentrum Dr Risch, Koeniz, Switzerland
| | - Philippe Cottagnoud
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland.,Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Tanja Hermann
- Swiss Institute for Translational and Entrepreneurial Medicine, Stiftung Lindenhof, Bern, Switzerland
| | - Andreas Limacher
- Clinical Trial Unit, CTU Bern, University of Bern, Bern, Switzerland
| | - Brigitta Gahl
- Clinical Trial Unit, CTU Bern, University of Bern, Bern, Switzerland
| | - Jan Bruegger
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Novelli A, Cho C, Fuchs H, Hofzumahaus A, Rohrer F, Tillmann R, Kiendler-Scharr A, Wahner A, Vereecken L. Experimental and theoretical study on the impact of a nitrate group on the chemistry of alkoxy radicals. Phys Chem Chem Phys 2021; 23:5474-5495. [DOI: 10.1039/d0cp05555g] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The chemistry of nitrated alkoxy radicals, and its impact on RO2 measurements using the laser induced fluorescence (LIF) technique, is examined by a combined theoretical and experimental study.
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Affiliation(s)
- A. Novelli
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - C. Cho
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - H. Fuchs
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - A. Hofzumahaus
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - F. Rohrer
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - R. Tillmann
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - A. Kiendler-Scharr
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - A. Wahner
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
| | - L. Vereecken
- Institute for Energy and Climate Research
- Forschungszentrum Jülich GmbH
- 52428 Jülich
- Germany
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Schlag P, Rubach F, Mentel TF, Reimer D, Canonaco F, Henzing JS, Moerman M, Otjes R, Prévôt ASH, Rohrer F, Rosati B, Tillmann R, Weingartner E, Kiendler-Scharr A. Ambient and laboratory observations of organic ammonium salts in PM1. Faraday Discuss 2017; 200:331-351. [DOI: 10.1039/c7fd00027h] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ambient measurements of PM1aerosol chemical composition at Cabauw, the Netherlands, implicate higher ammonium concentrations than explained by the formation of inorganic ammonium salts. This additional particulate ammonium is called excess ammonium (eNH4). Height profiles over the Cabauw Experimental Site for Atmospheric Research (CESAR) tower, of combined ground based and airborne aerosol mass spectrometric (AMS) measurements on a Zeppelin airship show higher concentrations ofeNH4at higher altitudes compared to the ground. Through flights across the Netherlands, the Zeppelin based measurements furthermore substantiateeNH4as a regional phenomenon in the planetary boundary layer. The excess ammonium correlates with mass spectral signatures of (di-)carboxylic acids, making a heterogeneous acid–base reaction the likely process of NH3uptake. We show that this excess ammonium was neutralized by the organic fraction forming particulate organic ammonium salts. We discuss the significance of such organic ammonium salts for atmospheric aerosols and suggest that NH3emission control will have benefits for particulate matter control beyond the reduction of inorganic ammonium salts.
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Kunz A, Müller R, Homonnai V, Jánosi IM, Hurst D, Rap A, Forster PM, Rohrer F, Spelten N, Riese M. Extending water vapor trend observations over Boulder into the tropopause region: Trend uncertainties and resulting radiative forcing. J Geophys Res Atmos 2013; 118:11269-11284. [PMID: 29263978 PMCID: PMC5734648 DOI: 10.1002/jgrd.50831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Thirty years of balloon-borne measurements over Boulder (40°N, 105°W) are used to investigate the water vapor trend in the tropopause region. This analysis extends previously published trends, usually focusing on altitudes greater than 16 km, to lower altitudes. Two new concepts are applied: (1) Trends are presented in a thermal tropopause (TP) relative coordinate system from -2 km below to 10 km above the TP, and (2) sonde profiles are selected according to TP height. Tropical (TP z > 14 km), extratropical (TP z < 12 km), and transitional air mass types (12 km < TP z < 14 km) reveal three different water vapor reservoirs. The analysis based on these concepts reduces the dynamically induced water vapor variability at the TP and principally favors refined water vapor trend studies in the upper troposphere and lower stratosphere. Nonetheless, this study shows how uncertain trends are at altitudes -2 to +4 km around the TP. This uncertainty in turn has an influence on the uncertainty and interpretation of water vapor radiative effects at the TP, which are locally estimated for the 30 year period to be of uncertain sign. The much discussed decrease in water vapor at the beginning of 2001 is not detectable between -2 and 2 km around the TP. On lower stratospheric isentropes, the water vapor change at the beginning of 2001 is more intense for extratropical than for tropical air mass types. This suggests a possible link with changing dynamics above the jet stream such as changes in the shallow branch of the Brewer-Dobson circulation.
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Affiliation(s)
- A. Kunz
- Institut für Energie– und Klimaforschung: Stratosphäre, Forschungszentrum Jülich, Jülich, Germany
| | - R. Müller
- Institut für Energie– und Klimaforschung: Stratosphäre, Forschungszentrum Jülich, Jülich, Germany
| | - V. Homonnai
- Department of Physics of Complex Systems, Eötvös Loránd University, Budapest, Hungary
| | - I. M. Jánosi
- Department of Physics of Complex Systems, Eötvös Loránd University, Budapest, Hungary
| | - D. Hurst
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado, USA
- Global Monitoring Division, NOAA Earth System Research Laboratory, Boulder, Colorado, USA
| | - A. Rap
- School of Earth and Environment, University of Leeds, Leeds, UK
| | - P. M. Forster
- School of Earth and Environment, University of Leeds, Leeds, UK
| | - F. Rohrer
- Institut für Energie– und Klimaforschung: Troposphäre, Forschungszentrum Jülich, Jülich, Germany
| | - N. Spelten
- Institut für Energie– und Klimaforschung: Stratosphäre, Forschungszentrum Jülich, Jülich, Germany
| | - M. Riese
- Institut für Energie– und Klimaforschung: Stratosphäre, Forschungszentrum Jülich, Jülich, Germany
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Elshorbany YF, Kleffmann J, Hofzumahaus A, Kurtenbach R, Wiesen P, Brauers T, Bohn B, Dorn HP, Fuchs H, Holland F, Rohrer F, Tillmann R, Wegener R, Wahner A, Kanaya Y, Yoshino A, Nishida S, Kajii Y, Martinez M, Kubistin D, Harder H, Lelieveld J, Elste T, Plass-Dülmer C, Stange G, Berresheim H, Schurath U. HOxbudgets during HOxComp: A case study of HOxchemistry under NOx-limited conditions. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jd017008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kunz A, Konopka P, Müller R, Pan LL, Schiller C, Rohrer F. High static stability in the mixing layer above the extratropical tropopause. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2009jd011840] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hofzumahaus A, Rohrer F, Lu K, Bohn B, Brauers T, Chang CC, Fuchs H, Holland F, Kita K, Kondo Y, Li X, Lou S, Shao M, Zeng L, Wahner A, Zhang Y. Amplified Trace Gas Removal in the Troposphere. Science 2009; 324:1702-4. [DOI: 10.1126/science.1164566] [Citation(s) in RCA: 465] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Bohn B, Koppmann R, Rohrer F. Seasonal variations and profile measurements of photolysis frequenciesj(O1D) andj(NO2) at the ECHO forest field site. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005jd006856] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Toenges-Schuller N, Stein O, Rohrer F, Wahner A, Richter A, Burrows JP, Beirle S, Wagner T, Platt U, Elvidge CD. Global distribution pattern of anthropogenic nitrogen oxide emissions: Correlation analysis of satellite measurements and model calculations. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005jd006068] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gautrois M, Brauers T, Koppmann R, Rohrer F, Stein O, Rudolph J. Seasonal variability and trends of volatile organic compounds in the lower polar troposphere. ACTA ACUST UNITED AC 2003. [DOI: 10.1029/2002jd002765] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Gautrois
- Institut für Chemie und Dynamik der Geosphäre; Institut II: Troposphäre, Forschungszentrum Jülich; Jülich Germany
| | - T. Brauers
- Institut für Chemie und Dynamik der Geosphäre; Institut II: Troposphäre, Forschungszentrum Jülich; Jülich Germany
| | - R. Koppmann
- Institut für Chemie und Dynamik der Geosphäre; Institut II: Troposphäre, Forschungszentrum Jülich; Jülich Germany
| | - F. Rohrer
- Institut für Chemie und Dynamik der Geosphäre; Institut II: Troposphäre, Forschungszentrum Jülich; Jülich Germany
| | - O. Stein
- Institut für Chemie und Dynamik der Geosphäre; Institut II: Troposphäre, Forschungszentrum Jülich; Jülich Germany
| | - J. Rudolph
- Chemistry Department and Centre for Atmospheric Chemistry; York University; Toronto Ontario Canada
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Affiliation(s)
- D. H. Ehhalt
- Forschungszentrum Jülich Institut II: Troposphäre Jülich Germany
| | - F. Rohrer
- Forschungszentrum Jülich Institut II: Troposphäre Jülich Germany
| | - S. Schauffler
- National Center for Atmospheric Research Boulder Colorado USA
| | - W. Pollock
- National Center for Atmospheric Research Boulder Colorado USA
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Kenner RD, Rohrer F, Papenbrock T, Stuhl F. Excitation mechanism for hydroxyl(A) in the argon fluoride excimer laser photolysis of nitric acid. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100398a018] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ehhalt DH, Rohrer F, Wahner A, Prather MJ, Blake DR. On the use of hydrocarbons for the determination of tropospheric OH concentrations. ACTA ACUST UNITED AC 1998. [DOI: 10.1029/98jd01106] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ehhalt DH, Rohrer F, Kraus AB, Prather MJ, Blake DR, Rowland FS. On the significance of regional trace gas distributions as derived from aircraft campaigns in PEM-West A and B. ACTA ACUST UNITED AC 1997. [DOI: 10.1029/97jd01498] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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24
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Poppe D, Zimmermann J, Bauer R, Brauers T, Brüning D, Callies J, Dorn HP, Hofzumahaus A, Johnen FJ, Khedim A, Koch H, Koppmann R, London H, Müller KP, Neuroth R, Plass-Dülmer C, Platt U, Rohrer F, Röth EP, Rudolph J, Schmidt U, Wallasch M, Ehhalt DH. Comparison of measured OH concentrations with model calculations. ACTA ACUST UNITED AC 1994. [DOI: 10.1029/94jd00378] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Rohrer F, Stuhl F. The 193 (and 248) nm photolysis of HN3: Formation and internal energy distributions of the NH (a 1Δ, b 1∑+, A 3Π, and c 1Π) states. J Chem Phys 1988. [DOI: 10.1063/1.454691] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.7] [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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Kenner R, Rohrer F, Stuhl F. Determination of the excitation mechanism for photofragment emission in the ArF laser photolysis of NH3, N2H4, HNO3 and CH3NH2. Chem Phys Lett 1985. [DOI: 10.1016/0009-2614(85)80187-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rohrer F, Wirz K. Über den Pleuradruck. J Mol Med (Berl) 1923. [DOI: 10.1007/bf01716233] [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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Rohrer F. LXXI. On the Relation between the Formation of the Auricle of Anthropoid Monkeys, and Certain Congenital Malformations of the Human Auricle. Ann Otol Rhinol Laryngol 1902. [DOI: 10.1177/000348940201100418] [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: 11/15/2022]
Affiliation(s)
- F. Rohrer
- Docent of Otology at the University of Zurich
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Rohrer F. Ueber die Anwendung des Pyoktanins (Merck) in der Ohrenheilkunde. Eur Arch Otorhinolaryngol 1891. [DOI: 10.1007/bf01804775] [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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Rohrer F. Ein Fall von Zwerghaftigkeit als Beitrag zur Aetiologie der Wachsthumshemmung. Virchows Arch 1885. [DOI: 10.1007/bf01995010] [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: 11/28/2022]
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