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Floege J, Jayne DRW, Sanders JSF, Tesar V, Balk EM, Gordon CE, Adam G, Tonelli MA, Cheung M, Earley A, Rovin BH. Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Management of ANCA-Associated Vasculitis. Kidney Int 2024; 105:447-449. [PMID: 38388147 DOI: 10.1016/j.kint.2023.10.009] [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: 09/11/2023] [Revised: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 02/24/2024]
Abstract
In 2021, the Kidney Disease: Improving Global Outcomes (KDIGO) Guideline for the Management of Glomerular Diseases was published. KDIGO is committed to providing the nephrology community with periodic updates, based on new developments for each disease. For patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), avacopan received regulatory approval in late 2021, leading to this KDIGO guideline update. In addition, the evidence supporting a lower-dose glucocorticoid induction regimen or even complete replacement of glucocorticoids has become stronger. Herein, an executive summary of the most important guideline changes from the AAV chapter is provided as a quick reference.
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Affiliation(s)
- Jürgen Floege
- Division of Nephrology, University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany.
| | - David R W Jayne
- Division of Experimental Medicine & Immunotherapeutics, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jan-Stephan F Sanders
- Division of Nephrology, Department of Internal Medicine, University of Groningen, Groningen, The Netherlands
| | - Vladimír Tesar
- Department of Nephrology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Craig E Gordon
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Marcello A Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Brad H Rovin
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Lund N, Wieboldt H, Fischer L, Muschol N, Braun F, Huber T, Sorriento D, Iaccarino G, Müllerleile K, Tahir E, Adam G, Kirchhof P, Fabritz L, Patten M. Overexpression of VEGFα as a biomarker of endothelial dysfunction in aortic tissue of α-GAL-Tg/KO mice and its upregulation in the serum of patients with Fabry's disease. Front Cardiovasc Med 2024; 11:1355033. [PMID: 38374995 PMCID: PMC10875336 DOI: 10.3389/fcvm.2024.1355033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Fabry's disease is an X-linked lysosomal storage disorder caused by reduced activity of α-galactosidase A (GAL), leading to premature death on account of renal, cardiac, and vascular organ failure. Accumulation of the GAL substrate globotriaosylceramide (Gb3) in endothelial and smooth muscle cells is associated with early vascular cell damage, suggesting endothelial dysfunction as a driver of cardiorenal organ failure. Here, we studied the vascular expression of the key angiogenic factors, VEGFα and its antagonist angiostatin, in Fabry α-GAL-Tg/KO mice and determined circulating VEGFα and angiostatin serum levels in patients with Fabry's disease and healthy controls. Methods Cryopreserved aortic vessels from six α-GAL-Tg/KO and six wild-type (WT) mice were obtained and VEGFα and angiostatin levels were determined by performing Western blot analysis. VEGFα expression was visualized by an immunohistochemical staining of paraffin aortic rings. In addition, VEGFα and angiostatin serum levels were measured by using an enzyme-linked immunosorbent assay in 48 patients with genetically verified Fabry's disease (50% male) and 22 healthy controls and correlated with disease severity markers such as lyso-Gb3, albuminuria, NTproBNP, high-sensitive troponin T (hsTNT), and myocardial wall thickness. Results It was found that there was a significant increase in VEGFα protein expression (1.66 ± 0.35 vs. 0.62 ± 0.16, p = 0.0009) and a decrease in angiostatin expression (0.024 ± 0.007 vs. 0.053 ± 0.02, p = 0.038) in aortic lysates from α-GAL-Tg/KO compared with that from WT mice. Immunohistochemical staining revealed an adventitial VEGFα signal in α-GAL-Tg/KO mice, whereas no VEGFα signal could be detected in WT mice aortas. No differences in aortic angiostatin expression between α-GAL-Tg/KO- and WT mice could be visualized. The serum levels of VEGFα were significantly upregulated in patients with Fabry's disease compared with that in healthy controls (708.5 ± 426.3 vs. 458.5 ± 181.5 pg/ml, p = 0.048) and positively associated with albuminuria (r = 0.82, p < 0.0001) and elevated NTproBNP (r = 0.87, p < 0.0001) and hsTNT values (r = 0.41, p = 0.048) in male patients with Fabry's disease. For angiostatin, no significant difference was found between patients with Fabry's disease and healthy controls (747.6 ± 390.3 vs. 858.8 ± 599.3 pg/ml). Discussion In conclusion, an overexpression of VEGFα and downregulation of its counter player angiostatin in aortic tissue of α-GAL-Tg/KO mice support the hypothesis of an underlying vasculopathy in Fabry's disease. Elevated VEGFα serum levels were also observed in patients with Fabry's disease and were positively associated with elevated markers of organ manifestation in males. These findings suggest that angiogenetic markers, such as VEGFα, may be potentially useful biomarkers for the detection of endothelial dysfunction in classical Fabry's disease.
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Affiliation(s)
- N. Lund
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - H. Wieboldt
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L. Fischer
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N. Muschol
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F. Braun
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Kidney Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T. Huber
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Kidney Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D. Sorriento
- Department of Advanced Biomedical Sciences, Interdepartmental Center of Research on Hypertension and Related Conditions of the Federico II University, Naples, Italy
| | - G. Iaccarino
- Department of Clinical Medicine and Surgery, Interdepartmental Center of Research on Hypertension and Related Conditions of the Federico II University, Naples, Italy
| | - K. Müllerleile
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E. Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G. Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P. Kirchhof
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L. Fabritz
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M. Patten
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Rovin BH, Ayoub IM, Chan TM, Liu ZH, Mejía-Vilet JM, Balk EM, Gordon CE, Adam G, Tonelli MA, Cheung M, Earley A, Floege J. Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Management of Lupus Nephritis. Kidney Int 2024; 105:31-34. [PMID: 38182299 DOI: 10.1016/j.kint.2023.09.001] [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: 08/02/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 01/07/2024]
Abstract
The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Glomerular Diseases was published in 2021. Since then, the pace of drug development for glomerular diseases has accelerated, due in large part to rapidly accumulating insights into disease pathogenesis from genetic and molecular studies of afflicted patients. To keep the Glomerular Diseases Guideline as current as possible, KDIGO made a commitment to the nephrology community to provide periodic updates, based on new developments for each disease. After the 2021 guideline was published, two novel drugs received regulatory approval for the management of lupus nephritis, leading to the first KDIGO guideline update. Herein, an executive summary of the most important guideline changes from the Lupus Nephritis chapter is provided as a quick reference.
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Affiliation(s)
- Brad H Rovin
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA.
| | - Isabelle M Ayoub
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Tak Mao Chan
- Division of Nephrology, Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Zhi-Hong Liu
- National Clinical Research Center of Kidney Diseases, Nanjing University School of Medicine, Nanjing, China
| | - Juan M Mejía-Vilet
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico City, Mexico
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Craig E Gordon
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | | | | | | | - Jürgen Floege
- Division of Nephrology, University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany
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Maftei R, Doroftei B, Vaduva CC, Harabor V, Adam AM, Harabor A, Adam G, Mihalceanu E, Vasilache IA, Bivoleanu A, Vicoveanu P, Lunguleac G, Cretu AM, Armeanu T, Cianga P. Fresh vs. frozen embryo transfers in patients with KIR Bx haplotype: impact on reproductive outcomes. Eur Rev Med Pharmacol Sci 2023; 27:11975-11987. [PMID: 38164860 DOI: 10.26355/eurrev_202312_34796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE A controversy persists over whether or not the type of embryo transfer (ET) influences reproductive outcomes. This study aimed to evaluate the reproductive outcomes of pregnant patients undergoing their first in vitro fertilization procedure and explore the influence of various KIR genotypes on these reproductive outcomes. PATIENTS AND METHODS Prospective enrollment of patients with infertility who sought treatment at Origyn Fertility Center in Iasi, Romania, was conducted between January 2019 and March 2023. Descriptive statistics and average treatment effects (ATE) using propensity-score matching were employed to analyze our data. RESULTS Our results indicated that both groups were homogenous regarding baseline characteristics. When we evaluated the ATE of fresh vs. frozen ET on the main outcomes, we discovered that only frozen ET significantly improved the pregnancy rates (ATE: 0.17, 95% CI: 0.04-0.30, p=0.011) and live birth rates (ATE: 0.36, 95% CI: 0.02-1.19, p=0.03). The miscarriage rates were similar between the two groups. None of the evaluated KIR genotypes had a significant influence on the ATE corresponding to fresh and frozen ET. CONCLUSIONS KIR screening is not necessary before an IVF cycle, except for specific situations such as recurrent pregnancy loss or recurrent implantation failure.
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Affiliation(s)
- R Maftei
- Department of Mother and Childcare, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
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Awan AAY, Berenguer MC, Bruchfeld A, Fabrizi F, Goldberg DS, Jia J, Kamar N, Mohamed R, Pessôa MG, Pol S, Sise ME, Balk EM, Gordon CE, Adam G, Cheung M, Earley A, Martin P, Jadoul M. Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2022 Clinical Practice Guideline. Ann Intern Med 2023; 176:1648-1655. [PMID: 38079642 DOI: 10.7326/m23-2391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
DESCRIPTION The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 clinical practice guideline on prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease (CKD) is an update of the 2018 guideline from KDIGO. METHODS The KDIGO Work Group (WG) updated the guideline, which included reviewing and grading new evidence that was identified and summarized. As in the previous guideline, the WG used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to appraise evidence and rate the strength of recommendations and used expert judgment to develop recommendations. New evidence led to updating of recommendations in the chapters on treatment of hepatitis C virus (HCV) infection in patients with CKD (Chapter 2), management of HCV infection before and after kidney transplant (Chapter 4), and diagnosis and management of kidney disease associated with HCV infection (Chapter 5). Recommendations in chapters on detection and evaluation of hepatitis C in CKD (Chapter 1) and prevention of HCV transmission in hemodialysis units (Chapter 3) were not updated because of an absence of significant new evidence. RECOMMENDATIONS The 2022 updated guideline includes 43 graded recommendations and 20 ungraded recommendations, 7 of which are new or modified on the basis of the most recent evidence and consensus among the WG members. The updated guidelines recommend expanding treatment of hepatitis C with sofosbuvir-based regimens to patients with CKD glomerular filtration rate categories G4 and G5, including those receiving dialysis; expanding the donor pool for kidney transplant recipients by accepting HCV-positive kidneys regardless of the recipient's HCV status; and initiating direct-acting antiviral treatment of HCV-infected patients with clinical evidence of glomerulonephritis without requiring kidney biopsy. The update also addresses the use of immunosuppressive regimens in such patients.
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Affiliation(s)
- Ahmed Arslan Yousuf Awan
- Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas (A.A.Y.A.)
| | - Marina C Berenguer
- Department of Gastroenterology, Hepatology Unit & Instituto de Investigación La Fe, Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); and School of Medicine, University of Valencia, Valencia, Spain (M.C.B.)
| | - Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, and Department of Renal Medicine, Karolinska University Hospital and CLINTEC Karolinska Institutet, Stockholm, Sweden (A.B.)
| | - Fabrizio Fabrizi
- Division of Nephrology, Maggiore Policlinico Hospital and IRCCS Cà Granda Foundation, Milano, Italy (F.F.)
| | - David S Goldberg
- Division of Digestive Health and Liver Diseases, University of Miami School of Medicine, Miami, Florida (D.S.G., P.M.)
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Transitional Medicine on Liver Cirrhosis; and National Clinical Research Center for Digestive Diseases, Beijing, China (J.J.)
| | - Nassim Kamar
- Departments of Nephrology and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR-BMT, Université Paul Sabatier, Toulouse, France (N.K.)
| | - Rosmawati Mohamed
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia (R.M.)
| | - Mário Guimarães Pessôa
- Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil (M.G.P.)
| | - Stanislas Pol
- Hepatology Department, Hôpital Cochin, Université Paris Descartes, INSERM U-1223, Institut Pasteur, Paris, France (S.P.)
| | - Meghan E Sise
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts (M.E.S.)
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island (E.M.B., G.A.)
| | - Craig E Gordon
- Tufts Medical Center, Division of Nephrology, Boston, Massachusetts (C.E.G.)
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island (E.M.B., G.A.)
| | | | | | - Paul Martin
- Division of Digestive Health and Liver Diseases, University of Miami School of Medicine, Miami, Florida (D.S.G., P.M.)
| | - Michel Jadoul
- Department of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium (M.J.)
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Guerreiro H, Schröder H, Huber G, Busch F, Sellenschloh K, Adam G, Ittrich H, Busch JD. Quantification of mechanical properties in long-term in vivo used silicone catheter lines according to DIN 10555-3. Clin Biomech (Bristol, Avon) 2023; 107:106015. [PMID: 37321163 DOI: 10.1016/j.clinbiomech.2023.106015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Totally implantable central venous access port devices are crucial for intravenous application of chemotherapeutics and long-term therapy for chronic disease. Common complications include thrombosis and device fracture related to altered material properties through exposure in situ. This study exhibits whether uniaxial tensile properties (DIN 10555-3) of in vivo used catheters prove inferior to unused catheters. MATERIAL AND METHODS 5 unused, originally packed silicone catheters were cut into 6 segments of 50 mm: 3 segments each were cleaned via cleaning solution (n = 15) while 3 segments were left unattended (n = 15). Distal segments (50 mm) of long-term in vivo used silicone catheters were cleaned before testing (n = 33). Overall mechanical behavior was tested in a custom-made self-centering, torsion free carrier. Maximum force stress at failure, strain at failure and Young's modulus were determined and statistically analyzed. FINDINGS Unused catheters showed no significant difference in testing. in vivo used catheters exhibited 20% lower maximal force than unused catheters (p < 0.001), strain at break (p 〈0,001), and 7% higher elastic modulus (p = 0.004; power: 0.845). Due to a constant cross section area, stress at failure was proportional to maximum force (p < 0.001). Relation between determined parameters and dwell times was non-significant. INTERPRETATION In vivo long-term used silicone catheters showed significantly lower ultimate strength than unused ones. It is likely that in situ altering changes the mechanical properties of catheters and may potentially lead to failure.
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Affiliation(s)
- H Guerreiro
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - H Schröder
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - G Huber
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - F Busch
- Division of Neonatology, Department of Pediatrics Bern University Hospital, University of Bern, Switzerland
| | - K Sellenschloh
- Institute of Biomechanics TUHH Hamburg University of Technology, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Ittrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J D Busch
- Department of Diagnostic, Interventional Radiology and Pediatrics Bern University Hospital, University of Bern, Switzerland
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Uhl S, Konnyu K, Wilson R, Adam G, Robinson KA, Viswanathan M. Parent perceptions and decision making about treatments for epilepsy: a qualitative evidence synthesis. BMJ Open 2023; 13:e066872. [PMID: 36720580 PMCID: PMC9890834 DOI: 10.1136/bmjopen-2022-066872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Epilepsy treatment decision making is complex and understanding what informs caregiver decision making about treatment for childhood epilepsy is crucial to better support caregivers and their children. We synthesised evidence on caregivers' perspectives and experiences of treatments for childhood epilepsy. DESIGN Systematic review of qualitative studies using a best-fit framework and Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. DATA SOURCES Searched Embase, PubMed, CINAHL, PsycINFO, SocINDEX and Web of Science from 1 January 1999 to 19 August 2021. ELIGIBILITY CRITERIA We included qualitative studies examining caregiver's perspectives on antiseizure medication, diet or surgical treatments for childhood epilepsy. We excluded studies not reported in English. DATA EXTRACTION AND SYNTHESIS We extracted qualitative evidence into 1 of 14 domains defined by the Theoretical Domains Framework (TDF). One reviewer extracted study data and methodological characteristics, and two reviewers extracted qualitative findings. The team verified all extractions. We identified themes within TDF domains and synthesised summary statements of these themes. We assessed our confidence in our summary statements using GRADE-CERQual. RESULTS We identified five studies (in six reports) of good methodological quality focused on parent perceptions of neurosurgery; we found limited indirect evidence on parents' perceptions of medications or diet. We identified themes within 6 of the 14 TDF domains relevant to treatment decisions: knowledge, emotion; social/professional role and identity; social influence; beliefs about consequences; and environmental context and resources. CONCLUSIONS Parents of children with epilepsy navigate a complex process to decide whether to have their child undergo surgery. Educational resources, peer support and patient navigators may help support parents through this process. More qualitative studies are needed on non-surgical treatments for epilepsy and among caregivers from different cultural and socioeconomic backgrounds to fully understand the diversity of perspectives that informs treatment decision making.
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Affiliation(s)
- Stacey Uhl
- Center for Clinical Evidence, ECRI, Plymouth Meeting, Pennsylvania, USA
| | - Kristin Konnyu
- Center for Evidence Synthesis in Health, Brown University, Providence, Rhode Island, USA
| | - Renee Wilson
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University, Providence, Rhode Island, USA
| | - Karen A Robinson
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Meera Viswanathan
- Evidence-based Practice Center, RTI International, Research Triangle Park, North Carolina, USA
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Knapp J, Tavares de Sousa M, Lenz A, Herrmann J, Zhang S, Kording F, Hergert B, Adam G, Bannas P, Schoennagel BP. Fetal 4D flow MRI of the great thoracic vessels at 3 Tesla using Doppler-ultrasound gating: a feasibility study. Eur Radiol 2023; 33:1698-1706. [PMID: 36271920 PMCID: PMC9935734 DOI: 10.1007/s00330-022-09167-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the feasibility of Doppler-ultrasound (DUS)-gated 4D flow MRI of the fetal great thoracic vessels at 3T in a clinical setting. METHODS Sixteen consecutive fetuses (range 30+4-38+5 weeks) with (n = 11) and without (n = 5) cardiovascular anomalies underwent 4D flow MRI of the great thoracic vessels at 3T. Direct fetal cardiac gating was obtained using a MR-compatible DUS device. 4D flow MRI-based visualisation and quantification of four target regions (ascending aorta (AAo), descending aorta (DAo), main pulmonary artery (MPA), and ductus arteriosus (DA)) were performed using dedicated software. RESULTS Fetal 4D flow MRI of the great thoracic vessels was successful in 12/16 fetuses (75%) by adopting clinical 4D flow MR protocols in combination with direct fetal cardiac DUS-gating. Four datasets were excluded due to artefacts by fetal movement or maternal breathing. 4D flow MRI-derived time-velocity curves revealed typical arterial blood flow patterns in the aorta. 4D flow quantification was achieved for the pre-defined target regions. Average velocity and flow volume were 21.1 ± 5.2 cm/s and 6.0 ± 3.1 mL/s in the AAo, 24.3 ± 6.7 cm/s and 8.4 ± 3.7 mL/s in the DAo, 21.9 ± 6.4 cm/s and 7.8 ± 4.2 mL/s in the MPA, and 23.4 ± 4.7 cm/s and 5.9 ± 3.6 mL/s in the DA, respectively. CONCLUSIONS Combination of DUS-gating of the fetal heart and 4D flow MRI allows comprehensive visualisation and quantification of haemodynamics in the fetal great thoracic vessels. DUS-gated fetal 4D flow MRI may provide a new diagnostic approach for prenatal assessment of blood flow haemodynamics. KEY POINTS • Fetal cardiac Doppler-ultrasound (DUS) gating and 4D flow MRI can be successfully combined. • DUS-gated fetal 4D flow MRI allowed visualisation and evaluation of streamline directionality, illustration of blood flow variations, and pulsatile arterial waveforms in the target vessels. • 4D flow MRI-based visualisation and quantification of the fetal great thoracic vessels were successful and flow metrics agreed with echocardiographic reference values.
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Affiliation(s)
- J. Knapp
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - M. Tavares de Sousa
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - A. Lenz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - J. Herrmann
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - S. Zhang
- Philips Healthcare, Röntgenstrasse 24, 22335 Hamburg, Germany
| | - F. Kording
- Northh Medical GmbH, Röntgenstrasse 24, 22335 Hamburg, Germany
| | - B. Hergert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - G. Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - P. Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
| | - B. P. Schoennagel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany
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Ali EH, Alkindi S, Mohamed AO, Awadalla KE, Abdlgadir O, Adam G, Magdi M, Ibrahim AK, Ghebremeskel K. Adverse Pregnancy Outcomes in Sickle Cell Trait: a Prospective Cohort Study Evaluating Clinical and Haematological Parameters in Postpartum Mothers and Newborns. Mediterr J Hematol Infect Dis 2023; 15:e2023002. [PMID: 36660349 PMCID: PMC9833303 DOI: 10.4084/mjhid.2023.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023] Open
Abstract
Background Sickle cell trait (SCT) is a congenital condition caused by the inheritance of a single allele of the abnormal haemoglobin beta gene, HbS. Carriers of SCT are generally asymptomatic, and they do not manifest the clinical and haematological abnormalities of sickle cell anaemia (SCA). However, there is evidence that they display some symptoms in stressful situations. Pregnancy is a stressful physiological event, and it is not clear if SCT adversely affects pregnancy outcomes, particularly in those from developing countries where people regularly suffer from nutritional insufficiency. Objective This study aims to investigate pregnancy outcomes in Sudanese women with SCT. Subjects and methods: Pregnant women with (HbAS, n=34) and without (HbAA, n=60) SCT were recruited during their first trimester at El Obeid Hospital, Kordofan, Western Sudan. Following appropriate ethical approval and informed consent from the participants, detailed anthropometric, clinical, haematological, obstetric, and birth outcome data were registered. In addition, blood samples were collected at enrolment and at delivery. Results At enrolment in the first trimester, the SCT group did not manifest SCA symptoms, and there was no difference in the haematological parameters between the SCT and control groups. However, at delivery, the women with SCT, compared with the control group, had lower levels of hemoglobin (Hb, p=0.000), packed cell volume (PCV, p=0.000), mean corpuscular haemoglobin (MCH, p=0.002) and neutrophil counts (p=0.045) and higher mean corpuscular volume (MCV, p=0.000) and platelet counts (p=0.000). Similarly, at delivery, the babies of SCT women had lower birth weight (p=0.000), lower Hb (p=0.045), PCV (p=0.000), MCH (p=0.000), and higher neutrophil (p=0.004) and platelet counts (p=0.000) than the babies of the healthy control group. Additionally, there were more miscarriages, stillbirths, and admissions to the Special Care Baby Unit (SCBU) in the SCT group. Conclusions The study revealed that SCT is associated with adverse pregnancy outcomes, including maternal and neonatal anaemia, low birth weight, and increased risk of stillbirth, miscarriage, and admission to SCBU. Therefore, pregnant women with SCT should be given appropriate pre-conceptual advice and multidisciplinary antenatal and postnatal care.
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Affiliation(s)
- E H Ali
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
| | - S Alkindi
- Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - A O Mohamed
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Sudan
| | | | - O Abdlgadir
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - G Adam
- Faculty of Education, Al Azhri University, Sudan
| | - M Magdi
- Directorate of Planning, Ministry of Health Oman, Muscat, Sultanate of Oman
| | - A K Ibrahim
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - K Ghebremeskel
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
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10
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Martin P, Awan AA, Berenguer MC, Bruchfeld A, Fabrizi F, Goldberg DS, Jia J, Kamar N, Mohamed R, Pessôa MG, Pol S, Sise ME, Balk EM, Gordon CE, Adam G, Cheung M, Earley A, Jadoul M. Executive Summary of the KDIGO 2022 Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in Chronic Kidney Disease. Kidney Int 2022; 102:1228-1237. [PMID: 36411019 DOI: 10.1016/j.kint.2022.07.012] [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: 06/30/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022]
Abstract
Infection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy or with a kidney transplant. Since the publication of the Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2018, advances in HCV management, particularly in the field of antiviral therapy and treatment of HCV-associated glomerular diseases, coupled with increased usage of HCV-positive kidney grafts, have prompted a reexamination of the 2018 guideline. As a result, the Work Group performed a comprehensive review and revised the 2018 guidance. This Executive Summary highlights key aspects of the updated guideline recommendations for 3 chapters: Chapter 2: Treatment of HCV infection in patients with CKD; Chapter 4: Management of HCV-infected patients before and after kidney transplantation; and Chapter 5: Diagnosis and management of kidney diseases associated with HCV infection.
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Affiliation(s)
- Paul Martin
- Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
| | - Ahmed A Awan
- Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Marina C Berenguer
- Department of Gastroenterology, Hepatology Unit & Instituto de Investigación La Fe, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Valencia, Spain; School of Medicine, University of Valencia, Valencia, Spain
| | - Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Renal Medicine, Karolinska University Hospital and CLINTEC Karolinska Institutet, Stockholm, Sweden
| | - Fabrizio Fabrizi
- Division of Nephrology, Maggiore Hospital and Foundation IRCCC Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - David S Goldberg
- Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Transitional Medicine on Liver Cirrhosis, National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Nassim Kamar
- Departments of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France; INFINITY- Inserm U1291-CNRS U5051, Toulouse, France; Université Paul Sabatier, Toulouse, France
| | - Rosmawati Mohamed
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Mário Guimarães Pessôa
- Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Stanislas Pol
- Hepatology Department, Hopital Cochin, Université Paris Descartes, Paris, France
| | - Meghan E Sise
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Craig E Gordon
- Tufts Medical Center, Division of Nephrology, Boston, Massachusetts, USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Michael Cheung
- Kidney Disease: Improving Global Outcomes (KDIGO), Brussels, Belgium
| | - Amy Earley
- Kidney Disease: Improving Global Outcomes (KDIGO), Brussels, Belgium
| | - Michel Jadoul
- Department of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
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11
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Nikorowitsch J, Tahir E, Erley J, Muellerleile K, Metzner A, Adam G, Blankenberg S, Kirchhof P, Toennis T, Fluschnik N. 3 Tesla magnetic resonance imaging in patients with cardiac electronic implantable devices: a single center experience. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.482] [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
Cardiac magnetic resonance imaging (MRI), a key method guiding medical diagnosis and therapy, is increasingly performed at 3 Tesla (T) field strength. Growing evidence suggests a relatively safe conductance of 1.5 T MRI in patients with cardiac implantable electronic devices (CIEDs), leading to conditional certification of some CIEDs for MRI. However, data on the safety of MRI imaging at 3 T in patients with CIEDs are scarce.
Purpose
We analysed the safety of clinically indicated 3 T MRI in patients with “3T MRI-conditional” and “3 T MRI-non-conditional” CIEDs.
Methods
We performed a retrospective single-center analysis of consecutive patients with CIEDs labelled by the manufacturer as “MRI non-conditional”, “1.5 T MRI-conditional” and “3 T MRI-conditional”. Patients underwent clinically indicated 3 T MRI of different thoracic and non-thoracic body regions from April 2020 to February 2022. Devices were interrogated and programmed appropriately before and after scanning. Statistics included median and interquartile range. Measurements of device and lead function and integrity before and after scanning were assessed. Adverse events included all-cause death, arrhythmias, loss of capture, inappropriate anti-tachycardia therapies, electrical reset and lead or generator failure during or shortly after MRI scan.
Results
One hundred twenty-eight 3 T MRI scans were performed in 94 patients (mean age 72±16 years, 36.2% female). 3T MRI scans were performed in patients with “non-MRI-conditional” devices (n=9), “1.5 T MRI-conditional” devices (n=22), and “3 T MRI-conditional” devices (n=97). Patients were pacemaker-dependent in 24 MRI scans. After MRI, lead impedance had changed by 100 Ohms or more in seven cases (4 atrial and 3 right ventricular leads). P-wave (−25%) reduction was noted in one, R-wave (−50%) reduction in two cases. Right atrial and ventricular threshold exceeded the limit of 0,5V in one case each only in “3 T MRI-conditional” devices. No clinically relevant adverse events occurred.
Conclusion
3 T MRI was safely conducted in patients with “3 T MRI-conditional” and “non-MRI conditional” CIEDs in our single-center study. Pending verification in independent series, our data suggest that clinically indicated 3T MRI scans should not be withheld from patients with cardiac pacemakers or defibrillators.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Nikorowitsch
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - E Tahir
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - J Erley
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - K Muellerleile
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - A Metzner
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - G Adam
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - S Blankenberg
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - P Kirchhof
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - T Toennis
- University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - N Fluschnik
- University Heart & Vascular Center Hamburg , Hamburg , Germany
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12
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Schneider JN, Jahnke C, Cavus E, Chevalier C, Bohnen S, Radunski UK, Riedl KA, Tahir E, Adam G, Kirchhof P, Blankenberg S, Lund GK, Müllerleile K. Feature tracking cardiovascular magnetic resonance reveals recovery of atrial function after acute myocarditis. Int J Cardiovasc Imaging 2022; 38:2003-2012. [PMID: 37726601 PMCID: PMC10509057 DOI: 10.1007/s10554-022-02576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/17/2022] [Indexed: 11/24/2022]
Abstract
Follow-up after acute myocarditis is important to detect persisting myocardial dysfunction. However, recovery of atrial function has not been evaluated after acute myocarditis so far. Thirty-five patients with strictly defined acute myocarditis underwent cardiovascular magnetic resonance (CMR, 1.5 T) in the acute stage at baseline (BL) and at 3 months follow-up (FU). The study population included 13 patients with biopsy-proven "cardiomyopathy-like" myocarditis (CLM) and 22 patients with "infarct-like" (ILM) clinical presentation. CMR feature tracking (FT) was performed on conventional cine SSFP sequences. Median LA-GLS increased from 33.2 (14.5; 39.2) at BL to 37.0% (25.2; 44.1, P = 0.0018) at FU in the entire study population. Median LA-GLS also increased from 36.7 (26.5; 42.3) at BL to 41.3% (34.5; 44.8, P = 0.0262) at FU in the ILM subgroup and from 11.3 (6.4; 21.1) at BL to 21.4% (14.2; 30.7, P = 0.0186) at FU in the CLM subgroup. Median RA-GLS significantly increased from BL with 30.8 (22.5; 37.0) to FU with 33.7% (26.8; 45.4, P = 0.0027) in the entire study population. Median RA-GLS also significantly increased from 32.7 (25.8; 41.0) at BL to 35.8% (27.7; 48.0, P = 0.0495) at FU in the ILM subgroup and from 22.8 (13.1; 33.9) at BL to 31.0% (26.0; 40.8, P = 0.0266) at FU in the CLM subgroup. Our findings demonstrate recovery of LA and RA function by CMR-FT strain analyses in patients after acute myocarditis independent from clinical presentation. Monitoring of atrial strain could be an important tool for an individual assessment of healing after acute myocarditis.
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Affiliation(s)
- J N Schneider
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany.
| | - C Jahnke
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - E Cavus
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - C Chevalier
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - S Bohnen
- Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany
| | - U K Radunski
- Department of Cardiology, Regio Clinics Pinneberg and Elmshorn, Hamburg, Germany
| | - K A Riedl
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - E Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - S Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - G K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Müllerleile
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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13
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Riedel C, Lenz A, Ristow I, Wright F, Adam G, Schönnagel B, Bannas P. Quantitative 4D Fluss MRT in TIPS Stents: Validierung mittels 3D-gedrucktem Flussphantom. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749781] [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: 11/07/2022]
Affiliation(s)
- C Riedel
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagn. und Interv. Radiologie, Hamburg
| | - A Lenz
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - I Ristow
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - F Wright
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - G Adam
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - B Schönnagel
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - P Bannas
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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14
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Streckenbach A, Sinn M, Brandi L, Ludwig S, Linder M, Schofer N, Seiffert M, Lund G, Schaefer A, Tahir E, Adam G, Meyer M. 483 High-pitch Non-ecg-gated Ct Angiography Fortranscatheter Aortic Valvereplacement Planning: A Comparison To A Ecg-gated Cta Protocol And Impact On Clinical Outcome. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.094] [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: 10/17/2022]
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15
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Molwitz I, Leiderer M, McDonough R, Fischer R, Ozga AK, Ozden C, Tahir E, Koehler D, Adam G, Yamamura J. Skeletal muscle fat quantification by dual-energy computed tomography in comparison with 3T MR imaging. Eur Radiol 2021; 31:7529-7539. [PMID: 33770247 PMCID: PMC8452571 DOI: 10.1007/s00330-021-07820-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/05/2020] [Revised: 01/25/2021] [Accepted: 02/19/2021] [Indexed: 12/01/2022]
Abstract
Objectives To quantify the proportion of fat within the skeletal muscle as a measure of muscle quality using dual-energy CT (DECT) and to validate this methodology with MRI. Methods Twenty-one patients with abdominal contrast-enhanced DECT scans (100 kV/Sn 150 kV) underwent abdominal 3-T MRI. The fat fraction (DECT-FF), determined by material decomposition, and HU values on virtual non-contrast-enhanced (VNC) DECT images were measured in 126 regions of interest (≥ 6 cm2) within the posterior paraspinal muscle. For validation, the MR-based fat fraction (MR-FF) was assessed by chemical shift relaxometry. Patients were categorized into groups of high or low skeletal muscle mean radiation attenuation (SMRA) and classified as either sarcopenic or non-sarcopenic, according to the skeletal muscle index (SMI) and cut-off values from non-contrast-enhanced single-energy CT. Spearman’s and intraclass correlation, Bland-Altman analysis, and mixed linear models were employed. Results The correlation was excellent between DECT-FF and MR-FF (r = 0.91), DECT VNC HU and MR-FF (r = - 0.90), and DECT-FF and DECT VNC HU (r = − 0.98). Intraclass correlation between DECT-FF and MR-FF was good (r = 0.83 [95% CI 0.71–0.90]), with a mean difference of - 0.15% (SD 3.32 [95% CI 6.35 to − 6.66]). Categorization using the SMRA yielded an eightfold difference in DECT VNC HU values between both groups (5 HU [95% CI 23–11], 42 HU [95% CI 33–56], p = 0.05). No significant relationship between DECT-FF and SMI-based classifications was observed. Conclusions Fat quantification within the skeletal muscle using DECT is both feasible and reliable. DECT muscle analysis offers a new approach to determine muscle quality, which is important for the diagnosis and therapeutic monitoring of sarcopenia, as a comorbidity associated with poor clinical outcome. Key Points • Dual-energy CT (DECT) material decomposition and virtual non-contrast-enhanced DECT HU values assess muscle fat reliably. • Virtual non-contrast-enhanced dual-energy CT HU values allow to differentiate between high and low native skeletal muscle mean radiation attenuation in contrast-enhanced DECT scans. • Measuring muscle fat by dual-energy computed tomography is a new approach for the determination of muscle quality, an important parameter for the diagnostic confirmation of sarcopenia as a comorbidity associated with poor clinical outcome.
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Affiliation(s)
- I Molwitz
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - M Leiderer
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - R McDonough
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - R Fischer
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.,UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - A-K Ozga
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - C Ozden
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - E Tahir
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - D Koehler
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - G Adam
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - J Yamamura
- Departement of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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16
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Lam M, Zhu JW, Maqbool T, Adam G, Tadrous M, Rochon P, Drucker AM. Inclusion of Older Adults in Randomized Clinical Trials for Systemic Medications for Atopic Dermatitis. JAMA Dermatol 2020; 156:1240. [DOI: 10.1001/jamadermatol.2020.2940] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Megan Lam
- Michael G. DeGroote School of Medicine, Faculty of Medicine, Hamilton, Ontario, Canada
| | - Jie Wei Zhu
- Michael G. DeGroote School of Medicine, Faculty of Medicine, Hamilton, Ontario, Canada
| | - Talha Maqbool
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island
| | - Mina Tadrous
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Paula Rochon
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Aaron M. Drucker
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Division of Dermatology, University of Toronto, Ontario, Canada
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17
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Maas KJ, Warncke M, Behzadi C, Welsch GH, Schoen G, Kaul MG, Adam G, Bannas P, Henes FO. Correlation of T2* relaxation times of the retropatellar cartilage with tibial tuberosity-trochlea groove distance in professional soccer players. Sci Rep 2020; 10:15355. [PMID: 32948810 PMCID: PMC7501245 DOI: 10.1038/s41598-020-72299-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/26/2020] [Accepted: 08/26/2020] [Indexed: 12/14/2022] Open
Abstract
The tibial tuberosity–trochlear groove (TT–TG) distance is a radiographic measurement that is used to quantify malalignment of the patellofemoral joint (PFJ) in cross-sectional imaging. There is an ongoing debate about the impact of the TT–TG-distance on lateral patellar instability and the initiating of cartilage degeneration. In this prospective study, the association of T2* relaxation times and TT–TG distances in professional soccer players was analyzed. 36 knees of 18 professional soccer players (age: 21 ± 2.8 years) were evaluated. Participants underwent knee MRI at 3 T. For qualitative image analysis, fat-saturated 2D PD-weighted Fast Spin Echo (FSE) and T1-weighted FSE sequences were used. For quantitative analysis, T2* measurements in 3D data acquisitions were performed. In a qualitative analysis there was no structural cartilage damage and no abnormalities of the patellar and trochlea shape. The highest T2* values (26.7 ± 5.9 ms) were observed in the central compartment of the patella. The mean TT–TG distance was 10 ± 4 mm (range 3–20 mm). There was no significant correlation between TT–TG distance and T2* relaxation times in all three compartments of the retropatellar cartilage. Our study shows that so long as patellar and trochlear morphology is normal, TT–TG distance alone does not affect the tissue structure of the retropatellar cartilage in professional soccer players.
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Affiliation(s)
- Kai-Jonathan Maas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - M Warncke
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - C Behzadi
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - G H Welsch
- UKE Athleticum-Center for Athletic Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - G Schoen
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - M G Kaul
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - P Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - F O Henes
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Grimes CL, Balk EM, Dieter AA, Singh R, Wieslander CK, Jeppson PC, Aschkenazi SO, Kim JH, Truong MD, Gupta AS, Keltz JG, Hobson DT, Sheyn D, Petruska SE, Adam G, Meriwether KV. Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews. Int J Gynaecol Obstet 2020. [PMCID: PMC9087699 DOI: 10.1002/ijgo.13276] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background COVID‐19 has impacted delivery of outpatient gynecology and shifted care toward use of telemedicine. Objective To rapidly review literature and society guidelines and create expert consensus to provide guidance regarding management of outpatient gynecology scenarios via telemedicine. Search strategy Searches were conducted in Medline and Cochrane databases from inception through April 15, 2020. Selection criteria Literature searches were conducted for articles on telemedicine and abnormal uterine bleeding, chronic pelvic pain, endometriosis, vaginitis, and postoperative care. Searches were restricted to available English language publications. Data collection and analysis Expedited literature review methodology was followed and 10 943 citations were single‐screened. Full‐text articles and relevant guidelines were reviewed and narrative summaries developed. Main results Fifty‐one studies on the use of telemedicine in gynecology were found. Findings were reported for these studies and combined with society guidelines and expert consensus on four topics (abnormal uterine bleeding, chronic pelvic pain and endometriosis, vaginal discharge, and postoperative care). Conclusions Guidance for treating gynecological conditions via telemedicine based on expedited literature review, review of society recommendations, and expert consensus is presented. Due to minimal evidence surrounding telemedicine and gynecology, a final consensus document is presented here that can be efficiently used in a clinical setting. Guidance for gynecologists using telemedicine during COVID‐19 based on rapid literature review, review of society recommendations, and expert consensus in accessible format.
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Affiliation(s)
- Cara L. Grimes
- Division of Female Pelvic Medicine and Reconstructive Surgery Departments of Obstetrics and Gynecology and Urology New York Medical College Valhalla NY USA
| | - Ethan M. Balk
- Center for Evidence Synthesis in Health Brown School of Public Health Brown University Providence RI USA
| | - Alexis A. Dieter
- Division of Urogynecology and Reconstructive Pelvic Surgery Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Ruchira Singh
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of Florida Jacksonville FL USA
| | - Cecilia K. Wieslander
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Peter C. Jeppson
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of New Mexico Albuquerque NM USA
| | - Sarit O. Aschkenazi
- Prohealth Women Services Division of Urogynecology Department of Obstetrics and Gynecology Waukesha Memorial Hospital Medical College of Wisconsin Waukesha WI USA
| | - Jin Hee Kim
- Division of Gynecologic Specialty Surgery Department of Obstetrics and Gynecology Columbia University Medical Center New York NY USA
| | - Mireille D. Truong
- Division of Minimally Invasive Gynecologic Surgery Department of Obstetrics and Gynecology Cedars‐Sinai Medical Center Los Angeles CA USA
| | - Ankita S. Gupta
- Department of Obstetrics & Gynecology University of Louisville Louisville KY USA
| | - Julia G. Keltz
- Department of Obstetrics and Gynecology New York Medical College Valhalla NY USA
| | - Deslyn T.G. Hobson
- Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA
| | - David Sheyn
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology MetroHealth Medical Center Cleveland OH USA
| | - Sara E. Petruska
- Department of Obstetrics & Gynecology University of Louisville Louisville KY USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health Brown School of Public Health Brown University Providence RI USA
| | - Kate V. Meriwether
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of New Mexico Albuquerque NM USA
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Salamon J, Dieckhoff J, Kaul MG, Jung C, Adam G, Möddel M, Knopp T, Draack S, Ludwig F, Ittrich H. Visualization of spatial and temporal temperature distributions with magnetic particle imaging for liver tumor ablation therapy. Sci Rep 2020; 10:7480. [PMID: 32366912 PMCID: PMC7198551 DOI: 10.1038/s41598-020-64280-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 07/16/2018] [Accepted: 04/09/2020] [Indexed: 11/09/2022] Open
Abstract
Temperature-resolved magnetic particle imaging (MPI) represents a promising tool for medical imaging applications. In this study an approach based on a single calibration measurement was applied for highlighting the potential of MPI for monitoring of temperatures during thermal ablation of liver tumors. For this purpose, liver tissue and liver tumor phantoms embedding different superparamagnetic iron oxide nanoparticles (SPION) were prepared, locally heated up to 70 °C and recorded with MPI. Optimal temperature MPI SPIONs and a corresponding linear model for temperature calculation were determined. The temporal and spatial temperature distributions were compared with infrared (IR) camera results yielding quantitative agreements with a mean absolute deviation of 1 °C despite mismatches in boundary areas.
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Affiliation(s)
- J Salamon
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | - J Dieckhoff
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - M G Kaul
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - C Jung
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - G Adam
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - M Möddel
- Section for Biomedical Imaging, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.,Institute for Biomedical Imaging, Hamburg University of Technology, 21073, Hamburg, Germany
| | - T Knopp
- Section for Biomedical Imaging, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.,Institute for Biomedical Imaging, Hamburg University of Technology, 21073, Hamburg, Germany
| | - S Draack
- Institute of Electrical Measurement Science and Fundamental Electrical Engineering, TU Braunschweig, 38106, Braunschweig, Germany
| | - F Ludwig
- Institute of Electrical Measurement Science and Fundamental Electrical Engineering, TU Braunschweig, 38106, Braunschweig, Germany
| | - H Ittrich
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
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20
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Grimes CL, Balk EM, Crisp CC, Antosh DD, Murphy M, Halder GE, Jeppson PC, Weber LeBrun EE, Raman S, Kim-Fine S, Iglesia C, Dieter AA, Yurteri-Kaplan L, Adam G, Meriwether KV. A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence. Int Urogynecol J 2020; 31:1063-1089. [PMID: 32342112 PMCID: PMC7185267 DOI: 10.1007/s00192-020-04314-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/17/2022]
Abstract
Introduction and hypothesis The COVID-19 pandemic and the desire to “flatten the curve” of transmission have significantly affected the way providers care for patients. Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) must provide high quality of care through remote access such as telemedicine. No clear guidelines exist on the use of telemedicine in FPMRS. Using expedited literature review methodology, we provide guidance regarding management of common outpatient urogynecology scenarios during the pandemic. Methods We grouped FPMRS conditions into those in which virtual management differs from direct in-person visits and conditions in which treatment would emphasize behavioral and conservative counseling but not deviate from current management paradigms. We conducted expedited literature review on four topics (telemedicine in FPMRS, pessary management, urinary tract infections, urinary retention) and addressed four other topics (urinary incontinence, prolapse, fecal incontinence, defecatory dysfunction) based on existing systematic reviews and guidelines. We further compiled expert consensus regarding management of FPMRS patients in the virtual setting, scenarios when in-person visits are necessary, symptoms that should alert providers, and specific considerations for FPMRS patients with suspected or confirmed COVID-19. Results Behavioral, medical, and conservative management will be valuable as first-line virtual treatments. Certain situations will require different treatments in the virtual setting while others will require an in-person visit despite the risks of COVID-19 transmission. Conclusions We have presented guidance for treating FPMRS conditions via telemedicine based on rapid literature review and expert consensus and presented it in a format that can be actively referenced.
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Affiliation(s)
- Cara L Grimes
- Departments of Obstetrics and Gynecology and Urology, New York Medical College, 19 Bradhurst Avenue, Suite 2700 South Hawthorne, Valhalla, NY, 10532, USA.
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Catrina C Crisp
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, TriHealth, Cincinnati, OH, USA
| | - Danielle D Antosh
- Department of Obstetrics and Gynecology, Division of Urogynecology, Houston Methodist Hospital, Houston, TX, USA
| | - Miles Murphy
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Gabriela E Halder
- Department of Women's Health, Dell Medical School, University of Texas Austin, Austin, TX, USA
| | - Peter C Jeppson
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA
| | - Emily E Weber LeBrun
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA
| | - Sonali Raman
- Department of Women's Health, Female Pelvic Medicine and Reconstructive Surgery, St. Elizabeth Healthcare, Fort Thomas, KY, USA
| | - Shunaha Kim-Fine
- Section of Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Iglesia
- Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA
| | - Alexis A Dieter
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ladin Yurteri-Kaplan
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Kate V Meriwether
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM, USA
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21
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Phan J, Bagley A, Adam G, Frank S, Gunn G, Rosenthal D, Reddy J, Fuller C, Morrison W, Shah S, Moreno A, Ferrarotto R, Sturgis E, Gross N. Reirradiation with SBRT, IMRT and Proton Therapy for Recurrent Oropharynx Squamous Cell Carcinoma: Efficacy and Toxicity Outcomes. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.211] [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: 10/24/2022]
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22
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Adam G, Darcourt J, Roques M, Ferrier M, Gramada R, Meluchova Z, Patsoura S, Viguier A, Cognard C, Larrue V, Bonneville F. Standard Diffusion-Weighted Imaging in the Brain Can Detect Cervical Internal Carotid Artery Dissections. AJNR Am J Neuroradiol 2020; 41:318-322. [PMID: 31948949 DOI: 10.3174/ajnr.a6383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The ICA is the most common site of cervical artery dissection. Prompt and reliable identification of the mural hematoma is warranted when a dissection is clinically suspected. The purpose of this study was to assess to capacity of a standard DWI sequence acquired routinely on the brain to detect dissecting hematoma related to cervical ICA dissections. MATERIALS AND METHODS This was a retrospective study of a cohort of 110 patients younger than 55 years of age (40 women; mean age, 46.79 years) admitted at the acute phase of a neurologic deficit, headache, or neck pain and investigated by at least a standard 3T diffusion-weighted sequence of the brain. Among them were 50 patients (14 women; mean age, 46.72 years) with subsequently confirmed ICA dissection. In the whole anonymized cohort, both a senior and junior radiologist separately assessed, on the DWI sequences only, the presence of a crescent-shaped or circular hypersignal projecting on the subpetrosal segment of the ICA arteries, assuming that it would correspond to a mural hematoma related to an ICA dissection. RESULTS The senior radiologist found 46 subpetrosal hyperintensities in 43/50 patients with ICA dissection and none in patients without dissection (sensitivity, 86%; specificity, 100%). The junior radiologist found 48 subpetrosal hyperintensities in 45/50 patients with dissection and none in patients without dissection (sensitivity, 90%; specificity, 100%). CONCLUSIONS In our cohort, a standard DWI sequence performed on the brain at the acute phase of a stroke or for a clinical suspicion of dissection detected nearly 90% of cervical ICA dissections.
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Affiliation(s)
- G Adam
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - J Darcourt
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - M Roques
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - M Ferrier
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - R Gramada
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - Z Meluchova
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - S Patsoura
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - A Viguier
- Neurology (A.V., V.L.), Centre Hospitalier Universitaire Toulouse, Pierre-Paul Riquet Hospital, Toulouse, France
| | - C Cognard
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
| | - V Larrue
- Neurology (A.V., V.L.), Centre Hospitalier Universitaire Toulouse, Pierre-Paul Riquet Hospital, Toulouse, France
| | - F Bonneville
- From the Departments of Diagnostic and Therapeutic Neuroradiology (G.A., J.D., M.R., M.F., R.G., Z.M., S.P., C.C., F.B.)
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Petersen J, Lenz A, Adam G, Reichenspurner H, Bannas P, Girdauskas E. Changes of Wall Shear Stress after Congenital Aortic Valve Repair Measured by 4D Flow Cardiovascular Magnetic Resonance Imaging. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Howell B, Shipe W, Adam G, Quan S, Li L, Sim C, Dunham R, Margolis D, Henry B, Hazuda D. Evaluation of IAP/SMAC mimetics as latency reversal agents in primary cells and cytokine induction in in vivo models predictive of cytokine release. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30079-0] [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: 11/30/2022] Open
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25
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Molwitz I, Ittrich H, Knopp T, Mummert T, Salamon J, Jung C, Adam G, Kaul MG. First magnetic particle imaging angiography in human-sized organs by employing a multimodal ex vivo pig kidney perfusion system. Physiol Meas 2019; 40:105002. [PMID: 31519009 DOI: 10.1088/1361-6579/ab4436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Magnetic particle imaging (MPI) is a new, fast 3D imaging technique, which is considered promising for angiographies. As available MPI scanners suffer from restricted spatial resolution and are mostly constructed for small animal imaging, no vessels within one organ have been depicted by MPI, yet. The purpose of this study was to develop an ex vivo organ perfusion system to display vessels within one organ of human size by MPI and to compare the results to an established 3D imaging technique. APPROACH An ex vivo porcine kidney perfusion system compatible with digital subtraction angiography (DSA), magnetic resonance tomography and MPI was developed. DSA was used to exemplarily prove intact vessel structures under ex vivo perfusion in two organs. Perfusion in nine organs was displayed by the 3D imaging techniques magnetic resonance angiography (MRA) and MPI angiography. All visible vessels in MRA and MPI were counted and their number compared between both techniques. MAIN RESULTS The ex vivo organ perfusion system allowed us to perform angiographies by DSA, MRA and MPI. With it, organs of human size could be imaged in small animal scanners, which permitted us to depict vessels within one organ by MPI for the first time. In comparison to MRA, 33% of all vessels were visible in MPI, a difference probably caused by restricted spatial resolution in MPI. SIGNIFICANCE The presented ex vivo organ perfusion system can serve to practically evaluate MPI's potential for angiography in human-sized organs. This is especially relevant as long as available, for angiography-suited MPI scanners still suffer from size and spatial resolution restrictions.
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Affiliation(s)
- I Molwitz
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lorenzen J, Schenzer-Hoffmann E, Braun C, Lorenzen M, Anders S, Adam G, Püschel K. Todesursachenbestimmung mit verblindeter koronaler Ganzkörper-MRT im Vergleich zur rechtsmedizinischen Untersuchung. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-0329-z] [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: 10/26/2022]
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Tavares de Sousa M, Hecher K, Yamamura J, Kording F, Ruprecht C, Fehrs K, Behzadi C, Adam G, Schoennagel BP. Dynamic fetal cardiac magnetic resonance imaging in four-chamber view using Doppler ultrasound gating in normal fetal heart and in congenital heart disease: comparison with fetal echocardiography. Ultrasound Obstet Gynecol 2019; 53:669-675. [PMID: 30381848 DOI: 10.1002/uog.20167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To investigate the diagnostic performance of dynamic fetal cardiac magnetic resonance imaging (MRI), using a MR-compatible Doppler ultrasound (DUS) device for fetal cardiac gating, in differentiating fetuses with congenital heart disease from those with a normal heart, and to compare the technique with fetal echocardiography. METHODS This was a prospective study of eight fetuses with a normal heart and four with congenital heart disease (CHD), at a median of 34 (range, 28-36) weeks' gestation. Dynamic fetal cardiac MRI was performed using a DUS device for direct cardiac gating. The four-chamber view was evaluated according to qualitative findings. Measurements of the length of the left and right ventricles, diameter of the tricuspid and mitral valves, myocardial wall thickness, transverse cardiac diameter and left ventricular planimetry were performed. Fetal echocardiography and postnatal diagnoses were considered the reference standards. RESULTS Direct cardiac gating allowed continuous triggering of the fetal heart, showing high temporal and spatial resolution. Both fetal cardiac MRI and echocardiography in the four-chamber view detected pathological findings in three of the 12 fetuses. Qualitative evaluation revealed overall consistency between echocardiography and MRI. On both echocardiography and MRI, quantitative measurements revealed significant differences between fetuses with a normal heart and those with CHD with respect to the length of the right (P < 0.01 for both) and left (P < 0.01 for both) ventricles and transverse cardiac diameter (P < 0.05 and P < 0.01, respectively). Tricuspid valve diameter on cardiac MRI was found to be significantly different in healthy fetuses from in those with CHD (P < 0.05). CONCLUSIONS For the first time, this study has shown that dynamic fetal cardiac MRI in the four-chamber view, using external cardiac gating, allows evaluation of cardiac anatomy and diagnosis of congenital heart disease in agreement with fetal echocardiography. Dynamic fetal cardiac MRI may be useful as a second-line investigation if conditions for fetal echocardiography are unfavorable. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M Tavares de Sousa
- University Medical Center Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg, Germany
| | - K Hecher
- University Medical Center Hamburg-Eppendorf, Department of Obstetrics and Fetal Medicine, Hamburg, Germany
| | - J Yamamura
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - F Kording
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - C Ruprecht
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - K Fehrs
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - C Behzadi
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - G Adam
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - B P Schoennagel
- University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
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Nguyen N, Varga E, Maragos C, Baumgartner S, Adam G, Berthiller F. Cross-reactivity of commercial and non-commercial deoxynivalenol-antibodies to emerging trichothecenes and common deoxynivalenol-derivatives. WORLD MYCOTOXIN J 2019. [DOI: 10.3920/wmj2018.2363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Immunoassay based techniques are an important and fast option for the detection and quantification of mycotoxins. They are frequently used as on-site screening tools in grain elevators, storage and production facilities. However, accurate quantification may be hampered by the co-recognition of structurally related metabolites by the used antibodies. Therefore, it is crucial to assess their cross-reactivity to avoid misinterpretation of the results. Several immunoassays for the determination of deoxynivalenol (DON) are commercially available. Recently, novel trichothecene mycotoxins with structures similar to DON, the NX-toxins (NX-2, NX-3 and NX-4), were discovered, which can potentially co-occur with DON in cereals. So far, no data about the cross-reactivity of those toxins with DON-antibodies are available. The aim of this study was to assess the cross-reactivities of NX-toxins and some other DON-related metabolites with DON-antibodies in buffer solutions. Six commercially available enzyme-linked immunosorbent assays (ELISAs) and two previously developed DON-antibodies (Mab#1 and Mab#22) were tested. Cross-reactivity with NX-metabolites was not observed for any of the ELISA-kits nor Mab#22, whereas Mab#1 reacted moderately against NX-3 and NX-4 (cross-reactivity based on a molar basis of 14 and 30%, respectively). Modifications at position C-3 (3-acetyl-DON and DON-3-glucoside) led to moderate or high cross-reactivity with Mab#22 and the commercial ELISA-kits, whereas these compounds were not recognised by Mab#1. Similar to NX-metabolites, 15-acetyl-DON interacted only weakly with Mab#22 and the commercial ELISA-kits, but strongly with Mab#1. The results demonstrate the importance of proper antibody characterisation. If NX-metabolites prove to be widely distributed and reach significant levels, the development of specific antibodies targeting these novel metabolites might become necessary.
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Affiliation(s)
- N.T. Nguyen
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences, Vienna, (BOKU), Konrad Lorenz Str. 24, 3430 Tulln, Austria
| | - E. Varga
- Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, BOKU, Konrad Lorenz Str. 20, 3430 Tulln, Austria
| | - C. Maragos
- Mycotoxin Prevention and Applied Microbiology Research Unit, USDA, ARS National Center for Agricultural Utilization Research, 1815 N. University St., Peoria, IL 61604, USA
| | - S. Baumgartner
- Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, BOKU, Konrad Lorenz Str. 20, 3430 Tulln, Austria
| | - G. Adam
- Department of Applied Genetics and Cell Biology, University of Natural Resources and Life Sciences, Vienna, (BOKU), Konrad Lorenz Str. 24, 3430 Tulln, Austria
| | - F. Berthiller
- Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, BOKU, Konrad Lorenz Str. 20, 3430 Tulln, Austria
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Bohnen S, Radunski UK, Lund GK, Ojeda F, Looft Y, Senel M, Radziwolek L, Avanesov M, Tahir E, Stehning C, Schnackenburg B, Adam G, Blankenberg S, Muellerleile K. Tissue characterization by T1 and T2 mapping cardiovascular magnetic resonance imaging to monitor myocardial inflammation in healing myocarditis. Eur Heart J Cardiovasc Imaging 2018; 18:744-751. [PMID: 28329275 DOI: 10.1093/ehjci/jex007] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/16/2017] [Indexed: 12/18/2022] Open
Abstract
Aims Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. Methods and Results Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. Conclusion Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR.
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Affiliation(s)
- S Bohnen
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - U K Radunski
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - G K Lund
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - F Ojeda
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - Y Looft
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Senel
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - L Radziwolek
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - M Avanesov
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - E Tahir
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - C Stehning
- Philips GmbH Market DACH, Roentgenstr. 22, 22335 Hamburg
| | | | - G Adam
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg
| | - S Blankenberg
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
| | - K Muellerleile
- Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany
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Stavrou V, Vavougios G, Karetsi E, Adam G, Daniil Z, Gourgoulianis KI. Evaluation of respiratory parameters in finswimmers regarding gender, swimming style and distance. Respir Physiol Neurobiol 2018; 254:30-31. [PMID: 29660484 DOI: 10.1016/j.resp.2018.04.003] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/23/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Abstract
AIM The purpose of our study was to investigate the differences in the finswimmers' physiological characteristics, as far as gender, the swimming style and the different swimming distance are concerned. METHODS 52 finswimmers participated in our study (Age: 17.4 ± 2.1yrs, BMI: 21.8 ± 2.3, body fat: 12.2 ± 4.7%) and were allocated into groups [Gender: Female vs. Male, swimming style: Bifin vs. Surface, and swimming distance: <200 m vs. ≥200 m]. Anthropometric characteristics, handgrip, estimated strength of inspiratory muscles (PImax) and pulmonary function parameters (FEV1, FVC and PEF) were measured. The Independent T-test was used for statistical comparisons between groups. Multivariate analyses were performed via binary logistic regression. RESULTS The results showed differences between groups in gender in PEF (p < 0.05), PImax (p < 0.05) and handgrip (p < 0.001) in swimming style in handgrip (p < 0.05), FEV1 (p < 0.05) and FVC (p < 0.05) and in swimming distance (p < 0.05) in hours/day spent at the gym (p < 0.05) and FVC (p < 0.05). In multivariate analyses handgrip remained an independent predictor of style (OR: 1.154; 95%CI: 1.022-1.303, p = .021), and hours/day spent at the gym was retained as an independent predictor of distance (OR: 131.607; 95%CI: 3.655-4739.441, p = .008). CONCLUSION The data from the present study reveal that handgrip was associated with style, and hours per day spent at the gym were associated with distance.
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Affiliation(s)
- V Stavrou
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, Larissa, Greece.
| | - G Vavougios
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, Athens Naval Hospital, Deinokratous 70, Athens, Greece
| | - E Karetsi
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, Larissa, Greece
| | - G Adam
- School of Physical Education and Sports Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Daniil
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, Larissa, Greece
| | - K I Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, University of Thessaly, Larissa, Greece
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Weinrich JM, Well L, Regier M, Behzadi C, Sehner S, Adam G, Laqmani A. MDCT in suspected lumbar spine fracture: comparison of standard and reduced dose settings using iterative reconstruction. Clin Radiol 2018; 73:675.e9-675.e15. [PMID: 29576224 DOI: 10.1016/j.crad.2018.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/16/2018] [Indexed: 01/16/2023]
Abstract
AIM To compare standard (SD-) and reduced-dose computed tomography (RD-CT) in combination with iterative reconstruction (IR) in emergency patients with suspected lumbar spine fracture. MATERIAL AND METHODS Forty emergency patients with suspected lumbar spinal disorder who underwent RD-CT and 40 body mass index-matched patients undergoing SD-CT were enrolled in this retrospective study. Raw data for RD-CT were reconstructed using two increasing IR levels (IRL) 4 and 6, while SD-CT was reconstructed with IRL3. Two radiologists assessed image quality, image noise, and reader confidence in interpreting findings of spinal fractures in a blinded manner. RESULTS Effective radiation dose was reduced by 50% using RD-CT. Overall subjective image quality (SIQ) was high for both protocols and slightly superior in the RD-CT protocol for both IRL compared to SD-CT. The detection rate of spinal disorders was high for both protocols with a high interobserver agreement. CONCLUSION RD-CT with higher levels of IR results in substantial dose reduction of 50% in lumbar spine CT while maintaining an excellent subjective image quality resulting in a high diagnostic confidence.
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Affiliation(s)
- J M Weinrich
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - L Well
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Regier
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Behzadi
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Laqmani
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Busch JD, Schröder H, Sellenschloh K, Adam G, Ittrich H, Huber G. Test method for mechanical properties of implantable catheters according to DIN 10555-3. J Mech Behav Biomed Mater 2018; 82:183-186. [PMID: 29605811 DOI: 10.1016/j.jmbbm.2018.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
To enable causal analysis of port catheter failure, this study aimed to develop an experimental setup for uniaxial tensile tests that addresses the specific requirements of highly elastic medical catheters; and to quantify parameters of the catheters' mechanical competence with respect to effects of artificial aging. Segments of 6F-polyurethane catheters were tested in their native status, after chemical and after mechanical aging. Tension experiments were performed with a rate of 220 mm/min until catheter failure. Material behavior was analyzed based on load cell measurements of the universal test system and an additional optical distance registration. The Young's modulus, the ultimate stress and the ultimate strain were determined. Chemical aging significantly decreased Young's modulus (84%; p = 0.001) and ultimate stress (83%; p < 0.001), whereas mechanical aged samples demonstrated similar results for the Young's modulus (p = 0.772) and a non-significant rise of ultimate stress (13%; p = 0.128). Ultimate strain did not differ significantly regardless of the pretreatment. The results proof reliability, reproducibility and sensitivity to quantify artificial aging induced variations and also promise to detect deviations in material features caused by long-term clinical usage of catheters.
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Affiliation(s)
- J D Busch
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
| | - H Schröder
- Institute of Biomechanics, Otto-von-Guericke University of Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - K Sellenschloh
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestraße 15, 21073 Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - H Ittrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - G Huber
- Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestraße 15, 21073 Hamburg, Germany
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Keller S, Venkatesh SK, Avanesov M, Weinrich JM, Zenouzi R, Schramm C, Adam G, Yamamura J. Gadolinium-based relative contrast enhancement in primary sclerosing cholangitis: additional benefit for clinicians? Clin Radiol 2018; 73:677.e1-677.e6. [PMID: 29576223 DOI: 10.1016/j.crad.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 02/13/2018] [Indexed: 02/06/2023]
Abstract
AIM To evaluate the benefit of extracellular gadolinium-based contrast agent (GBCA) enhanced magnetic resonance imaging (MRI) in addition to conventional non-enhanced T2-weighted imaging (WI) for quantification of inflammatory or fibrotic alterations in the liver parenchyma of patients with primary sclerosing cholangitis (PSC). MATERIAL AND METHODS MRI (3 T) examinations were reviewed retrospectively by two radiologists in 27 PSC patients (age 42.9±15.6 years), and 19 controls. Regions of interest (ROIs) were drawn onto T2 hyperintense and T2 isointense areas and copied to section position matched non-enhanced and delayed-phase contrast-enhanced T1WI. Signal intensities (SI) obtained from ROIs of the multiphase T1WI were used to calculate relative liver enhancement (RLE). The interobserver agreement of RLE and quantified T2 signal was calculated using Bland-Altman analysis. RLE assessed for both T2 hyperintense (RLEhyper) and T2 isointense (RLEiso) areas were compared in patients and controls (RLEhealthy). RESULTS The interobserver agreement of RLE in affected hyperintense areas (bias -0.77, limits of agreement -51.7 to 50.1) was superior to the quantification of T2 signal only in these areas (bias -3.35, limits of agreement -162.4 to 155.7). The RLEhyper (86.2±9.7%) was higher than the RLEiso (59.8±6.2%, p=0.03) and the RLEhealthy (53.2±2.7%, p=0.002). The mean RLEiso was not significantly different from the RLEhealthy (p=0.3). CONCLUSION The extracellular gadolinium-based RLE of T2 hyperintense areas could be a useful add-on for routine follow up MRI in the detection of early inflammatory changes, possibly preceding formation of fibrotic scarring in PSC patients, if validated in larger cohorts.
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Affiliation(s)
- S Keller
- University Medical Center Hamburg-Eppendorf (UKE), Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - S K Venkatesh
- Department of Radiology, Mayo Clinic Rochester, Rochester, MN, USA
| | - M Avanesov
- University Medical Center Hamburg-Eppendorf (UKE), Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - J M Weinrich
- University Medical Center Hamburg-Eppendorf (UKE), Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - R Zenouzi
- University Medical Center Hamburg-Eppendorf (UKE), Department of Internal Medicine, Hamburg, Germany
| | - C Schramm
- University Medical Center Hamburg-Eppendorf (UKE), Department of Internal Medicine, Hamburg, Germany
| | - G Adam
- University Medical Center Hamburg-Eppendorf (UKE), Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany
| | - J Yamamura
- University Medical Center Hamburg-Eppendorf (UKE), Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Hamburg, Germany.
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Kording F, Ruprecht C, Schoennagel B, Fehrs K, Yamamura J, Adam G, Goebel J, Nassenstein K, Maderwald S, Quick H, Kraff O. Doppler ultrasound triggering for cardiac MRI at 7T. Magn Reson Med 2017; 80:239-247. [DOI: 10.1002/mrm.27032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/09/2017] [Accepted: 11/13/2017] [Indexed: 01/31/2023]
Affiliation(s)
- F. Kording
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - C. Ruprecht
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - B. Schoennagel
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - K. Fehrs
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - J. Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - G. Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - J. Goebel
- Erwin L. Hahn Institute for Magnetic Resonance Imaging; University Duisburg-Essen; Essen Germany
- Department of Diagnostic and Interventional Radiology and Neuroradiology; University Hospital, University Duisburg-Essen; Essen Germany
| | - K. Nassenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology; University Hospital, University Duisburg-Essen; Essen Germany
| | - S. Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging; University Duisburg-Essen; Essen Germany
| | - H.H. Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging; University Duisburg-Essen; Essen Germany
- High Field and Hybrid MR Imaging; University Hospital, University Duisburg-Essen; Essen Germany
| | - O. Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging; University Duisburg-Essen; Essen Germany
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Spink C, Avanesov M, Schmidt T, Grass M, Schoen G, Adam G, Koops A, Ittrich H, Bannas P. Noise reduction angiographic imaging technology reduces radiation dose during bronchial artery embolization. Eur J Radiol 2017; 97:115-118. [PMID: 29153361 DOI: 10.1016/j.ejrad.2017.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/25/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Comparison of radiation doses in patients undergoing angiographic bronchial artery embolization (BAE) before and after a noise reduction imaging technology upgrade. METHODS We performed a retrospective study of 70 patients undergoing BAE. Procedures were performed before (n=32) and after (n=38) the technology upgrade containing additional filters and improved image-processing. Cumulative air kerma (AK), cumulative dose area product (DAP), number of exposure frames, total fluoroscopy time and amount of contrast agent were recorded. Mean values were calculated and compared using two-tailed t-tests. DSA image quality was assessed independently by two blinded readers and compared using the Wilcoxon signed-rank test. RESULTS Using the new technology resulted in a significant reduction of 59% in DAP (149.2 (103.1-279.1) vs. 54.8 (38.2-100.7) Gy*cm2, p<0.001) and a significant reduction of 60% for AK (1.3 (0.6-1.9) vs. 0.5 (0.3-0.9) Gy, p<0.001) in comparison to procedures before the upgrade. There was no significant difference between the number of exposure frames in both groups (251±181 vs. 254±133 frames, p=0.07), time of fluoroscopy (28.8 (18.5-50.4) vs. 28.1 (23.3-38.7) min, p=0.73), or the amount of contrast agent used (139.5±70.8 vs. 163.1±63.1ml, p=0.11). No significant difference regarding image quality could be detected (3 (2,3) vs. 3 (2-4), p=0.64). CONCLUSIONS The new angiographic noise reduction technology significantly decreases the radiation dose during bronchial artery embolization without compromising image quality or increasing time of fluoroscopy or contrast volume.
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Affiliation(s)
- C Spink
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - M Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Schmidt
- Philips Healthcare, Hamburg, Germany
| | - M Grass
- Philips Healthcare, Hamburg, Germany
| | - G Schoen
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Koops
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Ittrich
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Bannas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jung C, Salamon J, Swargulski P, Kaul M, Hofmann M, Gdaniec N, Adam G, Knopp T, Ittrich H. Multi-patch MPI zur Ganzkörperbildgebung der Maus unter Einsatz eines lang zirkulierenden Blood-Pool-Tracers. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Jung
- Interventionelle und Diagnostische Radiologie, Uniklinik Hamburg Eppendorf, Hamburg
| | - J Salamon
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Uniklinik Hamburg Eppendorf, Hamburg
| | - P Swargulski
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Experimentelle biomedizinische Bildgebung, Uniklinik Hamburg Eppendorf, Hamburg
| | - M Kaul
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Uniklinik Hamburg Eppendorf, Hamburg
| | - M Hofmann
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Experimentelle biomedizinische Bildgebung, Uniklinik Hamburg Eppendorf, Hamburg
| | - N Gdaniec
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Experimentelle biomedizinische Bildgebung, Uniklinik Hamburg Eppendorf, Hamburg
| | - G Adam
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Uniklinik Hamburg Eppendorf, Hamburg
| | - T Knopp
- Interventionelle und Diagnostische Radiologie und Nuklearmedizin, Experimentelle biomedizinische Bildgebung, Uniklinik Hamburg Eppendorf, Hamburg
| | - H Ittrich
- Interventionelle und Diagnostische Radiologie und Nukleramedizin, Uniklinik Hamburg Eppendorf, Hamburg
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Stáreková J, Tahir E, Avanesov M, Patten-Hamel M, Münch J, Weinrich J, Bohnen S, Radunski U, Müllerleile K, Stritzky A, Adam G, Lund G. Inzidenz, Lokalisation und Ausprägung von Myokardvernarbungen bei ambitionierten Triathleten im Kardio-MRT. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Stáreková
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - E Tahir
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Avanesov
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Patten-Hamel
- UHZ, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - J Münch
- UHZ, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - J Weinrich
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - S Bohnen
- UHZ, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - U Radunski
- UHZ, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - K Müllerleile
- UHZ, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - A Stritzky
- UHZ, Allgemeine und interventionelle Kardiologie, Hamburg
| | - G Adam
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Lund
- UKE, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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Sauer M, Strölin P, Salomon G, Budäus L, Adam G, Beyersdorff D. Wert der multiparametrischen Prostata MRT bei Patienten mit Gleason 3+3 Stanzbiopsie unter Active Surveillance oder vor radikaler Prostatektomie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Sauer
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - P Strölin
- Martini Klinik, Universitätsklinikum Hamburg Eppendorf, Hamburg
| | - G Salomon
- Martini Klinik, Universitätsklinikum Hamburg Eppendorf, Hamburg
| | - L Budäus
- Universitätsklinikum Hamburg Eppendorf, Martini Klinik, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - D Beyersdorff
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
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Dieckhoff J, Kaul M, Mummert T, Jung C, Salamon J, Adam G, Knopp T, Ittrich H. Magnetic Particle Imaging von Lebertumoren im Kleintiermodell. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Dieckhoff
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Kaul
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - T Mummert
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - C Jung
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - J Salamon
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - T Knopp
- Universitätsklinikum Hamburg-Eppendorf und Technische Universität Hamburg, Abteilung für experimentelle biomedizinische Bildgebung, Hamburg
| | - H Ittrich
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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40
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Kaul M, Salamon J, Frenzel T, Finsterbusch J, Adam G, Peldschus K. Single-Shot-Diffusionsgewichtete MRT mittels paralleler Bildgebung und 2D-RF-Anregung für die Intravoxel Incoherent Motion (IVIM) Analyse bei 7T im Xenograft-Tumormodell der Maus. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Kaul
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - J Salamon
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - T Frenzel
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Strahlentherapie und Radioonkologie, Hamburg
| | - J Finsterbusch
- Universitätsklinikum Hamburg-Eppendorf, Institut für Systemische Neurowissenschaften, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - K Peldschus
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
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41
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Stoffels M, Herrmann J, Groth M, Berliner C, Klutmann S, Adam G, Regier M. Diffusionsgewichtete MRT und FDG PET-CT in der Diagnostik des mediastinalen Lymphoms bei Kindern: Erlaubt der Apparent-Diffusion-Coefficient (ADC) die Dignitätsbestimmung mediastinaler Raumforderungen? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Stoffels
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - J Herrmann
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Groth
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - C Berliner
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - S Klutmann
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Regier
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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42
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Schriewer L, Bannas P, Koch-Nolte F, Adam G, Kunick V, Fumey W, Schütze K. CD38 spezifische Nanobodies für die in vivo Bildgebung von Lymphomen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- L Schriewer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - P Bannas
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - F Koch-Nolte
- Universitätsklinikum Hamburg-Eppendorf, Institut für Immunologie, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - V Kunick
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - W Fumey
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - K Schütze
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
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43
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Weinrich J, Roland D, Sauer M, Frank Oliver H, Meywald-Walter K, Adam G, Bannas P. Thorax-Röntgenuntersuchung von Flüchtlingen: eine Notwendigkeit? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Weinrich
- Zentrum für Radiologie und Endoskopie des Universitätsklinikums Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - D Roland
- LungenClinic Großhansdorf, Pneumologie, Hamburg
| | - M Sauer
- Zentrum für Radiologie und Endoskopie des Universitätsklinikums Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - H Frank Oliver
- Zentrum für Radiologie und Endoskopie des Universitätsklinikums Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | | | - G Adam
- Zentrum für Radiologie und Endoskopie des Universitätsklinikums Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - P Bannas
- Zentrum für Radiologie und Endoskopie des Universitätsklinikums Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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44
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Kaul M, Molwitz I, Jung C, Salamon J, Knopp T, Adam G, Ittrich H. Experimentelle ex vivo Flussstudien an Schweinenieren durch eine Multimodale Angiografie unter Verwendung von DSA, MRA und Magnetic Particle Imaging. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Kaul
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - I Molwitz
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - C Jung
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - J Salamon
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - T Knopp
- Universitätsklinikum Hamburg-Eppendorf, Abteilung für Biomedizinische Bildgebung, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
| | - H Ittrich
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Hamburg
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45
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Berliner C, Tienken M, Kobayashi Y, Kirchner U, Klutmann S, Budäus L, Wester H, Mester J, Adam G, Bannas P. Detektionsrate der [68Ga]PSMA I&T PET/CT bei Patienten mit biochemischen Prostatakarzinomrezidiv und Vergleich mit publizierten Detektionsraten von [68Ga]PSMA HBED-CC. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Berliner
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Tienken
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nukleardeizin, Hamburg
| | - Y Kobayashi
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - U Kirchner
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - S Klutmann
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - L Budäus
- Universitätsklinikum Hamburg-Eppendorf, Martini-Klinik, Hamburg
| | - H Wester
- Technische Universität München, Radiochemie und Pharmazeutische Radiochemie, Garching
| | - J Mester
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - P Bannas
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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46
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Sauer M, Weinrich J, Salomon G, Tennstedt P, Adam G, Beyersdorff D. Die präoperative Vorhersagegenauigkeit der multiparametrischen Prostata-MRT in der Detektion der Gefäßnervenbündel-Infiltration mithilfe von PI-RADS Version 2. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Sauer
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - J Weinrich
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Salomon
- Universitätsklinikum Hamburg Eppendorf, Martini Klinik, Hamburg
| | - P Tennstedt
- Universitätsklinikum Hamburg Eppendorf, Martini Klinik, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - D Beyersdorff
- Universitätsklinikum Hamburg Eppendorf, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Hamburg
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47
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Tahir E, Sinn M, Avanesov M, Bohnen S, Müllerleile K, Radunksi U, Stehning C, Säring D, Starekova J, Schnackenburg B, Adam G, Lund G. Quantitatives T1- und T2-Mapping CMR zur Differenzierung von akutem und chronischem Myokardinfarkt. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E Tahir
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - M Sinn
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - M Avanesov
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - S Bohnen
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - K Müllerleile
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | - U Radunksi
- Universitäres Herzzentrum Hamburg, Allgemeine und Interventionelle Kardiologie, Hamburg
| | | | - D Säring
- FH Wedel, Medizinische und Industrielle Bildverarbeitung, Wedel
| | - J Starekova
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | | | - G Adam
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
| | - G Lund
- Universitätsklinikum Eppendorf-Hamburg, Diagnostische und Interventionelle Radiologie, Hamburg
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48
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Schriewer L, Bannas P, Koch-Nolte F, Schütze K, Fumey W, Adam G. Bioluminescence imaging for monitoring therapeutic response of CD38-specific nanobody-Fc fusion proteins in a lymphoma model. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- L Schriewer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - P Bannas
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - F Koch-Nolte
- Universitätsklinikum Hamburg-Eppendorf, Institut für Immunologie, Hamburg
| | - K Schütze
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - W Fumey
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik für interventionelle und diagnostische Radiologie und Nuklearmedizin, Hamburg
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49
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Salamon J, Dieckhoff J, Jung C, Kaul M, Adam G, Knopp T, Ittrich H. Visualisierung des Temperaturverlaufes in einem Lebertumor-Ablationsmodell mittels Magnetic Particle Imaging. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Salamon
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - J Dieckhoff
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - C Jung
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - M Kaul
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - G Adam
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
| | - T Knopp
- Universitätsklinikum Hamburg-Eppendorf und Technische Universität Hamburg, Abteilung für experimentelle biomedizinische Bildgebung, Hamburg
| | - H Ittrich
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Hamburg
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50
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Chakrabarti B, Lastras-Montaño MA, Adam G, Prezioso M, Hoskins B, Payvand M, Madhavan A, Ghofrani A, Theogarajan L, Cheng KT, Strukov DB. A multiply-add engine with monolithically integrated 3D memristor crossbar/CMOS hybrid circuit. Sci Rep 2017; 7:42429. [PMID: 28195239 PMCID: PMC5307953 DOI: 10.1038/srep42429] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 09/30/2016] [Accepted: 01/09/2017] [Indexed: 11/24/2022] Open
Abstract
Silicon (Si) based complementary metal-oxide semiconductor (CMOS) technology has been the driving force of the information-technology revolution. However, scaling of CMOS technology as per Moore’s law has reached a serious bottleneck. Among the emerging technologies memristive devices can be promising for both memory as well as computing applications. Hybrid CMOS/memristor circuits with CMOL (CMOS + “Molecular”) architecture have been proposed to combine the extremely high density of the memristive devices with the robustness of CMOS technology, leading to terabit-scale memory and extremely efficient computing paradigm. In this work, we demonstrate a hybrid 3D CMOL circuit with 2 layers of memristive crossbars monolithically integrated on a pre-fabricated CMOS substrate. The integrated crossbars can be fully operated through the underlying CMOS circuitry. The memristive devices in both layers exhibit analog switching behavior with controlled tunability and stable multi-level operation. We perform dot-product operations with the 2D and 3D memristive crossbars to demonstrate the applicability of such 3D CMOL hybrid circuits as a multiply-add engine. To the best of our knowledge this is the first demonstration of a functional 3D CMOL hybrid circuit.
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Affiliation(s)
- B Chakrabarti
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA
| | - M A Lastras-Montaño
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA
| | - G Adam
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA
| | - M Prezioso
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA
| | - B Hoskins
- Materials Department, University of California, Santa Barbara, CA, 93106, USA
| | | | | | | | | | - K-T Cheng
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA.,School of Engineering, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - D B Strukov
- Electrical and Computer Engineering Department, University of California, Santa Barbara, CA, 93106, USA
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