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Stögbauer F, Beck S, Ourailidis I, Hess J, Poremba C, Lauterbach M, Wollenberg B, Buchberger AMS, Jesinghaus M, Schirmacher P, Stenzinger A, Weichert W, Boxberg M, Budczies J. Correction: Tumour budding-based grading as independent prognostic biomarker in HPV-positive and HPV-negative head and neck cancer. Br J Cancer 2024; 130:511. [PMID: 38191610 PMCID: PMC10844366 DOI: 10.1038/s41416-023-02521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Affiliation(s)
- Fabian Stögbauer
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
| | - Susanne Beck
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Iordanis Ourailidis
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Jochen Hess
- Section Experimental and Translational Head and Neck Oncology, Department of Otolaryngology, Head and Neck Surgery, University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | | | - Maren Lauterbach
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Anna Maria Stefanie Buchberger
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Moritz Jesinghaus
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- Institute of Pathology, University Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Peter Schirmacher
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg Partner Sites, Munich and Heidelberg, Germany
| | - Albrecht Stenzinger
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg Partner Sites, Munich and Heidelberg, Germany
| | - Wilko Weichert
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg Partner Sites, Munich and Heidelberg, Germany
| | - Melanie Boxberg
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany.
- Pathologie München-Nord, 80992, Munich, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg Partner Sites, Munich and Heidelberg, Germany.
| | - Jan Budczies
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg Partner Sites, Munich and Heidelberg, Germany.
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Stögbauer F, Beck S, Ourailidis I, Hess J, Poremba C, Lauterbach M, Wollenberg B, Buchberger AMS, Jesinghaus M, Schirmacher P, Stenzinger A, Weichert W, Boxberg M, Budczies J. Tumour budding-based grading as independent prognostic biomarker in HPV-positive and HPV-negative head and neck cancer. Br J Cancer 2023; 128:2295-2306. [PMID: 37045906 PMCID: PMC10241901 DOI: 10.1038/s41416-023-02240-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The prognostic significance of tumour budding (TB) and minimal cell nest size (MCNS) was shown in human papillomavirus (HPV)-negative head and neck squamous cell carcinomas (HNSCC). However, the optimisation of cutpoints, the prognostic impact in HPV-positive HNSCC, and the comparison with other histopathological grading systems are insufficiently investigated. METHODS TB and MCNS were analysed digitally in 1 and 10 high-power fields (HPF) of 331 HPV-positive and HPV-negative cases from TCGA. Optimising the cutpoints a new cellular dissociation grading (CDG) system was defined and compared to the WHO grading and the Brandwein-Gensler (BG) risk model. RESULTS The two-tiered CDG system based solely on TB yielded optimal prognostic stratification with shortened overall survival for CDG-high cases. Optimal cut-offs were two buds (1 HPF) and six buds (10 HPF), respectively. Analysing MCNS did not add prognostic significance to quantifying TB. CDG was a significant prognostic marker in HPV-negative and HPV-positive tumours and prognostically superior to the WHO and BG systems. High CDG was associated with clinically occult lymph-node metastases. CONCLUSIONS The most comprehensive study of TB in HNSCC so far confirmed its prognostic impact in HPV-negative tumours and for the first time in HPV-positive tumours. Further studies are warranted to evaluate its applicability for therapy guidance in HNSCC.
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Grants
- Speaker’s fees: AstraZeneca, Incyte, Janssen. Advisory Boards: BMS, MSD, AstraZeneca, Roche. Funding for research: Roche, Chugai, BMS, Novartis.
- Advisory Board/Speaker’s Bureau: Astra Zeneca, AGCT, Bayer, BMS, Eli Lilly, Illumina, Janssen, MSD, Novartis, Pfizer, Roche, Seattle Genetics, Takeda, Thermo Fisher. Grants: Bayer, BMS, Chugai, Incyte.
- Advisory Boards and speaker’s fees: Roche, MSD, BMS, AstraZeneca, Pfizer, Merck, Lilly, Boehringer, Novartis, Takeda, Bayer, Amgen, Astellas, Eisai, Illumina, Siemens, Agilent, ADC, GSK and Molecular Health. Funding for research: Roche, MSD, BMS and AstraZeneca.
- Deutsche Krebshilfe (German Cancer Aid)
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Affiliation(s)
- Fabian Stögbauer
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
| | - Susanne Beck
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Iordanis Ourailidis
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Jochen Hess
- Section Experimental and Translational Head and Neck Oncology, Department of Otolaryngology, Head and Neck Surgery, University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | | | - Maren Lauterbach
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Anna Maria Stefanie Buchberger
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Klinikum Rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
| | - Moritz Jesinghaus
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- Institute of Pathology, University Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Peter Schirmacher
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Albrecht Stenzinger
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Wilko Weichert
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany
| | - Melanie Boxberg
- Institute of Pathology, School of Medicine, Technical University of Munich (TUM), 81675, Munich, Germany.
- Pathologie München-Nord, 80992, Munich, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany.
| | - Jan Budczies
- University of Heidelberg, Institute of Pathology, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Munich and Heidelberg partner sites, Munich and Heidelberg, Germany.
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Prochaska JH, Göbel S, Keller K, Coldewey M, Ullmann A, Lamparter H, Schulz A, Schinzel H, Bickel C, Lauterbach M, Michal M, Hardt R, Binder H, Espinola-Klein C, Lackner KJ, Ten Cate H, Münzel T, Wild PS. e-Health-based management of patients receiving oral anticoagulation therapy: results from the observational thrombEVAL study. J Thromb Haemost 2017; 15:1375-1385. [PMID: 28457013 DOI: 10.1111/jth.13727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Indexed: 12/13/2022]
Abstract
Essentials e-Health based health care by an expert centre may advance management of oral anticoagulation. Outcome of patients was compared between an e-health based coagulation service and regular care. Patients in the coagulation service cohort experienced a significantly better clinical outcome. Lower risk for adverse events was related to anticoagulation-specific and non-specific outcome. SUMMARY Background Management of oral anticoagulation (OAC) therapy is essential to minimize adverse events in patients receiving vitamin K-antagonists (VKAs). Data on the effect of e-health-based anticoagulation management systems on the clinical outcome of OAC patients are limited. Objectives To compare the clinical outcome of OAC patients managed by an e-health-based coagulation service (CS) with that of patients receiving regular medical care (RMC). Methods The prospective multicenter cohort study thrombEVAL (NCT01809015) comprised 1558 individuals receiving RMC and 760 individuals managed by a CS. Independent study monitoring and adjudication of endpoints by an independent review panel were implemented. Results The primary study endpoint (composite of thromboembolism, clinically relevant bleeding and death) occurred in 15.7 per 100 patient-years (py) with RMC and in 7.0 per 100 py with the CS (rate ratio [RR], 2.3; 95% confidence interval [CI], 1.7-3.1). Rates for major and clinically relevant bleeding were higher with RMC than with the CS: 6.8 vs. 2.6 and 10.1 vs. 3.6 per 100 py, respectively. Thromboembolic events showed an RR of 1.5 (95% CI, 0.8-2.6) comparing RMC with the CS. Hospitalization (RR, 2.6; 95% CI, 2.3-3.0) and all-cause mortality (RR, 4.6; 95% CI, 2.8-7.7) were markedly more frequent with RMC. In Cox regression analysis with adjustment for age, sex, cardiovascular risk factors, comorbidities, treatment characteristics and sociodemographic status, hazard ratios (HR) for the primary endpoint (HR, 2.2; 95% CI, 1.5-3.4), clinically relevant bleeding (HR, 3.1; 95% CI, 1.7-5.5), hospitalization (HR, 2.2; 95% CI, 1.8-2.8) and all-cause mortality (HR, 5.6; 95% CI, 2.9-11.0) favored CS treatment. Conclusions In this study, e-health-based management of OAC therapy was associated with a lower frequency of OAC-specific and non-specific adverse events.
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Affiliation(s)
- J H Prochaska
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
| | - S Göbel
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
| | - K Keller
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - M Coldewey
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - A Ullmann
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Chrestos Concept GmbH, Ratingen, Germany
| | - H Lamparter
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - A Schulz
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - H Schinzel
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - C Bickel
- Department of Medicine I, Federal Armed Forces Central Hospital, Koblenz, Germany
| | - M Lauterbach
- Department of Medicine 3, Barmherzige Brüder Hospital, Trier, Germany
| | - M Michal
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - R Hardt
- Center for General Medicine and Geriatrics, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - H Binder
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - C Espinola-Klein
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - K J Lackner
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - H Ten Cate
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Thrombosis Expertise Center Maastricht, Cardiovascular Research Institute Maastricht and Maastricht University Medical Center, Maastricht, the Netherlands
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
| | - P S Wild
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
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Vosseler M, Abegunewardene N, Hoffmann N, Petersen SE, Becker D, Cleppien D, Kunz P, Kreitner KF, Lauterbach M, Bierbach B, Düber C, Gori T, Munzel T, Schreiber LM, Horstick G. Area at risk and viability after myocardial ischemia and reperfusion can be determined by contrast-enhanced cardiac magnetic resonance imaging. ACTA ACUST UNITED AC 2009; 43:13-23. [PMID: 19365131 DOI: 10.1159/000211716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 01/13/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Clinical differentiation between infarcted and viable myocardium in the ischemic area at risk is controversial. We investigated the potential of contrast-enhanced cardiac magnetic resonance imaging (ceCMRI) in determining the area at risk 24 h after ischemia. METHODS Myocardial ischemia was induced by percutaneous coronary intervention of the left anterior descending coronary artery in pigs. Coronary occlusion time was 30 min in group A, which caused little myocardial infarction and 45 min in group B, which led to irreversible damage. 24 h after reperfusion ceCMRI was performed at 2 and 15 min after administration of gadolinium-diethylenetriamine pentaacetic acid. The area at risk was determined by intravenous injection of Evans blue and myocardial viability by triphenyltetrazolium-chloride staining. RESULTS The signal-intense areas at 2 and 15 min after contrast administration matched the area at risk in groups A and B. Nonviable myocardium in group A was overestimated (14-15%) while good agreement was present in group B. CONCLUSION The area at risk of reperfused ischemic myocardium can be determined by ceCMRI 24 h after coronary recanalization. This type of information might have relevant clinical implications in the treatment and stratification of patients with acute coronary syndrome in particular after surgical interventions.
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Affiliation(s)
- M Vosseler
- 2nd Medical Clinic, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, Mainz, Germany
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von Mach MA, Hermanns-Clausen M, Koch I, Hengstler JG, Lauterbach M, Kaes J, Weilemann LS. Experiences of a Poison Center Network with Renal Insufficiency in Acetaminophen Overdose: An Analysis of 17 Cases. Clin Toxicol (Phila) 2008; 43:31-7. [PMID: 15732444 DOI: 10.1081/clt-44992] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Renal insufficiency is less common than liver failure in acetaminophen overdose but renal tubular damage occurs even in the absence of hepatotoxicity. Data published on this topic are rare consisting mostly of case reports or reports in a small number of patients. Presently, a larger number of patients with renal insufficiency associated with acetaminophen overdose should be analyzed using a multicenter approach. STUDY DESIGN Retrospective analysis of patients with acetaminophen-related nephrotoxicity reported to a poison center network from 1995 to 2003. Renal insufficiency was defined as elevated serum creatinine of more than double of the normal range (>2.4 mg/dL [212 micromol/L]). Patients were classified into 4 groups (A: creatinine 2.4-5.0 mg/dL, B: creatinine>5.0 mg/dL requiring no dialysis, C: creatinine>5.0 mg/dL requiring dialysis, D: creatinine>5.0 mg/dL with fatal outcome). RESULTS Seventeen patients were included (8 female, 9 male, average age 31.7 +/- 21.1 yrs) with 6 patients in group A (B: 7, C: 2, D: 2). In 5 patients renal insufficiency occurred without elevation of liver enzymes. Regarding possible risk factors 5 patients concomitantly ingested nephrotoxic substances, 4 presented with dehydration due to vomiting, 4 with chronic excessive dosing (overdose) of acetaminophen, 3 showed pre-existing renal insufficiency, 2 pre-existing liver disease and 2 died with multiple organ failure. CONCLUSIONS Renal insufficiency in acetaminophen overdose mostly resolved without dialysis and occurred isolated without hepatotoxicity in less than one-third of the investigated patients. Conditions which might play a role as influencing factors for renal complications included concomitant ingestion of nephrotoxic drugs, dehydration, chronic excessive dosing (overdose) of acetaminophen, pre-existing renal or liver disease and multiple organ failure. Renal function should be monitored in acetaminophen overdose particularly in patients showing the latter comorbidity.
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Affiliation(s)
- M A von Mach
- Division of Clinical Toxicology and Poison Center, II. Medical Department, University of Mainz, Mainz, Germany.
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Chen H, Simpson L, Feng W, Liu C, Sarkar A, Grimm J, Lauterbach M. SU-FF-J-11: Defining Picture Archiving and Communication System - Radiation Therapy Extension (PACS-RT) for Progressive Needs for IGRT, 4D CT/PET, TPS and the RT Workflow Management. Med Phys 2007. [DOI: 10.1118/1.2760516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lauterbach M, Horstick G, Plum N, Weilemann L, Münzel T, Kempski O. Occurrence and functional consequences of shunting of the microcirculation after mesenteric ischemia. Crit Care 2007. [PMCID: PMC4095323 DOI: 10.1186/cc5430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lauterbach M, Horstick G, Plum N, Lotz J, Lauterbach E, Weilemann L, Kempski O. Effect of C1-esterase inhibitor treatment on microcirculatory perfusion after superior mesenteric artery ischemia. Crit Care 2007. [PMCID: PMC4095084 DOI: 10.1186/cc5190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yang C, Peng L, Lauterbach M. TU-C-224A-05: Dosimetry Comparison of the Newly Implemented Multi-Criteria Optimization Tool for IMRT Planning. Med Phys 2006. [DOI: 10.1118/1.2241529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Blumenthal PD, Lauterbach M, Sellors JW, Sankaranarayanan R. Training for cervical cancer prevention programs in low-resource settings: Focus on visual inspection with acetic acid and cryotherapy. Int J Gynaecol Obstet 2005; 89 Suppl 2:S30-7. [PMID: 15823264 DOI: 10.1016/j.ijgo.2005.01.012] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The modern approach to cervical cancer prevention, characterized by use of cytology and multiple visits for diagnosis and treatment, has frequently proven challenging and unworkable in low-resource settings. Because of this, the Alliance for Cervical Cancer Prevention (ACCP) has made it a priority to investigate and assess alternative approaches, particularly the use of visual screening methods, such as visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI), for precancer and cancer detection and the use of cryotherapy as a precancer treatment method. As a result of ACCP experience in providing training to nurses and doctors in these techniques, it is now widely agreed that training should be competency based, combining both didactic and hands-on approaches, and should be done in a clinical setting that resembles the service-delivery conditions at the program site. This article reviews ACCP experiences and perceptions about the essentials of training in visual inspection and cryotherapy and presents some lessons learned with regard to training in these techniques in low-resource settings.
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Affiliation(s)
- P D Blumenthal
- JHPIEGO, Baltimore, 1615 Thames Street, Baltimore, MD 21231-3492, USA.
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von Mach MA, Hermanns-Clausen M, Koch I, Hengstler JG, Lauterbach M, Kaes J, Weilemann LS. Experiences of a Poison Center Network with Renal Insufficiency in Acetaminophen Overdose: An Analysis of 17 Cases. Clin Toxicol (Phila) 2005. [DOI: 10.1081/clt-200044992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dittmar T, Ondruschka B, Haupt J, Lauterbach M. Ermittlung des Einflusses von Fettrohstoff und Prozesstechnologie auf die Oxidationsstabilität von Fettsäuremethylester. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200400080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dittmar T, Ondruschka B, Haupt J, Lauterbach M. Verbesserung der Oxidationsstabilität von Fettsäuremethylester mit Antioxidantien– Grenzen des Rancimat-Tests. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200403423] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Haupt J, Dimmig T, Dittmar T, Ondruschka B, Heyn B, Lauterbach M. Herstellung von normgerechtem Biodiesel aus Rapsöl und Altfetten – Verfahrenskonzept. CHEM-ING-TECH 2003. [DOI: 10.1002/cite.200390150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dittmar T, Dimmig T, Ondruschka B, Heyn B, Haupt J, Lauterbach M. Herstellung von Fettsäuremethylestern aus Rapsöl und Altfetten im kontinuierlichen Betrieb. CHEM-ING-TECH 2003. [DOI: 10.1002/cite.200390116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dittmar T, Dimmig T, Ondruschka B, Heyn B, Haupt J, Lauterbach M. Herstellung von Fettsäuremethylestern aus Rapsöl und Altfetten im diskontinuierlichen Betrieb. CHEM-ING-TECH 2003. [DOI: 10.1002/cite.200390115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Von Mach MA, Lauterbach M, Kaes J, Hengstler JG, Weilemann LS. [Deliberate self-poisoning with paracetamol (acetaminophen): an analysis from 1995 to 2002]. Dtsch Med Wochenschr 2003; 128:15-9. [PMID: 12510244 DOI: 10.1055/s-2003-36333] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Paracetamol is frequently used in deliberate self-poisoning resulting in a major risk for the patients due to its dose-dependent hepatotoxicity. In the present study the cases of intoxications consulting our Poison Center should be analysed illustrating recent results and trends. PATIENTS AND METHODS From 38 065 patients (25 098 female, 12447 male, 520 sex unknown, average age 36.8 years) registered during the study period from 1.1.1995 until 31.5.2002 4021 with paracetamol intoxication were analysed with respect to the ingested dose, concomitant substances, the degree of observed symptoms and the length of hospital stay. RESULTS The use of paracetamol in deliberate self-poisoning continuously increased during the study period from 8.9 % in the year 1995 to 12.4 % in 2002. Paracetamol was mainly used from female patients and patients in the age group between 10 and 29 years. 88.6 % of cases were reported to the poison center within the first twelve hours after ingestion. Concomitantly non-steroidal antirheumatics (38.0 %), ethanol (20.6 %) and antibiotics (15.0 %) were ingested. Monointoxications as well as mixed intoxications with paracetamol caused severe intoxications and deaths less frequently as compared to the group of the remainder substances with the degree of symptoms tended to be dose-dependent. In 73.7 % of cases the length of hospital stay did not exceed 3 days. CONCLUSIONS In recent years, an increasing importance of paracetamol in deliberate self-poisoning was determined particularly concerning female and younger patients. The dose of paracetamol and the duration of exposition are crucial for prognosis. With an early antidote therapy hospitalization is usually observed for a few days only. A risk for complications are frequently used concomitant substances requiring a detailed registration.
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Affiliation(s)
- M A Von Mach
- Klinische Toxikologie und Beratungsstelle bei Vergiftungen, II. Medizinische Klinik und Poliklinik, Klinikum der Johannes Gutenberg-Universität Mainz, Germany.
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Siebers J, Keall P, Kim J, Jeraj R, Lauterbach M, Mohan R, Wu Q. Monte Carlo-based deliverable IMRT optimization. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03328-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Horstick G, Kempf T, Lauterbach M, Bhakdi S, Kopacz L, Heimann A, Malzahn M, Horstick M, Meyer J, Kempski O. C1-esterase-inhibitor treatment at early reperfusion of hemorrhagic shock reduces mesentry leukocyte adhesion and rolling. Microcirculation 2001; 8:427-33. [PMID: 11781815 DOI: 10.1038/sj/mn/7800115] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 03/07/2001] [Accepted: 09/05/2001] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Complement activation probably plays a pathogenic role in multiple organ failure in shock. This study evaluates the effects of C1-esterase-inhibitor treatment on leukocyte-endothelial interaction in the mesenteric microcirculation in hemorrhagic shock. METHODS Rats underwent median laparotomy and exteriorization of an ileal loop for intravital microscopy of the mesenteric microcirculation. Volume controlled hemorrhagic shock was provoked by arterial blood withdrawal (2.5 mL/100 g body wt. for 60 minutes) followed by a 4-hour reperfusion period. C1-INH (100 IU/kg body wt. i.v.) or 0.9% NaCl i.v. were administered as a bolus at the beginning of reperfusion. Reperfusion time mimicked a "pre-hospital" phase of 30 minutes followed by a quasi "in-hospital" phase of 3.5 hours. The "in-hospital" phase was initiated by substitution of blood followed by fluid resuscitation with normal saline. RESULTS Application of C1-INH markedly reduced rolling and adherent leukocytes to numbers approaching baseline values. Vmax and shear rate of the mesenteric microcirculation improved in both groups after reperfusion with a trend to higher values in the C1-INH group (n.s. p = 0.08). CONCLUSION C1-INH applied in a bolus dose of 100 IU/kg body wt. i.v. abrogated enhanced leukocyte adhesion and rolling in the mesenteric microcirculation after hemorrhagic shock. Single bolus treatment with a complement inhibitor may provide clinical benefit when applied at an early stage of reperfusion during hemorrhagic shock.
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Affiliation(s)
- G Horstick
- 2nd Medical Clinic, Johannes Gutenberg-University Mainz,
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Horstick G, Lauterbach M, Kempf T, Ossendorf M, Kopacz L, Heimann A, Lehr HA, Bhakdi S, Horstick M, Meyer J, Kempski O. Plasma protein loss during surgery: beneficial effects of albumin substitution. Shock 2001; 16:9-14. [PMID: 11442321 DOI: 10.1097/00024382-200116010-00002] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Plasma protein loss during abdominal surgery is a known phenomenon, but its possible pathophysiological relevance has remained unknown. The present study evaluates the effects of albumin substitution on systemic and local hemodynamics and cellular interactions in the mesenteric microcirculation. Rats underwent median laparotomy and exteriorization of an ileal loop for intravital microscopy of the mesenteric microcirculation. Plasma protein concentrations, systemic and local hemodynamics were recorded during the follow up period, with or without albumin substitution. Depending on the time course of plasma protein loss in control experiments, 80% of the calculated protein loss was infused during the first 2 h of surgery, and the other 20% over the following 5 h of intravital microscopy. The control group received a continuous infusion of normal saline. Plasma protein loss was mainly due to loss of albumin. A significant increase in adherent and rolling leukocytes was observed during the course of mesenteric exteriorization, which was almost entirely reversed by albumin replacement. Albumin substitution led to stabilisation of mean arterial pressure and abdominal blood flow and also attenuated reductions in arterial base excess. Albumin infusions to replace plasma protein loss may be a simple and effective measure to attenuate microcirculatory disturbances and may be of benefit in patients undergoing abdominal surgery.
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Affiliation(s)
- G Horstick
- 2nd Medical Clinic, and Institute for Neurosurgical Pathophysiology, Johannes Gutenberg-University, Mainz, Germany
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Abstract
The requirements and trade-offs between accuracy and speed for radiotherapy dose computations have been discussed for decades. Inverse planning used for intensity-modulated radiotherapy (IMRT) optimization imposes additional demands on dose calculation since it is an iterative process in which dose calculations might be repeated many (10's to 1000's) of times. This work discusses the accuracy and speed issues as related to IMRT dose calculations. A hybrid dose calculation method which accelerates the optimization process is proposed and applied in which a fast-pencil beam (PB) model is used for initial optimization iterations, followed by superposition/convolution (SC) calculations. Optimization dose results are compared for pure PB optimization, pure SC optimization, and PB optimization followed by SC optimization. Plans were evaluated in terms of isodose coverage, dose-volume histograms, and total dose calculation time for five head and neck cases with diverse locations, sizes, and shapes for tumors and critical structures. Patient plans were designed for nine equispaced beams. For one patient, an additional five-beam configuration was tested. We found that gross features of intensity distributions resulting from all schemes were similar, however there were differences in the fine detail. Differences were small between composite dose distributions optimized with PB and SC methods, yet differences in individual beam dose distributions were quite significant. When the SC method was used to compute dose following optimization with PB method, dose differences were reduced significantly both for composite plans and for individual beams. Substantial overall timesavings were observed, allowing IMRT dose planning to become a more interactive activity.
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Affiliation(s)
- J V Siebers
- VA Commonwealth University, P.O. Box 980058, 401 College Street, Richmond, Virginia 23298-0058,
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Horstick G, Kempf T, Lauterbach M, Ossendorf M, Kopacz L, Heimann A, Lehr HA, Bhakdi S, Meyer J, Kempski O. Plastic foil technique attenuates inflammation in mesenteric intravital microscopy. J Surg Res 2000; 94:28-34. [PMID: 11038299 DOI: 10.1006/jsre.2000.5990] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Interpretation of intravital microscopic observations is complicated by the "inflammatory"-type response to the trauma inflicted on the tissue by the surgical preparation. The present study evaluates different experimental conditions for prolonged observations of the mesenteric microcirculation in the rat. METHODS The mesentery was exteriorized through a median laparotomy and subjected to an organ bath or a modified plastic foil technique. Hemodynamic, metabolic, respiratory, and microcirculatory data were analyzed. RESULTS In contrast to the plastic foil technique, which yielded stable baseline values over a 5-h observation period, venular velocity and wall shear rates decreased significantly in the organ bath technique, and leukocyte adhesion to the endothelium was significantly increased. Likewise, abdominal blood flow decreased significantly by 35% and base excess declined (-10.0+/-0.4 mmol/L) in the organ bath, with reduced pco(2) (26.4+/-2.5 mm Hg vs. 33.7+/-1.1 mm Hg in plastic foil technique) due to respiratory pH compensation. CONCLUSIONS The plastic foil technique was found clearly superior to the organ bath technique for maintenance of stable baseline metabolic, hemodynamic, and microcirculatory conditions in mesenteric intravital microscopy.
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Affiliation(s)
- G Horstick
- 2nd Medical Clinic, Institute for Neurosurgical Pathophysiology, Langenbeckstrasse 1, Mainz, 55131, Germany.
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Lauterbach M, Engler E, Muzet N, Troxler L, Wipff G. Migration of Ionophores and Salts through a Water−Chloroform Liquid−Liquid Interface: Molecular Dynamics−Potential of Mean Force Investigations. J Phys Chem B 1998. [DOI: 10.1021/jp972939l] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Lauterbach
- Laboratoire MSM, Institut de Chimie, 4, rue B. Pascal, 67 000 Strasbourg, France
| | - E. Engler
- Laboratoire MSM, Institut de Chimie, 4, rue B. Pascal, 67 000 Strasbourg, France
| | - N. Muzet
- Laboratoire MSM, Institut de Chimie, 4, rue B. Pascal, 67 000 Strasbourg, France
| | - L. Troxler
- Laboratoire MSM, Institut de Chimie, 4, rue B. Pascal, 67 000 Strasbourg, France
| | - G. Wipff
- Laboratoire MSM, Institut de Chimie, 4, rue B. Pascal, 67 000 Strasbourg, France
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Wipff G, Lauterbach M. Complexation of alkali cations by calix[4]crown ionophores: Conformation and solvent dependent Na+/Cs+binding selectivity and extraction: MD simulations in the gas phase, in water and at the chloroform-water interface. Supramol Chem 1995. [DOI: 10.1080/10610279508032535] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lauterbach M, Wipff G. Alkali cation complexes of calix[4]crowns: Conformation and solvent dependent NA+/CS+ binding selectivity. A MD-FEP study. ACTA ACUST UNITED AC 1995. [DOI: 10.1063/1.47724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Appel KE, Görsdorf S, Menden M, Lauterbach M. DNA damage induced by N-nitrosodibenzylamine and N-nitroso-alpha-acetoxybenzyl-benzylamine in mammalian cell systems and in vivo. Toxicol Lett 1990; 52:269-77. [PMID: 2389257 DOI: 10.1016/0378-4274(90)90036-l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
N-nitrosodibenzylamine (NDBzA) and N-nitroso-alpha-acetoxybenzyl-benzylamine (alpha-acetoxy-NDBzA) were tested for induction of DNA single-strand breaks (SSBs) in V 79 Chinese hamster cells (V 79 cells) and isolated rat hepatocytes. The alkaline elution assay was used for the detection of DNA strand breaks. Treatment of V 79 cells with alpha-acetoxy-NDBzA effectively increased the rate of DNA SSBs, while with NDBzA, no DNA-damaging activity was detectable. Both substances produced significant DNA damage in rat hepatocytes. Interestingly, NDBzA was able to induce SSBs at significantly lower concentrations than alpha-acetoxy-NDBzA. The possible reasons for these findings are discussed. In contrast to these in vitro results, NDBzA exhibited very weak in vivo activity.
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Affiliation(s)
- K E Appel
- Max von Pettenkofer Institute, Federal Health Office, Berlin, F.R.G
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Lauterbach M. Energy audits can save dollars. Hosp Top 1986; 64:31-2. [PMID: 10280875 DOI: 10.1080/00185868.1986.9952452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Botzenhart K, Fischer P, Rüden H, Lauterbach M. [Criteria for the hygienic appraisal of intensive care units (author's transl)]. Zentralbl Bakteriol Orig B 1978; 166:314-21. [PMID: 654686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
7 intensiv-care-units (I.U.C.) were compared by analysing the charts of 100 patients from each station. They showed remarkable differences concerning the diagnosis of admittance, age and other factors related to the risk of infection. Consequently, kind and number of intensive care related medical procedures, the use of antibiotics, the duration of the patients stay on the station and the death rate differed widely. Some criteria concerning the layout, personnel, organisation and therapy on I.C.U. are named, which are mainly related to the patients condition and to the thereby given risk of infection.
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Williams W, Johnston J, Lauterbach M. Uterine Luteolytic Hormone Effect on Ovarian Progesterone Content. J Dairy Sci 1967. [DOI: 10.3168/jds.s0022-0302(67)87662-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Williams WF, Johnston JO, Lauterbach M, Fagan B. Luteolytic effect of a bovine uterine powder on the corpora lutea, follicular development, and progesterone synthesis of the pseudo-pregnant rabbit ovary. J Dairy Sci 1967; 50:555-7. [PMID: 6068420 DOI: 10.3168/jds.s0022-0302(67)87464-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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