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Kalbhenn J, Marx O, Müller-Peltzer K, Kunze M, Bürkle H, Bansbach J. [Pregnant women with COVID-19 ARDS on the intensive care unit]. Anaesthesiologie 2024:10.1007/s00101-024-01405-5. [PMID: 38671334 DOI: 10.1007/s00101-024-01405-5] [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] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 02/29/2024] [Accepted: 03/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease progression. Comorbidities, such as chronic arterial hypertension, diabetes mellitus, advanced maternal age and high body mass index, may predispose to severe disease. The management of pregnant COVID-19 patients on the intensive care unit (ICU) is challenging and requires careful consideration of maternal, fetal and ethical issues. OBJECTIVE Description and discussion of intensive care treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory distress syndrome (CARDS). MATERIAL AND METHODS We analyzed the demographic data, maternal medical history, clinical intensive care management, complications, indications and management of extracorporeal membrane oxygenation (ECMO) and infant survival of all pregnant patients treated for severe CARDS in the anesthesiological ICU of a German university hospital between March and November 2021. RESULTS The cohort included 9 patients with a mean age of 30.3 years (range 26-40 years). The gestational age ranged from 21 + 3 weeks to 37 + 2 weeks. None of the patients had been vaccinated against SARS-CoV‑2. Of the nine patients seven were immigrants and communication was hampered by inadequate Central European language skills. Of the patients five had a PaO2/FiO2 index < 150 mm Hg despite escalated invasive ventilation (FiO2 > 0.9 and a positive end-expiratory pressure [PEEP] of 14 mbar) and were therefore treated with repeated prolonged prone positioning maneuvers (5-14 prone positions for 16 h each, a total of 47 prone positioning treatments) and 2 required treatment with inhaled nitric oxide and venovenous ECMO. The most common complications were bacterial superinfection of the lungs, urinary tract infection and delirium. All the women and five neonates survived. All newborns were delivered by cesarean section, two patients were discharged home with an intact pregnancy and two intrauterine fetal deaths were observed. None of the newborns tested positive for SARS-CoV‑2 at birth. CONCLUSION High survival rates are possible in pregnant patients with CARDS. The peripartum management of pregnant women with CARDS requires close interdisciplinary collaboration and should prioritize maternal survival in early pregnancy. In our experience, prolonged prone positioning, an essential evidence-based cornerstone in the treatment of ARDS, can also be safely used in advanced stages of pregnancy. Inhaled nitric oxide (iNO) and ECMO should be considered as life-saving treatment options for carefully selected patients. For cesarean section, neuraxial anesthesia can be safely performed in patients with mild CARDS if well planned but the therapeutic anticoagulation recommended for COVID-19 may increase the risk of bleeding complications, making general anesthesia a more viable alternative, especially in severe disease.
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Affiliation(s)
- J Kalbhenn
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinik Freiburg, Hugstetter Str. 55, Freiburg, Deutschland
| | - O Marx
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinik Freiburg, Hugstetter Str. 55, Freiburg, Deutschland
| | - K Müller-Peltzer
- Klinik für Radiologie, Universitätsklinik Freiburg, Freiburg, Deutschland
| | - M Kunze
- Klinik für Frauenheilkunde, Geburtshilfe und Perinatologie, Universitätsklinik Freiburg, Freiburg, Deutschland
| | - H Bürkle
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinik Freiburg, Hugstetter Str. 55, Freiburg, Deutschland
| | - J Bansbach
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinik Freiburg, Hugstetter Str. 55, Freiburg, Deutschland.
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Wienbeck S, Andrijevska V, Kück F, Perske C, Unterberg-Buchwald C, Fischer U, Lotz J, Kunze M. Comparison between cone-beam breast-CT and full-field digital mammography for microcalcification detection depending on breast density. Medicine (Baltimore) 2023; 102:e33900. [PMID: 37266644 DOI: 10.1097/md.0000000000033900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
The purpose of this study was to evaluate the impact of breast density on the diagnostic performance of cone-beam breast-CT (CBBCT) in comparison to full-field digital mammography (FFDM) for the detection of microcalcifications. This retrospective IRB-approved study was conducted between December 2015 and March 2017 and enrolled 171 women with Breast Imaging Reporting and Data System category 4 or 5 lesions on FFDM and additional CBBCT; 56 of which were ineligible. The inclusion was restricted to 83 women (90 breasts, 90 lesions) with microcalcifications. All lesions underwent histology or were monitored by FFDM and a clinical examination at least 2 years after enrollment. Two breast radiologists independently read each data set twice. Sensitivity, specificity and area under the curve were compared between the modalities. Thirty-two breasts (35.5%) were grouped as non-dense breasts (American College of Radiology types a/b) and 58 breasts (64.5%) as dense breasts (American College of Radiology types c/d). Histopathological assessment was performed in 61 of 90 breast lesions (32 malignant, 1 high-risk and 28 benign). Area under the curve was larger for FFDM than for CBBCT (P = .085). The sensitivity was significantly higher for FFDM compared to CBBCT (P = .009). The specificity showed no significant differences comparing FFDM (both readers: 0.62) versus CBBCT (reader 1: 0.76, reader 2: 0.60; P = .192). Inter-observer-reliability on BI-RADS readings was almost perfect for FFDM and moderate for CBBCT (κ = 0.84, κ = 0.54, respectively). Intra-observer agreement was substantial to almost perfect for both methods and readers. Compared with FFDM, CBBCT demonstrated non-comparable results for microcalcification detection in dense and non-dense breasts.
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Affiliation(s)
- Susanne Wienbeck
- University Medical Center Goettingen, Institute of Diagnostic and Interventional Radiology, Goettingen, Germany
- Radiology Practice Schwarzer Baer MVZ, Hannover, Germany
| | | | - Fabian Kück
- Core Facility Medical Biometry and Statistical Bioinformatics, University of Goettingen, Goettingen, Germany
| | - Christina Perske
- University Medical Center Goettingen, Institute for Pathology, Goettingen, Germany
| | - Christina Unterberg-Buchwald
- University Medical Center Goettingen, Institute of Diagnostic and Interventional Radiology, Goettingen, Germany
- University Medical Center Goettingen, Department of Cardiology and Pneumology, Goettingen, Germany
| | - Uwe Fischer
- Diagnostic Breast Center, Goettingen, Germany
| | - Joachim Lotz
- University Medical Center Goettingen, Institute of Diagnostic and Interventional Radiology, Goettingen, Germany
| | - Meike Kunze
- University Medical Center Goettingen, Institute of Diagnostic and Interventional Radiology, Goettingen, Germany
- Städtisches Klinikum Karlsruhe, Institute for Diagnostic and Interventional Radiology, Karlsruhe, Germany
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Spielberger B, Pfeil J, Assaad K, von Both U, Janda A, Kitz C, Kobbe R, Kunze M, Lindert J, Ritz N, Trapp S, Hufnagel M. Infektiologische Versorgung minderjähriger Flüchtlinge am Beispiel der Ukraine. Monatsschr Kinderheilkd 2022; 170:1103-1112. [PMID: 36188233 PMCID: PMC9510227 DOI: 10.1007/s00112-022-01607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
Hintergrund Bis Anfang Juni 2022 sind ca. 300.000 Kinder und Jugendliche aus der Ukraine im deutschen Ausländerzentralregister registriert worden. Die vorliegenden Handlungsempfehlungen sollen die Grundlage für eine evidenzbasierte und zielgerichtete infektiologische Versorgung minderjähriger Flüchtlinge am Beispiel der Ukraine schaffen. Ziele Die Handlungsempfehlungen sollen medizinisches Personal in der Versorgung minderjähriger Flüchtlinge aus der Ukraine unterstützen, um 1. einen unvollständigen Impfschutz frühzeitig zu erkennen und zu vervollständigen; 2. übliche Infektionskrankheiten zu diagnostizieren und zu behandeln; 3. in Deutschland seltene Infektionskrankheiten frühzeitig zu erkennen und zu therapieren. Material und Methoden Die Handlungsempfehlungen wurden als durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) koordinierte Leitlinie der Stufe 1 verfasst und an die Situation Flucht aus der Ukraine angepasst. Die Empfehlungen wurden durch eine repräsentativ zusammengesetzte Expertengruppe der beteiligten Fachgesellschaften im informellen Konsens erarbeitet und final von den Vorständen der Fachgesellschaften offiziell verabschiedet. Ergebnisse Es werden Empfehlungen für den Umfang der Anamnese und der körperlichen Untersuchung minderjähriger Flüchtlinge, angepasst an die Situation Flucht aus der Ukraine, ausgesprochen. Für alle minderjährigen Flüchtlinge werden die Bestimmung eines Differenzialblutbilds sowie Untersuchungen auf Tuberkulose, Hepatitis B und C sowie eine Human-Immunodeficiency-Virus(HIV)-Infektion empfohlen. Zur raschen Vervollständigung des Impfstatus wird eine alters- und Indikationsbezogene Priorisierung einzelner Impfungen vorgenommen. Diskussion Angesichts anhaltend hoher Flüchtlingszahlen nicht nur aus der Ukraine ist eine weitere Professionalisierung der medizinischen Versorgung minderjähriger Flüchtlinge notwendig. Hierzu sollten die notwendigen strukturellen und personellen Rahmenbedingungen geschaffen werden.
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Affiliation(s)
- B. Spielberger
- Abteilung Pädiatrische Infektiologie und Rheumatologie, Klinik für Allgemeine Pädiatrie und Jugendmedizin, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Mathildenstr. 1, 79106 Freiburg, Deutschland
| | - J. Pfeil
- Praxis für Kinder- und Jugendmedizin, Schwaigern, Deutschland
| | - K. Assaad
- Gesundheitsamt Rhein-Neckar-Kreis, Heidelberg, Deutschland
| | - U. von Both
- Abteilung für Pädiatrische Infektiologie, Dr. von Haunersches Kinderspital, München, Deutschland
| | - A. Janda
- Universitätsklinik für Kinder- und Jugendmedizin, Ulm, Deutschland
| | - C. Kitz
- Praxis für Kinder- und Jugendmedizin, Veitshöchheim, Deutschland
| | - R. Kobbe
- Zentrum für Innere Medizin, Institut für Infektionsforschung und Impfstoffentwicklung, STAKOB, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - M. Kunze
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J. Lindert
- Klinik für Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - N. Ritz
- Kinderspital, Luzerner Kantonsspital, Luzern, Schweiz
| | - S. Trapp
- Praxis für Kinder- und Jugendmedizin, Bremen, Deutschland
| | - M. Hufnagel
- Abteilung Pädiatrische Infektiologie und Rheumatologie, Klinik für Allgemeine Pädiatrie und Jugendmedizin, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Mathildenstr. 1, 79106 Freiburg, Deutschland
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Kunze M, Schäfer B, Andrijevska V, Al Machot F, Fischer U, Lotz J, Wienbeck S. Interpretierbares maschinelles Lernen in der Diagnostik von Verkalkungen in der Brust in der Cone-beam Brust CT und digitalen Vollfeldmammographie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749851] [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)
- M Kunze
- Universitätsmedizin Göttingen, Institut für Diagnostische und Interventionelle Radiologie, Göttingen
| | - B Schäfer
- Faculty of Science and Technology, Norwegian University of Life Sciences, 1432 Ås, Norwegen
| | | | - F Al Machot
- Faculty of Science and Technology, Norwegian University of Life Sciences, 1432 Ås, Norwegen
| | - U Fischer
- Diagnostisches Brustzentrum Göttingen, Göttingen
| | - J Lotz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Göttingen
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Makarevic A, Markfeld-Erol F, Prömpeler H, Kunze M, Juhasz-Böss I. Zwei akute Blutungsereignisse in der Frühschwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718297] [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: 10/23/2022] Open
Affiliation(s)
| | | | - H Prömpeler
- Universitätsfrauenklinik Freiburg, Pränataldiagnostik
| | - M Kunze
- Universitätsfrauenklinik Freiburg
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Meschede J, Bertz H, Kunze M, Juhasz-Böss I, Markfeld-Erol F. Progredientes metastasiertes Colonkarzinom in der Schwangerschaft- eine interdisziplinäre Herausforderung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717951] [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: 10/23/2022] Open
Affiliation(s)
- J Meschede
- Universitätsklinik Freiburg, Frauenklinik
| | - H Bertz
- Universitätsklinik Freiburg, Innere Medizin 1
| | - M Kunze
- Universitätsklinik Freiburg, Frauenklinik
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7
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Medl M, Kunze M, Juhasz-Böss I, Markfeld-Erol F. Management einer großen Ovarialzyste in einer fortgeschrittenen Schwangerschaftswoche. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718298] [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: 10/23/2022] Open
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Snoeck V, Kunze M, Juhasz-Böss I, Markfeld-Erol F. Fulminantes postpartales HELLP-Syndrom. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718319] [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: 10/23/2022] Open
Affiliation(s)
- V Snoeck
- Uniklinik Freiburg, Klinik für Frauenheilkunde
| | - M Kunze
- Uniklinik Freiburg, Klinik für Frauenheilkunde
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Zavala G, González F, Hidalgo C, Kunze M, Khoury M, Acevedo J. Injectable functionalized-gelatin derived from cold-adapted species balances between arthroscopic extrudability prerequisite, chondrocompatibility and biomechanical requirements for precise arthroscopic restoration. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.357] [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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Stavropoulou D, Hentschel R, Rädecke J, Kunze M, Niemeyer C, Uhl M, Grohmann J. Preoperative selective embolization with vascular coiling of giant sacrococcygeal teratoma. J Neonatal Perinatal Med 2020; 12:345-349. [PMID: 30932896 DOI: 10.3233/npm-180066] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Sacrococcygeal teratoma is one of the most common congenital tumors. Its optimal management requires interdisciplinary care by obstetricians, radiologists, pediatric surgeons, and neonatologists. Early surgery entailing complete tumor excision is the main therapy aim, but a substantial risk of life-threatening complications remains, especially uncontrollable intraoperative hemorrhage. To reduce the risk of bleeding in a female neonate with a giant sacrococcygeal teratoma, we successfully coil-embolized the tumor's main feeding arteries. Her subsequent complete surgical resection was uneventful, and the child is well with favorable reconstructive and functional status of all involved and adjacent organ systems.
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Affiliation(s)
- D Stavropoulou
- Department of General Pediatrics, Adolescent Medicine, Division of Neonatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Hentschel
- Department of General Pediatrics, Adolescent Medicine, Division of Neonatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Rädecke
- Department of Pediatric Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Kunze
- Department of Obstetrics and Gynecology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C Niemeyer
- Department of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Uhl
- Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Hagenah HP, Dudenhausen JW, Schild RL, Stein W, Kunze M, Voigt M. Zur Beurteilung der fetalen Gewichtschätzung unter Berücksichtigung von Korrekturwerten für Körperhöhe und Körpergewicht der Mutter und daraus resultierenden Konsequenzen in der täglich klinischen Praxis. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671161] [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: 10/28/2022] Open
Affiliation(s)
- HP Hagenah
- Agaplesion Diakonieklinikum Rotenburg, Frauenklinik, Rotenburg, Deutschland
| | - JW Dudenhausen
- Dept. of Obstetrics and Gynecology, Weill Cornell Medicine, New York, Vereinigte Staaten von Amerika
- Charité Universitätsmedizin, Berlin, Deutschland
| | - RL Schild
- DIAKOVERE Henriettenstift und Friederikenstift, Hannover, Deutschland
| | - W Stein
- Agaplesion Diakonieklinikum Rotenburg, Frauenklinik, Rotenburg, Deutschland
| | - M Kunze
- Universitätsklinikum Freiburg, Frauenklinik, Abt. Geburtshilfe, Freiburg, Deutschland
| | - M Voigt
- Center for Medicine and Society, University of Freiburg, Freiburg, Deutschland
- Medizinische Fakultät der Universität Freiburg, Freiburg, Deutschland
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Winkler K, Contini C, König B, Krumrey B, Pütz G, Zschiedrich S, Pecks U, Stavropoulou D, Prömpeler H, Kunze M, Markfeld-Erol F. Treatment of very preterm preeclampsia via heparin-mediated extracorporeal LDL-precipitation (H.E.L.P.) apheresis: The Freiburg preeclampsia H.E.L.P.-Apheresis study. Pregnancy Hypertens 2018; 12:136-143. [PMID: 29858106 DOI: 10.1016/j.preghy.2018.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/02/2018] [Accepted: 04/11/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Soluble Fms-like tyrosine kinase-1 (sFlt-1) is thought to be causative in the pathogenesis of preeclampsia (PE) and specific removal of sFlt-1 via dextran sulfate cellulose (DSC)-apheresis was suggested as cure to allow prolongation of pregnancy in preterm PE. However, in addition a deranged lipoprotein metabolism may impact endothelial and placental function in PE. Lipoprotein-apheresis by heparin-mediated extracorporeal LDL-precipitation (H.E.L.P.) was previously applied and has been shown to alleviate symptoms in PE. This clinical trial reevaluates the clinical efficacy of H.E.L.P.-apheresis in PE considering sFlt-1. STUDY DESIGN Open pilot study assessing the prolongation by H.E.L.P.-apheresis in 6 women (30-41 years) with very preterm PE (24+4 to 27+0 gestational weeks (GW)) (NCT01967355) compared to a historic control-group matched for GW at admission (<28 GW; n = 6). Clinical outcome of mothers and babies, and pre- and post H.E.L.P.-apheresis levels of sFlt-1 and PlGF were monitored. MAIN OUTCOME MEASURES In apheresis patients (2-6 treatments), average time from admission to birth was 15.0 days (6.3 days in controls; p = 0.027). Lung maturation was induced in all treated cases, and all children were released in healthy condition. Apheresis reduced triglycerides and LDL-cholesterol by more than 40%. Although H.E.L.P.-apheresis induced a transient peak baseline levels did not change and rather stabilized sFlt-1 levels at pre-apheresis levels throughout treatments, with sFlt-1/PLGF ratio remaining unaffected. CONCLUSIONS H.E.L.P.-apheresis proved again to be safe and prolongs pregnancies in PE. However, without changing sFlt-1 levels below baseline lowering lipids or other yet undefined factors appear to be of more relevance than reducing sFlt-1.
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Affiliation(s)
- K Winkler
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Freiburg, Freiburg, Germany.
| | - C Contini
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - B König
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - B Krumrey
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - G Pütz
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - S Zschiedrich
- Renal Division, Department of Medicine, University Hospital Freiburg, Germany
| | - U Pecks
- Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein Campus, Kiel, Germany
| | - D Stavropoulou
- Department of Neonatology, Children's Hospital, University of Freiburg, Germany
| | - H Prömpeler
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Germany
| | - M Kunze
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Germany
| | - F Markfeld-Erol
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Germany
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Kranz J, Schmidt S, Lebert C, Schneidewind L, Vahlensieck W, Sester U, Fünfstück R, Helbig S, Hofmann W, Hummers E, Kunze M, Kniehl E, Naber K, Mandraka F, Mündner-Hensen B, Schmiemann G, Wagenlehner FME. Epidemiologie, Diagnostik, Therapie, Prävention und Management unkomplizierter, bakterieller, ambulant erworbener Harnwegsinfektionen bei erwachsenen Patienten. Urologe A 2017; 56:746-758. [DOI: 10.1007/s00120-017-0389-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Winkler K, Markfeld-Erol F, Kunze M, Christine C, König B, Krumrey B, Pütz G, Zschiedrich S, Pecks U, Hentschel R, Prömpeler H. Verlängerung der Schwangerschaft mittels Heparin-induzierter, extrakorporaler LDL-Präzipitation (H.E.L.P.-Apherese) bei Präeklampsie: Die Freiburg Preeclampsia H.E.L.P.-Apheresis Study. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1600080] [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] Open
Affiliation(s)
- K Winkler
- Universitätsklinikum Freiburg, Institut für Klinische Chemie und Laboratoriumsmedizin, Freiburg, Deutschland
| | - F Markfeld-Erol
- Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Freiburg, Deutschland
| | - M Kunze
- Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Freiburg, Deutschland
| | - C Christine
- Universitätsklinikum Freiburg, Institut für Klinische Chemie und Laboratoriumsmedizin, Freiburg, Deutschland
| | - B König
- Universitätsklinikum Freiburg, Institut für Klinische Chemie und Laboratoriumsmedizin, Freiburg, Deutschland
| | - B Krumrey
- Universitätsklinikum Freiburg, Institut für Klinische Chemie und Laboratoriumsmedizin, Freiburg, Deutschland
| | - G Pütz
- Universitätsklinikum Freiburg, Institut für Klinische Chemie und Laboratoriumsmedizin, Freiburg, Deutschland
| | - S Zschiedrich
- Universitätsklinikum Freiburg, Klinik für Innere Medizin IV, Schwerpunkt Nephrologie und Allgemeinmedizin, Freiburg, Deutschland
| | - U Pecks
- Universitätsklinikum Schleswig-Holstein, Klinik für Gynäkologie und Geburtshilfe, Kiel, Deutschland
| | - R Hentschel
- Universitätsklinikum Freiburg, Klinik für Allgemeine Kinder- und Jugendmedizin, Freiburg, Deutschland
| | - H Prömpeler
- Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Freiburg, Deutschland
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Voigt M, Hentschel R, Kunze M, Nikischin W, Olbertz D, Hagenah HP, Wittwer-Backofen U, Strauss A. Vergleich der Perzentilkurven von Körpermaßen neugeborener Einlinge, Zwillinge und Drillinge. Z Geburtshilfe Neonatol 2017; 221:43-44. [PMID: 28363233 DOI: 10.1055/s-0043-101731] [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 Voigt
- Zentrum für Medizin und Gesellschaft, Universität Freiburg, Freiburg
| | - R Hentschel
- Klinik für Allgemeine Kinder- und Jugendmedizin Funktionsbereich Neonatologie/Intensivmedizin, Universitätsklinikum Freiburg, Freiburg
| | - M Kunze
- Frauenklinik, Abteilung Geburtshilfe, Universität Freiburg, Freiburg
| | - W Nikischin
- Kinderklinik, Abteilung Neonatologie, Universität Kiel, Kiel
| | - D Olbertz
- Abteilung Neonatologie und Neonatologische Intensivmedizin, Klinikum Südstadt, Rostock
| | - H P Hagenah
- Frauenklinik, Abteilung Geburtshilfe, Agaplesion-Klinikum, Rotenburg
| | | | - A Strauss
- Christian-Albrechts-Universität, Kiel
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Hug C, Markfeld-Erol F, Kunze M, Prömpeler H. Schwangerschaft bei dialysepflichtiger schwerer Nierenerkrankung oder nach erfolgreicher Nierentransplantation. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593203] [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: 10/20/2022] Open
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Westermann C, Markfeld-Erol F, Kunze M, Kalbhenn J, Prömpeler H. Maternale Bradykardie unter der Geburt – Die peripartale Kardiomyopathie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593176] [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: 10/20/2022] Open
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18
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Dany N, Markfeld-Erol F, Kunze M, Frankenschmidt A, Stenzel M, Pohl M, Kurz P, Prömpeler H. Rapide wachsendes mesoblastisches Nephrom in der Schwangerschaft. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593273] [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: 10/20/2022] Open
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Huhn EA, Fischer T, Göbl CS, Todesco Bernasconi M, Kreft M, Kunze M, Schoetzau A, Dölzlmüller E, Eppel W, Husslein P, Ochsenbein-Koelble N, Zimmermann R, Bäz E, Prömpeler H, Bruder E, Hahn S, Hoesli I. Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: study protocol for an international, prospective, multicentre cohort trial. BMJ Open 2016; 6:e012115. [PMID: 27733413 PMCID: PMC5073542 DOI: 10.1136/bmjopen-2016-012115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION As the accurate diagnosis and treatment of gestational diabetes mellitus (GDM) is of increasing importance; new diagnostic approaches for the assessment of GDM in early pregnancy were recently suggested. We evaluate the diagnostic power of an 'early' oral glucose tolerance test (OGTT) 75 g and glycosylated fibronectin (glyFn) for GDM screening in a normal cohort. METHODS AND ANALYSIS In a prospective cohort study, 748 singleton pregnancies are recruited in 6 centres in Switzerland, Austria and Germany. Women are screened for pre-existing diabetes mellitus and GDM by an 'early' OGTT 75 g and/or the new biomarker, glyFn, at 12-15 weeks of gestation. Different screening strategies are compared to evaluate the impact on detection of GDM by an OGTT 75 g at 24-28 weeks of gestation as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A new screening algorithm is created by using multivariable risk estimation based on 'early' OGTT 75 g and/or glyFn results, incorporating maternal risk factors. Recruitment began in May 2014. ETHICS AND DISSEMINATION This study received ethical approval from the ethics committees in Basel, Zurich, Vienna, Salzburg and Freiburg. It was registered under http://www.ClinicalTrials.gov (NCT02035059) on 12 January 2014. Data will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02035059.
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Affiliation(s)
- E A Huhn
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - T Fischer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus, Paracelsus Medical University, Salzburg, Austria
| | - C S Göbl
- Division of Obstetrics and Feto-maternal Medicine, Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - M Todesco Bernasconi
- Department of Obstetrics and Gynaecology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - M Kreft
- Department of Obstetrics and Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - M Kunze
- Department of Obstetrics and Gynaecology, University Hospital Freiburg, Freiburg, Germany
| | - A Schoetzau
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - E Dölzlmüller
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus, Paracelsus Medical University, Salzburg, Austria
| | - W Eppel
- Division of Obstetrics and Feto-maternal Medicine, Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - P Husslein
- Division of Obstetrics and Feto-maternal Medicine, Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - N Ochsenbein-Koelble
- Department of Obstetrics and Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - R Zimmermann
- Department of Obstetrics and Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - E Bäz
- Department of Obstetrics and Gynaecology, University Hospital Freiburg, Freiburg, Germany
| | - H Prömpeler
- Department of Obstetrics and Gynaecology, University Hospital Freiburg, Freiburg, Germany
| | - E Bruder
- Department of Pathology, University Hospital Basel, Basel, Switzerland
| | - S Hahn
- Department of Biomedicine, Laboratory of Perinatology, University Basel, Basel, Switzerland
| | - I Hoesli
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
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Voigt M, Olbertz D, Hentschel R, Kunze M, Hagenah HP, Scholz R, Wittwer-Backofen U, Hesse V, Straube S. Percentile Values for the Anthropometric Dimensions of Triplet Neonates - Analysis of German Perinatal Survey Data of 2007-2011 from all States of Germany. Z Geburtshilfe Neonatol 2016; 220:185. [PMID: 27392283 DOI: 10.1055/s-0042-111604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M Voigt
- Zentrum für Medizin und Gesellschaft, Universität Freiburg, Freiburg
| | - D Olbertz
- Abteilung Neonatologie und Neonatologische Intensivmedizin, Klinikum Südstadt, Rostock
| | - R Hentschel
- Klinik für Allgemeine Kinder- und Jugendmedizin, Funktionsbereich Neonatologie/Intensivmedizin, Universitätsklinikum Freiburg, Freiburg
| | - M Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg
| | - H-P Hagenah
- Abteilung Geburtshilfe, Agaplesion Klinikum Rotenburg, Rotenburg (Wümme)
| | - R Scholz
- Max-Planck-Institut für Demografische Forschung, Arbeitsbereich Demografische Daten, Rostock
| | | | - V Hesse
- Deutsches Zentrum für Wachstum, Entwicklung und Gesundheitsförderung im Kindes- und Jugendalter, Berlin
| | - S Straube
- Department of Medicine, Division of Preventive Medicine, University of Alberta, Edmonton, Alberta, Canada
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Afreen S, Bohler S, Kunze M, Weiss JM, Erlacher M. The role of the anti-apoptotic protein Bcl-xL for the maintenance of human hematopoiesis. Klin Padiatr 2016. [DOI: 10.1055/s-0036-1582503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Voigt M, Olbertz D, Hentschel R, Kunze M, Hagenah HP, Scholz R, Wittwer-Backofen U, Hesse V, Straube S. [Percentile Values for the Anthropometric Dimensions of Triplet Neonates - Analysis of German Perinatal Survey Data of 2007-2011 from all States of Germany]. Z Geburtshilfe Neonatol 2016; 220:66-73. [PMID: 27111593 DOI: 10.1055/s-0035-1564090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM We aimed to develop national reference values for birth weight, length, head circumference, and weight for length for newborn triplets based on data from the German perinatal survey of 2007-2011. MATERIAL AND METHODS Perinatal survey data of 3,690 newborn triplets from all the states of Germany were kindly provided to us by the AQUA Institute in Göttingen, Germany. Data of 3,567 newborn triplets were included in the analyses. Sex-specific percentile values were calculated using cumulative frequencies. Percentile values at birth were computed for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for 21-36 completed weeks of gestation. RESULTS AND CONCLUSIONS We present the first German reference values (tables and curves) for the anthropometric dimensions of triplet neonates and compare selected birth weight and length percentiles of triplets (after 32 and 34 completed weeks of gestation) to those of singletons and twins. The differences in the 50th birth weight percentiles between singletons and triplets after 32 completed weeks of gestation were 180 g for girls and 210 g for boys; after 34 weeks of gestation the differences were 320 and 325 g, respectively. The differences between twins and triplets after 32 weeks of gestation were 100 g for girls and 120 g for boys; after 34 weeks of gestation they were 130 and 135 g, respectively. The data presented here enable the classification of newborn triplets according to somatic parameters making reference to German perinatal data.
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Affiliation(s)
- M Voigt
- Zentrum für Medizin und Gesellschaft, Universität Freiburg, Freiburg
| | - D Olbertz
- Abteilung Neonatologie und Neonatologische Intensivmedizin, Klinikum Südstadt, Rostock
| | - R Hentschel
- Klinik für Allgemeine Kinder- und Jugendmedizin, Funktionsbereich Neonatologie/Intensivmedizin, Universitätsklinikum Freiburg, Freiburg
| | - M Kunze
- Frauenklinik, Universitätsklinikum Freiburg, Freiburg
| | - H-P Hagenah
- Abteilung Geburtshilfe, Agaplesion Klinikum Rotenburg, Rotenburg (Wümme)
| | - R Scholz
- Max-Planck-Institut für Demografische Forschung, Arbeitsbereich Demografische Daten, Rostock
| | | | - V Hesse
- Deutsches Zentrum für Wachstum, Entwicklung und Gesundheitsförderung im Kindes- und Jugendalter, Berlin
| | - S Straube
- Department of Medicine, Division of Preventive Medicine, University of Alberta, Edmonton, Alberta, Canada
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Hug C, Markfeld-Erol F, Kunze M, Prömpeler H. Uterusruptur nach B-Lynch-Nähten und Massentransfusion. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566575] [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: 10/22/2022]
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Voigt M, Kunze M, Strauss A, Hagenah HP, Wittwer-Backofen U, Straube S. Beziehungen zwischen Körperhöhe der Mütter, Schwangerschaftsdauer und dem Geburtsgewicht der Neugeborenen. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566699] [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: 10/22/2022]
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Kunze M, Markfeld-Erol F, Balafoutas D, Hasenburg A, Prömpeler H. Erfolgreiche Schwangerschaftsverlängerung nach Uterusruptur bei Plazenta increta und Geminigravidität in der 16. SSW. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566500] [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: 10/22/2022]
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Contini C, König B, Markfeld-Erol F, Kunze M, Krumrey B, Zschiedrich S, Prömpeler H, Pütz G, Winkler K. The Freiburg Preeclampsia H.E.L.P.-Apheresis Study: rationale for lipid-apheresis in preeclampsia. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566536] [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: 10/22/2022]
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Rasenack R, Baez E, Kunze M, Proempeler H. 40 Jahre Blutgruppen-Inkompatibilität am Perinatalzentrum. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566639] [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: 10/22/2022]
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Dany N, Neumann-Haefelin E, Siebers F, Kunze M, Prömpeler H. Reaktivierung eines hämolytisch-urämischen Syndroms in der Schwangerschaft und erfolgreiche Therapie mit dem monoklonalen Antikörper Eculizumab. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566541] [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: 10/22/2022]
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Markfeld-Erol F, Kunze M, Contini C, König B, Krumrey B, Zschiedrich S, Pütz G, Prömpeler H, Winkler K. Die „Freiburg Preeclampsia H.E.L.P. Apheresis Study“: Klinischer Verlauf. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566672] [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: 10/22/2022]
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Fendl D, Gerdes T, Weber K, Waletzky A, Kunze M, Stiller S, Leoni AL. Evaluation of a mouse model for scrotal heat stress. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.928] [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: 11/24/2022]
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Wewetzer SJ, Kunze M, Ladner T, Luchterhand B, Roth S, Rahmen N, Kloß R, Costa e Silva A, Regestein L, Büchs J. Parallel use of shake flask and microtiter plate online measuring devices (RAMOS and BioLector) reduces the number of experiments in laboratory-scale stirred tank bioreactors. J Biol Eng 2015; 9:9. [PMID: 26265936 PMCID: PMC4531433 DOI: 10.1186/s13036-015-0005-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 12/05/2014] [Accepted: 05/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conventional experiments in small scale are often performed in a 'Black Box' fashion, analyzing only the product concentration in the final sample. Online monitoring of relevant process characteristics and parameters such as substrate limitation, product inhibition and oxygen supply is lacking. Therefore, fully equipped laboratory-scale stirred tank bioreactors are hitherto required for detailed studies of new microbial systems. However, they are too spacious, laborious and expensive to be operated in larger number in parallel. Thus, the aim of this study is to present a new experimental approach to obtain dense quantitative process information by parallel use of two small-scale culture systems with online monitoring capabilities: Respiration Activity MOnitoring System (RAMOS) and the BioLector device. RESULTS The same 'mastermix' (medium plus microorganisms) was distributed to the different small-scale culture systems: 1) RAMOS device; 2) 48-well microtiter plate for BioLector device; and 3) separate shake flasks or microtiter plates for offline sampling. By adjusting the same maximum oxygen transfer capacity (OTRmax), the results from the RAMOS and BioLector online monitoring systems supplemented each other very well for all studied microbial systems (E. coli, G. oxydans, K. lactis) and culture conditions (oxygen limitation, diauxic growth, auto-induction, buffer effects). CONCLUSIONS The parallel use of RAMOS and BioLector devices is a suitable and fast approach to gain comprehensive quantitative data about growth and production behavior of the evaluated microorganisms. These acquired data largely reduce the necessary number of experiments in laboratory-scale stirred tank bioreactors for basic process development. Thus, much more quantitative information is obtained in parallel in shorter time.
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Affiliation(s)
- S. J. Wewetzer
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - M. Kunze
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - T. Ladner
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - B. Luchterhand
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - S. Roth
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - N. Rahmen
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - R. Kloß
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - A. Costa e Silva
- />University of Minho, CEB - Centre of Biological Engineering, Campus de Gualtar, 4700-057 Braga, Portugal
| | - L. Regestein
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
| | - J. Büchs
- />RWTH Aachen University, AVT - Biochemical Engineering, Worringer Weg 1, 52074 Aachen, Germany
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Markfeld-Erol F, Kunze M, Contini C, König B, Zschiedrich S, Pütz G, Prömpeler H, Winkler K. Das H.E.L.P.-Verfahren als mögliche Intervention bei Präeklampsie vor der 28. SSW: Klinischer Verlauf. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1548706] [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: 10/23/2022] Open
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Iborra S, Markfeld-Erol F, Kunze M, Rasenack R, Prömpeler H. Thrombotische Mikroangiopathie in der Schwangerschaft. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388166] [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] Open
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Pestka MA, Kunze M, Markfeld-Erol F, Rasenack R, Prömpeler H. Zur Differentialdiagnose der schweren Präeklampsie bei chronischer Niereninsuffizienz und Nierentransplantation. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388093] [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] Open
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Kunze M, Morfeld C, Klar M, Markfeld-Erol F, Rasenack R, Prömpeler H, Schäfer W. Interleukin-6 und Tumor necrosis factor-alpha als Prädiktoren eines Fetalen Inflammatory Response Syndrome beim frühen vorzeitigen Blasensprung. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388049] [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] Open
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Markfeld-Erol F, Kunze M, Gaupp N, Prömpeler H. Konseratives Management der Cervixschwangerschaft. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388165] [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] Open
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Hug C, Kunze M, Markfeld-Erol F, Rasenack R, Prömpeler H. Exorbitante Gallensäureerhöhung nach transjugulärer intrahepatischer portosystemischer Shunt (TIPS) – Anlage, endogen oder iatrogen? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388182] [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] Open
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Gaupp N, Kunze M, Markfeld-Erol F, Prömpeler H. Austragen einer Schwangerschaft trotz Implantation in der Sektionarbe. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388195] [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] Open
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Contini C, Puetz G, Markfeld-Erol F, Kunze M, Proempeler H, Koenig B, Zschiedrich S, Massing U, Merfort I, Winkler K. Influence of lipoproteins on endothelin receptor signalling in preeclampsia. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rasenack R, Lambers K, Gaupp N, Kabitz HJ, Kunze M, Prömpeler H. [Pneumomediastinum related to the second stage of labour - a report on 2 cases]. Z Geburtshilfe Neonatol 2014; 218:128-30. [PMID: 24999791 DOI: 10.1055/s-0034-1376991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report on 2 primigravidae developing pneumomediastinum and subcutaneous emphysema associated with the second stage of labor. Both of the newborns had a comparatively high birth-weight (3,855 g and 4,245 g, respectively). In the first case, the patient felt a sudden chest pain during expulsion followed by dyspnea and swelling of the face. The birth was terminated by vacuum extraction. In the second case, a mild shoulder dystocia occurred, which could be resolved by McRoberts maneuver. The patient exhibited a swollen face and shortness of breath on the first postpartum day. Physical examination revealed crackly skin over the lower face, both sides of the neck and the front of the chest. In both cases, CT scan of the chest revealed pneumomediastinum and a subcutaneous emphysema of the upper thorax, however without showing a pneumothorax. The first patient underwent bronchoscopy and esophagogastroduodenoscopy; there were no abnormalities detected. The pneumomediastinum and subcutaneous emphysema gradually diminished spontaneously in both cases. Appropriate pain management and empirical antibiotics were applied. Pneumomediastinum during labor and birth, typically with subcutaneous emphysema in the face and neck, is a rare condition, but there are reported cases in the literature. Based on the limited available evidence, it seems to have a benign, self-limiting course. A conservative management appears -appropriate and sufficient.
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Affiliation(s)
- R Rasenack
- Frauenklinik, Universitätsklinik Freiburg, Freiburg
| | - K Lambers
- Frauenklinik, Universitätsklinik Freiburg, Freiburg
| | - N Gaupp
- Frauenklinik, Universitätsklinik Freiburg, Freiburg
| | - H-J Kabitz
- Pneumonologie, Medizinische Universitätsklinik, Freiburg
| | - M Kunze
- Frauenklinik, Universitätsklinik Freiburg, Freiburg
| | - H Prömpeler
- Frauenklinik, Universitätsklinik Freiburg, Freiburg
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Kunze M, Zumstein AK, Markfeld-Erol F, Prömpeler H, Berner R, Hufnagel M. Klinische Epidemiologie von Streptokokken der Gruppe B: eine prospektive Single-Center Screeningstudie. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361243] [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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Kunze M, Morfeld CA, Klar M, Markfeld-Erol F, Rasenack R, Prömpeler H, Schäfer W. Prädiktion eines Fetal Inflammatory Response Syndrome beim frühen vorzeitigen Blasensprung durch Interleukin-6 und TNF-alpha bei nicht-invasiver Probengewinnung. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361242] [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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Raffauf AB, Kürschner A, Kunze M, Wölber JP, Wittmer A, Al-Ahmad A, Serr A, Vach K, Ratka-Krüger P. Zahnfleischentzündungen während der Schwangerschaft – erhöhtes Frühgeburtsrisiko? Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361292] [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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Rasenack R, Markfeld-Erol F, Kunze M, Proempeler HJ. Prävention in der Geburtshilfe. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361313] [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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Markfeld-Erol F, Kunze M, Rasenack R, Prömpeler H. Thrombotisch-Thrombozytopenische Purpura TTP in der Schwangerschaft. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361394] [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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Rodriguez-Granger J, Alvargonzalez JC, Berardi A, Berner R, Kunze M, Hufnagel M, Melin P, Decheva A, Orefici G, Poyart C, Telford J, Efstratiou A, Killian M, Krizova P, Baldassarri L, Spellerberg B, Puertas A, Rosa-Fraile M. Prevention of group B streptococcal neonatal disease revisited. The DEVANI European project. Eur J Clin Microbiol Infect Dis 2013; 31:2097-104. [PMID: 22314410 DOI: 10.1007/s10096-012-1559-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 01/16/2012] [Indexed: 02/01/2023]
Abstract
The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS) neonatal infections and the status of prevention policies in European countries and to present the DEVANI pan-European program, launched in 2008. The aim of this program was to assess the GBS neonatal infection burden in Europe, to design a new vaccine to immunize neonates against GBS infections, to improve the laboratory performance for the diagnosis of GBS colonization and infection, and to improve the methods for the typing of GBS strains. The current guidelines for GBS prevention in different countries were ascertained and a picture of the burden before and after the instauration of prevention policies has been drawn. After the issue of the Centers for Disease Control and Prevention (CDC) guidelines, many European countries have adopted universal screening for the GBS colonization of pregnant women and intrapartum prophylaxis to colonized mothers. Nevertheless, some European countries continue advocating the risk factor approach to GBS prevention. Most European countries have implemented policies to prevent GBS neonatal infections and the burden of the disease has decreased during the last several years. Nevertheless, further steps are necessary in order to develop new strategies of prevention, to improve microbiological techniques to detect GBS colonization and infection, and to coordinate the prevention policies in the EU.
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Affiliation(s)
- J Rodriguez-Granger
- Microbiology, University Hospital Virgen de las Nieves, La Caleta, Granada, 18014, Spain.
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Scheidt CE, Hasenburg A, Kunze M, Waller E, Pfeifer R, Zimmermann P, Hartmann A, Waller N. Are individual differences of attachment predicting bereavement outcome after perinatal loss? A prospective cohort study. J Psychosom Res 2012; 73:375-82. [PMID: 23062812 DOI: 10.1016/j.jpsychores.2012.08.017] [Citation(s) in RCA: 34] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 08/25/2012] [Accepted: 08/27/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the influence of attachment, social support and the quality of the current partnership on the outcome of bereavement after perinatal loss. METHODS In a prospective cohort design 33 women after perinatal loss were approached on admission to hospital and reassessed four weeks, four months and nine months later. The initial assessment included the Adult Attachment Interview and self-report questionnaires for social support and quality of the current partnership. Bereavement outcome was assessed using measures of grief (MTS), depression and anxiety (HADS), psychological distress (BSI), somatisation (BSI-SOM) and symptoms of PTSD (PDS). RESULTS All measures of outcome showed a significant improvement over time. Standardized effect sizes between the initial assessment and nine month follow-up ranged between .36 for anxiety (HADS) and 1.02 for grief (MTS). Social support, quality of the partnership and secure attachment correlated inversely, and insecure preoccupied attachment correlated positively with the outcome measures. Preoccupied attachment was included as a predictor in two multivariate statistical models of non-linear regression analysis, one with somatisation (adjusted R2=.698, P=.016), the other with posttraumatic stress symptoms at nine month follow-up (adjusted R2=.416, P=.002) as target variable. Initial assessment scores of psychological distress predicted the course of the respective measure during follow-up (adjusted R2=.432, P=.014). CONCLUSION Attachment, social support and the quality of the current partnership have an impact on the course of bereavement after perinatal loss. Secondary prevention after the event may focus on these factors in order to offer specific counselling and support.
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Affiliation(s)
- C E Scheidt
- Freiburg Institute of Advanced Studies, Interdisciplinary Research Groups, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Albert-Ludwigs-University Freiburg, Germany.
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Kunze M, Roth S, Bock S, Büchs J. Kombinierte Kultivierung in Kleinkultursystemen als Alternative zum Laborfermenter für die Bioprozessentwicklung. CHEM-ING-TECH 2012. [DOI: 10.1002/cite.201250346] [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: 11/10/2022]
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Markfeld-Erol F, Farthmann J, Prömpeler H, Kunze M. Fetale Niereninsuffizienz bei Therapie mit Hemmstoffen des Renin-Angiotensin-Systems in der Schwangerschaft. Dtsch Med Wochenschr 2012; 137:1297-300. [DOI: 10.1055/s-0032-1305063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | - M. Kunze
- Universitätsfrauenklinik Freiburg
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Kuhn A, Kunze M, Sreeraj P, Wiemhöfer HD, Thangadurai V, Wilkening M, Heitjans P. NMR relaxometry as a versatile tool to study Li ion dynamics in potential battery materials. Solid State Nucl Magn Reson 2012; 42:2-8. [PMID: 22364761 DOI: 10.1016/j.ssnmr.2012.02.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/30/2012] [Accepted: 02/01/2012] [Indexed: 05/20/2023]
Abstract
NMR spin relaxometry is known to be a powerful tool for the investigation of Li(+) dynamics in (non-paramagnetic) crystalline and amorphous solids. As long as significant structural changes are absent in a relatively wide temperature range, with NMR spin-lattice (as well as spin-spin) relaxation measurements information on Li self-diffusion parameters such as jump rates and activation energies are accessible. Diffusion-induced NMR relaxation rates are governed by a motional correlation function describing the ion dynamics present. Besides the mean correlation rate of the dynamic process, the motional correlation function (i) reflects deviations from random motion (so-called correlation effects) and (ii) gives insights into the dimensionality of the hopping process. In favorable cases, i.e., when temperature- and frequency-dependent NMR relaxation rates are available over a large dynamic range, NMR spin relaxometry is able to provide a comprehensive picture of the relevant Li dynamic processes. In the present contribution, we exemplarily present two recent variable-temperature (7)Li NMR spin-lattice relaxation studies focussing on Li(+) dynamics in crystalline ion conductors which are of relevance for battery applications, viz. Li(7) La(3)Zr(2)O(12) and Li(12)Si(7).
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Affiliation(s)
- A Kuhn
- Institute of Physical Chemistry and Electrochemistry, Leibniz University Hannover, Callinstr. 3-3a, 30167 Hannover, Germany.
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