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Urbanek C, Grau AJ. Abgeschlagenheit mit rechtsseitiger Lähmung und Sprachstörung 2 Wochen nach SARS-CoV‑2-Infektion. DGNeurologie 2022. [PMCID: PMC8990601 DOI: 10.1007/s42451-022-00427-w] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Urbanek
- Neurologische Klinik mit Klinischer Neurophysiologie, Klinikum der Stadt Ludwigshafen am Rhein, Bremserstr. 79, 67063 Ludwigshafen, Deutschland
| | - A. J. Grau
- Neurologische Klinik mit Klinischer Neurophysiologie, Klinikum der Stadt Ludwigshafen am Rhein, Bremserstr. 79, 67063 Ludwigshafen, Deutschland
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Barlinn J, Winzer S, Worthmann H, Urbanek C, Häusler KG, Günther A, Erdur H, Görtler M, Busetto L, Wojciechowski C, Schmitt J, Shah Y, Büchele B, Sokolowski P, Kraya T, Merkelbach S, Rosengarten B, Stangenberg-Gliss K, Weber J, Schlachetzki F, Abu-Mugheisib M, Petersen M, Schwartz A, Palm F, Jowaed A, Volbers B, Zickler P, Remi J, Bardutzky J, Bösel J, Audebert HJ, Hubert GJ, Gumbinger C. [Telemedicine in stroke-pertinent to stroke care in Germany]. Nervenarzt 2021; 92:593-601. [PMID: 34046722 PMCID: PMC8184549 DOI: 10.1007/s00115-021-01137-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Telemedical stroke networks improve stroke care and provide access to time-dependent acute stroke treatment in predominantly rural regions. The aim is a presentation of data on its utility and regional distribution. METHODS The working group on telemedical stroke care of the German Stroke Society performed a survey study among all telestroke networks. RESULTS Currently, 22 telemedical stroke networks including 43 centers (per network: median 1.5, interquartile range, IQR, 1-3) as well as 225 cooperating hospitals (per network: median 9, IQR 4-17) operate in Germany and contribute to acute stroke care delivery to 48 million people. In 2018, 38,211 teleconsultations (per network: median 1340, IQR 319-2758) were performed. The thrombolysis rate was 14.1% (95% confidence interval 13.6-14.7%) and transfer for thrombectomy was initiated in 7.9% (95% confidence interval 7.5-8.4%) of ischemic stroke patients. Financial reimbursement differs regionally with compensation for telemedical stroke care in only three federal states. CONCLUSION Telemedical stroke care is utilized in about 1 out of 10 stroke patients in Germany. Telemedical stroke networks achieve similar rates of thrombolysis and transfer for thrombectomy compared with neurological stroke units and contribute to stroke care in rural regions. Standardization of network structures, financial assurance and uniform quality measurements may further strengthen the importance of telestroke networks in the future.
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Affiliation(s)
- J Barlinn
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - S Winzer
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - H Worthmann
- Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - C Urbanek
- Klinik für Neurologie, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Deutschland
| | - K G Häusler
- Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Günther
- Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - H Erdur
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - M Görtler
- Klinik für Neurologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - L Busetto
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Wojciechowski
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Dresden, Dresden, Deutschland
| | - Y Shah
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - B Büchele
- Klinik für Neurologie, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - P Sokolowski
- Klinik für Neurologie und neurologische Intensivmedizin, Fachkrankenhaus Hubertusburg, Hubertusburg, Deutschland
| | - T Kraya
- Klinik für Neurologie, Klinikum St.Georg Leipzig, Leipzig, Deutschland
| | - S Merkelbach
- Klinik für Neurologie, Heinrich-Braun-Klinikum Zwickau, Zwickau, Deutschland
| | - B Rosengarten
- Klinik für Neurologie, Klinikum Chemnitz, Chemnitz, Deutschland
| | - K Stangenberg-Gliss
- Klinik für Neurologie, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Deutschland
| | - J Weber
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - F Schlachetzki
- Klinik für Neurologie, Universität Regensburg, Regensburg, Deutschland
| | - M Abu-Mugheisib
- Klinik für Neurologie, Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - M Petersen
- Klinik für Neurologie, Klinikum Osnabrück, Osnabrück, Deutschland
| | - A Schwartz
- Klinik für Neurologie, Klinikum Region Hannover, Hannover, Deutschland
| | - F Palm
- Klinik für Neurologie, Helios Klinikum Schleswig, Schleswig, Deutschland
| | - A Jowaed
- Klinik für Neurologie, Westküstenkliniken Heide, Heide, Deutschland
| | - B Volbers
- Klinik für Neurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - P Zickler
- Klinik für Neurologie und Klinische Neurophysiologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - J Remi
- Klinik für Neurologie, Klinikum der LMU München-Großhadern, München, Deutschland
| | - J Bardutzky
- Klinik für Neurologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Bösel
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - H J Audebert
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Centrum für Schlaganfallforschung Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - G J Hubert
- Klinik für Neurologie, München-Klinik Harlaching, München, Deutschland
| | - C Gumbinger
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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Kloss M, Kalashnikova L, Dobrynina L, Traenka C, Engelter ST, Metso TM, Tatlisumak T, Urbanek C, Grau A, Kellert L, Brandt T, Wieker CM, Grond-Ginsbach C, Pezzini A. Recurrent versus first cervical artery dissection - a retrospective study of clinical and vascular characteristics. Eur J Neurol 2020; 27:2185-2190. [PMID: 32596976 DOI: 10.1111/ene.14417] [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] [Received: 04/29/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Most recurrent cervical artery dissection (CeAD) events occur shortly after the acute first CeAD. This study compared the characteristics of recurrent and first CeAD events and searched for associations between subsequent events of an individual person. METHODS Cervical artery dissection patients with a new CeAD event occurring during a 3-6 month follow-up were retrospectively selected in seven specialized stroke centers. Clinical and vascular characteristics of the initial and the recurrent CeADs were compared. RESULTS The study sample included 76 patients. Recurrent CeADs were occlusive in one (1.3%) patient, caused cerebral ischaemia in 13 (17.1%) and were asymptomatic in 39 (51.3%) patients, compared to 29 (38.2%) occlusive, 42 (55.3%) ischaemic and no asymptomatic first CeAD events. In 52 (68.4%) patients, recurrent dissections affected both internal carotid arteries or both vertebral arteries, whilst 24 (31.6%) patients had subsequent dissections in both types of artery. Twelve (28.6%) of 42 patients with an ischaemic first dissection had ischaemic symptoms due to the recurrent CeADs, too. However, only one (1.3%) of 34 patients with a non-ischaemic first CeAD suffered ischaemia upon recurrence. CONCLUSION Recurrent CeAD typically affects the same site of artery. It causes ischaemic events less often than the first CeAD. The risk that patients who presented with solely non-ischaemic symptoms of a first CeAD will have ischaemic symptoms in the case of a recurrent CeAD seems very small.
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Affiliation(s)
- M Kloss
- Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - L Kalashnikova
- Research Center of Neurology, Russian Academy of Medical Sciences, Moscow, Russia
| | - L Dobrynina
- Research Center of Neurology, Russian Academy of Medical Sciences, Moscow, Russia
| | - C Traenka
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland.,Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - S T Engelter
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland.,Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - T M Metso
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - T Tatlisumak
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.,Department of Clinical Neuroscience/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Urbanek
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - A Grau
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - L Kellert
- Department of Neurology, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - T Brandt
- Suva/Swiss National Accident Insurance Fund, Lucerne, Switzerland
| | - C M Wieker
- Department of Vascular and Endovascular Surgery, University of Heidelberg, Heidelberg, Germany
| | - C Grond-Ginsbach
- Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - A Pezzini
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
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Magnet U, Urbanek C, Gaisberger D, Tomeva E, Dum E, Pointner A, Haslberger A. Topical equol preparation improves structural and molecular skin parameters. Int J Cosmet Sci 2017; 39:535-542. [DOI: 10.1111/ics.12408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/30/2017] [Indexed: 12/29/2022]
Affiliation(s)
- U. Magnet
- Department for Nutritional Sciences; University of Vienna; Vienna 1090 Austria
| | - C. Urbanek
- HealthBioCare; Mooslackengasse 17 Vienna 1090 Austria
| | - D. Gaisberger
- HealthBioCare; Mooslackengasse 17 Vienna 1090 Austria
| | - E. Tomeva
- Department for Nutritional Sciences; University of Vienna; Vienna 1090 Austria
| | - E. Dum
- Department for Nutritional Sciences; University of Vienna; Vienna 1090 Austria
| | - A. Pointner
- Department for Nutritional Sciences; University of Vienna; Vienna 1090 Austria
| | - A.G. Haslberger
- Department for Nutritional Sciences; University of Vienna; Vienna 1090 Austria
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Yesilot Barlas N, Putaala J, Waje-Andreassen U, Vassilopoulou S, Nardi K, Odier C, Hofgart G, Engelter S, Burow A, Mihalka L, Kloss M, Ferrari J, Lemmens R, Coban O, Haapaniemi E, Maaijwee N, Rutten-Jacobs L, Bersano A, Cereda C, Baron P, Borellini L, Valcarenghi C, Thomassen L, Grau AJ, Palm F, Urbanek C, Tuncay R, Durukan Tolvanen A, van Dijk EJ, de Leeuw FE, Thijs V, Greisenegger S, Vemmos K, Lichy C, Bereczki D, Csiba L, Michel P, Leys D, Spengos K, Naess H, Tatlisumak T, Bahar SZ. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur J Neurol 2013; 20:1431-9. [PMID: 23837733 DOI: 10.1111/ene.12228] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Risk factors for IS in young adults differ between genders and evolve with age, but data on the age- and gender-specific differences by stroke etiology are scare. These features were compared based on individual patient data from 15 European stroke centers. METHODS Stroke etiology was reported in detail for 3331 patients aged 15-49 years with first-ever IS according to Trial of Org in Acute Stroke Treatment (TOAST) criteria: large-artery atherosclerosis (LAA), cardioembolism (CE), small-vessel occlusion (SVO), other determined etiology, or undetermined etiology. CE was categorized into low- and high-risk sources. Other determined group was divided into dissection and other non-dissection causes. Comparisons were done using logistic regression, adjusting for age, gender, and center heterogeneity. RESULTS Etiology remained undetermined in 39.6%. Other determined etiology was found in 21.6%, CE in 17.3%, SVO in 12.2%, and LAA in 9.3%. Other determined etiology was more common in females and younger patients, with cervical artery dissection being the single most common etiology (12.8%). CE was more common in younger patients. Within CE, the most frequent high-risk sources were atrial fibrillation/flutter (15.1%) and cardiomyopathy (11.5%). LAA, high-risk sources of CE, and SVO were more common in males. LAA and SVO showed an increasing frequency with age. No significant etiologic distribution differences were found amongst southern, central, or northern Europe. CONCLUSIONS The etiology of IS in young adults has clear gender-specific patterns that change with age. A notable portion of these patients remains without an evident stroke mechanism according to TOAST criteria.
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Affiliation(s)
- N Yesilot Barlas
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Palm F, Kleemann T, Dos Santos M, Urbanek C, Buggle F, Safer A, Hennerici MG, Becher H, Zahn R, Grau AJ. Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS2, CHA2DS2-VASc score, underuse of oral anticoagulation, and implications for preventive measures. Eur J Neurol 2012; 20:117-23. [PMID: 22788384 DOI: 10.1111/j.1468-1331.2012.03804.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 05/29/2012] [Indexed: 12/01/2022]
Affiliation(s)
- F. Palm
- Department of Neurology; Klinikum Ludwigshafen; Ludwigshafen Germany
| | - T. Kleemann
- Department of Cardiology; Klinikum Ludwigshafen; Ludwigshafen Germany
| | - M. Dos Santos
- Department of Neurology; Klinikum Ludwigshafen; Ludwigshafen Germany
| | - C. Urbanek
- Department of Neurology; Klinikum Ludwigshafen; Ludwigshafen Germany
| | - F. Buggle
- Department of Neurology; Klinikum Ludwigshafen; Ludwigshafen Germany
| | - A. Safer
- Institute of Public Health; University of Heidelberg; Heidelberg Germany
| | - M. G. Hennerici
- Department of Neurology; Universitätsklinikum Mannheim; University of Heidelberg; Mannheim Germany
| | - H. Becher
- Institute of Public Health; University of Heidelberg; Heidelberg Germany
| | | | - A. J. Grau
- Department of Neurology; Klinikum Ludwigshafen; Ludwigshafen Germany
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Palm F, Urbanek C, Wolf J, Buggle F, Kleemann T, Hennerici M, Inselmann G, Hagar M, Safer A, Becher H, Grau A. Etiology, Risk Factors and Sex Differences in Ischemic Stroke in the Ludwigshafen Stroke Study, a Population-Based Stroke Registry. Cerebrovasc Dis 2012; 33:69-75. [DOI: 10.1159/000333417] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 09/05/2011] [Indexed: 11/19/2022] Open
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Urbanek C, Neumann K, Schoenhoff M, Dettling M. FC03-07 - Future strategies for vocational rehabilitation in schizophrenia. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70193-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Rose SB, Palm F, Bode B, Urbanek C, Buggle F, Grau A. Die Ludwigshafener Schlaganfallstudie Mortalität nach erstmaligem Schlaganfall. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238897] [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]
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Palm F, Urbanek C, Buggle F, Grau AJ. Chronische Bronchitis und Schlaganfallrisiko. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238596] [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]
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Neuhaus AH, Opgen-Rhein C, Urbanek C, Hahn E, Ta TMT, Seidelsohn M, Strathmann S, Kley F, Wieseke N, Sander T, Dettling M. COMT Val 158 Met polymorphism is associated with cognitive flexibility in a signal discrimination task in schizophrenia. Pharmacopsychiatry 2009; 42:141-4. [PMID: 19585392 DOI: 10.1055/s-0028-1112132] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Associations between the well-known functional single nucleotide polymorphism Val (158)Met in the gene encoding catechol- O-methyltransferase (COMT) and cognitive do-mains affected in schizophrenia are inconsistent regarding directionality and specific impact and call for a more fundamental cognitive endophenotype. Recent studies suggest that the COMT genotype contributes to cognitive flexibility, a fundamental cognitive ability that potentially influences an individual's performance in a variety of other neurocognitive tasks. METHODS We investigated the association between COMT Val (158)Met genotype and cognitive flexibility as assessed by signal discrimination in the Continuous Performance Test - Identical Pairs version in a cohort of 111 German schizophrenic patients. RESULTS COMT genotype was significantly associated with signal discrimination index d' in schizophrenia. The Val/Val genotype was associated with the highest and the Met/Met genotype with the lowest scores; heterozygous individuals displayed an intermediate performance. CONCLUSIONS Our data suggest that allelic variation at the COMT Val (158)Met locus may influence signal discrimination capacity in schizophrenia and confirm that Val loading, probably due to decreased prefrontal dopamine availability, is associated with greater cognitive flexibility, which in turn may influence other cognitive measures that have been associated with COMT to date.
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Affiliation(s)
- A H Neuhaus
- Department of Psychiatry, Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany.
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Opgen-Rhein C, Neuhaus A, Urbanek C, Wieseke N, Hahn E, Strathmann S, Dettling M. The ANT as a potential neurocognitive endophenotype of schizophrenia. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-918799] [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: 10/18/2022]
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Kollmar R, Henninger N, Urbanek C, Schäbitz W, Schneider A, Schwab S. Effects of G-CSF in combination with rt-PA after experimental thromboembolic stroke. Akt Neurol 2004. [DOI: 10.1055/s-2004-832994] [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: 10/28/2022]
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Dettling M, Urbanek C, Mossiaguine I, Roots I, Müller-Oerlinghausen B, Cascorbi I. The role of myeloperoxidase and NADPH oxidase polymorphisms in clozapine-induced agranulocytosis. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825301] [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: 10/25/2022]
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Röpke S, Bajbouj M, Lehmann A, Urbanek C, Schindler F, Anghelescu I, Neuhaus A, Szegedi A. Determination of predictors of twelve treatments (four weeks) outcome of titrated moderately suprathreshold (low dose) right unilateral (RUL) electroconvulsive therapy (ECT) in depression: a two year retrospective analysis. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825475] [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: 10/25/2022]
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Schindler F, Urbanek C, Anghelescu I. The NSAID rofecoxib reduces subjective cognitive impairment associated with ECT. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825498] [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: 10/25/2022]
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