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Macherey S, Meertens MM, Adler C, Braumann S, Heyne S, Tichelbäcker T, Nießen FS, Christ H, Ahrens I, Baer FM, Eberhardt F, Horlitz M, Meissner A, Sinning JM, Baldus S, Lee S. Impact of respiratory infectious epidemics on STEMI incidence and care. Sci Rep 2021; 11:23066. [PMID: 34845282 PMCID: PMC8630015 DOI: 10.1038/s41598-021-02480-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/15/2021] [Indexed: 01/12/2023] Open
Abstract
The effect of respiratory infectious diseases on STEMI incidence, but also STEMI care is not well understood. The Influenza 2017/2018 epidemic and the COVID-19 pandemic were chosen as observational periods to investigate the effect of respiratory virus diseases on these outcomes in a metropolitan area with an established STEMI network. We analyzed data on incidence and care during the COVID-19 pandemic, Influenza 2017/2018 epidemic and corresponding seasonal control periods. Three comparisons were performed: (1) COVID-19 pandemic group versus pandemic control group, (2) COVID-19 pandemic group versus Influenza 2017/2018 epidemic group and (3) Influenza 2017/2018 epidemic group versus epidemic control group. We used Student's t-test, Fisher's exact test and Chi square test for statistical analysis. 1455 patients were eligible. The daily STEMI incidence was 1.49 during the COVID-19 pandemic, 1.40 for the pandemic season control period, 1.22 during the Influenza 2017/2018 epidemic and 1.28 during the epidemic season control group. Median symptom-to-contact time was 180 min during the COVID-19 pandemic. In the pandemic season control group it was 90 min (p = 0.183), and in the Influenza 2017/2018 cohort it was 90 min, too (p = 0.216). Interval in the epidemic control group was 79 min (p = 0.733). The COVID-19 group had a door-to-balloon time of 49 min, corresponding intervals were 39 min for the pandemic season group (p = 0.038), 37 min for the Influenza 2017/2018 group (p = 0.421), and 38 min for the epidemic season control group (p = 0.429). In-hospital mortality was 6.1% for the COVID-19 group, 5.9% for the Influenza 2017/2018 group (p = 1.0), 11% and 11.2% for the season control groups. The respiratory virus diseases neither resulted in an overall treatment delay, nor did they cause an increase in STEMI mortality or incidence. The registry analysis demonstrated a prolonged door-to-balloon time during the COVID-19 pandemic.
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Affiliation(s)
- S. Macherey
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - M. M. Meertens
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - C. Adler
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - S. Braumann
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - S. Heyne
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - T. Tichelbäcker
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - F. S. Nießen
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - H. Christ
- grid.6190.e0000 0000 8580 3777Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - I. Ahrens
- Department of Cardiology, Augustinerinnen Hospital, Cologne, Germany
| | - F. M. Baer
- grid.459927.40000 0000 8785 9045Department of Cardiology, St. Antonius Hospital, Cologne, Germany
| | - F. Eberhardt
- grid.477199.50000 0004 0389 9672Department of Cardiology, Evangelisches Krankenhaus Kalk, Cologne, Germany
| | - M. Horlitz
- grid.477476.10000 0004 0559 3714Department of Cardiology, Krankenhaus Porz am Rhein, Cologne, Germany
| | - A. Meissner
- grid.491990.cDepartment of Cardiology, Krankenhaus Köln-Merheim, Cologne, Germany
| | - J. M. Sinning
- Department of Cardiology, St. Vinzenz Hospital, Cologne, Germany
| | - S. Baldus
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - S. Lee
- grid.6190.e0000 0000 8580 3777Clinic III for Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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Crichton M, Nucera R, Jenkins J, Canavan R, Mahoney S, Eberhardt F, Dalwood P, Dahl C, Marshall S. MON-PO360: Influence of Inpatient Dietary Restriction on Recovery from and Reoccurrence of Acute, Uncomplicated Diverticulitis. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32194-6] [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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Eberhardt F, Jenkins J, Nucera R, Dalwood P, Canavan R, Marshall S. MON-PO330: A Lack of Knowledge and a Fear of Food Triggers Suffering in Patients with a History of Acute Diverticulitis: An Interpretative Phenomenological Analysis. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32165-x] [Citation(s) in RCA: 1] [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: 10/26/2022]
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Eberhardt F, Köhler C, Winter K, Alef M, Kiefer I. [Sonographically detectable changes in abdominal lymph nodes in dogs with malignant lymphoma. Evaluation with special consideration of the Solbiati-Index]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2015; 43:309-16. [PMID: 26076988 DOI: 10.15654/tpk-150078] [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: 01/29/2015] [Accepted: 05/22/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Characterization of the disorders of abdominal lymph nodes in dogs with malignant lymphoma and evaluation of the Solbiati-Index (SI) and the relationship between the short axis and the length of the lymph node (S : L ratio) as malignancy criteria. MATERIAL AND METHODS Retrospective analysis of data from dogs with malignant lymphoma. Inclusion criteria were cytological or histological diagnosis of the malignant lymphoma and an ultrasound examination of the abdomen prior to initiation of therapy. Criterion for exclusion was the application of a cytostatic agent prior to diagnosis. Furthermore, abdominal lymph nodes with non-neoplastic disorders were examined, when sonography as well as cytological/histological examinations were available. RESULTS A total of 261 lymph nodes (127 dogs) with malignant lymphoma and 17 lymph nodes (nine dogs) with benign disorders were evaluated. Sonography revealed massively rounded, clearly enlarged lymph nodes in 115/127 dogs (91%) with malignant lymphoma, while the lymph nodes of the other 12 dogs (9%) displayed an enlargement in the long axis. All 17 lymph nodes with benign disorders were enlarged in the long axis. The nodal parenchyma of 91% of the 127 dogs (malignant lymphoma) presented as hypoechoic to anechoic, and the cortex and medulla could not be differentiated. In the remaining 9% of dogs, a physiological isoechoic nodal parenchyma was observed. The parenchyma of lymph nodes with benign disorders was sonographically inconspicuous. In 71% of the 127 dogs with malignant lymphoma, the SI was < 2 and the S : L ratio > 0.5 (indicative for malignancy). Of the nine dogs with benign lymph node disorders, 71% had an SI of > 2 and 76% of them had an S : L ratio < 0.5 (indicative of a benign process). CONCLUSION AND CLINICAL RELEVANCE The significant increase in the size, rounding and hypoechoic changes in the lymph nodes in dogs with malignant lymphoma are indicative parameters of malignancy. In addition, the SI and the S:L ratio serve as a differentiation between benign and malign processes. Because of blurred boundaries between the malignant and benign changes, the various parameters should always be considered in conjunction.
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Affiliation(s)
- F Eberhardt
- Franziska Eberhardt, Klinik für Kleintiere, der Universität Leipzig, An den Tierkliniken 23, 04104 Leipzig, E-Mail:
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Eberhardt F, Köhler C, Krastel D, Winter K, Alef M, Kiefer I. [Sonographically detectable splenic disorders in dogs with malignant lymphoma]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2015; 43:215-20. [PMID: 26076898 DOI: 10.15654/tpk-140881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/21/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the frequency of different sonographic splenic disorders in dogs with different anatomic forms of malignant lymphoma. Additionally, the occurrence of the moth-eaten pattern in the parenchyma of the spleen in patients with diseases other than lymphoma should be investigated. MATERIAL AND METHODS Retrospective analysis of patient data collected from dogs histologically or cytologically diagnosed with malignant lymphoma and for which ultrasonographic images were available before the initiation of therapy. Patient data from dogs with a moth-eaten pattern within the splenic parenchyma were evaluated separately. Exclusion criterion was the administration of cytostatic agents prior to diagnosis. RESULTS In 84% of 164 dogs with malignant lymphoma, an altered pattern of the spleen was diagnosed ultrasonographically. Ninety-four of these 137 patients had a moth-eaten pattern of the splenic parenchyma and 43 dogs displayed abnormalities in the form of splenomegaly, coarse echotexture or other changes of the parenchyma. When a moth-eaten pattern was diagnosed, the affected dogs suffered significantly more often from a multicentric lymphoma (95%) than from any other anatomical lymphoma form. Only one dog displayed a moth-eaten pattern of the splenic parenchyma without diagnosis of a malignant lymphoma. The positive predictive value of the moth-eaten pattern for malignant lymphoma was 99% and, in particular, for the multicentric lymphoma this was 95%. In total, 84% of the 164 dogs displayed a multicentric lymphoma, 5% a mediastinal or a cutaneous lymphoma, respectively, 4% a gastrointestinal lymphoma, and one animal had an ocular or renal lymphoma, respectively. CONCLUSION AND CLINICAL RELEVANCE Sonographic changes of the spleen are often diagnosed in dogs with malignant lymphoma, independent of the anatomical lymphoma form. When the moth-eaten pattern is observed, it is very likely that the affected dog suffers from a malignant lymphoma, most probably a multicentric lymphoma.
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Affiliation(s)
- F Eberhardt
- Franziska Eberhardt, Klinik für Kleintiere der Universität Leipzig, An den Tierkliniken 23, 04104 Leipzig, E-Mail:
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Abstract
In etiolierten Rotkohlkeimlingen kann die Anthocyanbildung durch Zuckerfütterung erhöht und durch 10-7 g/ccm β-Indolylessigsäure noch weiter gesteigert werden. Die Pigmentproduktion in belichteten und etiolierten Keimlingen fällt stets in eine Phase erhöhten Gaswechsels (O2-Aufnahme und CO2-Abgabe) und sie ist am intensivsten, wenn der RQ seinen tiefsten Wert in den Keimlingen durchläuft, der von der Mobilisierung des Reservefettes bestimmt wird. In Blättern von Saxifragaraga crassifolia setzt nach Zuckerfütterung Anthocyanbildung ein und der Gasumsatz steigt an. Werden die Blattstückchen nach Zuckergabe mit Jodessigsäure behandelt, so wird der Atmungsumsatz stark gesenkt und die Anthocyanbildung bleibt aus. Mit 2.4-Dinitrophenol wird die Pigmentsynthese ebenfalls unterbunden, aber der Gaswechsel steigt sehr stark an. In „jugendroten“ Laubblättern entsteht bei der Blattentwicklung ein Enzymsystem, das zugegebenes Anthocyan entfärbt und deshalb wohl für die natürliche Entrötung verantwortlich ist. Es wird damit wahrscheinlich, daß die sog. Blutvarietäten, z. B. von Fagus silvatica, Mutanten sind, die das Enzym zur Anthocyanausbleichung verloren haben.
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Affiliation(s)
- K. Paech
- Aus dem Botanischen Institut der Universität Tübingen
| | - F. Eberhardt
- Aus dem Botanischen Institut der Universität Tübingen
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Eberhardt F. Notizen: Zur Anwendung fluorometrischer Verfahren bei der papierchromatographischen Analyse von Pflanzenstoffen. Zeitschrift für Naturforschung B 2014. [DOI: 10.1515/znb-1960-0119] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Köhler C, Alef M, Eberhardt F, Oechtering G, Kiefer I. [Sonographic measurement of soft-palate thickness and comparison with the measurement by computed tomography]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2014; 42:20-28. [PMID: 24518944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 07/15/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to measure the thickness of the soft palate at specific locations in normocephalic dogs using sonography and computed tomography (CT), and to subsequently compare the two different methods. MATERIAL AND METHODS A total of 15 normocephalic dogs were examined under general anesthesia. The CT was performed while patients were in a sternal recumbent position, their mouth held open by placing their upper jaw on a positioning device. Dorsal recumbency together with submental and midsagittal positioning of the transducer were chosen for sonography. Measurements were made in both sonographic and reconstructed sagittal CT images. Two measuring points (MP) were defined for measuring the cranial and the middle part of the soft palate (MP1: 1 cm caudal to the transition from the hard to the soft palate; MP2: at the origin of the dorsal pharyngeal muscles). It was investigated whether repeated procedures with one measuring method provided consistent values and, furthermore, whether the two different measuring methods (sonography and CT) provided comparable data. RESULTS The data acquired by repeat measurements within one method corresponded very well. However, the data provided by the two different measurement methods showed varying results for the first measuring point and was even greater for the second measuring point. Sonography overestimated the measurements obtained by CT by up to 0.26 cm for MP1 and up to 0.79 cm for MP2. CONCLUSION Due to the significant discrepancies in their results, the two measurement methods are not interchangeable. Sonography showed good reliability for repeat measurements. Consequently, the variable values between CT and sonography appeared to result from differing examination conditions. Sonography may be a rapid and non-invasive diagnostic tool to measure soft palate thickness if the applied method proves to be applicable in clinical practice.
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Affiliation(s)
- C Köhler
- Claudia Köhler, Klinik für Kleintiere der Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, E-Mail:
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Hörster R, Marxsen J, Eberhardt F, Welling J, Dalhoff K, Drömann D. Idiopathische lymphozytäre interstitielle Pneumonie mit sequentiell auftretendem pulmonalem Non-Hodgkin-Lymphom. Pneumologie 2012. [DOI: 10.1055/s-0032-1302846] [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: 10/28/2022]
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Ingerl H, Gesierich W, Morresi-Hauf A, Weis A, Fertl A, Eberhardt F, Karl H. Renaissance der transbronchialen Biopsie bei der Diagnostik diffuser Lungenparenchymerkrankungen durch Kryotechnik? Pneumologie 2011. [DOI: 10.1055/s-0031-1272306] [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: 10/18/2022]
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Heringlake M, Kox T, Poeling J, Klaus S, Hanke T, Franz N, Eberhardt F, Heinze H, Armbruster FP, Bahlmann L. The effects of physical exercise on plasma levels of relaxin, NTproANP, and NTproBNP in patients with ischemic heart disease. Eur J Med Res 2009; 14:106-12. [PMID: 19380280 PMCID: PMC3352058 DOI: 10.1186/2047-783x-14-3-106] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The insulin-like and vasodilatatory polypeptide relaxin (RLX), formerly known as a pregnancy hormone, has gained interest as a potential humoral mediator in human heart failure. Controversy exists about the relation between plasma levels of RLX and the severity of heart failure. The present study was designed to determine the course of RLX, atrial, and brain natriuretic peptide (NT-proANP and NT-proBNP) during physical exercise in patients with ischemic heart disease (IHD) and to relate hormone levels to peak cardiac power output (CPO) as a measure of cardiopulmonary function with prognostic relevance. 40 patients with IHD were studied during right-heart-catheterization at rest and during supine bicycle ergometry. RLX, NTproBNP, and NTproANP were determined before, during exercise, and after recovery. NT-proANP and NT-proBNP levels increased during maximal charge, and recovery while RLX levels decreased. Cardiac power output at maximal charge correlated inversely with NTproANP and NTproBNP but positively with RLX. Patients with high degree heart failure (CPO < 1.96 W) had higher NTproANP and NTproB-NP and lower RLX levels than patients with low degree heart failure. While confirming the role of NTproANP and NTproBNP as markers for the severity of heart failure, the present data do not support the concept that plasma levels of RLX are related to the severity of myocardial dysfunction and that systemic RLX acts as a compensatory vasodilatatory response hormone in ischemic heart disease.
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van Ree R, Chapman MD, Ferreira F, Vieths S, Bryan D, Cromwell O, Villalba M, Durham SR, Becker WM, Aalbers M, André C, Barber D, Cistero Bahima A, Custovic A, Didierlaurent A, Dolman C, Dorpema JW, Di Felice G, Eberhardt F, Fernandez Caldas E, Fernandez Rivas M, Fiebig H, Focke M, Fötisch K, Gadermaier G, Das RG, Gonzalez Mancebo E, Himly M, Kinaciyan T, Knulst AC, Kroon AM, Lepp U, Marco FM, Mari A, Moingeon P, Monsalve R, Neubauer A, Notten S, Ooievaar-de Heer P, Pauli G, Pini C, Purohit A, Quiralte J, Rak S, Raulf-Heimsoth M, San Miguel Moncin MM, Simpson B, Tsay A, Vailes L, Wallner M, Weber B. The CREATE project: development of certified reference materials for allergenic products and validation of methods for their quantification. Allergy 2008; 63:310-26. [PMID: 18269676 DOI: 10.1111/j.1398-9995.2007.01612.x] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [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: 11/30/2022]
Abstract
Allergen extracts have been used for diagnosis and treatment of allergy for around 100 years. During the second half of 20th century, the notion increasingly gained foothold that accurate standardization of such extracts is of great importance for improvement of their quality. As a consequence, manufacturers have implemented extensive protocols for standardization and quality control. These protocols have overall IgE-binding potencies as their focus. Unfortunately, each company is using their own in-house reference materials and their own unique units to express potencies. This does not facilitate comparison of different products. During the last decades, most major allergens of relevant allergen sources have been identified and it has been established that effective immunotherapy requires certain minimum quantities of these allergens to be present in the administered maintenance dose. Therefore, the idea developed to introduce major allergens measurements into standardization protocols. Such protocols based on mass units of major allergen, quantify the active ingredients of the treatment and will at the same time allow comparison of competitor products. In 2001, an EU funded project, the CREATE project, was started to support introduction of major allergen based standardization. The aim of the project was to evaluate the use of recombinant allergens as reference materials and of ELISA assays for major allergen measurements. This paper gives an overview of the achievements of the CREATE project.
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Affiliation(s)
- R van Ree
- Academic Medical Center, Amsterdam, The Netherlands
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Welling J, Heinemann S, Martin C, Lepp U, Eberhardt F, Peter Z, Uhlig S. Eine randomisierte, doppel-blind, placebo-konrollierte Studie zur Untersuchung des Einflusses von Ramatroban/Montelukast auf die allergische Frühreaktion beim leichtgradigen allergischen (Hausstaubmilbe) Asthma bronchiale. Pneumologie 2007. [DOI: 10.1055/s-2007-973128] [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: 10/21/2022]
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Eberhardt F, Hanke T, Weil J, Wiegand UKH, Gellissen J. Diagnosis and management of a massive true inferobasal ventricular aneurysm ante perforationem. Clin Res Cardiol 2006; 95:685-8. [PMID: 16998739 DOI: 10.1007/s00392-006-0444-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 08/10/2006] [Indexed: 10/24/2022]
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Schmoller A, Eberhardt F, Schultes B, Schweiger U, Born J, Zabel P, Fehm HL, Peters A, Oltmanns KM. CPAP therapy decreases evening cortisol levels in patients with severe obstructive sleep apnea. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schmoller A, Eberhardt F, Schultes B, Schweiger U, Born J, Zabel P, Fehm HL, Peters A, Oltmanns KM. CPAP therapy decreases evening cortisol levels in patients with severe obstructive sleep apnea. Exp Clin Endocrinol Diabetes 2005. [DOI: 10.1055/s-2005-920468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Eberhardt F, Bode F, Bonnemeier H, Boguschewski F, Schlei M, Peters W, Wiegand UKH. Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity. Heart 2005; 91:500-6. [PMID: 15772212 PMCID: PMC1768857 DOI: 10.1136/hrt.2003.025411] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To determine how short and long term complication rates after pacemaker implantation are influenced by patient morbidity, operator experience, and choice of pacing system. DESIGN Retrospective analysis of 1884 patients who received VVI (n = 610), VDD (n = 371), or DDD devices (n = 903) between 1990 and 2001. Follow up period was 64 (34) months. The influence of age, sex, coronary artery disease, myocardial infarction, reduced left ventricular (LV) function, right ventricular (RV) dilatation, atrial fibrillation, device type, and operator experience on operation time and complication rate were analysed. RESULTS Operation time was prolonged in patients with coronary artery disease, inferior myocardial infarction, reduced LV function, and RV dilatation. Implantation of DDD pacemakers prolonged operation time, particularly among operators with a low or medium level of experience. The overall complication rate was 4.5%. Sixty seven per cent of these complications occurred within the first three months. Complication rate was increased by age, reduced LV function, and RV dilatation. Implantation of DDD systems led to a higher complication rate (6.3%) than implantation of VVI (2.6%) or VDD pacemakers (3.2%). These differences were present only among operators with a low or medium level of experience. CONCLUSIONS Operation time and complication rate increased with age, impaired LV function, and RV dilatation. Complication rates were higher with DDD than with VVI or VDD implantation and were excessive among inexperienced but not experienced operators.
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Affiliation(s)
- F Eberhardt
- Universitätsklinik Schleswig Holstein, Campus Luebeck, Medizinische Klinik II, Ratzeburger Allee 160, 23538 Luebeck, Germany.
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Thiel M, Drews O, Behrendt H, Görg A, Traidl-Hoffmann C, Kasche A, Klaus S, Buters J, Weichenmeier I, Krämer U, Gehlhar K, Betzel C, Werner S, Weber W, Bufe A, Rozynek P, Gaspar Â, Rihs HP, Pires G, Brüning T, Raulf-Heimsoth M, Boldt A, Bade S, Gorris HH, Reese G, Riecken S, Becker WM, Viebranz J, Randow S, Lauer I, Moncin MSM, Lehrer SB, Vieths S, van Kampen V, Haamann F, Merget R, Sander I, Jappe U, Hoffmann M, Burow G, Enk A, Kespohl S, Foerster S, Eyerich K, Lubitz S, Schober W, Belloni B, Eberlein-König B, Stassen M, Klein M, Klein-Heßling S, Palmetshofer A, Serfling E, Bopp T, Richter C, Schild H, Schmitt E, Blume C, Förster S, Petersen A, Güttsches A, Zähringer U, Löseke S, Ebling A, Draheim R, Rundfeldt C, Rieber EP, Schäkel K, Abraham S, Meurer M, Rieber P, Gutermuth J, O’Keeffe M, Alessandrini F, Schlatter B, Ring J, Hochrein H, Jakob T, Heib V, Schmitt S, Kubach J, Lutter P, Huter E, Ohlemacher S, Weingarten P, Müller C, Bailey S, Becker C, Knop J, Blüggel M, Hüls C, Jonuleit H, Bellinghausen I, König B, Böttcher I, Saloga J, Hüter E, Schneider FJ, Wicklein D, Stöcker M, Klockenbring T, Huhn M, Barth S, Trujillo-Vargas CM, Erb KJ, Milovanovic M, Heine G, Landeck L, Sabat R, Worm M, Veres T, Weikum O, Weigt H, Krug N, Braun A, Hahn C, Schuhmann B, Mkhlof S, Pirayesh A, Renz H, Nockher WA, Erpenbeck VJ, Sommer S, Malherbe DC, Wright JR, Hohlfeld JM, Bilitewski C, Reinitz-Rademacher K, Rohde G, Ewig S, Schmelz S, Zindler E, Montermann E, Reske-Kunz AB, Sudowe S, Darcan Y, Galle J, Ahmed J, Seitzer U, Sel S, Wegmann M, Nassenstein C, Pollock K, Dawbarn D, Allen SJ, Gupta S, Schulz-Maronde S, Kutzleb C, Kapp A, Forssmann WG, Forssmann U, Elsner J, Fuchs B, Bälder R, Escher SE, Heitland A, Borelli C, Scharrer E, Oppel T, Przybilla B, Ludwig R, Schindewolf M, Hirsch K, Lindhoff-Last E, Kaufmann R, Boehncke WH, Ruäff F, Albert K, Bauer C, Weimer G, Tas E, Bircher A, Kleine-Tebbe J, Herold DA, Ribel M, Hartz C, Miguel-Moncin MMS, Cistero-Bahima A, Conti A, Scheurer S, Fiedler EM, Illner AK, Lee H, Ernst D, Backhaus B, Raithel M, Hahn EG, Nabe A, Straube S, Weidenhiller M, Konturek P, Simon K, Kressel J, Wildner S, Simon D, Mart H, Heer P, Simon HU, Braathen LR, Straumann A, Brockow K, Huss-Marp J, Braun-Falco M, Schmelz M, Darsow U, Preussner LM, Ristau T, Sotlar K, Hartmann K, Gerbaulet A, Baldus SE, Magerl M, Siebenhaar F, Maurer M, Wittmann M, Purwar R, Hartmann C, Stünkel T, Werfel T, Mrabet-Dahbi S, Ahmad-Nejad P, Breuer K, Klotz M, Herz U, Heeg K, Neumaier M, Langer K, Wollenberg A, Soost S, Zuberbier T, Biedermann T, Günther C, Tangemann K, Schwärzler C, Lametschwandtner G, Rot A, Carballido JM, Gibbs BF, Zillikens D, Grabbe J, Zahradnik E, Fleischer C, Dorn I, Eberhardt F, Hartwig D, Rueff F, Hipler UC, Vetter M, Heitmann M, Bauer A, Elsner P, Herzinger T, Summer B, Maier S, Ghoreschi K, Roider G, Thomas P, Freising C, Glaser S, Schäfer T. 17. Mainzer Allergie-Workshop. Allergo J 2005. [DOI: 10.1007/bf03370389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Eberhardt F, Mehlhorn U, Larosé K, De Vivie ER, Dhein S. Structural myocardial changes after coronary artery surgery. Eur J Clin Invest 2000; 30:938-46. [PMID: 11114955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Postoperative contractile dysfunction or 'myocardial stunning' has been described after coronary artery bypass grafting (CABG). In the present study we sought to determine if and to what extent clinical, structural and histochemical evidence of myocardial changes associated with stunning could be found in patients after CABG and cold crystalloid cardioplegia. MATERIALS AND METHODS Left ventricular (LV) biopsies were obtained from CABG patients (n = 10) prior to and at the end of cardiopulmonary bypass (CPB). These biopsies were immunostained for the inducible heat-shock protein 70 (HSP-70i), intercellular adhesion molecule-1 (ICAM-1) and actin. ATP was measured by bioluminescence. RESULTS Biopsies pre-CPB showed no evidence of myocardial damage as HSP-70i was absent and a regular actin cross-striation pattern and only constitutive ICAM-1-expression were present. After CPB we found significantly increased HSP-70i and ICAM-1 levels as well as a deranged actin cross-striation pattern with a widening of actin bands. ATP levels declined from 10 mmol L-1 pre-CPB to 4.9 mmol L-1 after CPB. Correspondingly, coronary sinus effluent showed a significant lactate production. Although, cardiac function determined by transoesophageal echocardiography did not deteriorate, significant inotropic support was necessary to maintain cardiac output. CONCLUSIONS Our results present clinical and structural evidence of 'myocardial stunning' after CABG and cold crystalloid cardioplegia. Increased HSP-70i and ICAM-1 expression, as well as a deranged actin cross-striation pattern, might be structural markers to determine 'myocardial stunning' in clinical settings.
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Affiliation(s)
- F Eberhardt
- University of Cologne, University of Halle, Germany.
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Mehlhorn U, Sauer H, Kuhn-Régnier F, Südkamp M, Dhein S, Eberhardt F, Grond S, Horst M, Hekmat K, Geissler HJ, Warters RD, Allen SJ, Rainer de Vivie E. Myocardial beta-blockade as an alternative to cardioplegic arrest during coronary artery surgery. Cardiovasc Surg 1999; 7:549-57. [PMID: 10499899 DOI: 10.1016/s0967-2109(99)00022-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The authors' recent experimental work has demonstrated that myocardial protection using continuous coronary perfusion with warm beta-blocker-enriched blood avoids myocardial ischaemia and minimizes myocardial oedema formation, thus completely preserving left ventricle function. The purpose of this clinical study was to compare this alternative technique in terms of structural and functional myocardial protection with the routinely used crystalloid Bretschneider cardioplegia. Sixty coronary artery surgery patients were randomized to receive either crystalloid cardioplegia or continuous coronary perfusion with warm blood enriched with the ultra-short acting beta-blocker esmolol. Cardiac function was evaluated using transoesophageal echocardiography (fractional area of contraction) and cardiac metabolism using arterial-coronary sinus lactate concentration difference (a - csD(LAC)). From left ventricular biopsies, the authors determined myocardial oedema, heat-shock-protein-70, intercellular-adhesion-molecule and actin pattern. Patients with crystalloid cardioplegia received 3.6 +/- 0.8 grafts during 64 +/- 20 min cross-clamp time (beta-blocker: 3.5 +/- 0.9 grafts during 68 +/- 22 min; NS). Following cross-clamp removal crystalloid cardioplegia hearts released significant lactate amounts (a- csD(LAC)) - 1.0 +/- 0.6 versus - 0.1 +/- 0.2 mmol/litre in beta-blocker hearts; P < 0.05). In crystalloid cardioplegia hearts, myocardial water content increased from 82.1 +/- 2.1% pre-cardiopulmonary bypass to 83.2 +/- 1.7% at the end of cardiopulmonary bypass (P < 0.05); in beta-blocker hearts myocardial water content remained unchanged (pre-cardiopulmonary bypass: 82.3 +/- 1.9%; end of cardiopulmonary bypass: 82.4 +/- 1.7%; NS). At the end of cardiopulmonary bypass, left ventricular biopsies of beta-blocker hearts showed less structural damage as determined by heat shock protein-70, intercellular adhesion molecule-I and deranged actin cross-striation pattern as compared with crystalloid cardioplegia hearts (P < 0.05). The post-cardiopulmonary bypass fractional area of contraction was similar in both groups (beta-blocker: 65 +/- 14%; crystalloid cardioplegia: 62 +/- 16%); however, beta-blocker patients required less inotropic stimulation (dopamine: beta-blocker: 2.9 +/- 2.5 versus crystalloid cardioplegia: 5.0 +/- 2.3 microg/kg per min; P < 0.05). The data suggest that continuous coronary perfusion with warm esmolol-enriched blood results in better myocardial protection compared with crystalloid cardioplegia. It is concluded that the concept of beta-blocker-induced cardiac surgical conditions may be a useful alternative for myocardial protection during coronary artery surgery.
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Affiliation(s)
- U Mehlhorn
- Department of Cardiovascular Surgery, University of Cologne, Germany.
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Scheper T, Müller C, Anders K, Eberhardt F, Plötz F, Schelp C, Thordsen O, Schügerl K. Optical sensors for biotechnological applications. Biosens Bioelectron 1994. [DOI: 10.1016/0956-5663(94)80017-0] [Citation(s) in RCA: 12] [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: 10/18/2022]
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Eberhardt F. [Polishing instruments for metalloceramics]. Osterr Zahntech Handwerk 1975; 20:6-14. [PMID: 1076443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Eberhardt F. [Grindling wheels for metal and ceramics]. Dent Labor (Munch) 1974; 22:376-82. [PMID: 4525339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Eberhardt F, Marxkors R. [Working model with "periodontium"]. Dent Labor (Munch) 1973; 21:1169-71. [PMID: 4599558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Eberhardt F. [3. Crown and bridgework]. DDZ 1969; 23:386-7. [PMID: 5257078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Eberhardt F. [Obtaining stable occlusion through use of crowns and bridgework]. Dent Labor (Munch) 1969; 17:325-9. [PMID: 4894930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Eberhardt F. [The construction of bridgework from metal and porcelain and use of Vitadur-profiles]. Dent Labor (Munch) 1969; 17:9-12 passim. [PMID: 5254698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Eberhardt F. [Temporary crowns for prepared teeth]. Dent Labor (Munch) 1968; 16:329-32. [PMID: 5247445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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