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dos Santos E, Wollmann GM, Nagel V, Ponte HMS, Furtado LETA, Martins-Filho RKV, Weiss G, Martins SCO, Ferreira LE, de França PHC, Cabral NL. Incidence, lethality, and post-stroke functional status in different Brazilian macro-regions: The SAMBA study (analysis of stroke in multiple Brazilian areas). Front Neurol 2022; 13:966785. [PMID: 36188387 PMCID: PMC9520622 DOI: 10.3389/fneur.2022.966785] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/12/2022] [Indexed: 11/14/2022] Open
Abstract
Background Stroke is the second leading cause of death in Brazil. The social and financial burden of stroke is remarkable; however, the epidemiological profile remains poorly understood. Objective The aim of this study was to report the incidence, lethality, and functional status at 30 and 90 days post-stroke in the cities of different Brazilian macro-regions. Methods This is an observational, prospective, and population-based study, led in Canoas (South), Joinville (South, reference center), Sertãozinho (Southeast), and Sobral (Northeast) in Brazil. It was developed according to the three-step criteria recommended by the World Health Organization to conduct population-based studies on stroke. Using different sources, all hospitalized and ambulatory patients with stroke were identified and the same criteria were kept in all cities. All first events were included, regardless of sex, age, or type of stroke. Demographic and risk factor data were collected, followed by biochemical, electrocardiographic, and radiological test results. Functional status and lethality were obtained using the mRankin scale through telephonic interview (validated Brazilian version). Results In 1 year, 932 stroke cases were registered (784 ischemic stroke, 105 hemorrhagic stroke, and 43 subarachnoid hemorrhage). The incidence rates per 100,000 inhabitants, adjusted for the world population, were 63 in Canoas, 106 in Joinville, 72 in Sertãozinho, and 96 in Sobral. The majority (70.8%) were followed for 90 days. Kaplan-Meier curves showed that 90-day survival was different among cities. Sobral, which has the lowest socioeconomic indexes, revealed the worst results in terms of lethality and functional status. Conclusion This study expands the knowledge of stroke epidemiology in Brazil, a middle-income country with enormous socioeconomic and cultural diversity. The discrepancy observed regarding the impact of stroke in patients from Joinville and Sobral highlights the need to improve the strategic allocation of resources to meet the health priorities in each location.
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Affiliation(s)
- Emily dos Santos
- Postgraduate Program on Health and Environment, University of the Region of Joinville–Univille, Joinville, Brazil
| | - Giulia M. Wollmann
- Department of Medicine, University of the Region of Joinville–Univille, Joinville, Brazil
| | - Vivian Nagel
- Joinville Stroke Registry, Hospital Municipal São José, Joinville, Brazil
| | | | | | - Rui K. V. Martins-Filho
- Hospital das Clínicas de Ribeirão Preto, University of São Paulo–USP, Ribeirão Preto, Brazil
| | - Gustavo Weiss
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Sheila C. O. Martins
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Leslie E. Ferreira
- Postgraduate Program on Health and Environment, University of the Region of Joinville–Univille, Joinville, Brazil
- Department of Medicine, University of the Region of Joinville–Univille, Joinville, Brazil
| | - Paulo H. C. de França
- Postgraduate Program on Health and Environment, University of the Region of Joinville–Univille, Joinville, Brazil
- Department of Medicine, University of the Region of Joinville–Univille, Joinville, Brazil
| | - Norberto L. Cabral
- Postgraduate Program on Health and Environment, University of the Region of Joinville–Univille, Joinville, Brazil
- Department of Medicine, University of the Region of Joinville–Univille, Joinville, Brazil
- Joinville Stroke Registry, Hospital Municipal São José, Joinville, Brazil
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Serrano Comes C, Pastor Leary C, Hörmann-Kröpfl M, Schenk M, Weiss G. P-141 The good, the bad and the ugly – The fate of collapsed blastocysts in frozen embryo transfer. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.136] [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: 11/14/2022] Open
Abstract
Abstract
Study question
What is the clinical outcome of collapsed blastocysts without signals of re-expansion in frozen embryo transfers (FET)?
Summary answer
FET of non-re-expanded blastocysts after thawing showed a live-birth rate in 11.5% of the cases. Embryos vitrified on day 5 revealed the best results.
What is known already
Embryo viability is crucial for FET to be successful. Since the introduction of vitrification techniques, outcomes have improved substantially and are even comparable to fresh transfers. Nevertheless, some indicators may help predict the outcome of frozen-thawed blastocysts. Blastocoele re-expansion after thawing has been widely studied and is a strong predictor of clinical pregnancy outcome. However, accurate data on non-re-expanded blastocysts after FET is still not available. Hence, this study aims to evaluate the clinical outcome of non-re-expanded blastocyst after FET.
Study design, size, duration
The retrospective study was designed and conducted at the Kinderwunsch Institut Schenk GmbH (Dobl, Austria). Data was collected from FET performed between 2017 and 2021. In total, 104 FET cycles of collapsed blastocysts were analysed. All the transfers performed were single embryo transfers (SET). Patient’s average age was of 33.6 years at the time of embryo vitrification. Embryos were excluded if they showed more fragmentation than before vitrification.
Participants/materials, setting, methods
Patients were divided into two groups following the time of blastocyst cryopreservation: day 5 (44 SET) and day 6 (60 SET); which was dependant on the time of blastocoel expansion. They were further divided according to the trophectoderm quality: good (42 SET) and poor (62 SET) and the overall embryo quality, considering trophectoderm and inner cell mass (ICM): good (37 SET) and poor (67 SET). In both cases quality was assessed before vitrification.
Main results and the role of chance
A total of 104 collapsed blastocysts were transferred (SET). 16.3% of the patients had a positive biochemical pregnancy. 11.5% of the pregnancies resulted in a live birth and 4.8% of the pregnancies ended in abortion. FET with day 5 non-re-expanded blastocysts after thawing showed better results than day 6 thawed blastocysts regarding biochemical pregnancy (29.5% vs 6.6%, p = 0.02) and live birth rate (20.4% vs 5%, p = 0.017). Good embryo quality before vitrification showed a trend for better clinical outcome, however, results were not significant. A good trophectoderm quality before vitrification revealed a live birth rate of 16.7% compared to 8.1% in poor trophectoderm quality. Regarding overall embryo quality (trophectoderm and ICM quality) the results were 14.3% deliveries for good quality blastocysts vs 7.6% for poor quality blastocysts.
Limitations, reasons for caution
The sample size may be seen as a study limitation. However, statistically significant results were obtained. Nonetheless, results should be confirmed with a bigger sample size.
Wider implications of the findings
The present study revealed a lower chance of live birth for non-re-expanded blastocysts after thawing, which should nevertheless not be overlooked; specially in cases with good quality embryos frozen and thawed on day 5. Transfer of collapsed embryos after thawing would be recommended taking into consideration the study results.
Trial registration number
Not Applicable
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Affiliation(s)
- C Serrano Comes
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
| | - C Pastor Leary
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
| | - M Hörmann-Kröpfl
- Das Kinderwunsch Institut Schenk GmbH, Clinical Embryology , Dobl bei Graz, Austria
| | - M Schenk
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
- Medical University of Graz, Institute of Human Genetics , Graz, Austria
| | - G Weiss
- Das Kinderwunsch Institut Schenk GmbH, Science Department , Dobl bei Graz, Austria
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Feil K, Braun A, Reiser E, Weiss G, von Steuben T, Pinggera GM, Köhn F, Toth B. SARS-CoV-2-Infektion, Corona-Impfung und Reproduktion. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750212] [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: 10/17/2022] Open
Affiliation(s)
- K Feil
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - A Braun
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - E Reiser
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - G Weiss
- Universitätsklinik für Innere Medizin II, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - T von Steuben
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - G-M Pinggera
- Universitätsklinik für Urologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - F Köhn
- Andrologicum, München, Deutschland
| | - B Toth
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
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Schenk M, Voroshilina E, Boldyreva M, Koranda M, Reinschissler N, Weiss G. P–196 Bacterial influence on oocyte quality - the secret of a successful fertilization. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.195] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there a difference in bacterial composition of follicular fluid between oocytes developing a good quality blastocyst and oocytes that fail fertilization?
Summary answer
Follicular fluids of oocytes failing fertilization show a different bacterial profile compared to follicular fluids of oocytes that were successfully fertilized.
What is known already
The presence of pathogens in the female reproductive tract has been intensively investigated. Lactobacillus species are mainly associated with a healthy genital tract and good prognosis for a successful pregnancy. Studies of the bacterial composition of follicular fluids have been mainly undertaken in women participating in reproductive medicine treatment because of the nature to obtain the specimen. In most studies follicular fluids have been pooled for analysis. Information on separately collected follicular fluids is still rare. We hypothesized that the composition of bacteria within follicular fluids is responsible for the success of the fertilization process.
Study design, size, duration
The study was designed and conducted at the Kinderwunsch Institut Schenk GmbH (Dobl, Austria) together with DNA-Technology. Follicular fluids from 46 patients undergoing IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) treatment were included and analyzed.
Participants/materials, setting, methods
Follicular fluids from 46 patients were collected separately. 2 follicular fluids from each patient were screened for common bacteria of the genital tract. One from an oocyte developing a good quality blastocyst and one displaying fertilization failures. Samples were analyzed for bacterial composition using the Femoflor16 (DNA-Technology).
Main results and the role of chance
Quantitative analysis revealed a higher total bacteria mass in follicles from oocytes that failed fertilization. Furthermore, Lactobacillus were not present in those follicles compared to good blastocyst follicles. In addition, Chlamydia trachomatis was found mainly in follicular fluid of not fertilized oocytes together with Eubacterium, Gardnarella and Trichomonas species. Interestingly, a trend of elevated levels of Ureaplasma species in follicular fluids of oocytes developing good quality blastocysts was observed.
Limitations, reasons for caution
Contamination of follicular fluids due to the procedure of oocyte pick up and follicular fluid retrieval cannot be completely excluded. Results should be confirmed with a higher sample size.
Wider implications of the findings: We assume that different bacterial compositions in follicular fluids are responsible for the destiny of the oocyte. It is tempting to speculate that bacterial analysis of follicular fluids may be beneficial to select to best oocytes in future IVF/ICSI treatments.
Trial registration number
Not applicable
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Affiliation(s)
- M Schenk
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
| | - E Voroshilina
- Ural State Medical University, Research, Yekaterinburg, Russia C.I.S
| | - M Boldyreva
- Ural State Medical University, Research, Yekaterinburg, Russia C.I.S
- DNA-Technology, Research, Moscow, Russia C.I.S
| | - M Koranda
- DNA-Technology, Research, Moscow, Russia C.I.S
| | - N Reinschissler
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
| | - G Weiss
- Das Kinderwunsch Institut Schenk GmbH, Research & Development, Dobl bei Graz, Austria
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Barros-Pinkelnig M, Demetz E, Hilbe R, Halper J, Tancevski I, Weiss G. Lipid dyshomeostasis and the control of bacterial infection by macrophages. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.222] [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: 10/20/2022]
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Tymoszuk P, Petzer V, Asshoff M, Schroll A, Seifert M, Hansen R, Milutinovic S, Strouse B, Hassig C, Weiss G, Theurl I. SAT0020 MOMELOTINIB, A JANUS KINASE 1/2 AND ACTIVIN RECEPTOR 1 INHIBITOR, AMELIORATES JOINT INFLAMMATION, SYSTEMIC TH17 DIFFERENTIATION AND ARTHRITIS-LINKED ANEMIA IN PRE-CLINICAL AUTOIMMUNE RA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Janus kinases (JAKs) serve as signaling hubs orchestrating inflammation, innate and adaptive immunity and erythropoiesis. Unfortunately, some of these agents cause suppression of JAK-dependent erythropoiesis, thereby exacerbating inflammation-associated anemia, leading to potential under-dosing and reduced therapeutic benefit. We previously showed that the JAKi momelotinib (MMB) can correct anemia in a rat model of RA, an effect that has been clinically reproduced in myelofibrosis patients treated with MMB. Subsequently, the molecular basis for MMB’s anemia benefit was determined to be a consequence of its potent inhibition of Activin Receptor Type 1 (ACVR1), resulting in decreased hepcidin and, as a consequence, increased systemic iron availability and improved erythropoiesis.Objectives:The goal of the current study was to investigate the effects of MMB on arthritis in pre-clinical RA models.Methods:The anti-arthritic activity of daily administration of MMB was assessed in Streptococcus cell wall-induced arthritis in Lewis rats (PG-PS model) and in collagen antibody-induced arthritis (CAIA) in DBA/1 mice. Consecutive assessment of arthritis was performed by joint thickness measurements and paw scoring. Following 3 weeks of treatment, synovial immune cell infiltration and T cell subset differentiation was quantified. Cytokine gene expression was profiled by quantitative rt-PCR. Anemia was assessed by determination of blood hemoglobin and serum, spleen and liver iron levels.Results:MMB reduced inflammatory granulocyte and macrophage infiltration in synovial tissue by more than 60% at all tested doses as compared to vehicle treatment in PG-PS animals. Importantly, MMB treatment effectively decreased arthritogenic Th17 cell differentiation and overall CD4+ T cells in the synovia beginning at the lowest tested dose and coincided with complete remission of joint swelling at 25 mg/kg. Anti-arthritic activity of MMB was confirmed with significant reductions in arthritis scoring, which demonstrated non-inferiority versus the TNF-α inhibitor, etanercept, in the CAIA model. Consistent with its inhibitory activity on the ACVR1-hepcidin axis, MMB reduced circulating hepcidin levels and mobilized systemic iron, resulting in substantial improvement of the RA-associated anemia in rats.Conclusion:MMB is a highly efficacious anti-arthritic agent that ameliorates local joint inflammation and reduces the systemic differentiation of major arthritogenic effector cell population, Th17 lymphocytes. In accord with our previous report, MMB is distinct from other JAKi due to its ability to inhibit ACVR1 signaling leading to decreased plasma hepcidin, improved iron homeostasis and increased erythropoiesis. The dual anti-inflammatory and anemia-improving pharmacologic activities of MMB position it as a promising and differentiated therapeutic agent for the treatment of RA and other inflammatory diseases with an anemia component.Disclosure of Interests:Piotr Tymoszuk: None declared, Verena Petzer: None declared, Malte Asshoff: None declared, Andrea Schroll: None declared, Markus Seifert: None declared, Ryan Hansen Employee of: I’m a former employee of Sierra Oncology, Snezana Milutinovic Employee of: I’m a former employee of Sierra Oncology, Bryan Strouse Employee of: I’m an employee of Sierra Oncology, Christian Hassig Employee of: I am a former employee of Sierra Oncology, Guenter Weiss: None declared, Igor Theurl Grant/research support from: I have received research support from Sierra Oncology, Consultant of: I have consulted for Kymba Ltd.
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Nasi LA, Martins SCO, Gus M, Weiss G, de Almeida AG, Brondani R, Rebello LC, DalPizzol A, Fuchs FD, Valença MJM, Wirth LF, Nunes G, Anderson CS. Early Manipulation of Arterial Blood Pressure in Acute Ischemic Stroke (MAPAS): Results of a Randomized Controlled Trial. Neurocrit Care 2020; 30:372-379. [PMID: 30460598 DOI: 10.1007/s12028-018-0642-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION There is uncertainty over the optimal level of systolic blood pressure (SBP) in the setting of acute ischemic stroke (AIS). The aim of this study was to determine the efficacy of the early manipulation of SBP in non-thrombolised patients. The key hypothesis under investigation was that clinical outcomes vary across ranges of SBP in AIS. METHODS 218 patients were randomized within 12 h of AIS to maintain the SBP during 24 h within three ranges: Group 1 140-160 mmHg, Group 2 161-180 mmHg or Group 3 181-200 mmHg. Vasoactive drugs and fluids were used to achieve these targets. Good outcome was defined as a modified Rankin score 0-2 at 90-days. RESULTS The median SBP in the three groups in 24 h was: 153 mmHg, 163 mmHg, and 178 mmHg, respectively, P < 0.0001. Good clinical outcome did not differ among the different groups (51% vs 52% vs 39%, P = 0.27). Symptomatic intracranial hemorrhage (SICH) was more frequent in the higher SBP range (1% vs 2.7% vs 9.1%, P = 0.048) with similar mortality rates. No patient had acute neurological deterioration related to the SBP reduction in the first 24 h. In our logistic regression analysis, the odds of having good clinical outcome was higher in Group 2 (OR 2.83) after adjusting for important confounders. Regardless of the assigned group, the probability of good outcome was 47% in patients who were manipulated to increase the BP, 42% to decrease and 62% in non-manipulated (P = 0.1). Adverse effects were limited to Group 2 (4%) and Group 3 (7.6%) and were associated with the use of norepinephrine (P = 0.05). CONCLUSIONS Good outcome in 90 days was not significantly different among the 3 blood pressure ranges. After logistic regression analysis, the odds of having good outcome was greater in Group 2 (SBP 161-180 mmHg). SICH occurred more frequently in Group 3 (181-200 mmHg).
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Affiliation(s)
- Luiz Antonio Nasi
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.
| | - Sheila Cristina Ouriques Martins
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Miguel Gus
- Hypertension Group, Cardiology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Weiss
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andrea Garcia de Almeida
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rosane Brondani
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Costa Rebello
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Angélica DalPizzol
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávio Danni Fuchs
- Hypertension Group, Cardiology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Júlia Monteiro Valença
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil.,Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia F Wirth
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil
| | - Gerson Nunes
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, Porto Alegre, RS, CEP 90 035-903, Brazil
| | - Craig S Anderson
- The George Institute for Global Health, Royal Prince Alfred Hospital, University of New South Wales, Sydney, Australia
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Grabenwöger M, Mach M, Mächler H, Folkmann S, Harrer M, Bonatti J, Czerny M, Weiss G. Further Development of the “Frozen Elephant Trunk Technique” with a Side-Branch Stent for the Left Subclavian Artery (FET-SSB): A Feasibility Study in a Human Anatomical Model. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Martins SCO, Weiss G, Almeida AG, Brondani R, Carbonera LA, de Souza AC, Martins MCO, Nasi G, Nasi LA, Batista C, Sousa FB, Rockenbach MABC, Gonçalves FM, Vedolin LM, Nogueira RG. Validation of a Smartphone Application in the Evaluation and Treatment of Acute Stroke in a Comprehensive Stroke Center. Stroke 2019; 51:240-246. [PMID: 31847753 DOI: 10.1161/strokeaha.119.026727] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- The increasing demand and shortage of experts to evaluate and treat acute stroke patients has led to the development of remote communication tools to aid stroke management. We aimed to evaluate the JOIN App smartphone system-a low-cost tool for rapid clinical and neuroimaging data sharing to expedite decision-making in stroke. Methods- Consecutive acute ischemic stroke patients treated at a University Hospital in Brazil from December 2014 to December 2015 were evaluated. The analysis included all patients presenting with acute ischemic stroke who underwent initial evaluation by neurology residents followed by JOIN teleconsultation with a stroke neurologist on call for management decisions. An expert panel of stroke neurologists and neuroradiologists revised all cases using a standard Picture Archiving and Communication System imaging workstation within 24 hours and analyzed the decision made with remote assistance during the emergency setting. Results- A total of 720 stroke codes were evaluated with 442 acute ischemic stroke qualifying. Seventy-eight (18%) patients were treated with intravenous thrombolysis. The main reasons for tPA (tissue-type plasminogen activator) exclusion were symptom onset >4.5 hours (n=295; 67%) and hypodense middle cerebral artery territory area >1/3 (n=31; 7%). The agreement rates between Picture Archiving and Communication System versus JOIN-based thrombolysis decisions were 100% for the stroke (unblinded) and 99.3% for the neuroradiologist (blinded) experts. The use of the application resulted in a significant reduction in the door-to-needle times across the pre- versus postimplementation periods (median, 90 [interquartile range, 75-106] versus 63 [interquartile range, 61-117] minutes; P=0.03). The rates of 90-day excellent outcomes (modified Rankin Scale, 0-1) were 51.3%; 90-day mortality, 2.6%; and symptomatic intracranial hemorrhage, 3.8%. Conclusions- The JOIN smartphone system allows rapid sharing of clinical and imaging data to facilitate decisions for stroke treatment. The remote application-based decisions seem to be as accurate as the physical presence of stroke experts and might lead to faster times to treatment. This system represents an easily implementable low-cost telemedicine solution for centers that cannot afford the full-time presence of stroke specialists.
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Affiliation(s)
- Sheila C O Martins
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Gustavo Weiss
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Andrea G Almeida
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Rosane Brondani
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil
| | - Leonardo A Carbonera
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Ana Claudia de Souza
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Magda Carla O Martins
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Guilherme Nasi
- Department of Internal Medicine, Jackson Memorial Hospital, Miami, FL (G.N.)
| | - Luiz A Nasi
- Department of Internal Medicine, Hospital Moinhos de Vento, Porto Alegre, Brazil (L.A.N.)
| | - Carlos Batista
- From the Stroke Unit, Department of Neurology, (S.C.O.M., G.W., A.G.A., R.B., L.A.C., A.C.d.S., M.C.O.M., C.B.), Hospital de Clínicas de Porto Alegre, Brazil.,Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., M.C.O.M., C.B.)
| | - Fabrício B Sousa
- Department of Radiology (F.B.S., M.A.B.C.R.), Hospital de Clínicas de Porto Alegre, Brazil
| | | | - Felipe M Gonçalves
- Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.)
| | - Leonardo M Vedolin
- Post Graduation in Stroke Neurology, Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.C.O.M., G.W., A.G.A., L.A.C., A.C.d.S., F.M.G., L.M.V.).,Department of Pathology and Imaging, DASA, São Paulo, Brazil (L.M.V.)
| | - Raul G Nogueira
- Department of Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University, Atlanta, GA (R.G.N.)
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10
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Megyesfalvi Z, Kugler C, Fülöp A, Gergely S, Megyesfalvi B, Kerpel-Fronius A, Döme B, Korn R, Weiss G, Lohinai Z. P1.04-49 Quantitative Computed Tomography (CT) Based Texture Analysis (QTA) Might Identify Responders to Immunotherapy in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.952] [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: 11/16/2022]
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11
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Sehgal K, Shea M, Mcdonald D, Huberman M, Weiss G, Vanderlaan P, Costa D, Rangachari D. P2.04-60 Pembrolizumab-Based Regimens Administered at Non-Standard Frequency in Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1565] [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: 10/25/2022]
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12
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Nasi LA, Martins SCO, Rebello LC, Gus M, Weiss G, de Almeida AG, Brondani R, DalPizzol A, Fuchs FD, Valença MJM, Wirth LF, Nunes G, Anderson CS. Response to Letter to the Editor: New Insights and Old Questions in Acute Stroke Blood Pressure Control. Neurocrit Care 2019; 30:698-699. [PMID: 30809757 DOI: 10.1007/s12028-019-00683-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Luiz Antônio Nasi
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Sheila Cristina Ouriques Martins
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Costa Rebello
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Miguel Gus
- Hypertension Group, Cardiology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Weiss
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andrea Garcia de Almeida
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rosane Brondani
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Angélica DalPizzol
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávio Danni Fuchs
- Hypertension Group, Cardiology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Júlia Monteiro Valença
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Stroke Division, Neurology Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia F Wirth
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gerson Nunes
- Vascular Unit, Emergency Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Craig S Anderson
- The George Institute for Global Health, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
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Wunsch S, Krause R, Valentin T, Prattes J, Janata O, Lenger A, Bellmann-Weiler R, Weiss G, Zollner-Schwetz I. Multicenter clinical experience of real life Dalbavancin use in gram-positive infections. Int J Infect Dis 2019; 81:210-214. [PMID: 30794940 DOI: 10.1016/j.ijid.2019.02.013] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [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: 01/14/2019] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 11/28/2022] Open
Abstract
Dalbavancin, a lipoglycopeptide with prolonged half-life approved for the treatment of acute bacterial skin and soft tissue infections, can be used for the treatment of infections caused by gram-positive bacteria requiring long term treatment such as endocarditis, prosthetic joint infections (PJI) or osteomyelitis. Clinical data are limited in these settings. OBJECTIVES To evaluate indications, safety, tolerability and long-term outcomes of dalbavancin-treated patients. Patients and methods Our multicenter, retrospective study includes patients who received dalbavancin in Austria from September 2016 to March 2018. 90-day outcomes and tolerability were determined. RESULTS A total of 101 patients were included in 3 centers (57% male, median age 65 years). The treated infections were PJI (31%), osteomyelitis (29%), endocarditis (25%) and acute bacterial skin and soft tissue infections (12%). Concomitant use of other antimicrobial substances was common (63%). The mean total cumulative dose of dalbavancin was 3,357mg (±2,283mg). Clinical success rate was 89%. Side effects occurred in 3/101 patients. CONCLUSION In this real-life study dalbavancin was primarily used in off-label indications for treatment of PJI, osteomyelitis and endocarditis. Success rate was high (89%), tolerability and safety were excellent in this setting. Dalbavancin may therefore be used in these off-label indications as alternative treatment approach.
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Affiliation(s)
- S Wunsch
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - R Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - T Valentin
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - J Prattes
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - O Janata
- Department of Hygiene and Infection Control, Danube Hospital, Vienna, Austria
| | - A Lenger
- Department of Hygiene and Infection Control, Danube Hospital, Vienna, Austria
| | - R Bellmann-Weiler
- Department of Internal Medicine II (Infectious Disease, Immunology, Rheumatology, Pneumology), Medical University of Innsbruck, Austria
| | - G Weiss
- Department of Internal Medicine II (Infectious Disease, Immunology, Rheumatology, Pneumology), Medical University of Innsbruck, Austria
| | - I Zollner-Schwetz
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria.
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Mach M, Szalkiewicz P, Poschner T, Cuhaj C, Watzal V, Winkler B, Weiss G, Grabenwöger M. A Comparison of Semi- and Noncompliant Balloon Systems in Transcatheter Aortic Valve Implantation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678766] [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: 10/27/2022]
Affiliation(s)
- M. Mach
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - P. Szalkiewicz
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - T. Poschner
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - C. Cuhaj
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - V. Watzal
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - B. Winkler
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - G. Weiss
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - M. Grabenwöger
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
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15
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Mach M, Watzal V, Cuhaj C, Winkler B, Wallner S, Weiss G, Grabenwöger M. The Impact of Antiplatelet and Antithrombotic Therapy on Outcome and Survival after Transcatheter Aortic Valve Implantation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678995] [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: 10/27/2022]
Affiliation(s)
- M. Mach
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - V. Watzal
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - C. Cuhaj
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - B. Winkler
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - S. Wallner
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - G. Weiss
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - M. Grabenwöger
- Department for Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
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Plank F, Stowasser B, Till D, Schgör W, Dichtl W, Hintringer F, Weiss G, Stühlinger M. Reduction of fluoroscopy dose for cardiac electrophysiology procedures: A feasibility and safety study. Eur J Radiol 2019; 110:105-111. [DOI: 10.1016/j.ejrad.2018.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/14/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
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17
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Margreiter R, Aichberger C, Königsrainer A, Reibnegger G, Weiss G, Wachter H. Biliary neopterin for differentiation between liver allograft rejection and viral graft infection. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Fuchs D, Gostner JM, Griesmacher A, Melichar B, Reibnegger G, Weiss G, Werner ER. 37th International Winter-Workshop Clinical, Chemical and Biochemical Aspects of Pteridines and Related Topics. Pteridines 2018. [DOI: 10.1515/pteridines-2018-0006] [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: 11/15/2022] Open
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20
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Graupp M, Rinner B, Frisch MT, Weiss G, Fuchs J, Sundl M, El-Heliebi A, Moser G, Kamolz LP, Karbiener M, Gugatschka M. Towards an in vitro fibrogenesis model of human vocal fold scarring. Eur Arch Otorhinolaryngol 2018. [PMID: 29520499 PMCID: PMC5893733 DOI: 10.1007/s00405-018-4922-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Vocal fold (VF) scarring remains a therapeutic dilemma and challenge in modern laryngology. To facilitate corresponding research, we aimed to establish an in vitro fibrogenesis model employing human VF fibroblasts (hVFF) and the principles of macromolecular crowding (MMC). Methods Fibrogenesis was promoted by addition of transforming growth factor-β1 to standard medium and medium containing inert macromolecules (MMC). Hepatocyte growth factor (HGF) and Botox type A were tested for their antifibrotic properties in various doses. Experiments were analyzed with respect to the biosynthesis of collagen, fibronectin, and α-smooth muscle actin using immunofluorescence, silver stain and western blot. Results MMC led to favourable enhanced deposition of collagen and other extracellular matrix components, reflecting fibrotic conditions. Low doses of HGF were able to dampen profibrotic effects. This could not be observed for higher HGF concentrations. Botox type A did not show any effects. Conclusion Based on the principles of MMC we could successfully establish a laryngeal fibrogenesis model employing hVFF. Our finding of dose-dependent HGF effects is important before going into clinical trials in humans and has never been shown before. Our model provides a novel option to screen various potential antifibrotic compounds under standardized conditions in a short time. Electronic supplementary material The online version of this article (10.1007/s00405-018-4922-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Graupp
- Department of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - B Rinner
- Division of Biomedical Research, Core Facility Alternative Biomodels and Preclinical Imaging, Medical University of Graz, Graz, Austria
| | - M T Frisch
- Division of Biomedical Research, Core Facility Alternative Biomodels and Preclinical Imaging, Medical University of Graz, Graz, Austria
| | - G Weiss
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - J Fuchs
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - M Sundl
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - A El-Heliebi
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - G Moser
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - L P Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - M Karbiener
- Department of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.
| | - M Gugatschka
- Department of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
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Martins SC, Souza AC, Carbonera LA, Martins MC, Martin K, Portal M, Parrini M, Almeida AG, Brondani R, Weiss G, Nasi LA. Abstract TP314: Comparison of Patient-centered Outcome Measures of the International Consortium for Health Outcomes Measurements (ICHOM) Between Private and Public Healthcare System in Brazil. Stroke 2018. [DOI: 10.1161/str.49.suppl_1.tp314] [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: 11/16/2022]
Abstract
Introduction:
An international experts panel was assembled to create a standard set of outcome measures for use in both low and high-income countries. Additionally, the panel intended to represent the most relevant outcomes for subsequent cost-effectiveness analysis. For implementing the tool, it was necessary to make it feasible in different healthcare systems. The objective of this study was to implement and compare the ICHOM outcome measures between two different stroke centers: a university public hospital and a private hospital.
Methods:
the medical data of all patients with stroke diagnosis consecutively admitted in the two hospitals were registered. ICHOM outcomes in the 3-month follow-up were measured by interviews in person, by phone or by e-mail, and the results were compared between the hospitals.
Results:
90-day outcome measurements were available for 328 patients (169 in the private hospital and 159 in the public), corresponding to 87% of the patients admitted with stroke diagnosis in these hospitals. The mean age was 68 years in the private vs. 65 in the public, with a mean NIHSS of 7, and 90% had ischemic strokes (18% received IV thrombolysis in the private setting vs. 16% in the public). Public hospital inpatients had a greater number of comorbidities. The mortality rate was 14% in both hospitals, and functional independence (mRS 0-2) occurred in 51% of private setting patients and 39% of the public. The greater proportion of patients needing help for dressing or toileting, as well as having language issues, was in the public setting. Better outcomes were measured in the private hospital regarding the resumption of the social role (64% vs 40%), satisfaction with social activities (65% vs 57%) and good quality of life (66% vs 57%). In both hospitals, 34% had access to physiotherapy after hospital discharge.
Conclusions:
In patients with acute stroke from private and public hospitals the thrombolysis eligibility are similar, without increasing the mortality rates in the public setting. However, better functional outcomes were found in private patients, probably due to less comorbidities, better prevention and post-discharge rehabilitation care.
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Affiliation(s)
| | - Ana C Souza
- Neurology, Hosp Moinhos de Vento, Porto Alegre, Brazil
| | | | | | - Kelin Martin
- Neurology, Hosp Moinhos de Vento, Porto Alegre, Brazil
| | | | | | - Andrea G Almeida
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Rosane Brondani
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Gustavo Weiss
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
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22
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Martins SC, Martins MC, Carbonera LA, Souza AC, Portal M, Martin K, Rodrigues G, Cuervo LM, Brondani R, Almeida AG, Weiss G, Parrini M, Nasi LA. Abstract TP312: Assessment of the Data Collection Strategies for Stroke Patient-centered Outcomes: Implementation of the International Consortium for Health Outcomes in Brazil. Stroke 2018. [DOI: 10.1161/str.49.suppl_1.tp312] [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: 11/16/2022]
Abstract
Introduction:
In 2015, international experts defined a standard set of patient-centered outcome measures after stroke as part of the International Consortium for Health Outcomes (ICHOM). It aims to make outcomes comparable around the world, allowing the value-based healthcare delivery. In developing countries, it is still a challenge to implement outcome measurement for stroke patients after hospital discharge, due to different structures and healthcare network characteristics. The study objective is to assess the implementation strategies of the outcome measures of ICHOM stroke in 6 Brazilian hospitals.
Methods:
For 1 year, we progressively implemented ICHOM outcome measurements in 6 stroke centers: 1 private, 1 public university and 4 primary stroke centers with telemedicine guidance. The data collection strategies included: in person interview, interview by phone or a link to an online form sent by e-mail.
Results:
429 patients were included in the 90-day follow-up interview. In person interview was made for 80 patients (mean interview time of 5 minutes), by phone in 285 (mean interview time 8 minutes) and by e-mail in 64. There was loss of follow-up in 15% of in-person interviews, 28% on phone and 62% on e-mail. In the private hospital, where there is better data registry, only 18% of the patients were lost to follow-up, while 54% of telemedicine patients weren’t found for the interview, mainly because of lack of phone number register or even wrong number. Higher succeeded attempts occurred on evening calls compared to business hours’ calls.
Conclusion:
The data collection for outcome measurements of stroke patients in Brazil is still a challenge. The barrier for phone interviews was data registry error, and the correct phone number being registered allows the follow-up. Though requiring further validation, e-mail contact seems to be a good initial strategy, decreasing the need for phone calls and saving time. The phone calls are the option for patients who do not answer e-mails.
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Affiliation(s)
| | | | | | - Ana C Souza
- Neurology, Hosp Moinhos de Vento, Porto Alegre, Brazil
| | | | - Kelin Martin
- Neurology, Hosp Moinhos de Vento, Porto Alegre, Brazil
| | | | | | - Rosane Brondani
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Andrea G Almeida
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Gustavo Weiss
- Neurology, Hosp de Clinicas de Porto Alegre, Porto Alegre, Brazil
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23
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Santer D, Weiss G, Oliva S, Niederbichler L, Pisarik H, Arnold Z, Mach M, Nagel F, Huf W, Grabenwöger M, Moidl R. Surgical Aortic Valve Replacement in Small Aortic Roots for Aortic Stenosis. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627891] [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]
Affiliation(s)
- D. Santer
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - G. Weiss
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - S. Oliva
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - L. Niederbichler
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - H. Pisarik
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - Z. Arnold
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - M. Mach
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - F. Nagel
- LBC for Cardiovascular Research, Department for Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - W. Huf
- Hospital Hietzing, Vienna, Austria
| | - M. Grabenwöger
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
| | - R. Moidl
- Department of Cardiovascular Surgery, Karl Landsteiner Research Institute for Cardiovascular Surgical Research, Hospital Hietzing, Vienna, Austria
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Weiss G, Arnold Z, Santer D, Mach M, Wallner S, Moidl R, Gorlitzer M, Grabenwöger M. Twelve Years of Frozen Elephant Trunk Repairs for Complex Aortic Pathologies: A Single Centre Experience in 110 Consecutive Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627887] [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]
Affiliation(s)
- G. Weiss
- Hospital Hietzing, Vienna, Austria
| | | | | | - M. Mach
- Hospital Hietzing, Vienna, Austria
| | | | - R. Moidl
- Hospital Hietzing, Vienna, Austria
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Ferreira LE, França PHCD, Nagel V, Venancio V, Safanelli J, Reis FID, Furtado L, Martins RK, Weiss G, Oda E, Lopes-Cendes I, Pontes-Neto O, Cabral NL. Joinville stroke biobank: study protocol and first year’s results. Arq Neuro-Psiquiatr 2017; 75:881-889. [DOI: 10.1590/0004-282x20170157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/08/2017] [Indexed: 02/07/2023]
Abstract
ABSTRACT Aiming to contribute to studies that use detailed clinical and genomic information of biobanks, we present the initial results of the first Latin American Stroke Biobank. Methods: Blood samples were collected from patients included in the Joinville Stroke Registry and four Brazilian cities. Demographic socio-economic data, cardiovascular risk factors, Causative Classification System for Ischemic Stroke, Trial of Org 10172 in Acute Stroke Treatment and National Institutes of Health scores, functional stroke status (modified Rankin) and brain images were recorded. Additionally, controls from both geographic regions were recruited. High-molecular-weight genomic DNA was obtained from all participants. Results: A total of 2,688 patients and 3,282 controls were included. Among the patients, 76% had ischemic stroke, 12% transient ischemic attacks, 9% hemorrhagic stroke and 3% subarachnoid hemorrhage. Patients with undetermined ischemic stroke were most common according the Trial of Org 10172 in Acute Stroke Treatment (40%) and Causative Classification System for Ischemic Stroke (47%) criteria. A quarter of the patients were under 55 years of age at the first-ever episode. Conclusions: We established the Joinville Stroke Biobank and discuss its potential for contributing to the understanding of the risk factors leading to stroke.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Elder Oda
- Universidade Federal do Rio Grande do Sul, Brasil
| | - Iscia Lopes-Cendes
- Universidade de Campinas, Brasil; Instituto Brasileiro de Neurociência e Neurotecnologia, Brasil
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Weiss G, Lai C, Fife ME, Grabiec AM, Tildy B, Snelgrove RJ, Xin G, Lloyd CM, Hussell T. Reversal of TREM-1 ectodomain shedding and improved bacterial clearance by intranasal metalloproteinase inhibitors. Mucosal Immunol 2017; 10:1021-1030. [PMID: 27966555 DOI: 10.1038/mi.2016.104] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 10/07/2016] [Indexed: 02/04/2023]
Abstract
Triggering receptor expressed on myeloid cells-1 (TREM-1) is expressed on neutrophils and monocyte/macrophages and amplifies Toll-like receptor-mediated inflammation during infection. TREM-1 also exists in an antagonistic soluble form (sTREM-1) that has been used as a peripheral biomarker in sepsis, though the mechanisms of its release are not entirely clear. The requirement of TREM-1 in single microbial infections is controversial, with some studies showing a protective role and others a contribution to immunopathology. Furthermore, the role of membrane-bound and sTREM-1 in polygenic infections is currently unknown. In a mouse co-infection model where preceding viral infection greatly enhances bacteria co-infection, we now determine a mechanisms for the striking increase in sTREM-1 and the loss of TREM-1 on surface of neutrophils. We identified a matrix metalloproteinase (MMP)-9 cleavage site in TREM-1 and that the increase of MMP-9 in bronchoalveolar lavage fluid mirrors sTREM-1 release. In vitro studies with neutrophils and MMP-9 and the reduction of sTREM-1 in vivo after MMP-9 inhibition verifies that this enzyme cleaves TREM-1. Intriguingly, MMP-9 inhibition significantly reduces bacterial load and ensuing immunopathology in a co-infection model. This highlights MMP-9 inhibition as a potential therapeutic via blocking cleavage of TREM-1.
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Affiliation(s)
- G Weiss
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - C Lai
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - M E Fife
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Manchester, UK
| | - A M Grabiec
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Manchester, UK
| | - B Tildy
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - R J Snelgrove
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - G Xin
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - C M Lloyd
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
| | - T Hussell
- National Heart and Lung Institute, Department of Inflammation, Development &Repair, Imperial College London, London, UK
- Manchester Collaborative Centre for Inflammation Research (MCCIR), Manchester, UK
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Weiss G, Carver PL. Role of divalent metals in infectious disease susceptibility and outcome. Clin Microbiol Infect 2017; 24:16-23. [PMID: 28143784 DOI: 10.1016/j.cmi.2017.01.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/21/2017] [Accepted: 01/22/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Divalent metals play important roles in maintaining metabolism and cellular growth of both eukaryotic hosts and invading microbes. Both metal deficiency and overload can result in abnormal cellular function or damage. Given its central role in host-pathogen interactions, subtle alterations of divalent metal homeostasis can occur in the course of infectious diseases which aim, from the host perspective, either to reduce the availability of respective metals to microbes or to use toxic metal accumulation to eliminate pathogens. AIMS To provide the reader with background information and clinical data on divalent metal homeostasis in host-pathogen interactions, how this affects the course of infectious disease and whether correction of metal disturbances has shown benefit in infections. SOURCES An in-depth analysis of PubMed articles related to the topic of this review published in English between 1970 and 2016 was performed. CONTENT From the microbial perspective, divalent metals are essential for growth and pathogenicity and to mount effective protection against antimicrobial host responses, including toxic radical formation. Microbes have evolved multiple strategies to control their access to divalent metals. From the clinical perspective, alterations of divalent metal levels may result in increased or decreased susceptibility to infection and often occur in response to infections. However, keeping in mind the strategies underlying such alterations, for which the term 'nutritional immunity' was coined, the uncritical correction of such divalent metal imbalances may cause harm to patients. This review addresses the role of the divalent metals iron, selenium, zinc, manganese and copper in infectious diseases from a mechanistic and clinical perspective. IMPLICATIONS We point out areas of research needed to expand our limited knowledge, hoping to improve the clinical management of patients with infections and to identify promising new targets for treatment by modulation of host or microbe divalent metal metabolism.
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Affiliation(s)
- G Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
| | - P L Carver
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
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Bazhenova L, Gettinger S, Langer C, Salgia R, Gold K, Rosell R, Shaw A, Weiss G, Haney J, Rivera V, Haluska F, Kerstein D, Camidge D. Brigatinib (BRG) in patients (Pts) with anaplastic lymphoma kinase (ALK)–positive non–small cell lung cancer (NSCLC) in a phase 1/2 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Khemka V, Haire P, Waypa J, Weiss G. P-278 Phase Ib/II study of nivolumab plus CAPIRI: Initial results of metastatic colon cancer and pancreatic adenocarcinoma patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Rieger E, Sonnweber T, Cima K, Weiss G, Löffler-Ragg J. Iron deficiency in pulmonary arterial hypertension: a matter of definition! Pneumologie 2016. [DOI: 10.1055/s-0036-1583507] [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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31
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Pizzini A, Sahanic A, Kurz K, Weiss G, Bellmann-Weiler R. Diagnostic and prognostic value of inflammatory parameters including neopterin in pneumonia, COPD and acute exacerbations of COPD. Pneumologie 2016. [DOI: 10.1055/s-0036-1583511] [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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Weiss G, Hasinger O, Esche S, Martini M, König T, Schlegel A. 31PD DNA methylation of SHOX2 and PTGER4 as a plasma-based tool to differentiate between patients with malignant and benign lung disease. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30145-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Szebeni J, Fishbane S, Hedenus M, Howaldt S, Locatelli F, Patni S, Rampton D, Weiss G, Folkersen J. Hypersensitivity to intravenous iron: classification, terminology, mechanisms and management. Br J Pharmacol 2015; 172:5025-36. [PMID: 26265306 DOI: 10.1111/bph.13268] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 07/20/2015] [Accepted: 07/23/2015] [Indexed: 12/19/2022] Open
Abstract
Intravenous (IV) iron therapy is widely used in iron deficiency anaemias when oral iron is not tolerated or ineffective. Administration of IV-iron is considered a safe procedure, but severe hypersensitivity reactions (HSRs) can occur at a very low frequency. Recently, new guidelines have been published by the European Medicines Agency with the intention of making IV-iron therapy safer; however, the current protocols are still non-specific, non-evidence-based empirical measures which neglect the fact that the majority of IV-iron reactions are not IgE-mediated anaphylactic reactions. The field would benefit from new specific and effective methods for the prevention and treatment of these HSRs, and the main goal of this review was to highlight a possible new approach based on the assumption that IV-iron reactions represent complement activation-related pseudo-allergy (CARPA), at least in part. The review compares the features of IV-iron reactions to those of immune and non-immune HSRs caused by a variety of other infused drugs and thus make indirect inferences on IV-iron reactions. The process of comparison highlights many unresolved issues in allergy research, such as the unsettled terminology, multiple redundant classifications and a lack of validated animal models and lege artis clinical studies. Facts and arguments are listed in support of the involvement of CARPA in IV-iron reactions, and the review addresses the mechanism of low reactogenic administration protocols (LRPs) based on slow infusion. It is suggested that consideration of CARPA and the use of LRPs might lead to useful new additions to the management of high-risk IV-iron patients.
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Affiliation(s)
- J Szebeni
- Nanomedicine Research and Education Center, Semmelweis University, Budapest, Hungary.,Department of Nanobiotechnology and Regenerative Medicine, Miskolc University, Miskolc, Hungary
| | - S Fishbane
- Hofstra North Shore-LIJ School of Medicine, New York, NY, USA
| | - M Hedenus
- Department for Internal Medicine, Sundsvalls Hospital, Sundsvall, Sweden
| | - S Howaldt
- Research Institute for IBD, HaFCED GmbH & Co. KG, Hamburg, Germany
| | - F Locatelli
- Department of Nephrology, Alessandro Manzoni Hospital, Lecco, Italy
| | - S Patni
- Birmingham Heartlands Hospital, Birmingham, UK
| | - D Rampton
- Barts and the London School of Medicine and Dentistry, London, UK
| | - G Weiss
- Department for Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
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Moser G, Weiss G, Gauster M, Sundl M, Huppertz B. Evidence from the very beginning: endoglandular trophoblasts penetrate and replace uterine glands in situ and in vitro. Hum Reprod 2015; 30:2747-57. [PMID: 26493408 DOI: 10.1093/humrep/dev266] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [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: 07/29/2015] [Accepted: 09/30/2015] [Indexed: 12/23/2022] Open
Abstract
STUDY QUESTION How is histiotrophic nutrition of the embryo secured during the first trimester of pregnancy? SUMMARY ANSWER Rather than specifically focusing on invasion into spiral arteries, extravillous trophoblasts also invade into uterine glands (endoglandular trophoblast) from the very beginning and open them toward the intervillous space. WHAT IS KNOWN ALREADY Extravillous trophoblasts can be found in close contact and within the lumen of uterine glands, sometimes replacing glandular epithelial cells. STUDY DESIGN, SIZE, DURATION As well as extensive screening of specimens from first trimester placentation sites in situ we used a previously established three-dimensional co-culture in vitro model system of first trimester villous explants with non-invaded decidua parietalis. PARTICIPANTS/MATERIALS, SETTING, METHODS First trimester placentas were obtained from elective terminations of pregnancies (n = 48) at 5-11 weeks of gestational age. A subset was processed for confrontation co-culture (n = 31). Invaded decidua basalis was obtained from 20 placentas. All tissues were sectioned, subsequently immunostained and immunodoublestained with antibodies against keratin 7 (KRT7), major histocompatibility complex, class I, G (HLA-G), matrix metallopeptidase 9 (MMP9), von Willebrand factor (VWF) and the appropriate Immunoglobulin G (IgG) negative controls. Replacement of endothelial/epithelial cells by extravillous trophoblasts was quantified semi-quantitatively. Additionally, hematoxylin and eosin-stained archival specimens from early implantation sites were assessed. MAIN RESULTS AND THE ROLE OF CHANCE The earliest available specimen was from around Day 10 after conception; already at this stage trophoblasts had penetrated into uterine glands and had started to replace the epithelium of the glands. Endoglandular trophoblasts replaced uterine glands in vitro and in situ and could be found in the lumen of invaded glands. Quantitative analysis revealed significantly more replacement of epithelial cells in glands (63.8 ± 22.1%) compared with endothelial cells in vessels (26.4 ± 8.8%). Accumulated detached glandular epithelial cells could be repeatedly observed in the lumen of invaded glands. Additionally, in areas of trophoblast invasion the glandular epithelium seemed to be completely disintegrated compared with glandular epithelium in the non-invaded parts of the decidua. Whole tissue specimens were used in vitro and in situ instead of cell lines; these systems mostly maintain the context of the in vivo situation. LIMITATIONS, REASONS FOR CAUTION This is a descriptive study supported by in vitro experiments. However, a histological section will always only be a snapshot and quantification from histological sections has its limitations. WIDER IMPLICATIONS OF THE FINDINGS This study further strengthens the hypothesis of histiotrophic nutrition of the embryo prior to the establishment of the maternal blood flow toward the placenta. Invasion of uterine glands by endoglandular trophoblasts may have more impact on the outcome of early pregnancy than assumed up to now.
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Affiliation(s)
- G Moser
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, 8010 Graz, Austria
| | - G Weiss
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, 8010 Graz, Austria
| | - M Gauster
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, 8010 Graz, Austria
| | - M Sundl
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, 8010 Graz, Austria
| | - B Huppertz
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, 8010 Graz, Austria
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Niu J, Andres G, Kramer K, Kundranda M, Weiss G, Klimant E, Parikh A, Tan B, Staren E, Markman M. 1884 The incidence and clinical significance of ESR1 mutations in patients with heavily pretreated metastatic breast cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30834-6] [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: 11/29/2022]
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Rosner J, Mosheimer-Feistritzer B, Gruber J, Herold M, Mur E, Weiss G. FRI0083 Prevalence of Anemia in a Cohort of Rheumatoid Arthritis Patients- An Interim Analysis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Weiss G, Santer D, Folkmann SV, Dumfarth J, Pisarik H, Harrer M, Waldenberger F, Grabenwoger M. 254 * EVALUATION OF THE DOWNSTREAM AORTA AFTER FROZEN ELEPHANT TRUNK REPAIR FOR AORTIC DISSECTIONS IN TERMS OF DIAMETER AND FALSE LUMEN STATUS. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.254] [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: 11/13/2022] Open
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Sahanic A, Bellmann-Weiler R, Geiregger M, Eller P, Eller K, Weiss G, Mur E. Klinische Evaluierung von physiotherapeutischen Verfahren in der Behandlung der ambulant erworbenen Pneumonie. Pneumologie 2014. [DOI: 10.1055/s-0034-1375921] [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: 10/25/2022]
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Locatelli F, Choukroun G, Fliser D, Moecks J, Wiggenhauser A, Gupta A, Swinkels DW, Lin V, Guss C, Pratt R, Carrilho P, Martins AR, Alves M, Mateus A, Gusmao L, Parreira L, Assuncao J, Rodrigues I, Stamopoulos D, Mpakirtzi N, Afentakis N, Grapsa E, Zitt E, Sturm G, Kronenberg F, Neyer U, Knoll F, Lhotta K, Weiss G, Robinson BM, Larkina M, Bieber B, Kleophas W, Li Y, Locatelli F, McCullough K, Nolen JG, Port FK, Pisoni RL, Kalicki RM, Uehlinger DE, Ogawa C, Kanda F, Tomosugi N, Maeda T, Kuji T, Fujikawa T, Shino M, Shibata K, Kaneda T, Nishihara M, Satta H, Kawata SI, Koguchi N, Tamura K, Hirawa N, Toya Y, Umemura S, Chanliau J, Martin H, Stamatelou K, Gonzalez-Tabares L, Manamley N, Farouk M, Addison J, Donck J, Schneider A, Gutjahr-Lengsfeld L, Ritz E, Scharnagl H, Gelbrich G, Pilz S, Macdougall IC, Wanner C, Drechsler C, Kuntsevich V, Charen E, Kobena D, Sheth N, Siktel H, Levin NW, Winchester JF, Kotanko P, Kaysen G, Kuragano T, Kida A, Yahiro M, Nanami M, Nagasawa Y, Hasuike Y, Nakanishi T, Stamopoulos D, Mpakirtzi N, Dimitratou V, Griveas I, Lianos E, Grapsa E, Sasaki Y, Yamazaki S, Fujita K, Kurasawa M, Yorozu K, Shimonaka Y, Suzuki N, Yamamoto M, Zwiech R, Szczepa ska J, Bruzda-Zwiech A, Rao A, Gilg J, Caskey F, Kirkpantur A, Balci MM, Turkvatan A, Afsar B, Alkis M, Mandiroglu F, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Hasuike Y, Kida A, Oue M, Yamamoto K, Kimura T, Fukao W, Yahiro M, Kaibe S, Nanami M, Nakanishi T, Djuric PS, Ikonomovski J, Tosic J, Jankovic A, Majster Z, Stankovic Popovic V, Dimkovic N, Aicardi Spalloni V, Del Vecchio L, Longhi S, Violo L, La Milia V, Pontoriero G, Locatelli F, Shino M, Kuji T, Fujikawa T, Toya Y, Umemura S, Macdougall I, Rumjon A, Mangahis E, Goldstein L, Ryzlewicz T, Becker F, Kilgallon W, Fukasawa M, Otake Y, Yamagishi T, Kamiyama M, Kobayashi H, Takeda M, Toida T, Sato Y, Fujimoto S. DIALYSIS ANAEMIA. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu176] [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: 11/12/2022] Open
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Gomollón F, Chowers Y, Danese S, Dignass A, Haagen Nielsen O, Lakatos PL, Lees CW, Lindgren S, Lukas M, Mantzaris GJ, Michetti P, Moum B, Peyrin-Biroulet L, Toruner M, van der Woude J, Weiss G, Stoevelaar H, Reinisch W. Letter: European Medicines Agency recommendations for allergic reactions to intravenous iron-containing medicines. Aliment Pharmacol Ther 2014; 39:743-4. [PMID: 24588280 DOI: 10.1111/apt.12648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/14/2014] [Indexed: 12/08/2022]
Affiliation(s)
- F Gomollón
- CIBEREHD, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. ,
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Folkmann S, Weiss G, Pisarik H, Czerny M, Grabenwoger M. Thoracoabdominal aortic aneurysm repair after frozen elephant trunk procedure. Eur J Cardiothorac Surg 2014; 47:115-9; discussion 119. [DOI: 10.1093/ejcts/ezu096] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aschauer S, Gouya G, Klickovic U, Storka A, Weisshaar S, Vollbracht C, Krick B, Weiss G, Wolzt M. Effect of systemic high dose vitamin C therapy on forearm blood flow reactivity during endotoxemia in healthy human subjects. Vascul Pharmacol 2014; 61:25-9. [PMID: 24512733 DOI: 10.1016/j.vph.2014.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 07/31/2013] [Revised: 01/25/2014] [Accepted: 01/30/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Acute inflammation induced by administration of Escherichia coli lipopolysaccharide endotoxin (LPS) reduces plasma concentrations of vitamin C and impairs vascular endothelium-derived nitric oxide (NO) bioactivity. We tested the hypothesis that systemically administered high dose vitamin C restores the endogenous anti-oxidant potential and improves NO-dependent vasodilatation in the forearm vasculature. DESIGN & SETTING 36 male subjects were enrolled in this balanced, placebo controlled cross-over study. Forearm blood flow (FBF) reactivity to acetylcholine (ACh) and glyceryl-trinitrate (GTN), a sensitive test for endothelial function, was assessed at baseline and 4h after LPS-administration (20 IU/kg i.v). The effect of two different doses of intravenous vitamin C (Vitamin C-Injektopas®), 320 mg/kg and 480 mg/kg over 2h, or placebo on forearm vascular function was studied after LPS. MAIN RESULTS LPS caused transient flu-like symptoms, decreased plasma vitamin C concentrations and reduced the ACh-dependent increase in FBF by up to 76%. Vitamin C at a mean plasma concentration of 3.2 or 4.9 mmol/L restored the response to ACh compared to baseline. CONCLUSION High dose systemic vitamin C recovers LPS-induced endothelium-dependent vasodilation in the forearm resistance vasculature. This provides a rationale for a further clinical study of the systemic vitamin C effect under inflammatory conditions.
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Affiliation(s)
- S Aschauer
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - G Gouya
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - U Klickovic
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - A Storka
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - S Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - C Vollbracht
- Pascoe Pharmazeutische Präparate GmbH, Giessen, Germany
| | - B Krick
- Pascoe Pharmazeutische Präparate GmbH, Giessen, Germany
| | - G Weiss
- Pascoe Pharmazeutische Präparate GmbH, Giessen, Germany
| | - M Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Austria.
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Reinisch W, Chowers Y, Danese S, Dignass A, Gomollón F, Nielsen OH, Lakatos PL, Lees CW, Lindgren S, Lukas M, Mantzaris GJ, Michetti P, Moum B, Peyrin-Biroulet L, Toruner M, van der Woude J, Weiss G, Stoevelaar H. The management of iron deficiency in inflammatory bowel disease--an online tool developed by the RAND/UCLA appropriateness method. Aliment Pharmacol Ther 2013; 38:1109-18. [PMID: 24099472 PMCID: PMC3886296 DOI: 10.1111/apt.12493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 06/24/2013] [Accepted: 08/28/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND Iron deficiency is a common and undertreated problem in inflammatory bowel disease (IBD). AIM To develop an online tool to support treatment choice at the patient-specific level. METHODS Using the RAND/UCLA Appropriateness Method (RUAM), a European expert panel assessed the appropriateness of treatment regimens for a variety of clinical scenarios in patients with non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA). Treatment options included adjustment of IBD medication only, oral iron supplementation, high-/low-dose intravenous (IV) regimens, IV iron plus erythropoietin-stimulating agent (ESA), and blood transfusion. The panel process consisted of two individual rating rounds (1148 treatment indications; 9-point scale) and three plenary discussion meetings. RESULTS The panel reached agreement on 71% of treatment indications. 'No treatment' was never considered appropriate, and repeat treatment after previous failure was generally discouraged. For 98% of scenarios, at least one treatment was appropriate. Adjustment of IBD medication was deemed appropriate in all patients with active disease. Use of oral iron was mainly considered an option in NAID and mildly anaemic patients without disease activity. IV regimens were often judged appropriate, with high-dose IV iron being the preferred option in 77% of IDA scenarios. Blood transfusion and IV+ESA were indicated in exceptional cases only. CONCLUSIONS The RUAM revealed high agreement amongst experts on the management of iron deficiency in patients with IBD. High-dose IV iron was more often considered appropriate than other options. To facilitate dissemination of the recommendations, panel outcomes were embedded in an online tool, accessible via http://ferroscope.com/.
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Affiliation(s)
- W Reinisch
- Department Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Weiss G, Tsagakis K, Jakob HG, Di Bartolomeo R, Barberio G, Mascaro J, Mestres C, Sioris T, Grabenwoger M. 115 * THE FROZEN ELEPHANT TRUNK TECHNIQUE FOR THE TREATMENT OF COMPLICATED TYPE B AORTIC DISSECTION: EARLY MULTICENTRE EXPERIENCE. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.115] [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: 11/14/2022] Open
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Folkmann S, Weiss G, Pisarik H, Moidl R, Gorlitzer M, Grabenwoger M. 297 * CONVENTIONAL THORACOABDOMINAL AORTIC ANEURYSM REPAIR AFTER FROZEN ELEPHANT TRUNK OPERATION. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.297] [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: 11/13/2022] Open
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Werner ER, Mayer B, Prast H, Schmidt K, Werner-Felmayer G, Weiss G, Wachter H. Current Knowledge on Pteridine Dependence of Nitric Oxide Synthase. Pteridines 2013. [DOI: 10.1515/pteridines.1991.3.12.49] [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: 11/15/2022] Open
Affiliation(s)
- E. R. Werner
- Institut für Medizinische Chemie und Biochemie der Universität Innsbruck, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
| | - B. Mayer
- Institut für Pharmakodynamik und Toxikologie der Universität Graz, Universitätsplatz 2, A-8010 Graz, Austria
| | - H. Prast
- Institut für Pharmakodynamik und Toxikologie der Universität Innsbruck, Peter Mayr-Str. 1, A-6020 Innsbruck, Austria
| | - K. Schmidt
- Institut für Pharmakodynamik und Toxikologie der Universität Graz, Universitätsplatz 2, A-8010 Graz, Austria
| | - G. Werner-Felmayer
- Institut für Medizinische Chemie und Biochemie der Universität Innsbruck, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
| | - G. Weiss
- Institut für Medizinische Chemie und Biochemie der Universität Innsbruck, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
| | - H. Wachter
- Institut für Medizinische Chemie und Biochemie der Universität Innsbruck, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria
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Brunner J, Giner T, Weiss G, Fuchs D. AB0156 Biomarker of inflammation in juvenile idiopathic arthritis (jia). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2479] [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: 11/03/2022]
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Bellmann-Weiler R, Schobersberger B, Alessandrini P, Klug G, Brunner A, Weiss G. Abszedierende Pneumonie bei einem Feuerschlucker. Pneumologie 2013. [DOI: 10.1055/s-0033-1345058] [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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