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Steinert RE, Mueller M, Serra M, Lehner-Sigrist S, Frost G, Gero D, Gerber PA, Bueter M. Effect of inulin on breath hydrogen, postprandial glycemia, gut hormone release, and appetite perception in RYGB patients: a prospective, randomized, cross-over pilot study. Nutr Diabetes 2024; 14:9. [PMID: 38448413 PMCID: PMC10918168 DOI: 10.1038/s41387-024-00267-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Large intestinal fermentation of dietary fiber may control meal-related glycemia and appetite via the production of short-chain fatty acids (SCFA) and the secretion of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY). We investigated whether this mechanism contributes to the efficacy of the Roux-en-Y gastric bypass (RYGB) by assessing the effect of oligofructose-enriched inulin (inulin) vs. maltodextrin (MDX) on breath hydrogen (a marker of intestinal fermentation), plasma SCFAs, gut hormones, insulin and blood glucose concentrations as well as appetite in RYGB patients. METHOD Eight RYGB patients were studied on two occasions before and ~8 months after surgery using a cross-over design. Each patient received 300 ml orange juice containing 25 g inulin or an equicaloric load of 15.5 g MDX after an overnight fast followed by a fixed portion snack served 3 h postprandially. Blood samples were collected over 5 h and breath hydrogen measured as well as appetite assessed using visual analog scales. RESULTS Surgery increased postprandial secretion of GLP-1 and PYY (P ≤ 0.05); lowered blood glucose and plasma insulin increments (P ≤ 0.05) and reduced appetite ratings in response to both inulin and MDX. The effect of inulin on breath hydrogen was accelerated after surgery with an increase that was earlier in onset (2.5 h vs. 3 h, P ≤ 0.05), but less pronounced in magnitude. There was, however, no effect of inulin on plasma SCFAs or plasma GLP-1 and PYY after the snack at 3 h, neither before nor after surgery. Interestingly, inulin appeared to further potentiate the early-phase glucose-lowering and second-meal (3-5 h) appetite-suppressive effect of surgery with the latter showing a strong correlation with early-phase breath hydrogen concentrations. CONCLUSION RYGB surgery accelerates large intestinal fermentation of inulin, however, without measurable effects on plasma SCFAs or plasma GLP-1 and PYY. The glucose-lowering and appetite-suppressive effects of surgery appear to be potentiated with inulin.
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Affiliation(s)
- R E Steinert
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland.
| | - M Mueller
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - M Serra
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - S Lehner-Sigrist
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - G Frost
- Section for Nutrition Research, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - D Gero
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - P A Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - M Bueter
- Department of Surgery and Transplantation, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
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Wilkinson R, Mleczko MM, Brewin RJW, Gaston KJ, Mueller M, Shutler JD, Yan X, Anderson K. Environmental impacts of earth observation data in the constellation and cloud computing era. Sci Total Environ 2024; 909:168584. [PMID: 37979853 DOI: 10.1016/j.scitotenv.2023.168584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
Numbers of Earth Observation (EO) satellites have increased exponentially over the past decade reaching the current population of 1193 (January 2023). Consequently, EO data volumes have mushroomed and data storage and processing have migrated to the cloud. Whilst attention has been given to the launch and in-orbit environmental impacts of satellites, EO data environmental footprints have been overlooked. These issues require urgent attention given data centre water and energy consumption, high carbon emissions for computer component manufacture, and difficulty of recycling computer components. Doing so is essential if the environmental good of EO is to withstand scrutiny. We provide the first assessment of the EO data life-cycle and estimate that the current size of the global EO data collection is ~807 PB, increasing by ~100 PB/year. Storage of this data volume generates annual CO2 equivalent emissions of 4101 t. Major state-funded EO providers use 57 of their own data centres globally, and a further 178 private cloud services, with considerable duplication of datasets across repositories. We explore scenarios for the environmental cost of performing EO functions on the cloud compared to desktop machines. A simple band arithmetic function applied to a Landsat 9 scene using Google Earth Engine (GEE) generated CO2 equivalent (e) emissions of 0.042-0.69 g CO2e (locally) and 0.13-0.45 g CO2e (European data centre; values multiply by nine for Australian data centre). Computation-based emissions scale rapidly for more intense processes and when testing code. When using cloud services such as GEE, users have no choice about the data centre used and we push for EO providers to be more transparent about the location-specific impacts of EO work, and to provide tools for measuring the environmental cost of cloud computation. The EO community as a whole needs to critically consider the broad suite of EO data life-cycle impacts.
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Affiliation(s)
- R Wilkinson
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - M M Mleczko
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - R J W Brewin
- Department of Earth and Environmental Science, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - K J Gaston
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - M Mueller
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - J D Shutler
- Department of Earth and Environmental Science, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - X Yan
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom
| | - K Anderson
- Environment and Sustainability Institute, University of Exeter, Penryn Campus, Cornwall TR10 9FE, United Kingdom.
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Mueller M, Losert H, Sterz F, Gelbenegger G, Girsa M, Gatterbauer M, Zajicek A, Grassmann D, Krammel M, Holzer M, Uray T, Schnaubelt S. Prehospital emergency medicine research by additional teams on scene - Concepts and lessons learned. Resusc Plus 2023; 16:100494. [PMID: 38026141 PMCID: PMC10658399 DOI: 10.1016/j.resplu.2023.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
While the initial minutes of acute emergencies significantly influence clinical outcomes, prehospital research often receives inadequate attention due to several challenges. Retrospective chart reviews carry the risk of incomplete and inaccurate data. Furthermore, prehospital intervention trials frequently encounter difficulties related to extensive training requirements, even during the planning phase. Consequently, we have implemented prospective research concepts involving additional paramedics and physicians directly at the scene during major emergency calls. Three concepts were used: (I) Paramedic field supervisor units, (II) a paramedic + physician field supervisor unit, (III) a special physician-based research car. This paper provides insights into our historical perspective, the current situation, and the lessons learned while overcoming certain barriers and using existing and novel facilitators. Our objective is to support other research groups with our experiences in their planning of upcoming prehospital trials.
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Affiliation(s)
- Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Georg Gelbenegger
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | | | | | - Daniel Grassmann
- Emergency Medical Service Vienna, Austria
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
| | - Mario Krammel
- Emergency Medical Service Vienna, Austria
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Thomas Uray
- Department of Cardiology, Clinic Floridsdorf, Vienna Healthcare Group, Austria
| | - Sebastian Schnaubelt
- Department of Emergency Medicine, Medical University of Vienna, Austria
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
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Stommel AM, Högler S, Mueller M, Magnet IAM, Kodajova P, Ullram B, Szinovatz A, Panzer FP, Engenhart-Seyrl A, Kaschmekat J, Schütz T, Holzer M, Weihs W. A ventricular fibrillation cardiac arrest model with extracorporeal cardiopulmonary resuscitation in rats: 8 minutes arrest time leads to increased myocardial damage but does not increase neuronal damage compared to 6 minutes. Front Vet Sci 2023; 10:1276588. [PMID: 38026669 PMCID: PMC10655001 DOI: 10.3389/fvets.2023.1276588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging strategy in highly selected patients with refractory cardiac arrest (CA). Animal models can help to identify new therapeutic strategies to improve neurological outcome and cardiac function after global ischemia in CA. Aim of the study was to establish a reproducible ECPR rat model of ventricular fibrillation CA (VFCA) that leads to consistent neuronal damage with acceptable long-term survival rates, which can be used for future research. Materials and methods Male Sprague Dawley rats were resuscitated with ECPR from 6 min (n = 15) and 8 min (n = 16) VFCA. Animals surviving for 14 days after return of spontaneous resuscitation (ROSC) were compared with sham operated animals (n = 10); neurological outcome was assessed daily until day 14. In the hippocampal cornu ammonis 1 region viable neurons were counted. Microglia and astrocyte reaction was assessed by Iba1 and GFAP immunohistochemistry, and collagen fibers in the myocardium were detected in Azan staining. QuPath was applied for quantification. Results Of the 15 rats included in the 6 min CA group, all achieved ROSC (100%) and 10 (67%) survived to 14 days; in the 8 min CA group, 15 (94%) achieved ROSC and 5 (31%) reached the endpoint. All sham animals (n = 10) survived 2 weeks. The quantity of viable neurons was significantly decreased, while the area displaying Iba1 and GFAP positive pixels was significantly increased in the hippocampus across both groups that experienced CA. Interestingly, there was no difference between the two CA groups regarding these changes. The myocardium in the 8 min CA group exhibited significantly more collagen fibers compared to the sham animals, without differences between 6- and 8-min CA groups. However, this significant increase was not observed in the 6 min CA group. Conclusion Our findings indicate a uniform occurrence of neuronal damage in the hippocampus across both CA groups. However, there was a decrease in survival following an 8-min CA. Consequently, a 6-min duration of CA resulted in predictable neurological damage without significant cardiac damage and ensured adequate survival rates up to 14 days. This appears to offer a reliable model for investigating neuroprotective therapies.
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Affiliation(s)
| | - Sandra Högler
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Petra Kodajova
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Benjamin Ullram
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander Szinovatz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Felix Paul Panzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Julia Kaschmekat
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Tamara Schütz
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Weihs
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Zifarelli A, Cantatore A, Sampaolo A, Mueller M, Rueck T, Hoelzl C, Rossmadl H, Patimisco P, Spagnolo V. Multivariate analysis and digital twin modelling: Alternative approaches to evaluate molecular relaxation in photoacoustic spectroscopy. Photoacoustics 2023; 33:100564. [PMID: 38021285 PMCID: PMC10658604 DOI: 10.1016/j.pacs.2023.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023]
Abstract
A comparative analysis of two different approaches developed to deal with molecular relaxation in photoacoustic spectroscopy is here reported. The first method employs a statistical analysis based on partial least squares regression, while the second method relies on the development of a digital twin of the photoacoustic sensor based on the theoretical modelling of the occurring relaxations. Methane detection within a gas matrix of synthetic air with variable humidity level is selected as case study. An interband cascade laser emitting at 3.345 µm is used to target methane absorption features. Two methane concentration ranges are explored targeting different absorptions, one in the order of part-per-million and one in the order of percent, while water vapor absolute concentration was varied from 0.3 % up to 2 %. The results achieved employing the detection techniques demonstrated the possibility to efficiently retrieve the target gas concentrations with accuracy > 95 % even in the case of strong influence of relaxation effects.
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Affiliation(s)
- A. Zifarelli
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
| | - A.F.P. Cantatore
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
| | - A. Sampaolo
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
| | - M. Mueller
- Sensorik-ApplikationsZentrum (SappZ), Regensburg University of Applied Sciences, 93053 Regensburg, Germany
- Institute of Analytical Chemistry, Chemo, and Biosensors, University of Regensburg, 93053 Regensburg, Germany
| | - T. Rueck
- Sensorik-ApplikationsZentrum (SappZ), Regensburg University of Applied Sciences, 93053 Regensburg, Germany
| | - C. Hoelzl
- Thorlabs GmbH, Münchner Weg 1, 85232 Bergkirchen, Germany
| | - H. Rossmadl
- Thorlabs GmbH, Münchner Weg 1, 85232 Bergkirchen, Germany
| | - P. Patimisco
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
| | - V. Spagnolo
- PolySense Lab, Dipartimento Interateneo di Fisica, University and Politecnico of Bari, Via Amendola 173, 70126 Bari, Italy
- PolySense Innovations S.R.L. via Amendola 173, Bari, Italy
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Dekkiche S, Dubruc E, Kanbar M, Feki A, Mueller M, Meuwly JY, Mathevet P. Accessory and cavitated uterine masses: a case series and review of the literature. Front Reprod Health 2023; 5:1197931. [PMID: 37662068 PMCID: PMC10469797 DOI: 10.3389/frph.2023.1197931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/04/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives The purpose of this study is to report nine patients of young women who underwent a surgical treatment of an accessory and cavitated uterine mass (ACUM) in our hospital between 2014 and 2022 and review all cases described in the literature. Material and methods The principal outcomes measured are the imaging techniques used to determine the diagnosis, the type of surgery used and the post-operative evolution of symptoms. We also report and analyse the 79 patients found in the literature since 1996 in addition to our 9 patients. Results Surgical excision is the only long-lasting treatment. Small invasive surgery with laparoscopic access is the gold standard and most widely used (83.0%). Some new therapeutic procedures have been recently described of which ethanol sclerotherapy seems very promising. Post-operatively, 54.5% of patients have a complete relief of symptoms. MRI is the best imaging technique to identify ACUM. Finally, we refine the description of this pathology and give a more precise definition of it. Conclusion Through our literature review and the analysis of our cases, we want to underline an important diagnostic criterion of this pathology: the fallopian tube on the homolateral side of the ACUM never communicates with the latter. It is a capital element for differential diagnosis.
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Affiliation(s)
- S. Dekkiche
- Gynaecology Department, Department Women-Mother-Child, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - E. Dubruc
- Institute of Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - M. Kanbar
- Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - A. Feki
- Department of Obstetrics and Gynaecology, HFR Fribourg Hôpital Cantonal, Fribourg, Switzerland
| | - M. Mueller
- Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland
| | - J-Y. Meuwly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
| | - P. Mathevet
- Gynaecology Department, Department Women-Mother-Child, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
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Perotti G, Christiaens V, Henning T, Tabone B, Waters LBFM, Kamp I, Olofsson G, Grant SL, Gasman D, Bouwman J, Samland M, Franceschi R, van Dishoeck EF, Schwarz K, Güdel M, Lagage PO, Ray TP, Vandenbussche B, Abergel A, Absil O, Arabhavi AM, Argyriou I, Barrado D, Boccaletti A, Caratti O Garatti A, Geers V, Glauser AM, Justannont K, Lahuis F, Mueller M, Nehmé C, Pantin E, Scheithauer S, Waelkens C, Guadarrama R, Jang H, Kanwar J, Morales-Calderón M, Pawellek N, Rodgers-Lee D, Schreiber J, Colina L, Greve TR, Östlin G, Wright G. Water in the terrestrial planet-forming zone of the PDS 70 disk. Nature 2023; 620:516-520. [PMID: 37488359 PMCID: PMC10432267 DOI: 10.1038/s41586-023-06317-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/13/2023] [Indexed: 07/26/2023]
Abstract
Terrestrial and sub-Neptune planets are expected to form in the inner (less than 10 AU) regions of protoplanetary disks1. Water plays a key role in their formation2-4, although it is yet unclear whether water molecules are formed in situ or transported from the outer disk5,6. So far Spitzer Space Telescope observations have only provided water luminosity upper limits for dust-depleted inner disks7, similar to PDS 70, the first system with direct confirmation of protoplanet presence8,9. Here we report JWST observations of PDS 70, a benchmark target to search for water in a disk hosting a large (approximately 54 AU) planet-carved gap separating an inner and outer disk10,11. Our findings show water in the inner disk of PDS 70. This implies that potential terrestrial planets forming therein have access to a water reservoir. The column densities of water vapour suggest in-situ formation via a reaction sequence involving O, H2 and/or OH, and survival through water self-shielding5. This is also supported by the presence of CO2 emission, another molecule sensitive to ultraviolet photodissociation. Dust shielding, and replenishment of both gas and small dust from the outer disk, may also play a role in sustaining the water reservoir12. Our observations also reveal a strong variability of the mid-infrared spectral energy distribution, pointing to a change of inner disk geometry.
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Affiliation(s)
- G Perotti
- Max Planck Institute for Astronomy, Heidelberg, Germany.
| | | | - Th Henning
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - B Tabone
- Université Paris-Saclay, CNRS, Institut d'Astrophysique Spatiale, Orsay, France
| | - L B F M Waters
- Department of Astrophysics/IMAPP, Radboud University, Nijmegen, the Netherlands
- SRON Netherlands Institute for Space Research, Leiden, the Netherlands
| | - I Kamp
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - G Olofsson
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - S L Grant
- Max-Planck Institut für Extraterrestrische Physik (MPE), Garching, Germany
| | - D Gasman
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - J Bouwman
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - M Samland
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - R Franceschi
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - E F van Dishoeck
- Max-Planck Institut für Extraterrestrische Physik (MPE), Garching, Germany
- Leiden Observatory, Leiden University, Leiden, the Netherlands
| | - K Schwarz
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - M Güdel
- Max Planck Institute for Astronomy, Heidelberg, Germany
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
- ETH Zürich, Institute for Particle Physics and Astrophysics, Zürich, Switzerland
| | - P-O Lagage
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - T P Ray
- Dublin Institute for Advanced Studies, Dublin, Ireland
| | | | - A Abergel
- Université Paris-Saclay, CNRS, Institut d'Astrophysique Spatiale, Orsay, France
| | - O Absil
- STAR Institute, Université de Liège, Liège, Belgium
| | - A M Arabhavi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - I Argyriou
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - D Barrado
- Centro de Astrobiología (CAB), CSIC-INTA, Villanueva de la Cañada, Spain
| | - A Boccaletti
- LESIA, Observatoire de Paris, Université PSL, CNRS, Sorbonne Université, Université de Paris, Meudon, France
| | - A Caratti O Garatti
- Dublin Institute for Advanced Studies, Dublin, Ireland
- INAF - Osservatorio Astronomico di Capodimonte, Napoli, Italy
| | - V Geers
- UK Astronomy Technology Centre, Royal Observatory Edinburgh, Edinburgh, UK
| | - A M Glauser
- ETH Zürich, Institute for Particle Physics and Astrophysics, Zürich, Switzerland
| | - K Justannont
- Chalmers University of Technology, Onsala Space Observatory, Onsala, Sweden
| | - F Lahuis
- SRON Netherlands Institute for Space Research, Groningen, the Netherlands
| | - M Mueller
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
| | - C Nehmé
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - E Pantin
- Université Paris-Saclay, Université Paris Cité, CEA, CNRS, AIM, Gif-sur-Yvette, France
| | - S Scheithauer
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - C Waelkens
- Institute of Astronomy, KU Leuven, Leuven, Belgium
| | - R Guadarrama
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
| | - H Jang
- Department of Astrophysics/IMAPP, Radboud University, Nijmegen, the Netherlands
| | - J Kanwar
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Groningen, the Netherlands
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- TU Graz, Fakultät für Mathematik, Physik und Geodäsie, Graz, Austria
| | - M Morales-Calderón
- Centro de Astrobiología (CAB), CSIC-INTA, Villanueva de la Cañada, Spain
| | - N Pawellek
- Dept. of Astrophysics, University of Vienna, Vienna, Austria
| | - D Rodgers-Lee
- Dublin Institute for Advanced Studies, Dublin, Ireland
| | - J Schreiber
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - L Colina
- Centro de Astrobiología (CAB, CSIC-INTA), Carretera de Ajalvir, Torrejón de Ardoz, Spain
| | - T R Greve
- DTU Space, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - G Östlin
- Department of Astronomy, Oskar Klein Centre, Stockholm University, Stockholm, Sweden
| | - G Wright
- UK Astronomy Technology Centre, Royal Observatory Edinburgh, Edinburgh, UK
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Hoermandinger C, Kaufmann F, Mulzer J, Mueller M, Falk V, Potapov E, Schoenrath F, Just I. Lysis Therapy vs. Pump Exchange for Intra-Pump Thrombosis of Left Ventricular Assist Devices. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.150] [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: 04/05/2023] Open
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Poppe M, Magnet IAM, Clodi C, Mueller M, Ettl F, Neumayer D, Losert H, Zeiner-Schatzl A, Testori C, Roeggla M, Schriefl C. Resuscitative transoesophageal echocardiography performed by emergency physicians in the emergency department: insights from a 1-year period. Eur Heart J Acute Cardiovasc Care 2023; 12:124-128. [PMID: 36443280 DOI: 10.1093/ehjacc/zuac150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
AIMS Transoesophageal echocardiography (TOE) has increasingly been described as a possible complementary and point-of-care approach for patients with cardiac arrest (CA). It provides information about potentially reversible causes and prognosis and allows monitoring of resuscitation efforts without affecting ongoing chest compressions. The aim of this study was to assess the feasibility of TOE performed by emergency physicians (EPs) during CA in an emergency department (ED). METHODS AND RESULTS This prospective study was performed at the Department of Emergency Medicine at the Medical University of Vienna from February 2020 to February 2021. All patients of ≥18 years old presenting with ongoing resuscitation efforts were screened. After exclusion of potential contraindications, a TOE examination was performed and documented by EPs according to a standardized four-view imaging protocol. The primary endpoint represents feasibility defined as successful probe insertion and acquisition of interpretable images. Of 99 patients with ongoing non-traumatic CA treated in the ED, a total of 62 patients were considered to be examined by TOE. The examination was feasible in 57 patients (92%) [females, 14 (25%), mean age 53 ± 13, and witnessed collapse 48 (84%)]. Within these, the examiners observed 51 major findings in 32 different patients (66%). In 21 patients (37%), these findings led to a direct change of therapy. In 18 patients (32%), the examiner found ventricular contractions without detectable pulse. No TOE-related complications were found. CONCLUSION Our findings suggest that EPs may be able to acquire and interpret TOE images in the majority of patients during CA using a standardized four-view imaging protocol.
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Affiliation(s)
- Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Ingrid A M Magnet
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - David Neumayer
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Andrea Zeiner-Schatzl
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Christoph Testori
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Martin Roeggla
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
| | - Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090 Vienna, Austria
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Khatamirad M, Fako E, Boscagli C, Mueller M, Ebert F, Naumann d'Alnoncourt R, Schäfer A, Schunk SA, Jevtovikj I, Rosowski F, De S. A Data-driven High-throughput Workflow Applied to Promoted In-oxide Catalysts for CO 2 Hydrogenation to Methanol. Catal Sci Technol 2023. [DOI: 10.1039/d3cy00148b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
We propose a novel high-throughput workflow, combining DFTderived atomic scale interaction parameters with experimental data to identify key performance-related descriptors in CO2 to methanol reaction, for In-based catalysts. Utilizing advanced...
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11
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Oxner M, Martinovic J, Forschack N, Lempe R, Gundlach C, Mueller M. Evidence against the signal suppression hypothesis in the capture-probe paradigm. J Vis 2022. [DOI: 10.1167/jov.22.14.3869] [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: 12/23/2022] Open
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12
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Ettl F, Schriefl C, Grafeneder J, Thallner DG, Mueller M, Fischer E, Schlegel R, Sigmund T, Holzer M, Schnaubelt S. A moodle course to substitute resuscitation teaching in a medical curriculum during the COVID-19 pandemic: A prospective pilot study. Front Public Health 2022; 10:991408. [PMID: 36438255 PMCID: PMC9691759 DOI: 10.3389/fpubh.2022.991408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Face-to-face medical education was restricted during the COVID-19 pandemic, leading to alternative teaching methods. Moodle® (Modular Object-Oriented Dynamic Learning Environment) - an online course format - has not yet been sufficiently evaluated for its feasibility and effectiveness in teaching cardiopulmonary resuscitation. Methods Medical students in the eighth semester took part in a Moodle® course teaching basic life support, the ABCDE-approach, airway management, and advanced life support. The content was presented using digital background information and interactive videos. A multiple-choice test was conducted at the beginning and at the end of the course. Subjective ratings were included as well. Results Out of 594 students, who were enrolled in the online course, 531 could be included in this study. The median percentage of correctly answered multiple-choice test questions increased after completing the course [78.9%, interquartile range (IQR) 69.3-86.8 vs. 97.4%, IQR 92.1-100, p < 0.001]. There was no gender difference in the median percentage of correctly answered questions before (female: 79.8%, IQR 70.2-86.8, male: 78.1%, IQR 68.4-86.8, p = 0.412) or after (female: 97.4%, IQR 92.1-100, male: 96.5%, IQR 92.6-100, p = 0.233) the course. On a 5-point Likert scale, 78.7% of students self-reported ≥4 when asked for a subjective increase in knowledge. Noteworthy, on a 10-point Likert scale, male students self-reported their higher confidence in performing CPR [female 6 (5-7), male 7 (6-8), p < 0.001]. Conclusion The Moodle® course led to a significant increase in theoretical knowledge. It proved to be a feasible substitute for face-to-face courses - both objectively and subjectively.
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Affiliation(s)
- Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria,*Correspondence: Christoph Schriefl
| | - Jürgen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Eva Fischer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria,Department of Anaesthesiology, Clinic Donaustadt, Vienna Healthcare Group, Vienna, Austria
| | - Raphael Schlegel
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Thorsten Sigmund
- Department of IT-Systems and Communications, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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13
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Macken WL, Falabella M, McKittrick C, Pizzamiglio C, Ellmers R, Eggleton K, Woodward CE, Patel Y, Labrum R, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Lakey A, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Mitchell J, Moutsianas L, Mueller M, Murugaesu N, Need AC, O’Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM, Zarowiecki M, Phadke R, Reilly MM, DeVile C, Sarkozy A, Footitt E, Davison J, Rahman S, Houlden H, Bugiardini E, Quinlivan R, Hanna MG, Vandrovcova J, Pitceathly RDS. Specialist multidisciplinary input maximises rare disease diagnoses from whole genome sequencing. Nat Commun 2022; 13:6324. [PMID: 36344503 PMCID: PMC9640711 DOI: 10.1038/s41467-022-32908-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022] Open
Abstract
Diagnostic whole genome sequencing (WGS) is increasingly used in rare diseases. However, standard, semi-automated WGS analysis may overlook diagnoses in complex disorders. Here, we show that specialist multidisciplinary analysis of WGS, following an initial 'no primary findings' (NPF) report, improves diagnostic rates and alters management. We undertook WGS in 102 adults with diagnostically challenging primary mitochondrial disease phenotypes. NPF cases were reviewed by a genomic medicine team, thus enabling bespoke informatic approaches, co-ordinated phenotypic validation, and functional work. We enhanced the diagnostic rate from 16.7% to 31.4%, with management implications for all new diagnoses, and detected strong candidate disease-causing variants in a further 3.9% of patients. This approach presents a standardised model of care that supports mainstream clinicians and enhances diagnostic equity for complex disorders, thereby facilitating access to the potential benefits of genomic healthcare. This research was made possible through access to the data and findings generated by the 100,000 Genomes Project: http://www.genomicsengland.co.uk .
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Affiliation(s)
- William L. Macken
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Micol Falabella
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Caroline McKittrick
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Chiara Pizzamiglio
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rebecca Ellmers
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Kelly Eggleton
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Cathy E. Woodward
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Yogen Patel
- Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | - Robyn Labrum
- grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,Neurogenetics Unit, Rare and Inherited Disease Laboratory, North Thames Genomic Laboratory Hub, London, UK
| | | | - Rahul Phadke
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Mary M. Reilly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine DeVile
- grid.424537.30000 0004 5902 9895Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Sarkozy
- grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Footitt
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - James Davison
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.420468.cNational Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Shamima Rahman
- grid.424537.30000 0004 5902 9895Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.83440.3b0000000121901201Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Henry Houlden
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Enrico Bugiardini
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Rosaline Quinlivan
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK ,grid.424537.30000 0004 5902 9895Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael G. Hanna
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Jana Vandrovcova
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Robert D. S. Pitceathly
- grid.83440.3b0000000121901201Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK ,grid.436283.80000 0004 0612 2631NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, UK
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Das D, Squires N, Mueller M, Collins S, Lewicky-Gaupp C, Bretschneider C, Geynisman-Tan J, Kenton K. Use of Novel Configuration with Suture Kit Device for Robotic-assisted Minimally Invasive Sacrocolpopexy. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.067] [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: 11/25/2022]
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15
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Shoemark A, Griffin H, Wheway G, Hogg C, Lucas JS, Camps C, Taylor J, Carroll M, Loebinger MR, Chalmers JD, Morris-Rosendahl D, Mitchison HM, De Soyza A, Brown D, Ambrose JC, Arumugam P, Bevers R, Bleda M, Boardman-Pretty F, Boustred CR, Brittain H, Caulfield MJ, Chan GC, Fowler T, Giess A, Hamblin A, Henderson S, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Moutsianas L, Mueller M, Murugaesu N, Need AC, O'Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM. Genome sequencing reveals underdiagnosis of primary ciliary dyskinesia in bronchiectasis. Eur Respir J 2022; 60:13993003.00176-2022. [PMID: 35728977 DOI: 10.1183/13993003.00176-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60-80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis. METHODS This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK. RESULTS Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5-10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing. CONCLUSIONS PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.
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Affiliation(s)
- Amelia Shoemark
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Helen Griffin
- Primary Immunodeficiency Group, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Gabrielle Wheway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Hogg
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Carme Camps
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Jenny Taylor
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Mary Carroll
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - James D Chalmers
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
| | - Deborah Morris-Rosendahl
- Clinical Genetics and Genomics, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust and NHLI, Imperial College London, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Department, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
- These authors contributed equally to this manuscript
| | - Anthony De Soyza
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
- These authors contributed equally to this manuscript
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Calvo-Schimmel A, Newman S, Sterba K, Mueller M, Miaskowski C, Qanungo S. Besoins non satisfaits en soins de soutien chez les survivants du cancer de la prostate à un stade avancé : exploration par méthodes mixtes. Can Oncol Nurs J 2022. [DOI: 10.5737/23688076324526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
But : Les hommes souffrant d’un cancer avancé de la prostate connaissent un large éventail d’effets secondaires découlant du cancer et de ses traitements qui nuisent à leur qualité de vie (QDV). Peu d’études ont évalué les besoins de soins de soutien chez ces personnes. Cette étude a été réalisée pour effectuer une évaluation globale des besoins en soins de soutien chez ces survivants en se fondant sur un cadre de soins de soutien en oncologie (Supportive Care Framework for Cancer Care, ou SCFCC). Méthodes : Dans le cadre d’une recherche menée selon une approche mixte, parallèle et convergente, des survivants du cancer de la prostate à un stade avancé (n = 188) ont répondu à un questionnaire d’enquête transversale. Quelques-uns de ces survivants (n = 20) ont participé à un entretien afin de mieux évaluer leurs besoins non satisfaits. Résultats : Les survivants ont déclaré des besoins non satisfaits de soins de soutien dans tous les domaines du cadre d’évaluation utilisé. Pas moins de 95,2 % des survivants avaient au moins un besoin non satisfait, avec une moyenne de 14,9 besoins (fourchette : 0–42). Plusieurs domaines de convergence entre les données quantitatives et qualitatives (fatigue, dysfonctionnement sexuel, domaines pratique et émotionnel/psychologique) et de divergence (domaines informationnel et spirituel, dépression, dysfonctionnement urinaire) ont été trouvés durant le processus d’intégration. Conclusion : Cette étude confirme que les survivants du cancer de la prostate à un stade avancé présentent des taux élevés de besoins non satisfaits en soins de soutien. Les résultats soulignent également une grande diversité dans ces besoins non satisfaits. Ces résultats pourraient contribuer au développement de plans de soins de soutien centrés sur le patient, adaptés aux besoins particuliers de ce groupe vulnérable de survivants du cancer. Mots-clés : cancer de la prostate; stade avancé; survivants; soins de soutien; besoins non satisfaits; qualité de vie; méthodes mixtes
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Calvo-Schimmel A, Newman S, Sterba K, Mueller M, Miaskowski C, Qanungo S. Unmet supportive care needs in prostate cancer survivors with advanced disease: A mixed-methods exploration. Can Oncol Nurs J 2022. [DOI: 10.5737/23688076324512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: Men with advanced prostate cancer experience a wide range of side effects from the cancer and its therapies, which have a negative effect on their quality of life (QOL). Few studies have evaluated supportive care needs in these individuals. The purpose of this study was to conduct a holistic supportive care needs assessment among these survivors guided by the Supportive Care Framework for Cancer Care. Methods: Using a convergent parallel mixed-methods approach, prostate cancer survivors with advanced disease (n = 188) completed a cross-sectional survey. A subset of these survivors (n = 20) participated in an interview to further explore their experience of unmet needs. Results: Survivors reported unmet supportive care needs in every domain of the framework. Up to 95.2% of the survivors had at least one unmet need, with a mean of 14.9 (range: 0–42). Several areas of convergence among the quantitative and qualitative data (fatigue, sexual dysfunction, practical, and emotional/psychological domains), as well as divergence (informational and spiritual domains, depression, urinary dysfunction) were found through the integration process. Conclusions: This study confirms that prostate cancer survivors with advanced disease experience high rates of unmet supportive care needs. The findings also highlight the diversity of those unmet needs. These results may assist with future development of patient-centered supportive care interventions that better meet the specific needs of this vulnerable group of cancer survivors. Keywords: prostate cancer; advanced disease; survivors; supportive care; unmet needs; quality of life; mixed-methods
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Skok J, Megušar P, Vodopivec T, Pregeljc D, Mencin N, Korenč M, Krušič A, Celjar AM, Pavlin N, Krušič J, Mueller M, McHugh K, Štrancar A, Sekirnik R. Gram‐Scale mRNA Production Using a 250‐mL Single‐Use Bioreactor. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202200133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Janja Skok
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Polona Megušar
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Tina Vodopivec
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Domen Pregeljc
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Nina Mencin
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Matevž Korenč
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Andreja Krušič
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | | | - Nejc Pavlin
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Jana Krušič
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Matthias Mueller
- Cell culture Technology, Sartorius Stedim Biotech GmbH August-Spindler-Straße 11 37079 Göttingen Germany
| | - Kevin McHugh
- Cell culture Technology, Sartorius Stedim Biotech GmbH August-Spindler-Straße 11 37079 Göttingen Germany
| | - Aleš Štrancar
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
| | - Rok Sekirnik
- Sartorius BIA Separations, d.o.o. Mirce 21 5270 Ajdovščina Slovenia
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Kokot K, Kneuer J, John D, Rebs S, Mueller M, Haas J, Thiele H, Mueller OJ, Hille S, Leuschner F, Dimmeler S, Streckfuss-Boemeke K, Meder B, Laufs U, Boeckel JN. Decrease of RNA editing in the failing heart leads to induction of circRNAs. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2962] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and purpose
Adenosine-to-Inosine (A-to-I) RNA editing is a post-transcriptional modification process that affects the secondary structure of RNAs. Changes in RNA editing have been associated with human diseases. We therefore aimed to analyze editing in the healthy and failing human heart.
Methods and results
Transcriptome sequencing of human heart samples of heart failure (HF) patients (n=20) and controls (n=10) revealed A-to-I editing as the major type of editing (>80%). In HF patients, RNA editing was reduced, which was primarily attributable to Alu elements in introns of protein-coding genes. We identified 166 upregulated circRNAs in HF, with the majority showing reduced RNA editing in their parental host gene (88.3%). CircRNA expression did not correlate with their corresponding host gene (R=0.07, P<0.05), suggesting that an alternative splicing mechanism gives rise to the elevated circRNA levels in HF. The RNA editing enzyme ADAR2, which binds to RNA regions that are edited from adenosine to inosine, was decreased in failing human hearts (−68.2%). In vitro, reduction of ADAR2 increased circRNA levels suggesting a causal effect of reduced ADAR2 levels on increased circRNAs in the failing human heart. To gain mechanistic insight, we examined the formation of circRNAs on one exemplary candidate. AKAP13 was among the top edited mRNAs in the human heart and gave rise to a circular transcript, which was elevated in HF. ADAR2 reduced the formation of double-stranded structures in AKAP13 pre-mRNA, thereby reducing the stability of Alu elements and the circularization of the resulting circRNA. Overexpression of circAKAP13 impaired the sarcomere regularity of human induced pluripotent stem cell-derived cardiomyocytes (−31.0%).
Conclusion
Our study shows that ADAR2 mediates A-to-I RNA editing in the human heart. We describe an alternative splicing mechanism of circRNAs in the human heart. In the healthy human heart, A-to-I RNA editing represses the formation of dsRNA structures of Alu elements thereby favoring linear mRNA splicing. Our results contribute to a better mechanistic understanding into the human-specific regulation of circRNA formation and are relevant to diseases with reduced RNA editing and increased circRNA levels.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Kokot
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - J Kneuer
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - D John
- Institute of Cardiovascular Regeneration , Frankfurt , Germany
| | - S Rebs
- Institute of Pharmacology and Toxicology , Würzburg , Germany
| | - M Mueller
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum , Bad Oeynhausen , Germany
| | - J Haas
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - H Thiele
- Heart Center of Leipzig , Leipzig , Germany
| | - O J Mueller
- University of Kiel, Department of Internal Medicine III , Kiel , Germany
| | - S Hille
- University of Kiel, Department of Internal Medicine III , Kiel , Germany
| | - F Leuschner
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - S Dimmeler
- Institute of Cardiovascular Regeneration , Frankfurt , Germany
| | | | - B Meder
- University of Heidelberg, Department of Internal Medicine III , Heidelberg , Germany
| | - U Laufs
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
| | - J N Boeckel
- University Hospital Leipzig, Klinik und Poliklinik für Kardiologie , Leipzig , Germany
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Drake T, Tan E, Georgakopoulou A, May S, Mueller M, Horrigan S, Holloway K, Chang J, Aras R, Bird T. The TBL1 inhibitor, Tegavivint, suppresses tumour growth and enhances T-cell infiltration in preclinical murine β-Catenin mutant hepatocellular carcinoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00852-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Innocenti G, Emig S, Meyer L, Mueller M, Hanf S, Schunk SA, Kindler AM, Sievers C. Reaction mechanism of tetrahydrofurfuryl alcohol hydrogenolysis on Ru/SiO2 studied by in‐situ FTIR spectroscopy. ChemCatChem 2022. [DOI: 10.1002/cctc.202200814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Giada Innocenti
- Georgia Institute of Technology School of Chemical & Biomolecular Engineering UNITED STATES
| | | | | | | | | | | | | | - Carsten Sievers
- Georgia Institute of Technology School of Chemical & Biomolecular Engineering 311 Ferst Dr. NW 30332-0100 Atlanta UNITED STATES
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22
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Mueller M, Jankow E, Grafeneder J, Schoergenhofer C, Poppe M, Schriefl C, Clodi C, Koch M, Ettl F, Holzer M, Losert H. The difference between arterial pCO 2 and etCO 2 after cardiac arrest - Outcome predictor or marker of unfavorable resuscitation circumstances? Am J Emerg Med 2022; 61:120-126. [PMID: 36096013 DOI: 10.1016/j.ajem.2022.08.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/13/2022] [Accepted: 08/28/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In former studies, the arterio-alveolar carbon dioxide gradient (ΔCO2) predicted in-hospital mortality after initially survived cardiac arrest. As early outcome predictors are urgently needed, we evaluated ΔCO2 as predictor for good neurological outcome in our cohort. METHODS We retrospectively analyzed all patients ≥18 years of age after non-traumatic in- and out of hospital cardiac arrest in the year 2018 from our resuscitation database. Patients without advanced airway management, incomplete datasets or without return of spontaneous circulation were excluded. The first arterial pCO2 after admission and the etCO2 in mmHg at the time of blood sampling were recorded from patient's charts. We then calculated ΔCO2 (pCO2 - etCO2). For baseline analyses, ΔCO2 was dichotomized into a low and high group with separation at the median. Good neurological outcome on day 30, expressed as Cerebral Performance Category 1-2, defined our primary endpoint. Survival to 30 days was used as secondary endpoint. RESULTS Out of 302 screened patients, 128 remained eligible for analyses. ΔCO2 was lower in 30-day survivors with good neurological outcome (12.2 mmHg vs. 18.8 mmHg, p = 0.009) and in 30-day survivors (12.5 mmHg vs. 20.0 mmHg, p = 0.001). In patients with high ΔCO2, a cardiac etiology of arrest was found less often. They had a higher body mass index, longer duration of resuscitation, higher amounts of epinephrine, lower pO2 levels but both higher pCO2 and blood lactate levels, resulting in lower blood pH and HCO3- levels at admission. In a crude binary logistic regression analysis, ΔCO2 was associated with 30-day neurological outcome (OR = 1.041 per mmHg of ΔCO2, 95% CI 1.008-1.074, p = 0.014). This association persisted after the adjustment for age, sex, witnessed arrest and shockable first rhythm. However, after addition of the duration of resuscitation or the cumulative epinephrine dosage to the model, ΔCO2 lost its association. CONCLUSION ΔCO2 at admission after a successfully resuscitated cardiac arrest is associated with 30 days survival with good neurological outcome. However, a higher ΔCO2 may rather be a surrogate for unfavorable resuscitation circumstances than an independent outcome predictor.
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Affiliation(s)
- Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Emmely Jankow
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Juergen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Austria.
| | | | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | | | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Moritz Koch
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Austria
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23
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Karolyi M, Pawelka E, Omid S, Koenig F, Kauer V, Rumpf B, Hoepler W, Kuran A, Laferl H, Seitz T, Traugott M, Rathkolb V, Mueller M, Abrahamowicz A, Schoergenhofer C, Hecking M, Assinger A, Wenisch C, Zeitlinger M, Jilma B, Zoufaly A. Camostat Mesylate Versus Lopinavir/Ritonavir in Hospitalized Patients With COVID-19—Results From a Randomized, Controlled, Open Label, Platform Trial (ACOVACT). Front Pharmacol 2022; 13:870493. [PMID: 35935856 PMCID: PMC9354138 DOI: 10.3389/fphar.2022.870493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background: To date, no oral antiviral drug has proven to be beneficial in hospitalized patients with COVID-19.Methods: In this randomized, controlled, open-label, platform trial, we randomly assigned patients ≥18 years hospitalized with COVID-19 pneumonia to receive either camostat mesylate (CM) (considered standard-of-care) or lopinavir/ritonavir (LPV/RTV). The primary endpoint was time to sustained clinical improvement (≥48 h) of at least one point on the 7-category WHO scale. Secondary endpoints included length of stay (LOS), need for mechanical ventilation (MV) or death, and 29-day mortality.Results: 201 patients were included in the study (101 CM and 100 LPV/RTV) between 20 April 2020 and 14 May 2021. Mean age was 58.7 years, and 67% were male. The median time from symptom onset to randomization was 7 days (IQR 5–9). Patients in the CM group had a significantly shorter time to sustained clinical improvement (HR = 0.67, 95%-CI 0.49–0.90; 9 vs. 11 days, p = 0.008) and demonstrated less progression to MV or death [6/101 (5.9%) vs. 15/100 (15%), p = 0.036] and a shorter LOS (12 vs. 14 days, p = 0.023). A statistically nonsignificant trend toward a lower 29-day mortality in the CM group than the LPV/RTV group [2/101 (2%) vs. 7/100 (7%), p = 0.089] was observed.Conclusion: In patients hospitalized for COVID-19, the use of CM was associated with shorter time to clinical improvement, reduced need for MV or death, and shorter LOS than the use of LPV/RTV. Furthermore, research is needed to confirm the efficacy of CM in larger placebo-controlled trials.Systematic Review Registration: [https://clinicaltrials.gov/ct2/show/NCT04351724, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-001302-30/AT], identifier [NCT04351724, EUDRACT-NR: 2020–001302-30].
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Affiliation(s)
- M. Karolyi
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
- *Correspondence: M. Karolyi,
| | - E. Pawelka
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - S. Omid
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - F. Koenig
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - V. Kauer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Rumpf
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - W. Hoepler
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - A. Kuran
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - H. Laferl
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - T. Seitz
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Traugott
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - V. Rathkolb
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - M. Mueller
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Abrahamowicz
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - C. Schoergenhofer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M. Hecking
- Department of Internal Medicine III, Clinical Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria
| | - A. Assinger
- Department of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C. Wenisch
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
| | - M. Zeitlinger
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - B. Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - A. Zoufaly
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten, Vienna, Austria
- Faculty of Medicine, Sigmund Freud University, Vienna, Austria
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24
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Gierschke P, Grebing C, Abdelaal M, Lenski M, Buldt J, Wang Z, Heuermann T, Mueller M, Gebhardt M, Rothhardt J, Limpert J. Nonlinear pulse compression to 51-W average power GW-class 35-fs pulses at 2-µm wavelength in a gas-filled multi-pass cell. Opt Lett 2022; 47:3511-3514. [PMID: 35838716 DOI: 10.1364/ol.462647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
We report on the generation of GW-class peak power, 35-fs pulses at 2-µm wavelength with an average power of 51 W at 300-kHz repetition rate. A compact, krypton-filled Herriott-type cavity employing metallic mirrors is used for spectral broadening. This multi-pass compression stage enables the efficient post compression of the pulses emitted by an ultrafast coherently combined thulium-doped fiber laser system. The presented results demonstrate an excellent preservation of the input beam quality in combination with a power transmission as high as 80%. These results show that multi-pass cell based post-compression is an attractive alternative to nonlinear spectral broadening in fibers, which is commonly employed for thulium-doped and other mid-infrared ultrafast laser systems. Particularly, the average power scalability and the potential to achieve few-cycle pulse durations make this scheme highly attractive.
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Wüest A, Imboden S, Dingeldein I, Mueller M. 063 Awareness of endometriosis for adolescence thru education in schools. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.092] [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: 11/25/2022]
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26
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Al-Zawity J, Afzal F, Awan A, Nordhoff D, Montier T, Le Gall T, Mueller M. P144 Impact of the sex steroid hormone estradiol on biofilm formation and phenotype of Pseudomonas aeruginosa isolates from cystic fibrosis patients. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Schriefl C, Schoergenhofer C, Buchtele N, Mueller M, Poppe M, Clodi C, Ettl F, Merrelaar A, Boegl MS, Steininger P, Holzer M, Herkner H, Schwameis M. Out-of-Sample Validity of the PROLOGUE Score to Predict Neurologic Function after Cardiac Arrest. J Pers Med 2022; 12:jpm12060876. [PMID: 35743661 PMCID: PMC9225634 DOI: 10.3390/jpm12060876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The clinical value of a prognostic score depends on its out-of-sample validity because inaccurate outcome prediction can be not only useless but potentially fatal. We aimed to evaluate the out-of-sample validity of a recently developed and highly accurate Korean prognostic score for predicting neurologic outcome after cardiac arrest in an independent, plausibly related sample of European cardiac arrest survivors. Methods: Analysis of data from a European cardiac arrest center, certified in compliance with the specifications of the German Council for Resuscitation. The study sample included adults with nontraumatic out-of-hospital cardiac arrest admitted between 2013 and 2018. Exposure was the PROgnostication using LOGistic regression model for Unselected adult cardiac arrest patients in the Early stages (PROLOGUE) score, including 12 clinical variables readily available at hospital admission. The outcome was poor 30-day neurologic function, as assessed using the cerebral performance category scale. The risk of a poor outcome was calculated using the PROLOGUE score regression equation. Predicted risk deciles were compared to observed outcome estimates in a complete-case analysis, a best-case analysis, and a multiple-data-imputation analysis using the Markov chain Monte Carlo method. Results: A total of 1051 patients (median 61 years, IQR 50–71; 29% female) were analyzed. A total of 808 patients (77%) were included in the complete-case analysis. The PROLOGUE score overestimated the risk of poor neurologic outcomes in the range of 40% to 100% predicted risk, involving 63% of patients. The model fit did not improve after missing data imputation. Conclusions: In a plausibly related sample of European cardiac arrest survivors, risk prediction by the PROLOGUE score was largely too pessimistic and failed to replicate the high accuracy found in the original study. Using the PROLOGUE score as an example, this study highlights the compelling need for independent validation of a proposed prognostic score to prevent potentially fatal mispredictions.
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Affiliation(s)
- Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | | | - Nina Buchtele
- Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria;
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Anne Merrelaar
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Magdalena Sophie Boegl
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Philipp Steininger
- Emergency Department, Clinic Hietzing, Vienna Healthcare Group, 1130 Vienna, Austria;
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
- Correspondence:
| | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (C.S.); (M.M.); (M.P.); (C.C.); (F.E.); (A.M.); (M.S.B.); (M.H.); (M.S.)
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Schriefl C, Schwameis M, Ettl F, Poppe M, Clodi C, Mueller M, Grafeneder J, Eskandary F, Reindl-Schwaighofer R, Warenits AM, Kupis A, Holzer M, Sterz F, Schoergenhofer C. Blood urea nitrogen kinetics in the early postcardiac arrest phase are associated with clinical outcome: A retrospective cohort study. Eur J Anaesthesiol 2022; 39:405-407. [PMID: 34261100 PMCID: PMC8900999 DOI: 10.1097/eja.0000000000001572] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Christoph Schriefl
- From the Department of Emergency Medicine (CSchr, MS, FE, MP, CC, MM, JG, AMW, MH, FS), Department of Medicine III (FE, RRS) and Department of Clinical Pharmacology (AK, CScho), Medical University of Vienna, Vienna, Austria
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Saad A, Mueller M, Pillai D. 25 Tender Is the Spine: Thoracolumbar Fractures and Patterns of Referrals. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.015] [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: 11/13/2022]
Abstract
Abstract
Introduction
This study investigates the pattern of referrals of thoracolumbar fractures between trauma and orthopaedic department in a district general trauma unit (TU) and the affiliated Major Trauma Centre (MTC). Our TU has got no out of hour emergency spinal surgeons on site. Patients who are admitted with thoracolumbar fractures get referred to MTC for advice on management. The TLICS score and the AO Thoracolumbar fracture classification system are two well recognized classification systems for thoracolumbar fractures. The main aim of this project is to evaluate current practice and its effectiveness.
Method
Data was retrospectively collected from the trauma board for patients referred to the orthopaedic on call services for thoracolumbar fractures over a 16-month period. Patients’ demographics, mechanism of injury, TLICS scores and AO classification were recorded, and outcome registered.
Results
From 92 patients identified most had low energy trauma and the majority had low TLICS score (<2) and AO class (A1,2,3). 24 of the patients were referred to MTC of whom 10 required a follow-up appointment. 39 were discussed with the local spinal consultants. 91 were treated conservatively and locally.
Conclusions
Most thoracolumbar fractures are treated locally. It can be argued that the emergency spinal services at MTC are unnecessarily burdened for advice and reassurance. A change of the current pathway can possibly be put in place for patients with low AO classification (A1,2,3), that can be treated with local spinal surgeon input. This calls for a follow-on multi-centre study.
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Affiliation(s)
- A.R. Saad
- Medway NHS Foundation Trust, Medway, United Kingdom
| | - M. Mueller
- Medway NHS Foundation Trust, Medway, United Kingdom
| | - D. Pillai
- Medway NHS Foundation Trust, Medway, United Kingdom
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30
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Mueller M, Bandl C, Kern W. Surface-Immobilized Photoinitiators for Light Induced Polymerization and Coupling Reactions. Polymers (Basel) 2022; 14:polym14030608. [PMID: 35160597 PMCID: PMC8839765 DOI: 10.3390/polym14030608] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 12/10/2022] Open
Abstract
Straightforward and versatile surface modification, functionalization and coating have become a significant topic in material sciences. While physical modification suffers from severe drawbacks, such as insufficient stability, chemical induced grafting processes efficiently modify organic and inorganic materials and surfaces due to covalent linkage. These processes include the “grafting from” method, where polymer chains are directly grown from the surface in terms of a surface-initiated polymerization and the “grafting to” method where a preformed (macro)-molecule is introduced to a preliminary treated surface via a coupling reaction. Both methods require an initiating species that is immobilized at the surface and can be triggered either by heat or light, whereas light induced processes have recently received increasing interest. Therefore, a major challenge is the ongoing search for suitable anchor moieties that provide covalent linkage to the surface and include initiators for surface-initiated polymerization and coupling reactions, respectively. This review containing 205 references provides an overview on photoinitiators which are covalently coupled to different surfaces, and are utilized for subsequent photopolymerizations and photocoupling reactions. An emphasis is placed on the coupling strategies for different surfaces, including oxides, metals, and cellulosic materials, with a focus on surface coupled free radical photoinitiators (type I and type II). Furthermore, the concept of surface initiation mediated by photoiniferters (PIMP) is reviewed. Regarding controlled radical polymerization from surfaces, a large section of the paper reviews surface-tethered co-initiators, ATRP initiators, and RAFT agents. In combination with photoinitiators or photoredox catalysts, these compounds are employed for surface initiated photopolymerizations. Moreover, examples for coupled photoacids and photoacid generators are presented. Another large section of the article reviews photocoupling and photoclick techniques. Here, the focus is set on light sensitive groups, such as organic azides, tetrazoles and diazirines, which have proven useful in biochemistry, composite technology and many other fields.
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Affiliation(s)
- Matthias Mueller
- Montanuniversitaet Leoben, Institute of Chemistry of Polymeric Materials, Otto-Glöckel-Straße 2, A-8700 Leoben, Austria; (C.B.); (W.K.)
- Correspondence: ; Tel.: +43-3842-402-2369
| | - Christine Bandl
- Montanuniversitaet Leoben, Institute of Chemistry of Polymeric Materials, Otto-Glöckel-Straße 2, A-8700 Leoben, Austria; (C.B.); (W.K.)
| | - Wolfgang Kern
- Montanuniversitaet Leoben, Institute of Chemistry of Polymeric Materials, Otto-Glöckel-Straße 2, A-8700 Leoben, Austria; (C.B.); (W.K.)
- Polymer Competence Center Leoben GmbH, Rosegger-Strasse 12, A-8700 Leoben, Austria
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Mueller M, Magnet IAM, Poppe M, Mitteregger T, Krammel M. Rhythm check three - A 2BCDE 3! - A new acronym to select eligible patients for extracorporeal cardiopulmonary resuscitation (eCPR). Resuscitation 2021; 171:30-32. [PMID: 34973342 DOI: 10.1016/j.resuscitation.2021.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, Vienna, Austria.
| | - Ingrid A M Magnet
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, Vienna, Austria
| | - Thomas Mitteregger
- Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Austria; PULS - Austrian Cardiac Arrest Awareness Association, Vienna, Austria
| | - Mario Krammel
- Emergency Medical Service Vienna, Vienna, Austria; PULS - Austrian Cardiac Arrest Awareness Association, Vienna, Austria
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Poppe M, Clodi C, Schriefl C, Mueller M, Sunder-Plaßmann R, Reiter B, Rechenmacher M, van Os W, van Hasselt JGC, Holzer M, Herkner H, Schwameis M, Jilma B, Schoergenhofer C, Weiser C. Targeted temperature management after cardiac arrest is associated with reduced metabolism of pantoprazole - A probe drug of CYP2C19 metabolism. Biomed Pharmacother 2021; 146:112573. [PMID: 34959115 DOI: 10.1016/j.biopha.2021.112573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/16/2021] [Accepted: 12/19/2021] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE Targeted temperature management (TTM) is part of standard post-resuscitation care. TTM may downregulate cytochrome enzyme activity and thus impact drug metabolism. This study compared the pharmacokinetics (PK) of pantoprazole, a probe drug of CYP2C19-dependent metabolism, at different stages of TTM following cardiac arrest. METHODS This prospective controlled study was performed at the Medical University of Vienna and enrolled 16 patients following cardiac arrest. The patients completed up to three study periods (each lasting 24 h) in which plasma concentrations of pantoprazole were quantified: (P1) hypothermia (33 °C) after admission, (P2) normothermia after rewarming (36 °C, intensive care), and (P3) normothermia during recovery (normal ward, control group). PK was analysed using non-compartmental analysis and nonlinear mixed-effects modelling. RESULTS 16 patients completed periods P1 and P2; ten completed P3. The median half-life of pantoprazole was 2.4 h (quartiles: 1.8-4.8 h) in P1, 2.8 h (2.1-6.8 h, p = 0.046 vs. P1, p = 0.005 vs. P3) in P2 and 1.2 h (0.9 - 2.3 h, p = 0.007 vs. P1) in P3. A two-compartment model described the PK data best. Typical values for clearance were estimated separately for each study period, indicating 40% and 29% reductions during P1 and P2, respectively, compared to P3. The central volume of distribution was estimated separately for P2, indicating a 64% increase compared to P1 and P3. CONCLUSION CYP2C19-dependent drug metabolism is downregulated during TTM following cardiac arrest. These results may influence drug choice and dosing of similarly metabolized drugs and may be helpful for designing studies in similar clinical situations.
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Affiliation(s)
- Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | | | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Raute Sunder-Plaßmann
- Clinical Institute of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Birgit Reiter
- Clinical Institute of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Wisse van Os
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | | | - Christoph Weiser
- Department of Emergency Medicine, Medical University of Vienna, Austria
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33
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Morozzi G, Rothen J, Toussaint G, De Lange K, Westritschnig K, Doelemeyer A, Ueberschlag VP, Kahle P, Lambert C, Obrecht M, Beckmann N, Ritter V, Panesar M, Stauffer D, Garnier I, Mueller M, Guerini D, Keller CG, Knehr J, Roma G, Bidinosti M, Brachat S, Morvan F, Fornaro M. STING regulates peripheral nerve regeneration and colony stimulating factor 1 receptor (CSF1R) processing in microglia. iScience 2021; 24:103434. [PMID: 34877494 PMCID: PMC8633968 DOI: 10.1016/j.isci.2021.103434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Inflammatory responses are crucial for regeneration following peripheral nerve injury (PNI). PNI triggers inflammatory responses at the site of injury. The DNA-sensing receptor cyclic GMP-AMP synthase (cGAS) and its downstream effector stimulator of interferon genes (STING) sense foreign and self-DNA and trigger type I interferon (IFN) immune responses. We demonstrate here that following PNI, the cGAS/STING pathway is upregulated in the sciatic nerve of naive rats and dysregulated in old rats. In a nerve crush mouse model where STING is knocked out, myelin content in sciatic nerve is increased resulting in accelerated functional axon recovery. STING KO mice have lower macrophage number in sciatic nerve and decreased microglia activation in spinal cord 1 week post injury. STING activation regulated processing of colony stimulating factor 1 receptor (CSF1R) and microglia survival in vitro. Taking together, these data highlight a previously unrecognized role of STING in the regulation of nerve regeneration. The cGAS/STING pathway is upregulated in sciatic nerve post nerve injury and in aging STING ablation increases myelin content and accelerates functional axon recovery STING KO mice reduces macrophage number in sciatic nerve and microglia activation post injury
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Affiliation(s)
- Giulio Morozzi
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Julian Rothen
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Gauthier Toussaint
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Katrina De Lange
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Katrin Westritschnig
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Arno Doelemeyer
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | | | - Peter Kahle
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Christian Lambert
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Michael Obrecht
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Nicolau Beckmann
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Veronique Ritter
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Moh Panesar
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Daniela Stauffer
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Isabelle Garnier
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Matthias Mueller
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Danilo Guerini
- Autoimmunity and Inflammation, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Caroline Gubser Keller
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Judith Knehr
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Guglielmo Roma
- Chemical Biology & Therapeutics, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Michael Bidinosti
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Sophie Brachat
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Frederic Morvan
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Mara Fornaro
- Musculoskeletal Disease Area, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
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Schriefl C, Steininger P, Clodi C, Mueller M, Poppe M, Ettl F, Nuernberger A, Grafeneder J, Losert H, Schwameis M, Holzer M, Sterz F, Schoergenhofer C. The association of early diarrhea after successful resuscitation following out-of-hospital cardiac arrest with neurological outcome: A retrospective observational study. Medicine (Baltimore) 2021; 100:e28164. [PMID: 34889287 PMCID: PMC8663854 DOI: 10.1097/md.0000000000028164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 11/16/2021] [Indexed: 01/05/2023] Open
Abstract
Gastrointestinal ischemia with reperfusion tissue injury contributes to post-cardiac arrest syndrome. We hypothesized that diarrhea is a symptom of intestinal ischemia/reperfusion injury and investigated whether the occurrence of early diarrhea (≤12 hours) after successful cardiopulmonary resuscitation is associated with an unfavorable neurological outcome.We analyzed data from the Vienna Clinical Cardiac Arrest Registry. Inclusion criteria comprised ≥18 years of age, a witnessed, non-traumatic out-of-hospital cardiac arrest, return of spontaneous circulation (ROSC), initial shockable rhythm, and ST-segment elevation in electrocardiogram after ROSC with consecutive coronary angiography. Patients with diarrhea caused by other factors (e.g., infections, antibiotic treatment, or chronic diseases) were excluded. The primary endpoint was neurological function between patients with or without "early diarrhea" (≤12 hours after ROSC) according to cerebral performance categories.We included 156 patients between 2005 and 2012. The rate of unfavorable neurologic outcome was higher in patients with early diarrhea (67% vs 37%). In univariate analysis, the crude odds ratio for unfavorable neurologic outcome was 3.42 (95% confidence interval, 1.11-10.56, P = .03) for early diarrhea. After multivariate adjustment for traditional prognostication markers the odds ratio of early diarrhea was 5.90 (95% confidence interval, 1.28-27.06, P = .02).In conclusion, early diarrhea within 12 hours after successful cardiopulmonary resuscitation was associated with an unfavorable neurological outcome.
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Affiliation(s)
- Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Philipp Steininger
- Emergency Department, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Juergen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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35
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Mueller M, Beitzke D, Scherz T, Loewe C, Mangold A, Marculescu R, Poppe M, Sterz F, Herkner H, Lang I, Testori C, Weiser C. Copeptin Levels Are Independent from Mild Therapeutic Hypothermia but Do Not Predict Infarct Size in Patients Presenting with ST-Segment Elevation Myocardial Infarction. J Cardiovasc Dev Dis 2021; 8:jcdd8100131. [PMID: 34677200 PMCID: PMC8539262 DOI: 10.3390/jcdd8100131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Mild therapeutic hypothermia (MTH) is a treatment adjunct in ST-segment elevation myocardial infarction (STEMI) that deserves investigation. Copeptin―a surrogate marker for vasopressin―is an early biomarker in STEMI. Data from cardiac arrest patients suggest a reduction of copeptin levels through MTH; however, copeptin levels have not been investigated in MTH during STEMI. Methods: We analyzed patients treated with MTH during STEMI in a sub-study of the STATIM trial (Testori, Heart 2019). Patients were randomized to normothermia or MTH with out-of-hospital initiation. Seven copeptin samples were collected from each patient. Primary endpoint was the difference in copeptin levels between the groups. As secondary endpoints, we defined differences in the kinetics between the sampling timepoints and the correlation between copeptin and the infarct size in relation to left ventricular myocardium. Results: We included 99 patients (MTH n = 47, control n = 52) in our intention to treat analysis. No differences in copeptin values at first medical contact between the MTH and normothermia groups were found. MTH showed no effect on copeptin levels, neither during cooling phase nor through the course. Copeptin peaked at first medical contact and hospital admission in both groups. No differences in kinetics between the timepoints were found. Copeptin showed no correlation with infarct size, neither at first medical contact nor hospital admission. Conclusions: Copeptin levels were not influenced by MTH in STEMI, suggesting the use of this biomarker also during temperature management. Furthermore, copeptin levels were not usable as a surrogate marker for infarct size at any timepoint.
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Affiliation(s)
- Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
| | - Dietrich Beitzke
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (D.B.); (C.L.)
| | - Thomas Scherz
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (T.S.); (A.M.); (I.L.)
| | - Christian Loewe
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (D.B.); (C.L.)
| | - Andreas Mangold
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (T.S.); (A.M.); (I.L.)
| | - Rodrig Marculescu
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
| | - Irene Lang
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria; (T.S.); (A.M.); (I.L.)
| | - Christoph Testori
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
- Correspondence: ; Tel.: +43-40-400-19640; Fax: +43-40-400-19650
| | - Christoph Weiser
- Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria; (M.M.); (M.P.); (F.S.); (H.H.); (C.W.)
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Kokot K, Kneuer J, John D, Moebius-Winkler M, Mueller M, Andritschke M, Gaul S, Sheikh B, Haas J, Thiele H, Leuschner F, Dimmeler S, Meder B, Laufs U, Boeckel JN. Reduced RNA editing in the failing human heart mediates alternative circular RNA splicing. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3195] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
Post-transcriptional RNA editing is an important mechanism in the development of human diseases. RNA editing can affect RNA stability and alternative splicing. The aim of our study was to characterize RNA editing and its impact on alternative RNA splicing in the healthy and failing human heart.
Methods and results
Human heart samples of heart failure (HF) patients (n=20) and controls (n=10) were analyzed using RNA sequencing with subsequent analysis of RNA editing. We identified adenosine-to-inosine (A-to-I) editing as the major form of RNA editing in human hearts, being reduced in HF patients. Consistently, we found the editing enzyme ADAR2 reduced in HF patients. A-to-I RNA editing predominantly occurred in intronic regions of protein-coding genes, specifically in repetitive, primate-specific Alu elements which can affect RNA splicing. Indeed, we found 173 circular RNAs (circRNAs) regulated by alternative mRNA splicing in the failing heart.
Loss of ADAR2 led to reduced RNA editing concomitant with an increase of circRNA, while overexpression reduced circRNA expression and enhanced RNA editing.
Conclusion
A-to-I editing is the major type of RNA editing in the human heart, being reduced in HF. We demonstrate a primate-specific alternative RNA splicing mechanism mediated by RNA editing in human hearts. The findings may be relevant to diseases with reduced RNA editing such as cancer, neurological and cardiac diseases.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Kokot
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - J Kneuer
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - D John
- Goethe University Hospital, Institute for Cardiovascular Regeneration, Frankfurt, Germany
| | - M Moebius-Winkler
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - M Mueller
- Herz- und Diabeteszentrum NRW, Ruhr-Universitaet Bochum, Bad Oeynhausen, Germany
| | - M Andritschke
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - S Gaul
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - B Sheikh
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), Leipzig, Germany
| | - J Haas
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - H Thiele
- Heart Center at University of Leipzig, Leipzig, Germany
| | - F Leuschner
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - S Dimmeler
- Goethe University Hospital, Institute for Cardiovascular Regeneration, Frankfurt, Germany
| | - B Meder
- University of Heidelberg, Department of Internal Medicine III, Heidelberg, Germany
| | - U Laufs
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
| | - J N Boeckel
- Leipzig University Hospital, Clinic and Polyclinic for Cardiology, Leipzig, Germany
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Mueller M, Grafeneder J, Schoergenhofer C, Schwameis M, Schriefl C, Poppe M, Clodi C, Koch M, Sterz F, Holzer M, Ettl F. Initial Blood pH, Lactate and Base Deficit Add No Value to Peri-Arrest Factors in Prognostication of Neurological Outcome After Out-of-Hospital Cardiac Arrest. Front Med (Lausanne) 2021; 8:697906. [PMID: 34604252 PMCID: PMC8483260 DOI: 10.3389/fmed.2021.697906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/19/2021] [Indexed: 12/23/2022] Open
Abstract
Background: In cardiac arrest survivors, metabolic parameters [pH value, lactate concentration, and base deficit (BD)] are routinely added to peri-arrest factors (including age, sex, bystander cardiopulmonary resuscitation, shockable first rhythm, resuscitation duration, adrenaline dose) to enhance early outcome prediction. However, the additional value of this strategy remains unclear. Methods: We used our resuscitation database to screen all patients ≥18 years who had suffered in- or out-of-hospital cardiac arrest (IHCA, OHCA) between January 1st, 2005 and May 1st, 2019. Patients with incomplete data, without return of spontaneous circulation or treatment with sodium bicarbonate were excluded. To analyse the added value of metabolic parameters to prognosticate neurological function, we built three models using logistic regression. These models included: (1) Peri-arrest factors only, (2) peri-arrest factors plus metabolic parameters and (3) metabolic parameters only. Receiver operating characteristics curves regarding 30-day good neurological function (Cerebral Performance Category 1-2) were analysed. Results: A total of 2,317 patients (OHCA: n = 1842) were included. In patients with OHCA, model 1 and 2 had comparable predictive value. Model 3 was inferior compared to model 1. In IHCA patients, model 2 performed best, whereas both metabolic (model 3) and peri-arrest factors (model 1) demonstrated similar power. PH, lactate and BD had interchangeable areas under the curve in both IHCA and OHCA. Conclusion: Although metabolic parameters may play a role in IHCA, no additional value in the prediction of good neurological outcome could be found in patients with OHCA. This highlights the importance of accurate anamnesis especially in patients with OHCA.
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Affiliation(s)
- Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Juergen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Moritz Koch
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Schriefl C, Schoergenhofer C, Poppe M, Clodi C, Mueller M, Ettl F, Jilma B, Grafeneder J, Schwameis M, Losert H, Holzer M, Sterz F, Zeiner-Schatzl A. Author Correction: Admission C-reactive protein concentrations are associated with unfavourable neurological outcome after out-of-hospital cardiac arrest. Sci Rep 2021; 11:18912. [PMID: 34535712 PMCID: PMC8448892 DOI: 10.1038/s41598-021-98687-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Juergen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Heidrun Losert
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Gruebl T, Ploeger B, Wranze-Bielefeld E, Mueller M, Schmidbauer W, Kill C, Betz S. Point-of-care testing in out-of-hospital cardiac arrest: a retrospective analysis of relevance and consequences. Scand J Trauma Resusc Emerg Med 2021; 29:128. [PMID: 34461967 PMCID: PMC8406837 DOI: 10.1186/s13049-021-00943-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background Metabolic and electrolyte imbalances are some of the reversible causes of cardiac arrest and can be diagnosed even in the pre-hospital setting with a mobile analyser for point-of-care testing (POCT).
Methods We conducted a retrospective observational study, which included analysing all pre-hospital resuscitations in the study region between October 2015 and December 2016. A mobile POCT analyser (Alere epoc®) was available at the scene of each resuscitation. We analysed the frequency of use of POCT, the incidence of pathological findings, the specific interventions based on POCT as well as every patient’s eventual outcome. Results N = 263 pre-hospital resuscitations were included and in n = 98 of them, the POCT analyser was used. Of these measurements, 64% were performed using venous blood and 36% using arterial blood. The results of POCT showed that 63% of tested patients had severe metabolic acidosis (pH < 7.2 + BE < − 5 mmol/l). Of these patients, 82% received buffering treatment with sodium bicarbonate. Potassium levels were markedly divergent normal (> 6.0 mmol/l/ < 2.5 mmol/l) in 17% of tested patients and 14% of them received a potassium infusion. On average, the pre-hospital treatment time between arrival of the first emergency medical responders and the beginning of transport was 54 (± 20) min without POCT and 60 (± 17) min with POCT (p = 0.07). Overall, 21% of patients survived to hospital discharge (POCT 30% vs no POCT 16%, p = 0.01, Φ = 0.16). Conclusions Using a POCT analyser in pre-hospital resuscitation allows rapid detection of pathological acid–base imbalances and potassium concentrations and often leads to specific interventions on scene and could improve the probability of survival.
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Affiliation(s)
- Tobias Gruebl
- Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, Ruebenacher Straße 170, 56072, Koblenz, Germany. .,Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany.
| | - B Ploeger
- Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - E Wranze-Bielefeld
- Department of Hazard Prevention and Emergency Service, District of Vogelsberg, Goldhelg 20, 36341, Lauterbach, Germany
| | - M Mueller
- German Red Cross Emergency Service of Mittelhessen gGmbH, Am Krekel 41, 35039, Marburg, Germany
| | - W Schmidbauer
- Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, Ruebenacher Straße 170, 56072, Koblenz, Germany
| | - C Kill
- Center of Emergency Medicine, University Hospital of Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - S Betz
- Center of Emergency Medicine, University Hospital of Marburg, Baldingerstraße, 35043, Marburg, Germany
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Sariali E, Mueller M, Klouche S. A higher reliability with a computed tomography scan-based three dimensional technique than with a two dimensional measurement for lower limb discrepancy in total hip arthroplasty planning. Int Orthop 2021; 45:3129-3137. [PMID: 34347133 DOI: 10.1007/s00264-021-05148-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal was to compare the reliability of a novel 3D method with the standard 2D technique for lower limb discrepancy (LLD) measurement during pre-operative THA planning. METHODS This prospective study included 100 consecutive patients who underwent THA using 3D planning based on a low-dose CT scan. The LLD was subdivided into three parameters: the intra-articular LLD (IA-LLD), the segmental extra-articular LLD (EA-LLD), and the total LLD (T-LLD). The LLD was assessed with a standard 2D technique on CT scanograms and also with a 3D method. A pelvic reference line (PBL) was determined as the 3D line joining the deepest part of the two great sciatic notches. The IA length was measured from the lesser trochanters (MLT) to the PBL. The EA length was measured from the MLT to the ankle center, and the total length was measured from the ankle center to the PBL. The intra- and inter-observer reliability of the measurements was assessed with the intra-class correlation coefficient (ICC). RESULTS The intra-observer ICC was higher with the 3D technique for IA-LLD (0.96-0.97 vs. 0.79-0.84), EA-LLD (0.96 vs. 0.78-0.92), and T-LLD (0.99 vs. 0.90-0.97). Inter-observer ICC was also higher with the 3D technique for IA-LLD (0.90-0.94 vs. 0.70-0.84) and EA-LLD (0.93-0.96 vs. 0.80-0.82), but not for T-LLD (0.91-0.94 vs. 0.91-0.94). CONCLUSION The presented 3D method has a higher reliability than 2D assessment of LLD during pre-operative THA planning. This article presents the first discussion of measuring LLD from 3D models. As 3D reconstruction becomes both more feasible and less-invasive, this study has interest to the orthopaedic surgeon.
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Affiliation(s)
- Elhadi Sariali
- Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, AP-HP, 75013, Paris, France.
- Hip and Knee Arthroplasty Department, Pitié Salpêtrière Teaching Hospital, 47-83 Bd de L'Hôpital, 75013, Paris, France.
| | - Matthias Mueller
- Symbios SA, Avenue des Sciences 1, 1400, Yverdon-les-Bains, Switzerland
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Mueller M, Poulsen P, Verbakel W, Berbeco R, Ferguson D, Wang L, Ren L, Mori S, Roeske J, Zhang P, Keall P. OC-0357 The MArkerless Lung target Tracking CHallenge (MATCH). Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06872-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schnaubelt S, Oppenauer J, Tihanyi D, Mueller M, Maldonado-Gonzalez E, Zejnilovic S, Haslacher H, Perkmann T, Strassl R, Anders S, Stefenelli T, Zehetmayer S, Koppensteiner R, Domanovits H, Schlager O. Arterial stiffness in acute COVID-19 and potential associations with clinical outcome. J Intern Med 2021; 290:437-443. [PMID: 33651387 PMCID: PMC8013324 DOI: 10.1111/joim.13275] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/17/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) interferes with the vascular endothelium. It is not known whether COVID-19 additionally affects arterial stiffness. METHODS This case-control study compared brachial-ankle pulse wave (baPWV) and carotid-femoral pulse wave velocities (cfPWV) of acutely ill patients with and without COVID-19. RESULTS Twenty-two COVID-19 patients (50% females, 77 [67-84] years) were compared with 22 age- and sex-matched controls. In COVID-19 patients, baPWV (19.9 [18.4-21.0] vs. 16.0 [14.2-20.4], P = 0.02) and cfPWV (14.3 [13.4-16.0] vs. 11.0 [9.5-14.6], P = 0.01) were higher than in the controls. In multiple regression analysis, COVID-19 was independently associated with higher cfPWV (β = 3.164, P = 0.004) and baPWV (β = 3.532, P = 0.003). PWV values were higher in nonsurvivors. In survivors, PWV correlated with length of hospital stay. CONCLUSION COVID-19 appears to be related to an enhanced PWV reflecting an increase in arterial stiffness. Higher PWV might be related to an increased length of hospital stay and mortality.
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Affiliation(s)
- S Schnaubelt
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - J Oppenauer
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - D Tihanyi
- Department of Pulmonology, Clinic Penzing, Vienna Health Care Group, Vienna, Austria
| | - M Mueller
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - E Maldonado-Gonzalez
- Department of Medicine I, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - S Zejnilovic
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - H Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - T Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - R Strassl
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - S Anders
- Department of Pulmonology, Clinic Penzing, Vienna Health Care Group, Vienna, Austria
| | - T Stefenelli
- Department of Medicine I, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - S Zehetmayer
- Centre for Medical Statistics, Information Technology and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - R Koppensteiner
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - H Domanovits
- From the, Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - O Schlager
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
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Schriefl C, Schoergenhofer C, Ettl F, Poppe M, Clodi C, Mueller M, Grafeneder J, Jilma B, Magnet IAM, Buchtele N, Boegl MS, Holzer M, Sterz F, Schwameis M. Change of Hemoglobin Levels in the Early Post-cardiac Arrest Phase Is Associated With Outcome. Front Med (Lausanne) 2021; 8:639803. [PMID: 34179033 PMCID: PMC8219926 DOI: 10.3389/fmed.2021.639803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The post-cardiac arrest (CA) phase is characterized by high fluid requirements, endothelial activation and increased vascular permeability. Erythrocytes are large cells and may not leave circulation despite massive capillary leak. We hypothesized that dynamic changes in hemoglobin concentrations may reflect the degree of vascular permeability and may be associated with neurologic function after CA. Methods: We included patients ≥18 years, who suffered a non-traumatic CA between 2013 and 2018 from the prospective Vienna Clinical Cardiac Arrest Registry. Patients without return of spontaneous circulation (ROSC), with extracorporeal life support, with any form of bleeding, undergoing surgery, receiving transfusions, without targeted temperature management or with incomplete datasets for multivariable analysis were excluded. The primary outcome was neurologic function at day 30 assessed by the Cerebral Performance Category scale. Differences of hemoglobin concentrations at admission and 12 h after ROSC were calculated and associations with neurologic function were investigated by uni- and multivariable logistic regression. Results: Two hundred and seventy-five patients were eligible for analysis of which 143 (52%) had poor neurologic function. For every g/dl increase in hemoglobin from admission to 12 h the odds of poor neurologic function increased by 26% (crude OR 1.26, 1.07–1.49, p = 0.006). The effect remained unchanged after adjustment for fluid balance and traditional prognostication markers (adjusted OR 1.27, 1.05–1.54, p = 0.014). Conclusion: Increasing hemoglobin levels in spite of a positive fluid balance may serve as a surrogate parameter of vascular permeability and are associated with poor neurologic function in the early post-cardiac arrest period.
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Affiliation(s)
- Christoph Schriefl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Florian Ettl
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Christian Clodi
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Juergen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | - Nina Buchtele
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Schwameis
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Brown O, Mou T, Lim S, Jones S, Kwasny M, Mueller M, Kenton K. 05 Do letters of recommendations for obstetrics and gynecology residency applicants differ by gender and race? a mixed-methods study. Am J Obstet Gynecol 2021. [DOI: 10.1016/j.ajog.2021.04.006] [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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Di Giovanni R, Solaro C, Grange E, Masuccio FG, Brichetto G, Mueller M, Tacchino A. A comparison of upper limb function in subjects with multiple sclerosis and healthy controls using an inertial measurement unit. Mult Scler Relat Disord 2021; 53:103036. [PMID: 34051695 DOI: 10.1016/j.msard.2021.103036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Upper limbs (UL) dysfunction is frequent in people with Multiple Sclerosis (PwMS). Several objective measures of UL function are proposed; however, their use is mostly confined to assess subjects with mild-to-moderate disability and requires fine motor skills, often impaired in high disability level subjects. Thus, a tool to score UL function in the advanced disease stage is lacking. The aim of the study is to analyse and compare UL unilateral and bilateral movements of healthy control (HC) and PwMS, at different disability levels, using an instrumented version (Inertial Measurement Unit, IMU) of the 15-seconds finger-to-nose test (FNT). Each movement cycle was segmented in going/adjusting/returning phases. The inter-hand interval (IHI) allowed assessing bilateral coordination (i.e. synchrony) in each phase. The larger IHI, the more severe the bilateral coordination impairment is. After stratifying PwMS for disability level (PwMSLOW, Expanded Disability Status Scale, EDSS≤5.5 and PwMSHIGH, EDSS≥6), the ANOVA on IHI showed significant differences between PwMS and HC (p<0.001) in all phases. However, only the going phase IHI showed significantly higher asynchrony in PwMSHIGH than PwMSLOW and HC (p<0.001) and no differences between PwMSLOW and HC. The going phase IHI seems to be a clinical marker specific for high disability level PwMS. These findings suggest inertial sensors during FNT could be an easy-to-use method for a more detailed quantitative characterization of UL function in PwMS also in subjects with EDSS greater than 6.
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Affiliation(s)
| | - C Solaro
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy.
| | - E Grange
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - F G Masuccio
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - G Brichetto
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
| | - M Mueller
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
| | - A Tacchino
- Italian Multiple Sclerosis Foundation (FISM), Scientific Research Area, Via Operai 40, 16149, Genoa, Italy
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Baehner T, Kiefer N, Ghamari S, Graeff I, Huett C, Pflugradt S, Sendzik B, Heinze I, Mueller M, Schindler E, Duerr GD, Ellerkmann R, Velten M. A National Survey: Current Clinical Practice in Pediatric Anesthesia for Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2021; 11:257-264. [PMID: 32294007 DOI: 10.1177/2150135120902122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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 Providing anesthesia for pediatric patients undergoing congenital cardiac surgery is complex and requires profound knowledge and clinical experience. Prospective studies on best anesthetic management are missing, partially due to different standards. The aim of the present study was to survey the current standard practice in anesthetic management in pediatric cardiac surgical centers in Germany. METHODS All 78 cardiac surgical centers in Germany were reviewed for a congenital cardiac surgery program. Centers with an active program for congenital cardiac surgery were interviewed to participate in the present online questionnaire to assess their current anesthetic practice. RESULTS Twenty-seven German centers running an active program for congenital heart surgery were identified, covering more than 3,000 pediatric cardiac surgeries annually. Of these centers, 96.3% (26/27) participated in our survey. Standard induction agents were etomidate in 26.9% (7/26), propofol in 19.2% (5/26), a combination of benzodiazepines and ketamine in 19.2% (5/26), and barbiturates in 11.5% (3/26). General anesthesia was preferentially maintained using volatile agents, 61.5% (16/26), with sevoflurane being the most common volatile agent within this group, 81.2% (13/16). Intraoperative first-choice/first-line inotropic drug was epinephrine, 53.8% (14/26), followed by milrinone, 23.1% (6/26), and dobutamine 15.4% (4/26). Fast-track programs performing on-table extubation depending on the type of surgical procedure were established at 61.5% (16/26) of the centers. CONCLUSION This study highlights the diversity of clinical standards in pediatric cardiac anesthesia for congenital cardiac surgery in Germany.
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Affiliation(s)
- Torsten Baehner
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Nicholas Kiefer
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Shahab Ghamari
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Ingo Graeff
- Emergency Department, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Christopher Huett
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Stefan Pflugradt
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Bjoern Sendzik
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Ingo Heinze
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Matthias Mueller
- Pediatric Heart Centre, Justus-Liebig University, Giessen, Germany
| | - Ehrenfried Schindler
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Georg Daniel Duerr
- Department of Cardiac Surgery, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
| | - Richard Ellerkmann
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany.,Department of Anesthesiology, Klinikum Dortmund, Dortmund, Germany
| | - Markus Velten
- Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany
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Lewin D, Nersesian G, Roehrich L, Mueller M, Mulzer J, Kukucka M, Starck C, Falk V, Potapov E. Impact of Cardiopulmonary Bypass for Implantation of Left Ventricular Assist Device on Postoperative Outcome. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725617] [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: 10/21/2022]
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Lanmueller P, Eulert-Grehn JJ, Felix S, Pieske B, Mulzer J, Mueller M, Falk V, Potapov E. Long-Term Mechanical Circulatory Support in Patients with Heart Failure with Preserved Ejection Fraction. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725791] [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: 10/21/2022]
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Mueller M, Zajonz T, Mann V, Koerner C, Akintuerk H, Yoerueker U, Heye K, Wetterling K, Reich B. Interrelations of Intraoperative Changes in Cerebral Tissue Oxygen Saturation with Brain Volumes and Neurodevelopment Outcome After the Comprehensive Stage II Procedure in Infants With Hypoplastic Left Heart Syndrome: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth 2020; 35:2907-2912. [PMID: 33431272 DOI: 10.1053/j.jvca.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The monitoring of cerebral tissue oxygen saturation by near-infrared spectroscopy (ScerebO2) is used widely in pediatric cardiac anesthesia. However, little information is available on the effects of changes in perioperative ScerebO2 on brain morphology and neurologic outcome. The primary hypothesis tested in this study was that intraoperative ScerebO2 during the comprehensive stage II procedure correlated with brain volumes assessed by magnetic resonance imaging and neurodevelopmental scores. DESIGN Retrospective observational cohort study. SETTING University Hospital, Pediatric Heart Centre. PATIENTS AND MEASUREMENTS In 19 infants, the intraoperative course of ScerebO2 during the comprehensive stage II procedure was examined. Minimal ScerebO2 and integrated ScerebO2 below 45% (AUC) during surgery, as well as cerebral magnetic resonance imaging (MRI) examinations and Bayley III test at the ages of two-to-three years, were analyzed. MAIN RESULTS A positive correlation between minimal ScerebO2 and intracranial volume (p = 0.0243), total brain volume (p = 0.0243), and white matter volume (p = 0.0276) was observed, as was a negative correlation between AUC and intracranial volume (p = 0.0454) and white matter volume (p = 0.0381), respectively. No association was found between ScerebO2 and Bayley-III Score. CONCLUSION The correlation between ScerebO2 and brain volumes measured by MRI pointed out a possible importance of neuroprotective strategies aimed at optimizing ScerebO2 during complex congenital heart surgery. That no correlation between ScerebO2 and Bayley III Score was found suggested multifactorial causes for neurologic outcome in children with congenital heart defects.
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Affiliation(s)
- Matthias Mueller
- Paediatric Cardiac Anesthesiology Service, Paediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany.
| | - Thomas Zajonz
- Paediatric Cardiac Anesthesiology Service, Paediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Valesco Mann
- Paediatric Cardiac Anesthesiology Service, Paediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Christian Koerner
- Paediatric Cardiac Anesthesiology Service, Paediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Hakan Akintuerk
- Department of Paediatric and Congenital Heart Surgery, Paediatric Heart Centre, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Uygar Yoerueker
- Department of Paediatric and Congenital Heart Surgery, Paediatric Heart Centre, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Kristina Heye
- Department of Paediatric Cardiology, University Children´s Hospital, Zurich, Switzerland
| | | | - Bettina Reich
- Department of Paediatric Cardiology, Paediatric Heart Centre, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
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Frey K, Goetze S, Mueller M, Rohrer L, Von Eckardstein A, Wollscheid B. The HDL synapse: Decoding a complex interaction network of HDL residing proteins and endothelial cell surface receptors. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.042] [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: 10/22/2022]
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