RepoMed (Medizinische Hochschule Hannover)
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Brain-Derived Neurotrophic Factor and Immune Cells in Osteoarthritis, Chronic Low Back Pain, and Chronic Widespread Pain Patients: Association with Anxiety and Depression.
No full textBackground and Objectives: Musculoskeletal dysfunction can induce several types of chronic pain syndromes. It is of particular interest to elucidate the pathomechanism of different forms of chronic pain. It is possible that patients who have developed chronic widespread pain (CWP) may endure different pathomechanisms as compared to those who suffer from local pain (osteoarthritis, OA) and regional pain (chronic low back pain, cLBP), especially with regard to pain regulation and its related biomediators. The aim of this study was to determine the differences in pathomechanisms among these patients by measuring pain-related biomediators, particularly brain-derived neurotrophic factor (BDNF). Additionally, subpopulations of immune cells were determined in parallel. Materials and Methods: Patients and healthy subjects (HSs) were recruited (age and gender-matched). BDNF was measured from serum samples of patients and HSs and the data of body composition parameters were recorded. Additionally, both patients and HSs were asked to fill in questionnaires related to pain intensity, anxiety, and depression. Results: Our results highlight that the levels of both free and total BDNF are significantly lower in pain patients compared to HSs, with p values of 0.041 and 0.024, respectively. The number of CD3- CD56bright natural killer (NK) cells shows significant differences between the groups. Comparing all chronic pain patients with HSs reveals a significantly lower number of CD4+ CD8+ T cells (p = 0.031), CD3- CD56bright NK cells (p = 0.049) and CD20+ CD3- cells (p = 0.007). Conclusions: To conclude, it seems that a general conformity between the pathomechanisms of different chronic pain diseases exists, although there are unique findings only in specific chronic pain patients
Klinische Bedeutung von persistierender klonaler Hämatopoese nach Chemotherapie bei Patienten mit akuter myeloischer Leukämie
No full textAssessment of midwifery care providers intrapartum care competencies, in four sub-Saharan countries: a mixed-method study protocol.
Get PDFBackground We aim to assess competencies (knowledge, skills and attitudes) of midwifery care providers as well as their experiences and perceptions of in-service training in the four study countries; Benin, Malawi, Tanzania and Uganda as part of the Action Leveraging Evidence to Reduce perinatal mortality and morbidity in sub-Saharan Africa project (ALERT). While today more women in low- and middle-income countries give birth in health care facilities, reductions in maternal and neonatal mortality have been less than expected. This paradox may be explained by the standard and quality of intrapartum care provision which depends on several factors such as health workforce capacity and the readiness of the health system as well as access to care. Methods Using an explanatory sequential mixed method design we will employ three methods (i) a survey will be conducted using self-administered questionnaires assessing knowledge, (ii) skills drills assessing basic intrapartum skills and attitudes, using an observation checklist and (iii) Focus Group Discussions (FGDs) to explore midwifery care providers' experiences and perceptions of in-service training. All midwifery care providers in the study facilities are eligible to participate in the study. For the skills drills a stratified sample of midwifery care providers will be selected in each hospital according to the number of providers and, professional titles and purposive sampling will be used for the FGDs. Descriptive summary statistics from the survey and skills drills will be presented by country. Conventional content analysis will be employed for data analysis of the FGDs. Discussion We envision comparative insight across hospitals and countries. The findings will be used to inform a targeted quality in-service training and quality improvement intervention related to provision of basic intrapartum care as part of the ALERT project. Trial registration PACTR202006793783148-June 17th, 2020
Impressionen : aus dem 10. Durchgang das Ina-Pichlmayr-Mentorings 2019 -2021: Mentoring für Wissenschaftlerinnen an der Medizinischen Hochschule Hannover
No full textLung Transplantation following Emergency Pneumonectomy in a Polytraumatized 18-Year-Old
No full textOn rare occasions, a pneumonectomy needs to be performed after a severe polytrauma. Statistically, this procedure increases the mortality rate to 50%. One option to reduce this high rate could be an organ transplantation if a matching organ can be found. However, the current literature lacks any documentation of such a case. One reason for this stems from the fact that regulations for organ transplantation are very restricted and rarely allow exceptions. In addition, the chance for survival of polytraumatized patients in need of organs in the acute phase of the therapy is often quite unsure. Case Presentation. In this paper, we present the case of an 18-year-old patient who was involved in a serious motorcycle accident. His injury severity score was 29, but he suffered from severe bleeding in his lung which made a pneumonectomy necessary. The procedure led to a severe deterioration of his overall condition. An ECMO therapy was initiated, which effectively only slowed the aggravation. Therefore, he was transferred to our clinic where he was stabilized temporarily. A few days later, his situation turned worse. Since he had no other chance of survival, he was scheduled for a lung transplantation and was assigned an organ. After the transplantation, he stabilized quickly and recovered almost completely. Discussion. In this report, we want to show that an exception to the rules for organ transplantation might make sense on rare occasions. However, to increase the chance for any success, patients must be transferred to highly specialized clinics capable of treating patients with severe conditions. This might be the only chance for those patients to survive