RepoMed (Medizinische Hochschule Hannover)
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Use of extracorporeal membrane oxygenation for eCPR in the emergency room in patients with refractory out-of-hospital cardiac arrest.
Get PDFBACKGROUND:Out-of-hospital cardiac arrest (OHCA) refractory to conventional high-quality cardiopulmonary resuscitation (CPR) may be rescued by extracorporeal CPR (eCPR) using veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Even when trying to identify eCPR candidates based on criteria assumed to be associated with a favourable neurological outcome, reported survival rates are frequently below 10%. METHODS:All patients undergoing implantation of V-A ECMO for eCPR between January 2018 and December 2019 (N = 40) were analysed (age 53±13 years; 75% male). Patients with refractory OHCA and potentially favourable circumstances (initial shockable rhythm, witnessed arrest, bystander CPR, absence of limiting comorbidities, age 15mmol/L in 30 out of 40 patients. Moreover, 22 out of 40 patients had a non-shockable rhythm on the first ECG. CONCLUSIONS:Despite our intention to select patients with potentially advantageous circumstances to achieve acceptable eCPR outcomes, the imminent deadly consequence of withholding eCPR obviously prompted individual physicians to perform the procedure also in presumably more unfavourable settings, resulting in similar mortality rates of eCPR as reported before
Limited influence of flail chest in patients with blunt thoracic trauma: a matched-pair analysis
Get PDFRegulation der Adhäsion, Transmigration und Chemotaxis von neutrophilen Granulozyten der Maus in vitro durch die Natriumkanal-α-Untereinheit Nav1.3
Get PDFDimensions and position of the Eustachian tube in Humans.
No full textEustachian tube (ET) dysfunction is one of the causes for chronic otitis media. To develop new therapies such as stents to facilitate middle ear ventilation, a better knowledge on dimensions and positions of the ET in individual patients is necessary. Cone beam CT scans of 143 patients were retrospectively investigated. Parameters such as lengths of the ET and its cartilaginous and bony parts, diameters, angles as well as distance of the ostium from the nasal conchae were determined and evaluated for side, gender and age specific differences. The average length of the cartilaginous and bony tubes was smaller in women than men. The average deviation from the horizontal plane was 1.7° larger on the left side (35.4°) compared to the right side (33.7°). Tools to manipulate the ET or to insert stents into the ET should cover angles from at least 42° to 64°. The distance of the pharyngeal orifices from the conchae nasalis inferior increased with age, becoming most prominent above 70 years of age. This investigation provides necessary information to develop stents for human application and tools for safe positioning of the stents
ADHS - Genealogie der Störungskonzepte und Etablierung der Pharmakotherapie in Deutschland: eine historische Diskursanalyse
No full textA Precision Driver Device for Intraoperative Stimulation of a Bone Conduction Implant.
No full textSemi-implantable bone conduction implants (BCI) and active middle ear implants (AMEI) for patients with sensorineural, conductive or mixed hearing loss commonly use an amplitude modulation technology to transmit power and sound signals from an external audio processor to the implant. In patients, the distance dependence of the signal amplitude is of minor importance as the skin thickness is constant and only varies between 3-7 mm. In this range, critical coupling transmission technique sufficiently reduces the variability in amplitude, but fails to provide well-defined amplitudes in many research and clinical applications such as intraoperative integrity tests where the distance range is exceeded by using sterile covers. Here we used the BCI Bonebridge (BB, Med-El, Austria) as an example to develop and demonstrate a system that synthesizes the transmission signal, determines the distance between the transmitter and the receiver implant coil and compensates transmission losses. When compared to an external audio processor (AP304) on an artificial mastoid, our system mainly decreased amplitude variability from over 11 dB to less than 3 dB for audio frequencies (0.1-10 kHz) at distances up to 15 mm, making it adequate for intraoperative and audiometric tests
Toxicity of fatty acid profiles of popular edible oils in human EndoC-βH1 beta-cells.
No full textAn inappropriate diet, particularly excessive consumption of dietary fats and oils, may have a major negative impact on beta-cell function and cause type 2 diabetes mellitus. To investigate this issue, we examined the toxicity of free fatty acid (FFA) compositions mirroring the FFA profiles of various popular edible oils in human EndoC-βH1 beta-cells and in rat islets. For this purpose, we made compositions consisting exclusively of various FFAs in different volumetric percentages mimicking these oils and additionally mixtures of these compositions. Human EndoC-βH1 beta-cells were incubated with different oil compositions and the toxicity, lipid droplet formation, ER-stress, and H2O2 production were analyzed. Compositions with prominent content of saturated as well as unsaturated long-chain FFAs showed moderate but significant toxicity both in human EndoC-βH1 beta-cells and rat islets, however, without further measurable metabolic impairments. On the other hand compositions with high content of medium-chain FFAs revealed no toxicity. A composition with 50% of the very long-chain unsaturated FFA erucic acid caused high toxicity with concomitant peroxisomal H2O2 production. The toxicity of FFAs to human EndoC-βH1 beta-cells was dampened in mixtures of FFA compositions with a significant content of medium-chain FFAs, but not with a significant proportion of unsaturated FFAs
Epidemiologie und Risikofaktoren der Periimplantitis: eine systematische Übersichtsarbeit und Meta-Analyse
No full textMindfulness and Psychological Flexibility areInversely Associated with Caregiver Burden inParkinson's Disease.
No full textParkinson's disease (PD) is a neurodegenerative movement disorder with progressiveimpairments in activities of daily living. With disease progression, people with PD (PwP) needmore help and care from their spouses or professional caregivers. Identifying factors that helpcaregivers to cope with their burden is needed to frame future interventions for PwP caregivers.Mindfulness and psychological flexibility might be factors contributing to resilience against theburden of giving care. In this cross-sectional questionnaire-based study, 118 PwP and theirrespective primary caregivers were included. Caregivers reported moderate burden and only milddepressive symptoms. Mindfulness measured by the Mindfulness Attention and Awareness scale(p 0.003) and psychological flexibility measured by Acceptance and Actions Questionnaire II (p0.001) correlated negatively with caregiver burden. Data from this study indicate mindfulness andpsychological flexibility are factors contributing to resilience against caregiver burden. Futureinterventions to reduce burden in PwP caregivers might be improved by the inclusion ofmindfulness training programs