RepoMed (Medizinische Hochschule Hannover)
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Strukturierte Identifikation von Patient_innen, die von einer Palliativversorgung profitieren können: eine Erprobung des Supportive and Palliative Care Indicators Tool (SPICT) im Krankenhaus
Get PDFEarly use of hemoadsorption in patients after out-of hospital cardiac arrest - a matched pair analysis.
Get PDFBACKGROUND:Pro- and anti-inflammatory mediators are released during and after cardiac arrest, which may be unfavourable. Small case-series and observational studies suggested that unselective hemoadsorption may reduce inadequately high cytokine levels during sepsis or cardiac surgery. We aimed to assess the effect of cytokine adsorbtion on mortality in patients following out-of-hospital cardiac arrest by comparing a patient cohort with hemoadsorption after resuscitation for out-of-hospital cardiac arrest to a control cohort without adsorption within the HAnnover COling REgistry (HACORE). METHODS:We adopted an early routine use of hemoadsorption in patients after out-of-hospital cardiac arrest with increased vasopressor need and performed a 1:2 match according to age, gender, time to return of spontaneous circulation, initial left-ventricular ejection fraction, extracorporeal membrane-oxygenation or left-ventricular unloading by Impella, need for renal replacement therapy, admission lactate, pH, glomerular filtration rate to patients without an adsorber from HACORE. The primary endpoint was 30-day mortality. RESULTS:Twenty-four patients receiving hemoadsorption were matched to 48 patients without hemoadsorption (mean age 62±13 years, 83% male). While there was no significant difference in baseline parameters, 30-day mortality was higher in patients treated with hemoadsorption than in the matched control group (83% vs 65%, Log rank p = 0.011). CONCLUSIONS:Routine use of hemoadsorption did not reduce, but seems to be associated with higher 30-day mortality in patients after OHCA. Prior to routine adoption in daily practice, hemoadsorption should be evaluated in properly sized randomized controlled trials
Biomechanical Assessment of Three Osteosynthesis Constructs by Periprosthetic Humerus Fractures.
Get PDFBackground:Biomechanical stability assessment of 3 different constructs for proximal fixation of a locking compression plate (LCP) in treating a Worland type C periprosthetic fracture after total shoulder arthroplasty. Methods:27 Worland type C fractures after shoulder arthroplasty in synthetic humeri were treated with 14-hole LCP that is proximally fixed using the following: (1) 1 × 1.5 mm cerclage wires and 2x unicortical-locking screws, (2) 3 × 1.5 mm cerclage wires, or (3) 2x bicortical-locking attachment plates. Torsional stiffness was assessed by applying an internal rotation moment of 5 Nm and then after unloading the specimen, an external rotation moment of 5 Nm at the same rate was applied. Axial stiffness was assessed by applying a 50 N preload, and then applying a cyclic load of 250 N, then increasing the load by 50 N each time, until a maximum axial load of 2500 N was reached or specimen failure occurred. Results:With regard to internal as well as external rotational stiffness, group 1 showed a mean stiffness of 0.37 Nm/deg and 0.57 Nm/deg, respectively, group 2 had a mean stiffness of 0.51 Nm/deg and 0.39 Nm/deg, respectively, while group 3 had a mean stiffness of 1.34 Nm/deg and 1.31 Nm/deg, respectively. Concerning axial stiffness, group 1 showed an average stiffness of 451.0 N/mm, group 2 had a mean stiffness of 737.5 N/mm, whereas group 3 had a mean stiffness of 715.8 N/mm. Conclusion:Group 3 displayed a significantly higher torsional stiffness while a comparable axial stiffness to group 2
Warum wenden sich plastisch operierte Patienten an die Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern?: eine retrospektive Auswertung der abgeschlossenen Fälle von 2005 bis 2015
Get PDFIn vitro disease modeling of "Mendelian Susceptibility to Mycobacterial Disease" (MSMD) using patient specific iPSC-technology
Get PDFNon-Invasive Luciferase Imaging of Type I Interferon Induction in a Transgenic Mouse Model of Biomaterial Associated Bacterial Infections: Microbial Specificity and Inter-Bacterial Species Interactions.
Get PDFThe performance of biomaterials is often compromised by bacterial infections and subsequent inflammation. So far, the conventional analysis of inflammatory processes in vivo involves time-consuming histology and biochemical assays. The present study employed a mouse model where interferon beta (IFN-β) is monitored as a marker for non-invasive rapid detection of inflammation in implant-related infections. The mouse model comprises subcutaneous implantation of morphologically modified titanium, followed by experimental infections with four taxonomically diverse oral bacteria: Streptococcus oralis, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Treponema denticola (as mono culture or selected mixed-culture). IFN-β expression increased upon infections depending on the type of pathogen and was prolonged by the presence of the implant. IFN-β expression kinetics reduced with two mixed species infections when compared with the single species. Histological and confocal microscopy confirmed pathogen-specific infiltration of inflammatory cells at the implant-tissue interface. This was observed mainly in the vicinity of infected implants and was, in contrast to interferon expression, higher in infections with dual species. In summary, this non-invasive mouse model can be used to quantify longitudinally host inflammation in real time and suggests that the polymicrobial character of infection, highly relevant to clinical situations, has complex effects on host immunity
Development and application of protein crystallography approaches for the elucidation of actin-based modulation of cytosolic myosin function
Get PDFAnti-Tumor Effects of Exosomes Derived from Drug-Incubated Permanently Growing Human MSC.
Get PDFSimilar to growth-limited human primary cultures of mesenchymal stroma/stem-like cells (MSC), the continuously proliferating human MSC544 cell line produced extracellular vesicles as characterized by expression of the tetraspanin molecules CD9, CD63, and CD81. Release of these particles was predominantly detectable during continuous cell growth of MSC544 in contrast to confluency-mediated transient growth arrest. For therapeutic use, these particles were isolated from proliferating MSC544 after taxol treatment and applied to different cancer cell cultures. A pronounced cytotoxicity of lung, ovarian, and breast cancer cells was observed primarily with taxol-loaded exosomes, similar to the effects displayed by application of taxol substance. While these findings suggested pronounced cancer cell targeting of MSC544 exosomes, a tumor therapeutic approach was performed using a mouse in vivo breast cancer model. Thus, intravenous injection of taxol-loaded MSC544 exosomes displayed superior tumor-reducing capabilities as compared to application of taxol exosomes by oral gavage. To broaden this therapeutic spectrum, epirubicin was applied to MSC544, and the derived exosomes likewise exhibited significant cytotoxic effects in different cancer cell cultures. These findings suggest an unlimited source for large-scale exosome production with reproducible quality to enable variable drug targeting of tumors or other diseases
The Effect of Transcutaneous Auricular Vagal Nerve Stimulation (taVNS) on P3 Event-Related Potentials during a Bayesian Oddball Task.
Get PDFTranscutaneous auricular Vagal Nerve Stimulation (taVNS) is a non-invasive brain stimulation technique associated with possible modulation of norepinephrinergic (NE) activity. NE is suspected to contribute to generation of the P3 event-related potential. Recent evidence has produced equivocal evidence whether taVNS influences the P3 in healthy individuals during oddball tasks. We examined the effect of taVNS on P3 amplitudes using a novel visual Bayesian oddball task, which presented 200 sequences of three stimuli. The three consecutive stimuli in each sequence are labelled Draw 1, Draw 2 and Draw 3. In total, 47 Subjects completed this visual Bayesian oddball task under randomised sham and active taVNS stimulation in parallel with an electroencephalographic (EEG) recording. We conducted exploratory analyses of the effect of taVNS on P3 amplitudes separately for Draws. We found typical oddball effects on P3 amplitudes at Draws 1 and 2, but not Draw 3. At Draw 2, the oddball effect was enhanced during active compared to sham taVNS stimulation. These data provide evidence that taVNS influences parietal P3 amplitudes under specific circumstances. Only P3 amplitudes at Draw 2 were affected, which may relate to closure of Bayesian inference after Draw 2. Our findings seemingly support previously reported links between taVNS and the NE system