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3. Verlängertes Koma durch Sedation mit Diazepam bei beatmeten Patienten: Diagnostische und therapeutische Anwendung des Benzodiazepin-Antagonisten Ro 15-1788

Author

Rapold Hj, Scollo-Lavizzari G, Ritz R, Follath F, and Kehl O

Subjects
Coma, Drug, Benzodiazepine, medicine.drug_class, business.industry, Sedation, media_common.quotation_subject, Antagonist, General Medicine, Urine, Diagnostic aid, Anesthesia, medicine, medicine.symptom, business, Diazepam, media_common, medicine.drug
Abstract

Repeated administration of diazepam in two ventilated patients had caused drug cumulation and coma over several days. In both cases central nervous depression could be demonstrated by the benzodiazepin antagonist Ro 15-1788 which induced reversal of coma. Estimation of plasma concentrations in a 70-year-old female patient 150 hours after the last administration showed a diazepam concentration of 437 ng/ml and a desmethyl-diazepam concentration of 483 ng/ml. The calculated elimination half-life of these substances were 109 and 403 hours. In the second case benzodiazepin could be demonstrated in urine for 10 days after withdrawal of medication. These observations suggest that diazepam is not a suitable drug for prolonged sedation in artificially ventilated patients. The benzodiazepin antagonist Ro 15-1788 represents a valuable diagnostic aid in ascertained or suspect cases of benzodiazepin intoxications. It can also be used therapeutically for reversal of central nervous depression.

Published
2008

4. Die klinische Untersuchung von Herz und Kreislauf

Author

Follath F

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, education, Physical examination, General Medicine, Auscultation, medicine.disease, Chest pain, Internal medicine, Heart failure, Heart sounds, cardiovascular system, Cardiology, medicine, Palpitations, Medical history, medicine.symptom, business, Central element
Abstract

The main manifestations of cardiac diseases are dyspnea, chest pain, palpitations, giddiness and syncope. A careful evaluation of subjective symptoms during history taking allows a rapid identification of an ischaemic heart disease, heart failure or cardiac arrhythmias. The additional clinical findings during bedside examination by inspection of the jugular veins, palpation of cardiac impulses and auscultation of heart sounds and murmurs are often sufficient to diagnose most of the frequent underlying disorders, such as valvular diseases, heart failure or pulmonary hypertension. The clinical assessment remains essential to select the most appropriate additional tests, such as echocardiography, scintigraphy, computer tomography or coronarography. Systematic teaching of the clinical skills should remain a central element in the formation of medical students and clinical fellows.

Published
2006

5. Depression, Stress und koronare Herzkrankheit – Epidemiologie, Prognose und therapeutische Folgen

Author

Follath F

Subjects
medicine.medical_specialty, business.industry, General Medicine, medicine.disease, Chest pain, Coronary artery disease, Orthostatic vital signs, Pharmacotherapy, Relative risk, Internal medicine, Epidemiology, medicine, Cardiology, Myocardial infarction, medicine.symptom, business, Depression (differential diagnoses)
Abstract

Depression and coronary heart disease may be related in several ways: (1) There is epidemiological evidence that high levels of depressive symptoms in male and female patients are associated with an increased risk of myocardial infarction and a higher mortality following an acute cardiac event. Furthermore, patients developing depression after myocardial infarction have more complications, including cardiac arrhythmias. (2) In patients with a chronic coronary heart disease depression also results in a worse cardiac functional status with more frequent and severe chest pain, more physical limitation, less treatment satisfaction and a lower perceived quality of life. Non-compliance with drug therapy is also more prevalent in depressed cardiac patients. (3) The possible pathophysiological mechanisms leading to more frequent complications of coronary heart disease in patients with depression are not fully explained, but could partly be due to higher sympatho-adrenergic stimulation and increased platelet aggregation. Some anti-depressant medications, on the other hand, may also cause cardiac symptoms and increase the risk in patients with coronary heart disease. The use of tricyclic antidepressants has been shown to result in a higher relative risk of myocardial infarction even after adjustment for other cardiovascular risk factors. Tricyclic anti-depressants may have direct cardiac effects, such as QT-prolongation with ventricular arrhythmias, orthostatic hypotension and, less frequently, myocardial dysfunction. In contrast such associations were not found with the newer serotonin re-uptake inhibitors. What are the practical consequences of the observed association between coronary artery disease and depression? First of all depression should better and earlier be recognised also by non-psychiatrists and treatment indications be discussed with specialists. At present, however, there is no clear evidence that ant-depressant drugs or psychotherapy will reduce the risk of myocardial infarction and improve prognosis. Further data are urgently needed to clarify the role of therapeutic interventions. Therefore, a closer research co-operation between cardiologists and psychiatrists should be promoted in future.

Published
2003

6. Rezidivierende Pneumonien

Author

Marincek B, Follath F, and Greutmann M

Subjects
medicine.medical_specialty, business.industry, General surgery, Recurrent pneumonia, Medicine, General Medicine, Disease, medicine.symptom, business, digestive system, Asymptomatic, digestive system diseases, Bronchoscopies
Abstract

We report the case of a 70-year old man with recurrent pneumonia due to aspiration from an otherwise asymptomatic small oesophageal diverticula in the mid-oesophageal region. The diagnosis was finally established by videofluoroscopy of the oesophagus after repeated bronchoscopies and CT scans in the proceeding months. After thoracoscopic removal of the diverticula the patient remained free of disease. Oesophageal diverticula as a rare cause of repeated pneumonias should be kept in mind, even though there are no symptoms of gastro-oesophageal disease.

Published
2004

7. The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

Author

Granger, C, Massie, B, Somaratne, J, Ahmed, A, Cowie, M, Gonzalez-Juanatey, J, Gorini, M, Kearney, M, di Lenarda, A, Lenzen, M, Macin, S, Madsen, B, Maggioni, A, McAlister, F, Oliva, F, Rich, M, Richards, M, Squire, I, Taffet, G, Earle, N, Perera, K, Dobson, J, Pocock, S, Poppe, K, Whalley, G, Andersson, B, Hall, C, Richards, AM, Troughton, R, Lainchbury, J, Berry, C, Hogg, K, Norrie, J, Stevenson, K, Brett, M, McMurray, J, Pfeffer, MA, Granger, CB, Held, P, McMurray, JJV, Michelson, EL, Olofsson, B, Ostergren, J, Yusuf, S, Torp-Pedersen, C, Lenzen, MJ, Reimer, WJMS, Boersma, E, Vantrimpont, PJMJ, Follath, F, Swedberg, K, Cleland, J, Komajda, M, Gotsman, I, Zwas, D, Planer, D, Azaz-Livshits, T, Admon, D, Lotan, C, Keren, A, Grigorian-Shamagian, L, Mazon-Ramos, P, Rigeiro-Veloso, P, Bandin-Dieguez, MA, Guazzi, M, Myers, J, Arena, R, McAlister, FA, Ezekowitz, J, Armstrong, PW, Cujec, B, Paterson, I, Cowie, MR, Wood, DA, Coats, AJS, Thompson, SG, Suresh, V, Poole-Wilson, PA, Sutton, GC, Martinez-Selles, M, Robles, JAG, Prieto, L, Munoa, MD, Frades, E, Diaz-Castro, O, Tarantini, L, Faggiano, P, Senni, M, Lucci, D, Bertoli, D, Porcu, M, Opasich, C, Tavazzi, L, Maggioni, AP, Kirk, V, Bay, M, Parner, J, Krogsgaard, K, Herzog, TM, Boesgaard, S, Hassager, C, Nielsen, OW, Aldershvile, J, Nielsen, H, Kober, L, Macin, SM, Perna, ER, Canella, JPC, Alvarenga, P, Pantich, R, Rios, N, Farias, EF, Badaracco, JR, Madsen, BK, Hansen, JF, Stokholm, KH, Brons, J, Husum, D, Mortensen, LS, Bayes-Genis, A, Vazquez, R, Puig, T, Fernandez-Palomeque, C, Bardaji, A, Pascual-Figal, D, Ordonez-Llanos, J, Valdes, M, Gabarrus, A, Pavon, R, Pastor, L, Almendral, J, Fiol, M, Nieto, V, Macaya, C, Cinca, J, de Luna, AB, Newton, JD, Blackledge, HM, Squire, IB, Wright, SP, Whalley, GA, Doughty, RN, Kerzner, R, Gage, BF, Huynh, BC, Rovner, A, Freedland, KE, Carney, RM, Rich, MW, Taffet, GE, Teasdale, TA, Bleyer, AJ, Kutka, NJ, Luchi, RJ, Tribouilloy, C, Rusinaru, D, Mahjoub, H, Souliere, V, Levy, F, Peltier, M, Tsutsui, H, Tsuchihashi, M, Takeshita, A, MacCarthy, PA, Kearney, MT, Cubbon, R, Nolan, J, Lee, AJ, Prescott, RJ, Shah, AM, Brooksby, WP, Fox, KAA, Varela-Roman, A, Gonzalez-Juanatey, JR, Basante, P, Trillo, R, Garcia-Seara, J, Martinez-Sande, JL, and Gude, F

Subjects
Meta-analysis, Heart failure, Prognosis
Abstract

A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF epsilon 50. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28), and have a history of hypertension (51 vs. 41). Ischaemic aetiology was less common (43 vs. 59) in patients with HF-PEF. There were 121 [95 confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95 CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95 CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40. Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Published
2012

8. The role of β-blockers in the management of hypertension: an Asian perspective

Author

Brian Tomlinson, Soenarta Aa, Park Cg, Huang J, Jamshed Dalal, Abdul Rashid Abdul Rahman, Low Lp, Follath F, Eugenio B. Reyes, and Anthony M. Heagerty

Subjects
Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Adrenergic beta-Antagonists, Alternative medicine, MEDLINE, Myocardial Infarction, Nice, Coronary Artery Disease, Pharmacology, Coronary artery disease, Excellence, medicine, Humans, Myocardial infarction, Intensive care medicine, Asia, Southeastern, media_common, computer.programming_language, Aged, Aged, 80 and over, Heart Failure, business.industry, General Medicine, Guideline, Middle Aged, medicine.disease, Heart failure, Hypertension, Practice Guidelines as Topic, Female, business, computer
Abstract

Following publication of the National Institute of Clinical Excellence (NICE) Guidelines in 2006, the use of β-blockers as first-line therapy in hypertension has been somewhat controversial. However, a recent reappraisal of the European Society of Hypertension guidelines highlights that these agents exhibit similar BP lowering efficacy to other classes of agents, prompting a re-examination of the utility of these agents in various patient populations. The authors felt that it is important to address this controversy and provide an Asian perspective on the place of β-blockers in current clinical practice and the benefits of β-blockade in selected patient populations. In addition to their use as a potential first-line therapy in uncomplicated hypertension, β-blockers have a particular role in patients with hypertension and comorbidities such as heart failure or coronary artery disease, including those who had a myocardial infarction. One advantage which β-blockers offer is the additional protective effects in patients with prior cardiovascular events. Some of the disadvantages attributed to β-blockers appear more related to the older drugs in this class and further appraisal of the efficacy and safety profile of newer β-blockers will lend support to the current guideline recommendations in Asian countries and encourage increased appropriate use of β-blockade in current clinical practice within Asia.

Published
2011

9. Ischemic vs non-ischemic heart failure – is there a difference?

Author

Follath F

Subjects
Gynecology, medicine.medical_specialty, business.industry, Heart failure, Etiology, Medicine, General Medicine, business, medicine.disease
Abstract

Die Prognose einer Herzinsuffizienz infolge koronarer Herzkrankheit ist schlechter als bei einer nicht-ischämischen Ursache. Auf eine Behandlung mit ACE-Hemmern, Betablockern und Diuretika sprechen zwar alle Formen der Herzinsuffizienz gut an, aber bei verschiedenen medikamentösen Therapien wurden Unterschiede beobachtet. Wichtig ist bei einer koronaren Herzkrankheit eine reversible ischämische Myokardschädigung (Hibernation) zu erkennen, um die Möglichkeit einer Revaskularisation nicht zu verpassen. Gezielte therapeutische Interventionen sind auch bei Hypertonie, äthylischer Kardiomyopathie und bei Herzinsuffizienz infolge Tachyarryhthmien möglich. Aus den genannten Gründen sollte die Ätiologie bei Herzinsuffizienz unbedingt abgeklärt werden.

Published
2000

10. High-resolution, hard x-ray photoemission investigation of BaFe2As2: Moderate influence of the surface and evidence for a low degree of Fe 3d-As 4p hybridization of electronic states near the Fermi energy

Author

de Jong, S., Huang, Y., Huisman, R., Massee, F., Thirupathaiah, R., Gorgoi, M., Schaefers, F., Follath, F., Goedkoop, J.B., Golden, M.S., and Hard Condensed Matter (WZI, IoP, FNWI)

Abstract

Photoemission data taken with hard x-ray radiation on cleaved single crystals of the barium parent compound of the MFe2As2 pnictide high-temperature superconductor family are presented. Making use of the increased bulk sensitivity upon hard x-ray excitation, and comparing the results to data taken at conventional vacuum ultraviolet photoemission excitation energies, it is shown that the BaFe2As2 cleavage surface provides an electrostatic environment that is slightly different to the bulk, most likely in the form of a modified Madelung potential. However, as the data argue against a different surface doping level, and the surface-related features in the spectra are by no means as dominating as seen in systems such as YBa2Cu3Ox, we can conclude that the itinerant, near-EF electronic states are almost unaffected by the existence of the cleavage surface. Furthermore, exploiting the strong changes in photoionization cross section between the Fe and As states across the wide photon energy range employed, it is shown that the degree of energetic overlap between the iron 3d and arsenic 4p valence bands is particularly small at the Fermi level, which can only mean a very low degree of hybridization between the Fe 3d and As 4p states near and at EF. Consequently, this means that the itinerancy of the charge carriers in this group of materials involves mainly the Fe 3d-Fe 3d overlap integrals with at best a minor role for the Fe 3d-As 4p hopping parameters and that the states which support superconductivity upon doping are essentially of Fe 3d character.

Published
2009

11. Management of patients with heart failure in clinical practice: differences between men and women

Author

Lenzen, Mattie, Rosengren, A, Scholte op Reimer, WJM (Wilma), Follath, F, Boersma, Eric, Simoons, Maarten, Cleland, JGF, Komajda, M, Cardiology, and Cardiothoracic Surgery

Subjects
SDG 3 - Good Health and Well-being
Abstract

Objectives: This study evaluated gender differences in clinical characteristics, treatment and outcome among patients with heart failure, and to what extent these differences are due to age and differences in left ventricular (LV) function. Although gender differences are observed among heart failure patients, few studies have been adequately powered to investigate these differences. Methods: A total of 8914 (out of 10 701) patients (47% women) from the Euro Heart Survey on Heart Failure with confirmed diagnosis of heart failure were included in the analyses. Results: Women were older (74.7 vs 68.3 years, p < 0.001), and less often had evidence of coronary artery disease (56% vs 66%, age-adjusted odds ratio (OR) 0.62; 95% CI 0.57 to 0.68). Women were more likely to have hypertension, diabetes, or valvular heart disease. Fewer women had an investigation of LV function (59% vs 74%, age-adjusted OR 0.67; 95% CI 0.61 to 0.74), and, among those investigated, fewer had moderate/severe left ventricular systolic dysfunction (44% vs 71%, age-adjusted OR 0.35; 95% CI 0.32 to 0.39). Drugs with a documented impact on survival, that is ACE-inhibitors and beta-blockers, were given less often to women, even in the adjusted analysis (OR 0.72; 95% CI 0.61 to 0.86 and OR 0.76; 95% CI 0.65 to 0.89, respectively). 12-week mortality was similar for men and women. Conclusions: Fewer women had an assessment of LV function, but, when investigated, women had better ventricular function. Women were less often treated with evidence-based drugs, even after adjustment for age and important clinical characteristics. Clinicians need to be aware of deficiencies in the treatment of women with heart failure and measures should be taken to rectify them.

Published
2008

15. Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: the ASSENT-3 randomised trial in acute myocardial infarction

Author

Van de Werf, F., Armstrong, P. W., Granger, C., Wallentin, L., Adgey, A. A. J., Aylward, P., Binbrek, A. S., Califf, R., Cassim, S., Diaz, R., Fanebust, R., Fioretti, P. M., Huber, K., Husted, S., Lindahl, B., Lopez-Sendon, J. L., Makijarvi, M., Meyer, J., Navarro Robles, J., Pfisterer, M., Seabra-Gomes, R., Soares-Piegas, L., Sugrue, D., Tendera, M., Theroux, P., Toutouzas, P., Vahanian, A., Verheugt, F., Sarelin, H., Goetz, G., Bluhmki, E., Daclin, V., Danays, T., Houbracken, K., Kaye, J., Reilly, P., Hacke, W., von Kummer, R., Lesaffre, E., Bogaerts, K., Peeters, C., Fox, K. A. A., Brower, R., Hirsh, J., Maggioni, A., Tijssen, J., Weaver, D., Beernaert, A., Beysen, N., Broos, K., De Prins, E., D'Hollander, K., Dupon, L., Fomyna, N., Fransen, A., Genesse, D., Goffin, L., Hendrickx, R., Jansen, B., Jorissen, F., Luys, C., Luyten, A., Marschal, C., Moreira, M., Munsters, K., Salerno, R., Schoovaerts, C., Sinnaeve, P., Schildermans, C., Vandenberghe, K., Vandeschoot, K., Van Gucht, H., Van Rompaey, P., Vlassak, S., Watzeels, M., Wittockx, H., Galan, K., Humeniuk, L., Seidel, A., Molina, M., Hafley, G., Alexander, J., Pascual, A., Bestilny, S., Temple, T., Ahuad Guerrero, R., Albisu, J. P., Bassani Arrieta, C. A., Bono, J., Caccavo, A., Cagnolatti, A., Cartasegna, L. R., Castellanos, R., Chekerdemian, S., Covelli, G., Cuello, J. L., Cuneo, C. A., Fernandez, A., Ferrara, C., Ferro-Queirel, E., Gambarte, A., Garcia-Duran, R., Hasbani, E., Hrabar, A., Keller, L., Lobo Marquez, L. L., Luciardi, H., Macin, S. M., Marinig, A., Marzetti, E., Muntaner, J., Nordaby, R., Orlandini, A. D., Piombo, A. C., Pomposiello, J. C., Quijano, R. A., Amerena, J., Aroney, G., Buckmaster, N., Carroll, P., Fitzpatrick, M., Newman, R., Rowe, M., Singh, B., Thomson, A., Winter, C., Eber, B., Gaul, G. B., Klein, W., Leisch, F., Mayr, H., Mlczoch, J., Niessner, H., Pachinger, O., Pall, H., Pichler, M., Roggla, G., Schaflinger, E., Schreiber, W., Slany, J., Traindl, O., Zenker, G., Beckers, J., Bekaert, I., Berthe, C., Bodur, G., Carlier, B., Carlier, M., Carpentier, J., Celen, H., Charlier, F., Clement, A., Coenen, A., Crochelet, L., De Keyser, F., De Man, F., de Meester, A., Dendale, P., Dhondt, E., Dhooghe, G., El Allaf, D., Elshot, S., Emmerechts, C., Foret, F., Gatera, E., Geraedts, J., Gerardy, A. C., Gysbrechts, M., Hallemans, R., Hellemans, S., Herssens, H., Huygens, L., Janssens, L., Lalmand, J., Maamar, R., Marechal, P., Mertens, D., Michel, P., Morandini, E., Nannan, M., Nguyen, D., Odeurs, W., Peerenboom, P., Pirenne, B., Quinonez, M., Raymenants, E., Renard, M., Silance, P. G., Standaert, A. M., Striekwold, H., Thiels, H., Valadi, D., van Brabandt, H., Van Dormael, M., Van Iseghem, P., Van Walleghem, U., Vanden Bosch, H., Vandenbossche, J. L., Vermylen, J., Verstraete, S., Vo Ngoc, P., Willems, P., Zenner, R., Campos de Albuquerque, D., Coutinho, M., de Camargo Carvalho, A. C., Fernandes Manenti, E. R., Ferreira Azevedo, A., Golin, V., Gun, C., Marin Neto, J. A., Marino, R. L., Miranda Abrantes, J. A., Nicolau, J. C., Porto Alegre Dancini, E. M., Rabelo, A., Ramos, R. F., Rizzi Coelho, O., Alexander, D., Bata, I. R., Bhargava, R. K., Bogaty, P., D'Amours, G., Darcel, I., Finnie, K. J. C., Fowlis, R., Gupta, M. K., Henderson, M., Howlett, M. K., Javier, J. J., Kieu, C. V., Kumar, G., Lebouthillier, P., Leduc, F., Lepage, S., Mcavinue, T., Mcgillen, J. E., Mcmeekin, J. D., Morse, J. W., Pistawka, K., Raimondo, E. F., Sandrin, F., Smith, H., Smylie, P. C., Tran, K., Turabian, M., Wagner, K. R., Winkler, L. H., Woo, K. S., Falstie-Jensen, N., Lind Rasmussen, S., Lomholt, P., Markenvard, J., Nielsen, H., Petersen, J., Romer, F., Ahonen, J., Huttunen, M., Kokkonen, L., Luukkonen, J., Mantyla, P., Melin, J., Mustonen, J., Valli, J., Voutilainen, S., Agraou, B., Allam, S., Baradat, G., Battistella, P., Bazin, P., Bouvier, J. -M., Destrac, S., Fouche, R., Fournier, P. -Y., Funck, F., Garnier, H., Grall, J. -Y., Gully, C., Lallement, P. -Y., Loiselet, P., Mycinsky, C., Page, A., Parisot, M., Range, G., Rocher, R., Tafani, C., Thisse, J. -Y., Tibi, T., Tissot, M., Wahl, P., Backenkohler, U., Bavastro, P., Beckmann-Hiss, H., Behnke, M., Bermes, M., Bernsmeier, R., Bethge, K. P., Bethge, H., Block, M., Burkhardt, W., Cieslinski, G., Claus, G., Deetjen, A., Diefenbach, A., Diehm, C., Dietz, A., Dippold, W. G., Eichner, A., Erckenbrecht, J. F., Gawlick, L., Gerber, V., Goppel, L., Gottwik, M., Grosch, B., Hammer, B., Hanheide, M., Hanrath, P., Haspel, J., Hennersdorf, F., Hermanns, M., Hoffmeister, H. M., Holzapfel, P., Hubner, H., Jansen, W., Jung, S., Kaddatz, J., Kienbock, H., Klein, H. H., Konz, K. H., Kulschbach, M., Leschke, M., Liebau, G., Linnartz, M., Lockert, G., Loesbrock, R., Lollgen, H., Ludwig, N., Mudra, H., Munzer, K., Nebel, B., Nellessen, U., Neu, C., Olbrich, H. G., Pfeffer, A., Pfeiffer, P., Plate, V., Pollock, B., Rapp, H., Rommele, U., Sauer, K., Scheffler, N., Schlotterbeck, K., Schmidt-Salzmann, A., Schnitzler, G., Schumann, H., Schuster, C. J., Schuster, P., Schweizer, P., Seitz, K., Simon, R., Spes, C., Szabo, S., Terhardt-Kasten, E., Theuerkauf, B., Tigges, R., Tinnappel, J., Topp, H., Trockel, P., Unland, N., Veth, V., Vom Dahl, J., Vossbeck, G., Weindel, K., Weib, D., Wiewel, D., Wirtz, P., Zipp, C., Apostolou, T., Chalkidis, C., Exadaktylos, N., Foussas, S., Hatseras, D., Karas, S., Karydis, K., Lambrou, S., Louridas, G., Manolis, A., Nanas, J., Novas, I., Panagiotidou, T., Papadopoulos, C., Papakonstantinou, D., Papasteriadis, E., Pavlidis, P., Pyrgakis, V., Skoufas, P., Stavrati, A., Tyrologos, A., Vardas, P., Vrouchos, G., Zacharoulis, A., Zarifis, J., Brown, A., Daly, K., Fennell, W., Horgan, J., Mccann, H., Mcdonald, K., O'Reilly, M., Sullivan, P., Altamura, G., Ambrosio, G., Auteri, A., Aveta, P., Azzarito, M., Badano, L. P., Barbiero, M., Barletta, C., Biscosi, C., Boccanelli, A., Bottero, M., Brizio, E., Brunazzi, M. C., Brunelli, C., Bugatti, U., Capozi, A., Capucci, A., Carfora, A., Caronna, A., Carrone, M., Casazza, F., Cauticci, A., Ceci, V., Ciconte, V., Circo, A., Ciricugno, S., Comito, F., Cornacchia, D., Corsini, G., D'Andrea, F., De Rosa, P., De Simone, M., Del Citerna, F., Del Pinto, M., Dell'Ali, C., Della Casa, S., Della Monica, R., Delogu, G., Di Biase, M., Di Chiara, A., Di Guardo, G., Di Marco, S., Di Mario, F., Di Napoli, T., Di Palma, F., Fadin, B. M., Fazzari, M., Ferraiuolo, G., Fiaschetti, R., Fontanelli, A., Fresco, C., Gambelli, G., Gasbarri, F., Gemelli, M., Giani, P., Gigantino, A., Giomi, A., Giorgi, G., Greco, C., Gregorio, G., Guagnozzi, G., Guiducci, U., Guzzardi, G., Izzo, A., La Rosa, A., Leone, F., Leone, G., Lo Bianco, F., Locuratolo, N., Maggiolini, S., Malinconico, M., Mancone, C., Mangiameli, S., Marchi, S. M., Maresta, A., Mauri, F., Mazzini, C. A., Michisanti, M., Miracapillo, G., Modena, M. G., Morgagni, G. L., Mossuti, E., Nascimbeni, F., Negrelli, M., Notaristefano, A., Pardi, S., Peci, P., Pettinati, G., Pietropaolo, F., Pirelli, S., Pretolani, M., Prinzi, D., Proietti, F., Raganelli, L., Rapino, S., Re, F., Ricci, R., Rinaldi, G., Rusticali, G., Severi, S., Spallarossa, P., Tartagni, F., Terrosu, P., Tortorella, G., Tota, F., Tritto, I., Tuccilo, B., Turco, V., Uscio, G., Valagussa, F., Vergoni, W., Verzuri, M. S., Vetrano, A., Villani, R., Zanini, R., Boisante, L., Niclou, R., Alcocer, L., Castro, A., Fragoso, J., Gonzalez, V., Gonzalez-Pacheco, H., Hernandez-Santamaria, I., Huerta, R., Huerta, D., Martinez, A., Mendoza, M., Moguel, R., Navarro, J., Portos, J. M., Rodriguez, I., Sierra, L., Valencia, S., Vazquez, A., Arnold, A. E. R., Boehmer, A. G., de Graaf, J. J., Funke Kupper, A. J., Gobel, E. J. A. M., Janus, C. L., Linssen, G. C. M., Sedney, M. I., Slegers, L. C., Spierenburg, H. A. M., Strikwerda, S., Tans, J. G. M., Twisk, S. P. M., van der Heijden, R., van Kalmthout, P. M., Verheugt, F. W. A., Holt, E., Skogsholm, A., Thorshaug, R., Thybo, N. K., Wang, H., Maciejewicz, J., Piotrowski, W., Pluta, W., Ruminski, W., Skura, M., Smielak-Korombel, W., Carranca, J., Carvalho, M., Catarino, C., Cunha, D., Ferreira, D., Ferreira, J., Ferreira da Costa, A. F., Lopes de Carvalho, J., Martins, L., Mourao, L., Oliveira Carrageta, M., Prazeres de Sa, E., Puig, J., Ramalho Dos Santos, M. J. J., Resende, M., Seabra Gomes, R., Baig, M. M. E., Bayat, J., Benjamin, J. D., Ranjith, N., Routier, R., Wittmer, H., Abizanda Campos, R., Alonso Garcia, M. A., Amaro Cendon, A., Arboleda Sanchez, J. A., Blanco Varela, J., Bruguera I Cortada, J., Carpintero Avellaneda, J. L., Caturla Such, J., Civeira Murillo, E., Fernandez Aviles, F., Fernandez Fernandez, R., Figueras Bellot, J., Fiol Sala, M., Froufe Sanchez, J., Garcia Calabozo, R., Garcia Palacios, J. L., Gonzalez Maqueda, I., Kallmeyer Martin, C., Lopez Sendon, J. L., Manzano Ramirez, A., Marine Rebull, J., Monton Rodriguez, A., Pique Gilart, M., Reina Toral, A., Rodriguez Llorian, A., Ruano Marco, M., Sanchez Miralles, A., Sanjose Garagarza, J. M., Santalo Bel, M., Torres Ruiz, J. M., Valentin Segura, V., Ahlstrom, P., Ahremark, U., Bandh, S., Bellinetto, A., Dahlberg, A., Hansen, O., Hurtig, U., Jonasson, L., Karlsson, J. E., Larsson, L. E., Moller, B., Ohlin, H., Persson, H., Sandstedt, L., Soderberg, S., Svennberg, L., Swahn, E., Tygesen, H., Broccard, A. F., Estlinbaum, W., Follath, F., Frutiger, A., Hess, N., Maggiorini, M., Marti, D., Muller, P., Rickenbacher, P., Schaller, M. D., Weinbacher, M., Abdulali, S., Ahmad, G., George, S., Ghazi, A., Rao, K. N., Bishop, A., Bridges, A., Canepa-Anson, R., Cave, M., Clarck, R., Cooper, I., de Belder, A., Farrer, M., Kendall, J. M., Ludman, P., Mattu, R., Mcglinchey, P., Moriarty, A. J., Muthusamy, S., Nee, P. A., Nolan, J., Papouchado, M., Rose, E. L., Shahi, M., Stephens, J., Trevelyan, J., Abdul-Karim, A., Adler, L., Arunasalam, S., Avington, D., Baron, S., Beel, T., Bellamy, B., Bennett, J., Berndt, T., Berrick, A., Bersin, R. M., Bethala, V., Bharath, S., Bouchard, A., Boulet, J. E., Bowerman, R., Boyek, T., Brar, R. S., Brodell, G., Bryant, B., Buckner, J. K., Cage, J., Cannon, J. D., Carducci, B., Carr, K., Chang, M., Chelliah, N., Chin, W. L., Chin, J., Church, D. H., Clark, R., Coulis, L., Dadkhah, S., Dearing, B., Defranco, A., Dharawat, M., Dharawat, R., Dhruva, N., Dicola, J., Dykstra, G., Eisenberg, S., El-Bialy, A., Fera, S., Ford, K., Foreman, R. D., Friedman, S., Friedman, V., Garibian, G., Gelormini, J., Geninatti, M. R., Genovese, R., Ghazi, F., Gilchrist, I., Gitler, B., Glover, R., Gonzalez, J., Goulah, R., Graham, B., Gray, R., Grodman, R., Habib, G. B., Hack, T., Hamroff, G., Hanna, G., Hart, M., Haught, H., Hawkins, J., Hempel, R., Hiremath, Y., Hiser, W., Holland, E., Jaffe, N., Jamal, N., James, K. F., Kalla, S., Kates, M., Kemper, A. J., Kennedy, J. J., Kerut, E. K., Killpack, M., King, J., T. Y., Ko, Kollar, K., Kontos, M., Kugelmassluu, A., Kumar, A., Kutscher, A. H., Lambrecht, C., Lancaster, L., Layden, J., Lazar, A., Lebow, M., Lee, C., Lee, A. B., Lehr, J., Levin, F. L., Levitt, R., Levy, R. M., Lieberman, A., Litman, G. I., Lui, H., Luu, M. Q., Macdonald, G., Madyoon, H., Mancherje, C., Marmulstein, M., Mclaurin, B. T., Mcnellis, M., Mendelson, R., Micale, P. J., Miller, M. J., Miller, M. S., Miller, J., Millman, A., Millsaps, R., Minor, S., Modica, J., Morse, H., Moskovits, N., Nester, B. A., Newton, A. S., Niazi, I., Niederman, A., Oatfield, R., Painter, J. A., Pamfilis, S. M., Pamulapati, K. M., Patel, N., Payne, R., Pearson, C., Peizner, D. S., Petrovich, L., Piriz, J., Pollack, M., Pollock, S., Popkave, A., Puma, J. A., Quesada, R., Quigley-Malcolm, D., Raby, K., Ravindran, K., Rees, A. P., Reiner, J., Rivera, E., Rogers, F., Rosenthal, A., Rowe, W. W., Ryan, P. F., Ryman, K., Salacata, A., Santolin, C., Saucedo, J., Savage, R., Savage, W., Schumacher, R., Segarra, S., Sharkey, S., Shonkoff, D., Silver, M., Silver, S. L., Singh, G., Sinyard, R. D., Sporn, D., Srivastava, N. K., Stomel, R., Suresh, D. P., Tallman, M., Togioka, T., Varma, S., Verant, R. P., Wallach, R., Weinberg, M., Weinberg, D., Weinstein, J. M., Wesley, G., Westerman, J. H., Wheeling, J., Whitaker, J., Widmer, M., Yasin, M., and Zakrzewski, M. J.

Subjects
Male, medicine.medical_specialty, Abciximab, Ischemia, Myocardial Infarction, Tenecteplase, Injections, Immunoglobulin Fab Fragments, Reperfusion therapy, Fibrinolytic Agents, Recurrence, Internal medicine, medicine, Humans, Myocardial infarction, Enoxaparin, Aged, Intention-to-treat analysis, Chi-Square Distribution, business.industry, Heparin, Antibodies, Monoclonal, General Medicine, Middle Aged, medicine.disease, Survival Analysis, Regimen, Treatment Outcome, Anesthesia, Tissue Plasminogen Activator, Cardiology, Drug Therapy, Combination, Female, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

BACKGROUND: Current fibrinolytic therapies fail to achieve optimum reperfusion in many patients. Low-molecular-weight heparins and platelet glycoprotein IIb/IIIa inhibitors have shown the potential to improve pharmacological reperfusion therapy. We did a randomised, open-label trial to compare the efficacy and safety of tenecteplase plus enoxaparin or abciximab, with that of tenecteplase plus weight-adjusted unfractionated heparin in patients with acute myocardial infarction. METHODS: 6095 patients with acute myocardial infarction of less than 6 h were randomly assigned one of three regimens: full-dose tenecteplase and enoxaparin for a maximum of 7 days (enoxaparin group; n=2040), half-dose tenecteplase with weight-adjusted low-dose unfractionated heparin and a 12-h infusion of abciximab (abciximab group; n=2017), or full-dose tenecteplase with weight-adjusted unfractionated heparin for 48 h (unfractionated heparin group; n=2038). The primary endpoints were the composites of 30-day mortality, in-hospital reinfarction, or in-hospital refractory ischaemia (efficacy endpoint), and the above endpoint plus in-hospital intracranial haemorrhage or in-hospital major bleeding complications (efficacy plus safety endpoint). Analysis was by intention to treat. FINDINGS: There were significantly fewer efficacy endpoints in the enoxaparin and abciximab groups than in the unfractionated heparin group: 233/2037 (11.4%) versus 315/2038 (15.4%; relative risk 0.74 [95% CI 0.63-0.87], p=0.0002) for enoxaparin, and 223/2017 (11.1%) versus 315/2038 (15.4%; 0.72 [0.61-0.84], p

Published
2001

18. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial

Author

Lechat, P, Brunhuber, Kw, Hofmann, R, Kuhn, P, Nesser, Hj, Slany, J, Weihs, W, Wiedermann, C, Wimmer, H, van Mieghem, W, Boland, J, Chaudron, Jm, Jordaens, L, Melchior, Jp, Aschermann, M, Bruthansl, J, Hradec, M, Kolbel, F, Semrad, B, Haghfelt, T, Fischer Hansen, J, Goetzsche, Co, Hildebrandt, P, Kassis, E, Rasmussen, V, Rokkedal, J, Thomassen, A, Groundstroem, K, Uusimaa, P, Le Heuzey JY, Aumont, Mc, Aupetit, Jf, Baille, N, Baudouy, P, Belin, A, Bonneau, A, Bonneric, G, Bousser, Jp, Citron, B, Dary, P, Decoulx, E, De Groote, P, Denolle, T, Dievart, F, Duriez, P, Eicher, Jc, Enjuto, G, Ferriere, M, Fournier, E, Garandeau, M, Gauthier, J, Genest, M, Gerbe, A, Godenir, Jp, Guillot, B, Guillot, Jp, Guillot, P, Heno, P, D'Ivernois, C, Jean, M, Kacet, S, Kalle, R, Komajda, M, Lacroix, A, Lallemand, R, Lardoux, H, Marquet, M, Martin, M, Martin, O, Mery, D, Mossaz, R, Mothes, P, Olive, T, Ostorero, M, Paganelli, F, Page, E, Pauly Laubry, C, Puel, J, Rousseau, Jf, Roux, Jj, Schenowitz, A, Sourdais, K, Tremel, F, Verdun, A, Witchiz, S, Wolf, Je, Hombach, V, Assmann, I, Beyer, T, Bischoff, Ko, Darius, H, Ertl, G, Fleck, E, Forster, K, Freytag, F, Gleichmann, U, Haasis, R, Henssge, R, Hey, D, Hesse, P, Hofs, T, Keck, M, Klein, H, Kromer, Et, Kruls Munch, J, Luderitz, B, Maisch, B, Mitrovic, V, Neubauer, S, Osterziel, Kj, Simon, H, Spitzer, Sg, Stohring, R, Taubert, G, Teichmann, W, Theisen, K, Wende, W, Wieser, H, Zotz, R, Preda, I, Csanady, M, Cserhalmi, L, Edes, I, Gesztesi, T, Karpati, P, Simon, K, Tarjan, J, Fogari, R, Tramarin, R, Galie, N, Giani, P, Milanese, U, Scalvini, S, Scrutinio, D, Sechi, Leonardo Alberto, Tettamanti, F, De Vito, F, Crean, P, Mccann, H, Mulcahy, D, Sugrue, D, van Hoogenhuyze DCA, van der Burgh PH, Ciampricotti, R, van Dantzig JM, Denhartog, Fr, Henneman, Ja, van Kesteren HAM, Kragten, Ja, Liem, Kl, Limburg, A, van der Linde MR, Linssen, Gcm, Pasteuning, H, Penn, Hjam, Van Rossum, P, Schaafsma, Hj, Schelling, A, Sloos, R, Wesdorp, Jcl, Korewicki, J, Achremczyk, P, Czestockowska, E, Dowgird, M, Dyduszynski, A, Gorski, J, Ilmurzynska, K, Janicki, K, Kornacewicz Jach, Z, Kraska, T, Krzeminska Pakula, M, Kuch, J, Nartowicz, E, Petelenz, T, Piwowarska, W, Rawczynska Englert, I, Ruzyllo, W, Swiatecka, G, Tendera, M, Wierzchowiecki, M, Wodniecki, J, Wojciechowoski, D, Wrabec, K, Wysocki, H, Gomes, Rs, Ceia, Mf, Lousada, N, Campos, Jmm, Providencia, La, de Moura ALZC, Marejev, Vj, Aronov, Dm, Arutjunov, Gp, Bart, Bj, Basechikin, Ss, Belenkov, Jn, Beloussov, Jb, Bokeria, Oa, Charchogljan, Ra, Doschytsin, V, Fedorova, Ta, Glezer, Mg, Gorbachenkov, A, Gorshkov, Va, Gospodarenko, Al, Ivashkin, Vt, Ivleva, Aj, Kyrichenko, Aa, Lavrov, Aa, Lazebnik, Lb, Marynov, A, Mazaev, Vp, Polejev, Nr, Shpektor, A, Sidorenko, Ba, Sobolev, Ke, Starodoubtsev, Ak, Storozhakhov, Gi, Syrkin, Al, Zodionchenko, Vs, Zvereva, Tv, Murin, J, Kaliska, G, Rybar, R, Valle, V, Artaza, M, Conthe, P, Cruz, Jm, Garcia Moll, M, Lopez Sendon JL, Martinez, A, Monzon, F, Ribas, M, Roig, E, Roldan, I, Hoglund, C, Ekdahl, S, Hjelmaeus, L, Lindberg, K, Lofdahl, P, Ulvenstam, G, Warselius, L, Follath, F, Anghern, W, Dubach, P, Erne, P, Gallino, A, Moccetti, T, Bridges, A, Adgey, J, Ambepitiya, G, Boon, N, Boyle, Rm, Cowley, Aj, Cripps, T, Davies, Mk, Dunn, F, Findlay, J, Forsey, P, Fyfe, T, Gould, B, Greenwood, Tw, Hubner, P, Khan, S, Lewis, P, Mackay, A, Maltz, M, Mcarthur, J, Mcleod, A, Mcleod, D, Metcalfe, M, Millar Craig, M, Mills, P, Nelson, Jk, Nicholls, D, Oakley, Gd, Patterson, Dlh, Pohl, Jef, Ray, S, Silke, B, Wilkinson, Pr, and Jmouro, Av

Published
1999

21. Editorial

Author

Follath F

Subjects
medicine.medical_specialty, business.industry, Internal medicine, medicine, Cardiology, General Medicine, Cardiac risk, business
Published
2003

22. Antiarrhythmische Wirkung von Perhexilin

Author

Ursula Anderes, Follath F, F. Burkart, and H.A. Dieterich

Subjects
World Wide Web, business.industry, Medicine, Pharmacology (medical), Cardiology and Cardiovascular Medicine, business
Published
1981

23. Herzmyxome

Author

Grädel E, Wolff G, Hasse J, Follath F, and K. E. Frede

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Atrial myxoma, Operative mortality, Myxoma, Hemodynamics, Signs and symptoms, General Medicine, medicine.disease, Surgery, cardiovascular system, Medicine, In patient, cardiovascular diseases, Angiocardiography, Embolization, business
Abstract

Between 1965 and 1974 ten patients were operared on for cardiac myxoma. There was a striking variety of signs and symptoms caused by tumour embolization, haemodynamic obstruction, and auto-immunological reactions. The diagnosis should be made early before the occurrence of irreversible complications, especially cerebral embolism. Echocardiography is a simple technique for the detection of atrial myxoma but a negative result does not exclude it, and diagnosis has to be confirmed by angiocardiography. The tumour should be removed as soon as possible after diagnosis. There is danger of tumour embolization in the course of operation. Operative mortality is low in patients with only haemodynamic complications, but in patients with previous cerebral embolism the risk is higher because of possible bleeding in the infarcted areas of the brain resulting from anticoagulation during cardio-pulmonary bypass. Nonetheless, the operation is indicated in all cases. If removal of the myxoma is complete, recurrence is rate and long-term results are good.

Published
1975

24. Clinical pharmacology of calcium antagonists

Author

Taeschner W and Follath F

Subjects
Pharmacology, Drug, Clinical pharmacology, Digoxin, media_common.quotation_subject, chemistry.chemical_element, Calcium, Calcium Channel Blockers, Bioavailability, law.invention, Pharmacokinetics, chemistry, law, Renal physiology, medicine, Humans, Cardiology and Cardiovascular Medicine, Active metabolite, media_common, medicine.drug
Abstract

The pharmacokinetics of the different calcium antagonists has many similarities and is characterized by incomplete bioavailability due to first-pass metabolism, predominant hepatic biotransformation with negligible amounts of unchanged renal excretion, and a high protein binding. Several of the newer dihydropyridine derivatives have prolonged half-lives allowing once-daily administration. Pharmacological effects usually depend on serum drug concentrations, but the presence of stereoisomers and active metabolites may influence the concentration-effect relationships. In patients with liver disease, the clearance of some calcium antagonists is markedly decreased, whereas in renal failure the elimination rate is not reduced. Calcium antagonists also participate in various drug interactions, in particular with digoxin.

Published
1988

25. Pharmacokinetics of cyclosporine G in patients with renal failure

Author

M. Bindschedler, Zuber M, Markus Wenk, Follath F, Gilbert Thiel, Vozeh S, Beveridge T, Keller Hp, Abisch E, and Costa E

Subjects
Volume of distribution, Adult, Male, Transplantation, medicine.medical_specialty, business.industry, Radioimmunoassay, Cyclosporins, Pilot Projects, Pharmacology, High-performance liquid chromatography, Bioavailability, Endocrinology, Pharmacokinetics, Oral administration, Internal medicine, Cyclosporine, Medicine, Humans, Kidney Failure, Chronic, Dosing, business
Abstract

The pharmacokinetics of the cyclosporine A (CsA, Sandimmune) analogue Nva2-cyclosporine, or cyclosporine G (CsG) was investigated in 6 patients with terminal renal failure after a 4-hr intravenous infusion (3.5 mg/kg) and after oral administration (600 mg) of the drug. Blood samples were collected up to 38 hr and CsG concentrations were measured by radioimmunoassay and high-performance liquid chromatography. The resulting pharmacokinetic parameters of CsG were similar to those described for CsA in the same patient population. Based on HPLC determinations, a mean terminal elimination half-life of 18.9 hr was calculated. The total body clearance was 0.55 L/hr/kg, the volume of the central compartment was 0.32 L/kg, and the steady-state volume of distribution was 5.97 L/kg. After oral administration maximum CsG concentrations in blood were reached between 2.5 and 3 hr, and the bioavailability was in the range of 24-55% (mean 36%). The ratios between the polyvalent RIA and HPLC determinations were considerably larger after oral dosing than after i.v. infusion. The blood-to-plasma ratio was 1.23, which is smaller than that observed for CsA. These results suggest that in patients undergoing renal transplantation the same dosing strategies can be applied for CsG as have been established for CsA.

Published
1988

26. Evaluation of a rapid ultrafiltration technique for determination of quinidine protein binding and comparison with equilibrium dialysis

Author

Vozeh S, H. R. Ha, and Follath F

Subjects
Quinidine, Free Radicals, Metabolite, Ultrafiltration, Plasma protein binding, High-performance liquid chromatography, Immunoenzyme Techniques, chemistry.chemical_compound, medicine, Humans, Pharmacology (medical), Equilibrium dialysis, Postural Balance, Chromatography, High Pressure Liquid, Pharmacology, Enzyme multiplied immunoassay technique, Chromatography, medicine.diagnostic_test, Orosomucoid, chemistry, Yield (chemistry), Dialysis, medicine.drug, Protein Binding
Abstract

The free level ultrafiltration (UF) assay by the enzyme multiplied immunoassay technique (EMIT) for determination of unbound quinidine concentration in serum (Qf) was evaluated in 50 samples obtained from cardiac patients treated with quinidine for ventricular arrhythmias. Equilibrium dialysis (ED) at 37 degrees C and high performance liquid chromatography (HPLC) served as standard methods for comparison. A good agreement was found between EMIT and HPLC at the low range of free quinidine concentration (0.1-0.7 mg/L) observed in our patients (r = 0.959). Although the correlation between UF and ED was high (r = 0.972), Qf was systematically underestimated by UF. This bias was due to the fact that UF was performed according to the recommendations of the manufacturer at 25 degrees C. No systematic differences were found when 20 additional samples were assayed by the two methods at the same temperature (25 degrees C; r = 0.992). The quinidine binding ratio showed a correlation with the serum concentration of alpha 1-acid-glycoprotein (r = 0.61). The metabolites 3(S)-hydroxyquinidine and quinidine-N-oxide did not influence the protein binding of the parent drug. The importance of adjusting the serum pH to physiological values before measurement of Qf was confirmed in this study. Our results show that, if performed under the same conditions, ED and UF yield practically identical values. Because of easy handling, the EMIT Free Level System II should be applicable under clinical conditions.

Published
1986

27. [Aortic valve insufficiency in Crohn disease]

Author

Wäckerlin A, Zünd G, Marco Maggiorini, Jenni R, Turina M, and Follath F

Subjects
Adult, Male, Aortitis, Crohn Disease, Aortic Valve, Heart Valve Prosthesis, Aortic Valve Insufficiency, Chronic Disease, Humans, Aorta
Abstract

We report on a 39-year-old man with Crohn's disease who was admitted with cardiogenic shock after a short history of progressive dyspnea. Echocardiographic examination (transthoracic echocardiography) showed severe aortic regurgitation, mild mitral regurgitation, and enlargement of the sinus of Valsalva and of the ascending aorta at the level of the right pulmonary artery. The left ventricular ejection fraction was 30%. After aortic valve replacement, histologic examination of the ascending aorta showed chronic aortitis resembling syphilitic aortitis (serology for syphilis was negative) and HLA B27 related aortitis. The aortic valve showed deformation and thickening of the cusps by fibrous tissue without evidence of endocarditis. The patient remained well after surgery and echocardiographic examination 6 months later showed normal function of the aortic valve prosthesis. The diameter of the sinus of Valsalva and of the ascending aorta was slightly bigger, possibly indicating ongoing destruction. The left ventricular ejection fraction nearly normalized. It seems possible that this type of aortitis, characterized by its proximity to the valve ring, is another extraintestinal cardiac manifestation of Crohn's disease. The possibility of ongoing destruction of the sinus of Valsalva and of the ascending aorta after valve replacement makes regular echocardiographic control necessary.

28. Serological evidence for the association of Bartonella henselae infection with arrhythmogenic right ventricular cardiomyopathy

Author

Fischer, A. H., Loo, B., Schär, G. M., Zbinden, R., Duru, F., Brunckhorst, C., Rousson, V., Delacrétaz, E., Stuber, T., Oechslin, E. N., Follath, F., Rolf Jenni, University of Zurich, and Jenni, R

Subjects
10179 Institute of Medical Microbiology, 10209 Clinic for Cardiology, 570 Life sciences, biology, 610 Medicine & health, General Medicine, Cardiology and Cardiovascular Medicine, 2705 Cardiology and Cardiovascular Medicine

29. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology

Author

Dickstein, K., Cohen-Solal, A., Filippatos, G., Mcmurray, J. J. V., Ponikowski, P., Poole-Wilson, P. A., Stromberg, A., Veldhuisen, D. J., Atar, D., Hoes, A. W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S. G., Swedberg, K., Vahanian, A., Camm, J., Caterina, R., Dean, V., Christian Funck-Brentano, Hellemans, I., Kristensen, S. D., Mcgregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Auricchio, A., Bax, J., Bohm, M., Corra, U., Della Bella, P., Elliott, P. M., Follath, F., Gheorghiade, M., Hasin, Y., Hernborg, A., Jaarsma, T., Komajda, M., Kornowski, R., Piepoli, M., Prendergast, B., Tavazzi, L., Vachiery, J. L., Verheugt, F. W. A., Zannad, F., Colaboracao Heart Failure, Associat, and Esicm

33. The IMPROVEMENT study (IMprovement PROgram in eValuation and managEMENT of heart failure) - Rationale and design | Załozenia programu IMPROVEMENT (IMprovement PROgram in eValuation and managEMENT of heart failure)

Author

Korewicki, J., Tendera, M., Browarek, A., Zieliński, T., Cleland, J. G. F., Cohen Solal, A., Cosin Aguilar, J., Dietz, R., Eastaugh, J., Follath, F., Nick Freemantle, Gavazzi, A., Gilst, W. H., Hobbs, F. D. R., Madeira, H. C., Preda, I., Swedberg, K., Widimski, J., Cieśliński, A., Dabrowski, M., Kornacewicz-Jach, Z., Krzemińska-Pakuła, M., Opolski, G., Poloński, L., Rynkiewicz, A., Wrabec, K., and Wysocki, H.

34. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008,Orientações de 2008 da ESC para o diagnóstico e tratamento da insuficiência cardíaca aguda e crónica

Author

Dickstein, K., Cohen-Solal, A., Filippatos, G., Mcmurray, J. J. V., Ponikowski, P., Poole-Wilson, P. A., Stromberg, A., Veldhuisen, D. J., Atar, D., Hoes, A. W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S. G., Swedberg, K., Vahanian, A., Camm, J., Caterina, R., Dean, V., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., Mcgregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Auricchio, A., Bax, J., Bohm, M., Corrà, U., Della Bella, P., Perry Elliott, Follath, F., Gheorghiade, M., Hasin, Y., Hernborg, A., Jaarsma, T., Komajda, M., Kornowski, R., Piepoli, M., Prendergast, B., Tavazzi, L., Vachiery, J. -L, Verheugt, F. W. A., and Zannad, F.

35. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure,Riassunto esecutivo delle linee guida sulla diagnosi e trattamento dello scompenso cardiaco acuto

Author

Nieminen, M. S., Böhm, M., Cowie, M. R., Drexler, H., Filippatos, G. S., Jondeau, G., Hasin, Y., Lopez-Sendon, J., Mebazaa, A., Rhodes, A., Swedberg, K., Priori, S. G., Garcia, M. A. A., Blanc, J. -J, Andrzej Budaj, Dean, V., Deckers, J., Burgos, E. F., Lekakis, J., Lindahl, B., Mazzotta, G., Morais, J., Oto, A., Smiseth, O. A., Dickstein, K., Albuquerque, A., Conthe, P., Crespo-Leiro, M., Ferrari, R., Follath, F., Janssens, U., Komajda, M., Moreno, R., Singer, M., Singh, S., Tendera, M., Thygesen, K., Gavazzi, A., and Metra, M.

37. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 | Orientações de 2008 da ESC para o diagnóstico e tratamento da insuficiência cardíaca aguda e crónica

Author

Dickstein, K., Cohen-Solal, A., Filippatos, G., john mcmurray, Ponikowski, P., Poole-Wilson, P. A., Stromberg, A., Veldhuisen, D. J., Atar, D., Hoes, A. W., Keren, A., Mebazaa, A., Nieminen, M., Priori, S. G., Swedberg, K., Vahanian, A., Camm, J., Caterina, R., Dean, V., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., Mcgregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Auricchio, A., Bax, J., Bohm, M., Corrà, U., Della Bella, P., Elliott, P. M., Follath, F., Gheorghiade, M., Hasin, Y., Hernborg, A., Jaarsma, T., Komajda, M., Kornowski, R., Piepoli, M., Prendergast, B., Tavazzi, L., Vachiery, J. -L, Verheugt, F. W. A., and Zannad, F.

38. Hungarian results of the IMPROVEMENT HF European survey on the everyday diagnostics and treatment of heart failure: Comparison of European and Hungarian data | Az IMPROVEMENT HF európai felmérés magyar eredményei a szívelégtelenség korszeru diagnosztikájának és kezelésének mindennapi gyakorlatáról: Az európai és hazai adatok összehasonlítása

Author

Préda, I., Cleland, J. G. F., Cosin-Aguilar, J., Cohen-Solal, A., Dietz, R., Follath, F., Freemantel, N., Gavazzi, A., richard hobbs, Korewicki, J., Madeira, H., Swedberg, K., Gilst, W., and Widimsky, J.

41. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF)

Author

Etienne Gayat, Fábio Vilas-Boas, Nigel Burrows, John Parissis, Alexandre Mebazaa, Juan F. Delgado, Raphaël Porcher, Mehmet Yilmaz, Anthony S. McLean, Ferenc Follath, [Follath, F.] Univ Zurich Hosp, Dept Internal Med, Off HAL 18 D2, CH-8091 Zurich, Switzerland -- [Yilmaz, M. B.] Cumhuriyet Univ, Sch Med, Dept Cardiol, Sivas, Turkey -- [Yilmaz, M. B.] Hosp Lariboisiere, INSERM, U942, Paris, France -- [Delgado, J. F.] Hosp Doce de Octubre, Heart Failure & Transplant Unit, Dept Cardiol, Madrid, Spain -- [Parissis, J. T.] Attikon Univ Hosp, Heart Failure Clin, Athens, Greece -- [Parissis, J. T.] Attikon Univ Hosp, Cardiol Dept 2, Athens, Greece -- [Porcher, R. -- Gayat, E.] Univ Paris 07, Dept Biostat & Informat Med, Hop St Louis, AP HP,INSERM,UMR S 717, Paris, France -- [Burrows, Nigel] IMS Hlth SpA, Milan, Italy -- [Mclean, A.] Univ Sydney, Dept Intens Care Med, Nepean Hosp, Penrith, NSW, Australia -- [Vilas-Boas, F.] Hosp Espanhol, Div Cardiol, Salvador, BA, Brazil -- [Vilas-Boas, F.] Hosp Espanhol, Heart Failure & Transplantat Program, Salvador, BA, Brazil -- [Mebazaa, A.] Hosp Lariboisiere, AP HP, Dept Anesthesiol & Crit Care Med, Paris, France -- [Mebazaa, A.] Univ Paris 07, INSERM, U942, Paris, France, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Delgado, Juan F. -- 0000-0002-5401-8324, Porcher, Raphael -- 0000-0002-5277-4679, GAYAT, Etienne -- 0000-0002-3334-3849, Mebazaa, Alexandre -- 0000-0001-8715-7753, University of Zurich, and Follath, F

Subjects
Male, medicine.medical_specialty, Internationality, Acute heart failure syndromes, 610 Medicine & health, Critical Care and Intensive Care Medicine, law.invention, law, Intensive care, Internal medicine, Surveys and Questionnaires, Outcome Assessment, Health Care, Medicine, Humans, Hospital Mortality, Aged, Aged, 80 and over, Heart Failure, Ejection fraction, business.industry, Standard treatment, Cardiogenic shock, Levosimendan, Middle Aged, medicine.disease, Classification, Prognosis, Intensive care unit, Surgery, Management, Intensive Care Units, Heart failure, Acute Disease, Dobutamine, Female, Therapy, 10029 Clinic and Policlinic for Internal Medicine, 2706 Critical Care and Intensive Care Medicine, business, medicine.drug
Abstract

WOS: 000289305700010, PubMed ID: 21210078, Purpose: We performed a survey on acute heart failure (AHF) in nine countries in four continents. We aimed to describe characteristics and management of AHF among various countries, to compare patients with de novo AHF versus patients with a pre-existing episode of AHF, and to describe subpopulations hospitalized in intensive care unit (ICU) versus cardiac care unit (CCU) versus ward. Methods and results: Data from 4,953 patients with AHF were collected via questionnaire from 666 hospitals. Clinical presentation included decompensated congestive HF (38.6%), pulmonary oedema (36.7%) and cardiogenic shock (11.7%). Patients with de novo episode of AHF (36.2%) were younger, had less comorbidities and lower blood pressure despite greater left ventricular ejection fraction (LVEF) and were more often admitted to ICU. Overall, intravenous (IV) diuretics were given in 89.7%, vasodilators in 41.1%, and inotropic agents (dobutamine, dopamine, adrenaline, noradrenaline and levosimendan) in 39% of cases. Overall hospital death rate was 12%, the majority due to cardiogenic shock (43%). More patients with de novo AHF (14.2%) than patients with a pre-existing episode of AHF (10.8%) (p = 0.0007) died. There was graded mortality in ICU, CCU and ward patients with mortality in ICU patients being the highest (17.8%) (p < 0.0001). Conclusions: Our data demonstrated the existence of different subgroups based on de novo or pre-existing episode(s) of AHF and the site of hospitalization. Recognition of these subgroups might improve management and outcome by defining specific therapeutic requirements., TUBITAK (Turkey); Abbott, All coauthors would like to thank Patrick Cepon, Helen Smith, Ches Manly and Melinda Swan for their support. MB Yilmaz received a grant from TUBITAK (Turkey).; Abbott funded the ALARM-HF survey; data were acquired by IMS. Analyses were performed by Departement de Biostatistique et Informatique Medicale, Hopital Saint-Louis, APHP; Universite Paris 7; INSERM - UMR-S 717, Paris France by RP and EG. AM, JP, FVB, JFD and FF received honorarium from Abbott for lectures and/or consulting.

Published
2009

42. Levosimendan: Molecular mechanisms and clinical implications Consensus of experts on the mechanisms of action of levosimendan

Author

Papp, Zoltan, Edes, Istvan, Fruhwald, Sonja, De Hert, Stefan G., Salmenpera, Markku, Leppikangas, Heli, Mebazaa, Alexandre, Landoni, Giovanni, Grossini, Elena, Caimmi, Philippe, YILMAZ, MEHMET BİRHAN, Morelli, Andrea, Guarracino, Fabio, Schwinger, Robert H. G., Meyer, Sven, Algotsson, Lars, Wikstrom, Bernt Gerhard, Jorgensen, Kirsten, Filippatos, Gerasimos, Parissis, John T., Garcia Gonzalez, Martin J., Parkhomenko, Alexander, Kivikko, Matti, Pollesello, Piero, Follath, Ferenc, Papp, Z, Edes, I, Fruhwald, S, De Hert, Sg, Salmenpera, M, Leppikangas, H, Mebazaa, A, Landoni, Giovanni, Grossini, E, Caimmi, P, Morelli, A, Guarracino, F, Schwinger, Rhg, Meyer, S, Algotsson, L, Wikstrom, Bg, Jorgensen, K, Filippatos, G, Parissis, Jt, Gonzalez, Mjg, Parkhomenko, A, Yilmaz, Mb, Kivikko, M, Pollesello, P, and Follath, F.

Subjects
Pyridazines, Clinical Trials as Topic, Cardiotonic Agents, Consensus, Ca2+-sensitization, Cardioprotection, Levosimendan, Mechanism of action, Positive inotropy, Vasodilation, Animals, Cardiovascular Diseases, Humans, Hydrazones, Vasodilator Agents, Medicine (all), Cardiology and Cardiovascular Medicine, Orvostudományok, Klinikai orvostudományok, Simendan
Abstract

The molecular background of the Ca2+-sensitizing effect of levosimendan relates to its specific interaction with the Ca2+-sensor troponin C molecule in the cardiac myofilaments. Over the years, significant preclinical and clinical evidence has accumulated and revealed a variety of beneficial pleiotropic effects of levosimendan and of its long-lived metabolite, OR-1896. First of all, activation of ATP-sensitive sarcolemmal K+ channels of smooth muscle cells appears as a powerful vasodilator mechanism. Additionally, activation of ATP-sensitive K+ channels in the mitochondria potentially extends the range of cellular actions towards the modulation of mitochondrial ATP production and implicates a pharmacological mechanism for cardioprotection. Finally, it has become evident, that levosimendan possesses an isoform-selective phosphodiesterase-inhibitory effect. Interpretation of the complex mechanism of levosimendan action requires that all potential pharmacological interactions are analyzed carefully in the framework of the currently available evidence. These data indicate that the cardiovascular effects of levosimendan are exerted via more than an isolated drug-receptor interaction, and involve favorable energetic and neurohormonal changes that are unique in comparison to other types of inodilators. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Published
2012

43. The problem of chronic refractory angina; report from the ESC Joint Study Group on the Treatment of Refractory Angina

Author

J Herlitz, Thomas F. Lüscher, Miralem Pasic, T Eliasson, F Follath, M R Chester, I Hellemans, A Collins, Dag S. Thelle, Mike J. L. DeJongste, C Mannheimer, Paolo G. Camici, Mannheimer, C, Camici, Paolo, Chester, Mr, Collins, A, Dejongste, M, Eliasson, T, Follath, F, Hellemans, I, Herlitz, J, Luscher, T, Pasic, M, and Thelle, D.

Subjects
refractory angina pectoris, THORACIC EPIDURAL-ANESTHESIA, ACUTE MYOCARDIAL-INFARCTION, European level, medicine.medical_specialty, CHOLESTEROL-LOWERING THERAPY, SPINAL-CORD STIMULATION, ENDOSCOPIC TRANSTHORACIC SYMPATHICOTOMY, MEDLINE, ELECTRICAL NERVE-STIMULATION, Angina Pectoris, Angina, Coronary artery disease, POSITRON-EMISSION-TOMOGRAPHY, Refractory, Epidemiology, medicine, Humans, Myocardial infarction, Intensive care medicine, business.industry, medicine.disease, TRANSMYOCARDIAL LASER REVASCULARIZATION, CORONARY-ARTERY DISEASE, ENDOTHELIAL GROWTH-FACTOR, Physical therapy, Cardiology and Cardiovascular Medicine, Refractory angina, business
Abstract

It has been recognized that there is a group of patients with severe disabling angina and coronary artery disease who are refractory to conventional forms of treatment. Although this issue has already been debated at the level of the National Societies, we felt that it was appropriate to also tackle it at the European level. This is particularly important in view of the rapid pace of growth of this problem and the lack of a standardized approach. This has encouraged the development of a variety of treatments that vary considerably in terms of cost-effectiveness and safety and require proper validation procedures. The aim of this paper is to draw attention to the problem and start a process that will lead to improvement and harmonization of the care of patients with refractory angina.

Published
2002

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