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17 results on '"Willms, A. G."'

1. Monocyte derived large extracellular vesicles in polytrauma.

Author

Wöhler, Aliona, Gries, Sabine K., Salzmann, Rebekka J. S., Krötz, Christina, Wang, Bingduo, Müller, Paula, Klein, Angelina, Schmidt‐Wolf, Ingo G. H., Schaaf, Sebastian, Schwab, Robert, Lukacs‐Kornek, Veronika, Willms, Arnulf G., and Kornek, Miroslaw T.

Subjects
TUMOR markers, EXTRACELLULAR vesicles, BIOMARKERS, TRAUMATOLOGY, SPLEEN
Abstract

Despite significant progress in the medical field, there is still a pressing need for minimal‐invasive tools to assist with decision‐making, especially in cases of polytrauma. Our team explored the potential of serum‐derived large extracellular vesicles, so called microparticles/microvesicles/ectosomes, to serve as a supportive tool in decision‐making in polytrauma situations. We focused on whether monocyte derived large EVs may differentiate between polytrauma patients with internal organ injury (ISS > 15) and those without. Thus, we compared our EV data to soluble biomarkers such as tumour necrosis factor alpha (TNF alpha) and Interleukin‐8 (IL‐8). From the blood of 25 healthy and 26 patients with polytrauma large EVs were isolated, purified, and characterized. TNF alpha and IL‐8 levels were quantified. We found that levels of these monocyte derived large EVs were significantly higher in polytrauma patients with internal organ damage and correlated with the ISS. Interestingly, we also observed a decline in AnnV+CD14+ large EVs during normal recovery after trauma. Thus, inflammatory serological markers as TNF alpha and as IL‐8 demonstrated an inability to discriminate between polytrauma patients with or without internal organ damage, such as spleen, kidney, or liver lacerations/ruptures. However, TNF and IL‐8 levels were elevated in polytrauma cases overall when contrasted with healthy non‐traumatic controls. These findings suggest that delving deeper into the potential of AnnV+ large EVs derived from monocytes could highly beneficial in the managment of polytrauma, potentially surpassing the efficacy of commonly used serum markers. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Factors influencing the fascial closure rate after open abdomen treatment : Results from the European Hernia Society (EuraHS) Registry Surgical technique matters

Author

Willms, A. G., Schwab, R., von Websky, M. W., Berrevoet, F., Tartaglia, D., Sorelius, K., Fortelny, R. H., Björck, Martin, Monchal, T., Brennfleck, F., Bulian, D., Beltzer, C., Germer, C. T., Lock, J. F., Willms, A. G., Schwab, R., von Websky, M. W., Berrevoet, F., Tartaglia, D., Sorelius, K., Fortelny, R. H., Björck, Martin, Monchal, T., Brennfleck, F., Bulian, D., Beltzer, C., Germer, C. T., and Lock, J. F.

Abstract

Purpose Definitive fascial closure is an essential treatment objective after open abdomen treatment and mitigates morbidity and mortality. There is a paucity of evidence on factors that promote or prevent definitive fascial closure. Methods A multi-center multivariable analysis of data from the Open Abdomen Route of the European Hernia Society included all cases between 1 May 2015 and 31 December 2019. Different treatment elements, i.e. the use of a visceral protective layer, negative-pressure wound therapy and dynamic closure techniques, as well as patient characteristics were included in the multivariable analysis. The study was registered in the International Clinical Trials Registry Platform via the German Registry for Clinical Trials (DRK00021719). Results Data were included from 630 patients from eleven surgical departments in six European countries. Indications for OAT were peritonitis (46%), abdominal compartment syndrome (20.5%), burst abdomen (11.3%), abdominal trauma (9%), and other conditions (13.2%). The overall definitive fascial closure rate was 57.5% in the intention-to-treat analysis and 71% in the per-protocol analysis. The multivariable analysis showed a positive correlation of negative-pressure wound therapy (odds ratio: 2.496, p < 0.001) and dynamic closure techniques (odds ratio: 2.687, p < 0.001) with fascial closure and a negative correlation of intra-abdominal contamination (odds ratio: 0.630, p = 0.029) and the number of surgical procedures before OAT (odds ratio: 0.740, p = 0.005) with DFC. Conclusion The clinical course and prognosis of open abdomen treatment can significantly be improved by the use of treatment elements such as negative-pressure wound therapy and dynamic closure techniques, which are associated with definitive fascial closure.

Published
2022
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5. Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

Author

Willms, Arnulf G., Oldhafer, Karl J., Conze, Sophie, Thasler, Wolfgang E., von Schassen, Christian, Hauer, Thorsten, Huber, Tobias, Germer, Christoph-Thomas, Guenster, Simone, Bulian, Dirk R., Hirche, Zarah, Filser, Joerg, Stavrou, Gregor A., Reichert, Martin, Malkomes, Patrizia, Seyfried, Steffen, Ludwig, Tobias, Hillebrecht, Hans C., Pantelis, Dimitrios, Brunner, Stefanie, Rost, Wilm, Lock, Johan F., Willms, Arnulf G., Oldhafer, Karl J., Conze, Sophie, Thasler, Wolfgang E., von Schassen, Christian, Hauer, Thorsten, Huber, Tobias, Germer, Christoph-Thomas, Guenster, Simone, Bulian, Dirk R., Hirche, Zarah, Filser, Joerg, Stavrou, Gregor A., Reichert, Martin, Malkomes, Patrizia, Seyfried, Steffen, Ludwig, Tobias, Hillebrecht, Hans C., Pantelis, Dimitrios, Brunner, Stefanie, Rost, Wilm, and Lock, Johan F.

Abstract

Purpose The COVID-19 pandemic has transformed medical care worldwide. General surgery has been affected in elective procedures, yet the implications for emergency surgery are unclear. The current study analyzes the effect of the COVID-19 lockdown in spring 2020 on appendicitis treatment in Germany. Methods Hospitals that provided emergency surgical care during the COVID-19 lockdown were invited to participate. All patients diagnosed with appendicitis during the lockdown period (10 weeks) and, as a comparison group, patients from the same period in 2019 were analyzed. Clinical and laboratory parameters, intraoperative and pathological findings, and postoperative outcomes were analyzed. Results A total of 1915 appendectomies from 41 surgical departments in Germany were included. Compared to 2019 the number of appendectomies decreased by 13.5% (1.027 to 888, p=0.003) during the first 2020 COVID-19 lockdown. The delay between the onset of symptoms and medical consultation was substantially longer in the COVID-19 risk group and for the elderly. The rate of complicated appendicitis increased (58.2 to 64.4%), while the absolute number of complicated appendicitis decreased from 597 to 569, (p=0.012). The rate of negative appendectomies decreased significantly (6.7 to 4.6%; p=0.012). Overall postoperative morbidity and mortality, however, did not change. Conclusion The COVID-19 lockdown had significant effects on abdominal emergency surgery in Germany. These seem to result from a stricter selection and a longer waiting time between the onset of symptoms and medical consultation for risk patients. However, the standard of emergency surgical care in Germany was maintained.

Published
2021

6. Liquid Biopsies in Hepatocellular Carcinoma: Are We Winning?

Author

Mocan, Tudor, primary, Simão, André L., additional, Castro, Rui E., additional, Rodrigues, Cecília M. P., additional, Słomka, Artur, additional, Wang, Bingduo, additional, Strassburg, Christian, additional, Wöhler, Aliona, additional, Willms, Arnulf G., additional, and Kornek, Miroslaw, additional

Published
2020
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8. Aqueous beclomethasone dipropionate nasal spray in the treatment of seasonal (ragweed) rhinitis

Author

Juniper, E F, Willms, D G, Guyatt, G H, and Ferrie, P J

Subjects
Adult, Male, Beclomethasone, Rhinitis, Allergic, Seasonal, Self Administration, Middle Aged, Cohort Studies, Treatment Outcome, Patient Satisfaction, Humans, Female, Prospective Studies, Administration, Intranasal, Research Article
Abstract

OBJECTIVES: To determine whether the provision of appropriate medication and comprehensive information before the ragweed pollen season enables patients to manage their hay fever successfully, achieving satisfactory symptom control and quality of life, to examine patient characteristics that may predict successful symptom management and to learn which factors patients consider when making treatment choices. DESIGN: Single-group prospective cohort management study. SUBJECTS: Ninety adults sensitive to ragweed pollen recruited from those who had participated in previous clinical studies and from those who responded to advertisements in the local media. INTERVENTION: Aqueous beclomethasone dipropionate nasal spray and comprehensive information about optimal therapy (starting before the ragweed pollen season and continued throughout at a dose of 400 micrograms/d) and how it may be used less intensively with an as-required regimen. MAIN OUTCOME MEASURES: Symptom control, patient satisfaction, quality of life and medication use. RESULTS: More than 80% of the patients reported very good symptom control and were very satisfied. In all, 62% chose to use less than the optimal daily dose. Patients who had less than optimal symptom control used significantly less of the nasal spray than those with very good control either because they wanted to keep medication use to a minimum or because they were unable to remember to take their medication. The only significant predictor of inadequate control was an acknowledged inability to remember to take medication. Symptoms and trust in the practitioner were the primary factors perceived by the patients to determine their treatment choices. CONCLUSION: When provided with aqueous beclomethasone dipropionate nasal spray and comprehensive information on the drug and dosing, most patients are successful in managing their hay fever.

Published
1992

9. An Ethnographic-Participatory Study of Commercial Sex Workers Responding to the Problem of HIVIAIDS in Khon Kaen, Thailand

Author

Kanato, Manop, Willms, Dennis G., Anthropology, Kanato, Manop, Willms, Dennis G., and Anthropology

Abstract

This thesis presents the findings of a study carried out in brothels in Khon Kaen, Thailand. The study examined efforts of the "voiceless" sex workers to organize in order to increase their control over decision-making processes. It also analyzed the difficulties, social forces, structures and ideologies which maintain an inequitable distribution of power. The broader aim was to clarify the notion of people's participation in order to make it operationally more useful with respect to AIDS prevention intervention to sex workers. A technocratic approach to issues of AIDS prevention and control among sex workers was rejected. The study embraced a number of complementary activities including: situation analysis of AIDS in the Thai context, specifically in the northeast, ethnographic study of the sex industry, and participatory action research. This study was initiated in late 1991 and completed in 1993. It was carried out in six brothels in downtown Khon Kaen. The study occurred in 4 phases: 1) situation assessment in which historical and documentary analysis were utilized ethnographic research on sex workers which served as a basis for constructing culturally appropriate interventions, 3) participatory action research emphasizing self determination of sex workers on AIDS prevention and control, and 4) evaluation of this "experiment." The research attempts to balance "classic ethnography" and "applied participatory research" to an AIDS prevention program for sex workers in Thailand. It was carried in collaboration with health professionals, landlords, pimps, and sex workers. Groups met and worked together in brothels to discuss the findings. Results were also presented to local health authorities. This study illustrates the opportunities for and the formidable difficulties of participation by sex workers in Thailand. Without strong support for non-formal AIDS education and self determination by sex workers, there is little chance that they can negotiate, Doctor of Philosophy (PhD)

Published
1994

14. A smoking cessation intervention program for family physicians

Author

Wilson, D M, Lindsay, E A, Best, J A, Gilbert, J R, Willms, D G, and Singer, J

Subjects
Chewing Gum, Ontario, Nicotine, Patient Education as Topic, Office Visits, Smoking, Methods, Humans, Family Practice, Physician's Role, Research Article
Abstract

Family physicians are able to approach many patients who smoke but are often hesitant to help them quit. Lack of knowledge about effective interventions is a major reason for this hesitancy. The important components that have been tested in physician-initiated smoking cessation interventions are advice to quit, information about the risks of smoking and techniques for quitting, nicotine gum, setting a date for quitting and offers of supportive follow-up visits. We describe a cessation program developed for family physicians that incorporates these factors into three types of visits over a 2-month period: the challenge visit, which occurs during a regular office visit and focuses on advice and setting a date to quit; the quit-date visit, which involves instructing patients on the proper use of nicotine gum, if applicable, and confirming their desire to quit; and four supportive follow-up visits, which provide continuing encouragement for 2 months and allow physicians to monitor withdrawal symptoms, relapses and other problems. Such a program can be effectively incorporated into a general practice.

Published
1987

17. Many Voices In Dialogue

Author

Walker, Susan H., Willms, Dennis G., and Anthropology

Subjects
dialogue, voices in dialogue, translating research evidence, community based HIV interventions, HIV interventions, HIV
Abstract

This applied research project responds to a critical problem in health and development: how to effectively translate our research evidence to the communities with and for whom we work in order to stimulate successful, sustainable health promotion activities and social change. The tangible product of this research is a handbook for health and outreach workers from immigrant communities from the Horn of Africa living in Toronto. The handbook is a resource which will be used as a starting point for the generation of community-based health initiatives, in this case, HIV/AIDS prevention programs. The research applies a conceptual approach which emphasizes participatory action research theory and methodology, and equitable, transcontextual research partnerships. It uses a model which merges both scientific evidence and experiential (ethnographic) evidence of risk and vulnerability to create new understandings on which to base the development of health programs. Stories, grounded in ethnographic evidence, are at the heart of the research strategy. The handbook is an example of experimental ethnographic writing: dialogue is used to communicate research evidence, health, and skills information; and a number of personal narrative:s have been constructed as resources to help health workers generate dialogue on issues of risk and vulnerability, and begin a process of reflection and action. In a larger context, the lessons learned as this work is implemented and evaluated in the community will contribute to the knowledge of intervention science. The research also serves as an example of ethical anthropology and raises for discussion ethnography's future project at the tum of the century. With attention to how anthropologists represent their work, 'moral ethnography' can serve a larger human project, helping us better understand what it is to be human and stimulating moral conversations about how we want to live. Thesis Master of Arts (MA)

Published
1999

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