68 results on '"Ludwig, C."'
Search Results
2. Heterogeneous toroidal spiral particles for islet encapsulation
- Author
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Peter D Rios, Yong Wang, Colin Foster, Jose Oberholzer, Paola Leon Plata, Maryam Zaroudi, Ludwig C. Nitsche, Ying Liu, and Chun-Yin Lee
- Subjects
Biocompatibility ,medicine.medical_treatment ,Cell ,Biomedical Engineering ,02 engineering and technology ,Islets of Langerhans ,Mice ,03 medical and health sciences ,Insulin Secretion ,medicine ,Animals ,Insulin ,General Materials Science ,Viability assay ,Cell encapsulation ,030304 developmental biology ,0303 health sciences ,geography ,geography.geographical_feature_category ,Chemistry ,021001 nanoscience & nanotechnology ,Islet ,Encapsulation (networking) ,Mice, Inbred C57BL ,Transplantation ,Diabetes Mellitus, Type 1 ,medicine.anatomical_structure ,0210 nano-technology ,Biomedical engineering - Abstract
Transplantable cell encapsulation systems present a promising approach to deliver a therapeutic solution from hormone-producing cells for the treatment of endocrine diseases like type 1 diabetes. However, the development of a broadly effective and safe transplantation system has been challenging. While some current micro-sized capsules have been optimized for adequate nutrient and metabolic transport, they lack the robustness and retrievability for the clinical safety translation that macro-devices may offer. An existing challenge to be addressed in the current macro-devices is their configuration which may lead to unsatisfactory mass transfer. Here, we design and characterize a millimeter-size particle system of poly-ethylene glycol (PEG) featuring internal toroidal spiral channels, called toroidal spiral particles (TSPs). The characteristic internal structure of the TSPs allows for large encapsulation capacity and large surface area available to all the encapsulated cell mass for effective molecular diffusion. The polymeric matrix renders the particle flexible yet robust for safe transplantation and retrieval. We demonstrate the feasibility of fabricating these particles with various polymer compositions, while optimizing their mechanical properties as well as glucose and insulin permeability. Encapsulation of islets of Langerhans is achieved with high loading capacity (∼160 IEQ per TSP) and excellent cell viability. TSP-encapsulated islets showed similar glucose-stimulated insulin secretion to the naked islets. Preliminary biocompatibility of the TSPs on naïve C57BL/6 mice shows minimal inflammatory response after 4-week transplantation into the intraperitoneal (IP) space. Long-term therapeutic efficacy of encapsulated islets needs to be confirmed in diabetic rodent models in the future, while determining minimal mass required to reverse diabetes. However, we believe from the in vitro favorable results and the TSPs' unique design that TSPs may provide a safe, effective method to transplant and retrieve therapeutic cells for type 1 diabetes treatment and may also be applicable for other cell therapies.
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- 2021
- Full Text
- View/download PDF
3. Joint Statement of the German Respiratory Society and German Society of Thoracic Surgery in Cooperation with the German Radiological Society : Structural Prerequisites of Centers for Interventional Treatment of Emphysema
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Gesierich, Dr. Med., Darwiche, Kaid, Döllinger, F., Eberhardt, R., Eisenmann, S., Grah, C., Heuβel, C.-P., Hübner, R.-H., Ley-Zaporozhan, J., Stanzel, F., Welter, S., Hoffmann, H., Pfeifer, M., Bauer, T.T., Randerath, W.J., Köhnlein, T., Rabe, K.F., Hofmann, H.-S., Welcker, K., Stoelben, E., Hillejan, L., Hecker, E., Bölükbas, S., Ludwig, C., Scheubel, R., Antoch, G., Schönberg, S.O., Barkhausen, J., Anton, F., Neumann, S., Layer, G., Dörfler, A., Körber, F., Weβling, J., and Wucherer, M.
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Pulmonary and Respiratory Medicine ,Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Patient care team ,030228 respiratory system ,business.industry ,Medizin ,medicine ,Interdisciplinary communication ,030212 general & internal medicine ,business - Abstract
ZusammenfassungDie interventionelle Emphysemtherapie bietet ein breites Spektrum an chirurgischen und endoskopischen Optionen zur Behandlung von Patienten mit fortgeschrittenem Lungenemphysem. Zur Sicherstellung der Behandlungsqualität ist eine interdisziplinäre Zusammenarbeit von Pneumologie, Thoraxchirurgie und bildgebenden Disziplinen in der Auswahl, Therapie und Nachsorge von Emphysem-Patienten erforderlich. Das vorliegende Positionspapier beschreibt erforderliche Struktur- und Qualitätsvoraussetzungen von Behandlungszentren.
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- 2020
- Full Text
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4. 30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study
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Singhal R., Wiggins T., Super J., Alqahtani A., Nadler E. P., Ludwig C., Tahrani A., Mahawar K., Pedziwiatr M., Major P., Zarzycki P., Pantelis A., Lapatsanis D. P., Stravodimos G., Matthys C., Focquet M., Vleeschouwers W., Spaventa A. G., Zerrweck C., Vitiello A., Berardi G., Musella M., Sanchez-Meza A., Cantu F. J., Mora F., Cantu M. A., Katakwar A., Reddy D. N., Elmaleh H., Hassan M., Elghandour A., Elbanna M., Osman A., Khan A., Layani L., Kiran N., Velikorechin A., Solovyeva M., Melali H., Shahabi S., Agrawal A., Shrivastava A., Sharma A., Narwaria B., Narwaria M., Raziel A., Sakran N., Susmallian S., Karagoz L., Akbaba M., Piskin S. Z., Ziya A., Senol Z., Manno E., Iovino M. G., Qassem M., Arana-Garza S., Povoas H. P., Vilas-Boas M. L., Naumann D., Li A., Ammori B. J., Balamoun H., Salman M., Nasta A. M., Goel R., Sanchez-Aguilar H., Herrera M. F., Abou-Mrad A., Cloix L., Mazzini G. S., Kristem L., Lazaro A., Campos J., Bernardo J., Gonzalez J., Trindade C., Viveiros O., Ribeiro R., Goitein D., Hazzan D., Segev L., Beck T., Reyes H., Monterrubio J., Garcia P., Benois M., Kassir R., Contine A., Elshafei M., Aktas S., Weiner S., Heidsieck T., Level L., Pinango S., Ortega P. M., Moncada R., Valenti V., Vlahovic I., Boras Z., Liagre A., Martini F., Juglard G., Motwani M., Saggu S. S., Al Momani H., Lopez L. A. A., Cortez M. A. C., Zavala R. A., D'Haese C., Kempeneers I., Himpens J., Lazzati A., Paolino L., Bathaei S., Bedirli A., Yavuz A., Buyukkasap C., Ozaydin S., Kwiatkowski A., Bartosiak K., Waledziak M., Santonicola A., Angrisani L., Iovino P., Palma R., Iossa A., Boru C. E., De Angelis F., Silecchia G., Hussain A., Balchandra S., Coltell I. B., Perez J. L., Bohra A., Awan A. K., Madhok B., Leeder P. C., Awad S., Al-Khyatt W., Shoma A., Elghadban H., Ghareeb S., Mathews B., Kurian M., Larentzakis A., Vrakopoulou G. Z., Albanopoulos K., Bozdag A., Lale A., Kirkil C., Dincer M., Bashir A., Haddad A., Hijleh L. A., Zilberstein B., de Marchi D. D., Souza W. P., Broden C. M., Gislason H., Shah K., Ambrosi A., Pavone G., Tartaglia N., Kona S. L. K., Kalyan K., Perez C. E. G., Botero M. A. F., Covic A., Timofte D., Maxim M., Faraj D., Tseng L., Liem R., Oren G., Dilektasli E., Yalcin I., AlMukhtar H., Al Hadad M., Mohan R., Arora N., Bedi D., Rives-Lange C., Chevallier J. -M., Poghosyan T., Sebbag H., Zinai L., Khaldi S., Mauchien C., Mazza D., Dinescu G., Rea B., Perez-Galaz F., Zavala L., Besa A., Curell A., Balibrea J. M., Vaz C., Galindo L., Silva N., Caballero J. L. E., Sebastian S. O., Marchesini J. C. D., da Fonseca Pereira R. A., Sobottka W. H., Fiolo F. E., Turchi M., Coelho A. C. J., Zacaron A. L., Barbosa A., Quinino R., Menaldi G., Paleari N., Martinez-Duartez P., Aragon Ramirez de Esparza D. G. M., Esteban V. S., Torres A., Garcia-Galocha J. L., Josa M. I., Pacheco-Garcia J. M., Mayo-Ossorio M. A., Chowbey P., Soni V., de Vasconcelos Cunha H. A., Castilho M. V., Ferreira R. M. A., Barreiro T. A., Charalabopoulos A., Sdralis E., Davakis S., Bomans B., Dapri G., Van Belle K., MazenTakieddine, Vaneukem P., Karaca E. S. A., Karaca F. C., Sumer A., Peksen C., Savas O. A., Chousleb E., Elmokayed F., Fakhereldin I., Aboshanab H. M., Swelium T., Gudal A., Gamloo L., Ugale A., Ugale S., Boeker C., Reetz C., Hakami I. A., Mall J., Alexandrou A., Baili E., Bodnar Z., Maleckas A., Gudaityte R., Guldogan C. E., Gundogdu E., Ozmen M. M., Thakkar D., Dukkipati N., Shah P. S., Shah S. S., Adil M. T., Jambulingam P., Mamidanna R., Whitelaw D., Jain V., Veetil D. K., Wadhawan R., Torres M., Tinoco T., Leclercq W., Romeijn M., van de Pas K., Alkhazraji A. K., Taha S. A., Ustun M., Yigit T., Inam A., Burhanulhaq M., Pazouki A., Eghbali F., Kermansaravi M., Jazi A. H. D., Mahmoudieh M., Mogharehabed N., Tsiotos G., Stamou K., Barrera Rodriguez F. J., Rojas Navarro M. A., Torres O. M. O., Martinez S. L., Tamez E. R. M., Millan Cornejo G. A., Flores J. E. G., Mohammed D. A., Elfawal M. H., Shabbir A., Guowei K., So J. B. Y., Kaplan E. T., Kaplan M., Kaplan T., Pham D. T., Rana G., Kappus M., Gadani R., Kahitan M., Pokharel K., Osborne A., Pournaras D., Hewes J., Napolitano E., Chiappetta S., Bottino V., Dorado E., Schoettler A., Gaertner D., Fedtke K., Aguilar-Espinosa F., Aceves-Lozano S., Balani A., Nagliati C., Pennisi D., Rizzi A., Frattini F., Foschi D., Benuzzi L., Parikh C. H. I. R. A. G., Shah H. A. R. S. H. I. L., Pinotti E., Montuori M., Borrelli V., Dargent J., Copaescu C. A., Hutopila I., Smeu B., Witteman B., Hazebroek E., Deden L., Heusschen L., Okkema S., Aufenacker T., den Hengst W., Vening W., van der Burgh Y., Ghazal A., Ibrahim H., Niazi M., Alkhaffaf B., Altarawni M., Cesana G. C., Anselmino M., Uccelli M., Olmi S., Stier C., Akmanlar T., Sonnenberg T., Schieferbein U., Marcolini A., Awruch D., Vicentin M., de Souza Bastos E. L., Gregorio S. A., Ahuja A., Mittal T., Bolckmans R., Baratte C., Wisnewsky J. A., Genser L., Chong L., Taylor L., Ward S., Hi M. W., Heneghan H., Fearon N., Plamper A., Rheinwalt K., Geoghegan J., Ng K. C., Kaseja K., Kotowski M., Samarkandy T. A., Leyva-Alvizo A., Corzo-Culebro L., Wang C., Yang W., Dong Z., Riera M., Jain R., Hamed H., Said M., Zarzar K., Garcia M., Turkcapar A. G., Sen O., Baldini E., Conti L., Wietzycoski C., Lopes E., Pintar T., Salobir J., Aydin C., Atici S. D., Ergin A., Ciyiltepe H., Bozkurt M. A., Kizilkaya M. C., Onalan N. B. D., Zuber M. N. B. A., Wong W. J., Garcia A., Vidal L., Beisani M., Pasquier J., Vilallonga R., Sharma S., Parmar C., Lee L., Sufi P., Sinan H., Saydam M., Singhal, R., Wiggins, T., Super, J., Alqahtani, A., Nadler, E. P., Ludwig, C., Tahrani, A., Mahawar, K., Pedziwiatr, M., Major, P., Zarzycki, P., Pantelis, A., Lapatsanis, D. P., Stravodimos, G., Matthys, C., Focquet, M., Vleeschouwers, W., Spaventa, A. G., Zerrweck, C., Vitiello, A., Berardi, G., Musella, M., Sanchez-Meza, A., Cantu, F. J., Mora, F., Cantu, M. A., Katakwar, A., Reddy, D. N., Elmaleh, H., Hassan, M., Elghandour, A., Elbanna, M., Osman, A., Khan, A., Layani, L., Kiran, N., Velikorechin, A., Solovyeva, M., Melali, H., Shahabi, S., Agrawal, A., Shrivastava, A., Sharma, A., Narwaria, B., Narwaria, M., Raziel, A., Sakran, N., Susmallian, S., Karagoz, L., Akbaba, M., Piskin, S. Z., Ziya, A., Senol, Z., Manno, E., Iovino, M. G., Qassem, M., Arana-Garza, S., Povoas, H. P., Vilas-Boas, M. L., Naumann, D., Li, A., Ammori, B. J., Balamoun, H., Salman, M., Nasta, A. M., Goel, R., Sanchez-Aguilar, H., Herrera, M. F., Abou-Mrad, A., Cloix, L., Mazzini, G. S., Kristem, L., Lazaro, A., Campos, J., Bernardo, J., Gonzalez, J., Trindade, C., Viveiros, O., Ribeiro, R., Goitein, D., Hazzan, D., Segev, L., Beck, T., Reyes, H., Monterrubio, J., Garcia, P., Benois, M., Kassir, R., Contine, A., Elshafei, M., Aktas, S., Weiner, S., Heidsieck, T., Level, L., Pinango, S., Ortega, P. M., Moncada, R., Valenti, V., Vlahovic, I., Boras, Z., Liagre, A., Martini, F., Juglard, G., Motwani, M., Saggu, S. S., Al Momani, H., Lopez, L. A. A., Cortez, M. A. C., Zavala, R. A., D'Haese, C., Kempeneers, I., Himpens, J., Lazzati, A., Paolino, L., Bathaei, S., Bedirli, A., Yavuz, A., Buyukkasap, C., Ozaydin, S., Kwiatkowski, A., Bartosiak, K., Waledziak, M., Santonicola, A., Angrisani, L., Iovino, P., Palma, R., Iossa, A., Boru, C. E., De Angelis, F., Silecchia, G., Hussain, A., Balchandra, S., Coltell, I. B., Perez, J. L., Bohra, A., Awan, A. K., Madhok, B., Leeder, P. C., Awad, S., Al-Khyatt, W., Shoma, A., Elghadban, H., Ghareeb, S., Mathews, B., Kurian, M., Larentzakis, A., Vrakopoulou, G. Z., Albanopoulos, K., Bozdag, A., Lale, A., Kirkil, C., Dincer, M., Bashir, A., Haddad, A., Hijleh, L. A., Zilberstein, B., de Marchi, D. D., Souza, W. P., Broden, C. M., Gislason, H., Shah, K., Ambrosi, A., Pavone, G., Tartaglia, N., Kona, S. L. K., Kalyan, K., Perez, C. E. G., Botero, M. A. F., Covic, A., Timofte, D., Maxim, M., Faraj, D., Tseng, L., Liem, R., Oren, G., Dilektasli, E., Yalcin, I., Almukhtar, H., Al Hadad, M., Mohan, R., Arora, N., Bedi, D., Rives-Lange, C., Chevallier, J. -M., Poghosyan, T., Sebbag, H., Zinai, L., Khaldi, S., Mauchien, C., Mazza, D., Dinescu, G., Rea, B., Perez-Galaz, F., Zavala, L., Besa, A., Curell, A., Balibrea, J. M., Vaz, C., Galindo, L., Silva, N., Caballero, J. L. E., Sebastian, S. O., Marchesini, J. C. D., da Fonseca Pereira, R. A., Sobottka, W. H., Fiolo, F. E., Turchi, M., Coelho, A. C. J., Zacaron, A. L., Barbosa, A., Quinino, R., Menaldi, G., Paleari, N., Martinez-Duartez, P., Aragon Ramirez de Esparza, D. G. M., Esteban, V. S., Torres, A., Garcia-Galocha, J. L., Josa, M. I., Pacheco-Garcia, J. M., Mayo-Ossorio, M. A., Chowbey, P., Soni, V., de Vasconcelos Cunha, H. A., Castilho, M. V., Ferreira, R. M. A., Barreiro, T. A., Charalabopoulos, A., Sdralis, E., Davakis, S., Bomans, B., Dapri, G., Van Belle, K., Mazentakieddine, Vaneukem, P., Karaca, E. S. A., Karaca, F. C., Sumer, A., Peksen, C., Savas, O. A., Chousleb, E., Elmokayed, F., Fakhereldin, I., Aboshanab, H. M., Swelium, T., Gudal, A., Gamloo, L., Ugale, A., Ugale, S., Boeker, C., Reetz, C., Hakami, I. A., Mall, J., Alexandrou, A., Baili, E., Bodnar, Z., Maleckas, A., Gudaityte, R., Guldogan, C. E., Gundogdu, E., Ozmen, M. M., Thakkar, D., Dukkipati, N., Shah, P. S., Shah, S. S., Adil, M. T., Jambulingam, P., Mamidanna, R., Whitelaw, D., Jain, V., Veetil, D. K., Wadhawan, R., Torres, M., Tinoco, T., Leclercq, W., Romeijn, M., van de Pas, K., Alkhazraji, A. K., Taha, S. A., Ustun, M., Yigit, T., Inam, A., Burhanulhaq, M., Pazouki, A., Eghbali, F., Kermansaravi, M., Jazi, A. H. D., Mahmoudieh, M., Mogharehabed, N., Tsiotos, G., Stamou, K., Barrera Rodriguez, F. J., Rojas Navarro, M. A., Torres, O. M. O., Martinez, S. L., Tamez, E. R. M., Millan Cornejo, G. A., Flores, J. E. G., Mohammed, D. A., Elfawal, M. H., Shabbir, A., Guowei, K., So, J. B. Y., Kaplan, E. T., Kaplan, M., Kaplan, T., Pham, D. T., Rana, G., Kappus, M., Gadani, R., Kahitan, M., Pokharel, K., Osborne, A., Pournaras, D., Hewes, J., Napolitano, E., Chiappetta, S., Bottino, V., Dorado, E., Schoettler, A., Gaertner, D., Fedtke, K., Aguilar-Espinosa, F., Aceves-Lozano, S., Balani, A., Nagliati, C., Pennisi, D., Rizzi, A., Frattini, F., Foschi, D., Benuzzi, L., Parikh, C. H. I. R. A. G., Shah, H. A. R. S. H. I. L., Pinotti, E., Montuori, M., Borrelli, V., Dargent, J., Copaescu, C. A., Hutopila, I., Smeu, B., Witteman, B., Hazebroek, E., Deden, L., Heusschen, L., Okkema, S., Aufenacker, T., den Hengst, W., Vening, W., van der Burgh, Y., Ghazal, A., Ibrahim, H., Niazi, M., Alkhaffaf, B., Altarawni, M., Cesana, G. C., Anselmino, M., Uccelli, M., Olmi, S., Stier, C., Akmanlar, T., Sonnenberg, T., Schieferbein, U., Marcolini, A., Awruch, D., Vicentin, M., de Souza Bastos, E. L., Gregorio, S. A., Ahuja, A., Mittal, T., Bolckmans, R., Baratte, C., Wisnewsky, J. A., Genser, L., Chong, L., Taylor, L., Ward, S., Hi, M. W., Heneghan, H., Fearon, N., Plamper, A., Rheinwalt, K., Geoghegan, J., Ng, K. C., Kaseja, K., Kotowski, M., Samarkandy, T. A., Leyva-Alvizo, A., Corzo-Culebro, L., Wang, C., Yang, W., Dong, Z., Riera, M., Jain, R., Hamed, H., Said, M., Zarzar, K., Garcia, M., Turkcapar, A. G., Sen, O., Baldini, E., Conti, L., Wietzycoski, C., Lopes, E., Pintar, T., Salobir, J., Aydin, C., Atici, S. D., Ergin, A., Ciyiltepe, H., Bozkurt, M. A., Kizilkaya, M. C., Onalan, N. B. D., Zuber, M. N. B. A., Wong, W. J., Garcia, A., Vidal, L., Beisani, M., Pasquier, J., Vilallonga, R., Sharma, S., Parmar, C., Lee, L., Sufi, P., Sinan, H., and Saydam, M.
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Male ,Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,bariatric surgery ,Context (language use) ,Pandemic ,Medicine ,Humans ,Pandemics ,COVID-19 ,pandemic ,SARS-CoV-2 ,Nutrition and Dietetics ,Manchester Cancer Research Centre ,business.industry ,Health Policy ,ResearchInstitutes_Networks_Beacons/mcrc ,Public Health, Environmental and Occupational Health ,medicine.disease ,Obesity ,Obesity, Morbid ,Treatment Outcome ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,Morbidity ,business ,Body mass index ,Cohort study ,Human - Abstract
Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n=122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n=146; 85.9%), only 42.4% (n=72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n=9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients.
- Published
- 2021
- Full Text
- View/download PDF
5. Partial Upper Sternotomy is a Safe Alternative in Mitral Annulus Decalcification
- Author
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Fabian Barbieri, Nikolaos Bonaros, D. Hoefer, Ulvi Cenk Oezpeker, Michael Grimm, and Ludwig C. Mueller
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Heart Valve Diseases ,Prom ,030204 cardiovascular system & hematology ,Inferior vena cava ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Mitral valve ,Risk of mortality ,medicine ,Cardiopulmonary bypass ,Humans ,Minimally Invasive Surgical Procedures ,Aged ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,Bone decalcification ,business.industry ,General Medicine ,Perioperative ,Length of Stay ,Middle Aged ,Intensive care unit ,Sternotomy ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,030228 respiratory system ,medicine.vein ,Thoracotomy ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
In patients with major annulus calcifications (MAC) requiring en-bloque decalcification anterolateral minithoracotomy is not suitable for safe and reproducible mitral valve surgery (MVS) procedures. In these cases, full sternotomy (FS) is still the preferred approach. Alternatively, less invasive MVS via partial upper sternotomy (PS) and transseptal access can be used in experienced centers. After reviewing the records of 1741 patients, who were treated with either isolated MVS or combined procedures, we identified 32 patients who had undergone en-bloque decalcification for MAC. The 2 techniques (PS-group n = 17, FS-cohort n = 15) were presented in terms of 1-year mortality as well as intra- and perioperative outcome. In the PS group, the age was 60.06 ± 7.56 patients, 64.7% were female and had a STS Predicted Risk of Mortality (PROM) score of 1.01 ± 1.06. In the FS group the patients (53.3% female) mean age was 58.47 ± 14.45 and had a STS PROM score 2.35 ± 2.73%. Rates of mitral repair were in the PS and FS cohort 64.7% and 46.7%, respectively. One-year mortality for PS-MVS was 5.9% (n = 1) and 20% (n = 3) for FS-MVS. The cardiopulmonary bypass (FS: 181.60 ± 49.99 minutes, PS: 192.83 ± 77.32 minutes and the cross-clamp times (FS: 119.67 ± 46.06, PS: 136.94 ± 54.37 minutes). The observed ventilation times in the PS and FS group were 5 hours (IQR 3.5–9) and 10 hours (IQR 5–15), respectively. A permanent pacemaker implantation was not necessary in any patient. In patients with MAC and en-bloque decalcification PS seems to be a safe access and might be a valid less invasive alternative to minithoracotomy.
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- 2021
6. Predictors of safety and success in minimally invasive surgery for degenerative mitral disease
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Nikolaos Bonaros, Herbert Hangler, Cenk Oezpeker, D. Hoefer, Juliane Kilo, Ludwig C. Mueller, Johannes Holfeld, Julia Dumfarth, Michael Grimm, Elfriede Ruttmann-Ulmer, and Can Gollmann-Tepekoeylue
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Pulmonary and Respiratory Medicine ,Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,medicine ,Extracorporeal membrane oxygenation ,Mitral valve prolapse ,Humans ,Minimally Invasive Surgical Procedures ,Myocardial infarction ,Child ,Stroke ,Mitral regurgitation ,Mitral Valve Prolapse ,Proportional hazards model ,business.industry ,Hazard ratio ,Mitral Valve Insufficiency ,General Medicine ,Perioperative ,medicine.disease ,Surgery ,Treatment Outcome ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES The aim of this study was to identify predictors of periprocedural success and safety in minimally invasive mitral valve surgery and to determine the impact of pathology localization and repair technique on reoperation-free survival. METHODS We isolated 686 patients (mean age 60.5, standard deviation 12.3 years, 69.4% male) who underwent surgery for mitral valve prolapse between 2002 and 2020 in a single institution. Patients with concomitant disease, redo or mitral pathology other than degenerative mitral disease were excluded from the analysis. Periprocedural safety was defined as: freedom from perioperative death, myocardial infarction, stroke, use of extracorporeal membrane oxygenation or reoperation for bleeding. Operative success was defined as: successful primary mitral repair without conversion to replacement or to larger thoracic incisions, without residual mitral regurgitation > mild at discharge or reoperation within 30 days. Predictors for perioperative success and safety were identified using univariable and multivariable analyses. The impact of prolapse localization and repair technique on reoperation-free survival was assessed by Cox regression. RESULTS The mitral repair rate and the need for concomitant tricuspid repair were 94.6% and 16.5%, respectively. Perioperative mortality occurred in 5 patients (0.7%). The criteria for perioperative safety and success were met in 646/686 (94.2%) and 648/686 (94.5%) patients, respectively. The absence of tricuspid disease requiring repair was the only independent predictor of safety in this cohort [hazard ratio (HR) 0.460 (0.225–0.941), P = 0.033]. The only independent predictor of operative success was the use of chordal replacement [0.27 (0.09–0.83), P = 0.022]. Reoperation-free survival was 98.5%, 94.5% and 86.9% at 1, 5 and 10 years, respectively. Posterior leaflet pathology demonstrated a higher reoperation-free survival as compared to other localizations (log-rank P = 0.002). The localization of leaflet pathology but not the repair method was an independent predictor for reoperation-free survival (HR 1.455, 95% confidence interval 1.098–1.930; P = 0.009). CONCLUSIONS In minimally invasive mitral surgery for degenerative disease, chordal replacement yields higher rates of periprocedural success than leaflet resection. Posterior leaflet pathology is an independent predictor of reoperation-free survival.
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- 2021
7. O-methylguanine-DNA methyltransferase (MGMT) mRNA expression predicts outcome in malignant glioma independent of MGMT promoter methylation.
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Simone Kreth, Niklas Thon, Sabina Eigenbrod, Juergen Lutz, Carola Ledderose, Rupert Egensperger, Joerg C Tonn, Hans A Kretzschmar, Ludwig C Hinske, and Friedrich W Kreth
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Medicine ,Science - Abstract
BackgroundWe analyzed prospectively whether MGMT (O(6)-methylguanine-DNA methyltransferase) mRNA expression gains prognostic/predictive impact independent of MGMT promoter methylation in malignant glioma patients undergoing radiotherapy with concomitant and adjuvant temozolomide or temozolomide alone. As DNA-methyltransferases (DNMTs) are the enzymes responsible for setting up and maintaining DNA methylation patterns in eukaryotic cells, we analyzed further, whether MGMT promoter methylation is associated with upregulation of DNMT expression.Methodology/principal findingsADULT PATIENTS WITH A HISTOLOGICALLY PROVEN MALIGNANT ASTROCYTOMA (GLIOBLASTOMA: N = 53, anaplastic astrocytoma: N = 10) were included. MGMT promoter methylation was determined by methylation-specific PCR (MSP) and sequencing analysis. Expression of MGMT and DNMTs mRNA were analysed by real-time qPCR. Prognostic factors were obtained from proportional hazards models. Correlation between MGMT mRNA expression and MGMT methylation status was validated using data from the Cancer Genome Atlas (TCGA) database (N = 229 glioblastomas). Low MGMT mRNA expression was strongly predictive for prolonged time to progression, treatment response, and length of survival in univariate and multivariate models (pConclusions/significanceMGMT mRNA expression plays a direct role for mediating tumor sensitivity to alkylating agents. Discordant findings indicate methylation-independent pathways of MGMT expression regulation. DNMT1 and DNMT3b are likely to be involved in CGI methylation. However, their exact role yet has to be defined.
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- 2011
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8. Praxissimulation mit Schauspielpatienten für Studierende im Praktischen Jahr im Skillslab der Martin-Luther-Universität Halle-Wittenberg
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Schubert, J, Ullrich, S, Ludwig, C, and Stoevesandt, D
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Am jeweils ersten Tertialtag wird für PJ'lerInnen des Universitätsklinikums Halle Saale die Veranstaltung „Praxissimulation mit SchauspielpatientInnen“ durchgeführt. Es finden 4 Simulationsfälle in Teamarbeit à zwei Studierenden in den Räumlichkeiten [zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)
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- 2019
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9. Die Interprofessionelle Lernstation 'Interprofessionelle Palliativ-Beratung' im Projekt »GReTL 2.0« Gesundheitsberufe im reflexiven und transformativen Lernen [Bericht über Entwicklungsprozess]
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Luderer, C, Stoevesandt, D, Ludwig, C, and Haucke, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Problemstellung/Ziele: Interprofessionelle Lernerfahrungen wirken positiv auf die Gesundheitsversorgung [ref:1]. Eine interprofessionelle Lerneinheit zur Palliativberatung für Medizin und Pflege wurde entwickelt und bezüglich Wissenserwerb, Kompetenzzuwachs, Transferperspektive[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)
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- 2018
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10. GReTL2.0 - Gesundheitsberufe im reflexiven & transformativen Lernen. Interprofessionelle Lehr-& Lernstationen für Medizinstudierende & Studierende/Auszubildende in der Pflege [Bericht über Entwicklungsprozess]
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Haucke, E., Stoevesandt, D., Ludwig, C., and Luderer, C.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Problemstellung/Ziele: Interprofessionell zusammenzuarbeiten und dabei unterschiedliche Fachkompetenzen und Sichtweisen effektiv für die Patientenversorgung zu nutzen, soll durch interprofessionelles Lernen verbessert werden. Projektbeschreibung: Mit Unterstützung der Robert Bosch[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)
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- 2018
11. Mitral Valve Surgery via Partial Upper Sternotomy: Closing the Gap between Conventional Sternotomy and Right Lateral Minithoracotomy
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Fabian Barbieri, D. Hoefer, Bastian Schneider, C. Oezpeker, Michael Grimm, Nikolaos Bonaros, and Ludwig C. Mueller
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Myocardial revascularization ,Time Factors ,Databases, Factual ,Operative Time ,Less invasive ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Risk Assessment ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Interquartile range ,law ,Risk Factors ,Retrospective analysis ,Medicine ,Humans ,Hospital Mortality ,Aged ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,business.industry ,Patient Selection ,Length of Stay ,Intensive care unit ,Sternotomy ,Surgery ,Treatment Outcome ,030228 respiratory system ,Thoracotomy ,Concomitant ,Heart Valve Prosthesis ,Cohort ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mitral valve surgery - Abstract
Background Minithoracotomy (MT) has gained broad acceptance for mitral valve surgery (MVS) in the last decade. In the presence of defined limitations of MT, however, full sternotomy (FS) is still widely preferred. We assume that the less investigated partial upper sternotomy (PS) will permit the gap between MT and FS in MVS to be closed. The purpose of this study is to investigate a valid less invasive alternative to MT for isolated MVS or multivalve surgery. Methods This retrospective analysis includes data on 1,639 patients, who underwent either isolated or combined primary MVS at our department from May 2011 to August 2017. Out of these, 663 patients were operated via MT access. One-hundred three patients had been judged as not suitable for MT but feasible for PS approach in which 53.4% (n = 55) had isolated MVS and 46.6% patients (n = 48) underwent multivalve surgery. Concomitant myocardial revascularization was performed in 2.9% of the study patients (n = 3). Results Operative, 90-day, and 1-year mortality in the PS-cohort was 0, 1.0% (n = 1), and 3.3% (n = 3), respectively. During a median follow-up time of 1,115 days (interquartile range 398–1806), all-cause mortality was 5.8% (n = 6). Operative times for cardiopulmonary-bypass and cross-clamping were 167 minutes (140–198) and 107 minutes (93–132), respectively. Median length of stay at the intensive care unit and hospital was 1 (1–2) and 7 days (7–10), respectively. Conclusion The presented results demonstrate that there is a cohort of patients, who are not candidates for MT in MVS but may be operated successfully by an alternative less invasive approach.
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- 2018
12. Minimally invasive mitral valve repair for Barlow’s syndrome with functional prolapse using artificial chords
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Daniel Hoefer and Ludwig C. Mueller
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medicine.medical_specialty ,Mitral valve repair ,S syndrome ,business.industry ,medicine.medical_treatment ,Gold standard ,medicine ,business ,Mitral valve regurgitation ,medicine.disease ,Surgery - Abstract
Mitral valve repair is the gold standard for mitral valve regurgitation. Minimally invasive approaches are established even in complex pathology like Barlow’s syndrome. A Barlow valve is considered difficult to repair, a comprehensive review concerning various successful repair techniques is given. The complex pathophysiology of a subgroup of patients presenting with functional prolapse is described and a simple repair strategy is highlighted. In the video a fully endoscopic mitral valve repair of a Barlow valve with functional prolapse is demonstrated.
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- 2019
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13. Setup for totally endoscopic mitral valve surgery, diagnosis and repair of a functional prolapse in Barlow’s syndrome, and repair results
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Daniel Hoefer and Ludwig C. Mueller
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medicine.medical_specialty ,S syndrome ,business.industry ,Materials Chemistry ,Medicine ,business ,Mitral valve surgery ,Surgery - Published
- 2019
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14. Heilung der Bronchusanastomose und Komplikationen nach Manschettenresektion in Abhängigkeit vom Operationszeitpunkt nach neoadjuvanter Radiochemotherapie
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Zalepugas, D, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Nach einer Radiochemotherapie soll eine Pneumonektomie vermieden. Dies ist durch den Einsatz der Manschettenlobektomie möglich. Der negative Einfluss der Radiochemotherapie auf die Wundheilung ist bekannt. Daten zu der Frage, wann der optimale Operationszeitpunkt ist, liegen nicht vor.[zum vollständigen Text gelangen Sie über die oben angegebene URL], 133. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2016
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15. Multislice Computed Tomography in Infective Endocarditis
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Johannes Bonatti, Hans Scheffel, Hatem Alkadhi, Florian Wolf, Thomas Schertler, Gudrun Feuchtner, André Plass, Ludwig C. Mueller, Paul Stolzmann, Silvana Mueller, Thomas Bartel, and Wolfgang Dichtl
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medicine.medical_specialty ,Heart disease ,business.industry ,Multislice computed tomography ,medicine.disease ,Cardiac surgery ,Infective endocarditis ,Medicine ,Endocarditis ,Multislice ,In patient ,Tomography ,Radiology ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objectives: The aim of this study was to assess the value of multislice computed tomography (CT) for the assessment of valvular abnormalities in patients with infective endocarditis (IE) in compari...
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- 2009
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16. Circulating microRNAs in Sera Correlate with Soluble Biomarkers of Immune Activation but Do Not Predict Mortality in ART Treated Individuals with HIV-1 Infection: A Case Control Study
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Murray, D. D., Suzuki, K., Law, M., Trebicka, J., Neuhaus, J., Wentworth, D., Johnson, M., Vjecha, M. J., Kelleher, A. D., Emery, S., Aagaard, B., Aragon, E., Arnaiz, J., Borup, L., Clotet, B., Dragsted, U., Fau, A., Gey, D., Grarup, J., Hengge, U., Herrero, P., Jansson, P., Jensen, B., Jensen, K., Juncher, H., Lopez, P., Lundgren, J. D., Matthews, C., Mollerup, D., Pearson, M., Phillips, A., Reilev, S., Tillmann, K., Varea, S., Angus, B., Babiker, A., Cordwell, B., Darbyshire, J., Dodds, W., Fleck, S., Horton, J., Hudson, F., Moraes, Y., Pacciarini, F., Palfreeman, A., Paton, N., Smith, N., Van Hooff, F., Bebchuk, J., Collins, G., Denning, E., Duchene, A., Fosdick, L., Harrison, M., Herman-Lamin, K., Krum, E., Larson, G., Neaton, J., Nelson, R., Quan, K., Quan, S., Schultz, T., Thompson, G., Wyman, N., Carey, C., Chan, F., Cooper, D., Courtney-Rodgers, D., Drummond, F., Harrod, M., Jacoby, S., Kearney, L., Lin, E., Pett, S., Robson, R., Seneviratne, N., Stewart, M., Watts, E., Finley, E., Gordin, F., Sanchez, A., Standridge, B., Belloso, W., Davey, R., Duprez, D., Gatell, J., Hoy, J., Lifson, A., Pederson, C., Perez, G., Price, R., Prineas, R., Rhame, F., Sampson, J., Worley, J., Modlin, J., Beral, V., Chaisson, R., Fleming, T., Hill, C., Kim, K., Murray, B., Pick, B., Seligmann, M., Weller, I., Cahill, K., Fox, L., Luzar, M., Martinez, A., Mcnay, L., Pierson, J., Tierney, J., Vogel, S., Costas, V., Eckstrand, J., Brown, S., Abusamra, L., Angel, E., Aquilia, S., Benetucci, J., Bittar, V., Bogdanowicz, E., Cahn, P., Casiro, A., Contarelli, J., Corral, J., Daciuk, L., David, D., Dobrzanski, W., Duran, A., Ebenrstejin, J., Ferrari, I., Fridman, D., Galache, V., Guaragna, G., Ivalo, S., Krolewiecki, A., Lanusse, I., Laplume, H., Lasala, M., Lattes, R., Lazovski, J., Lopardo, G., Losso, M., Lourtau, L., Lupo, S., Maranzana, A., Marson, C., Massera, L., Moscatello, G., Olivia, S., Otegui, I., Palacios, L., Parlante, A., Salomon, H., Sanchez, M., Somenzini, C., Suarez, C., Tocci, M., Toibaro, J., Zala, C., Agrawal, S., Ambrose, P., Anderson, C., Anderson, J., Baker, D., Beileiter, K., Blavius, K., Bloch, M., Boyle, M., Bradford, D., Britton, P., Brown, P., Busic, T., Cain, A., Carrall, L., Carson, S., Chenoweth, I., Chuah, J., Clark, F., Clemons, J., Clezy, K., Cortissos, P., Cunningham, N., Curry, M., Daly, L., D'Arcy-Evans, C., Del Rosario, R., Dinning, S., Dobson, P., Donohue, W., Doong, N., Downs, C., Edwards, E., Edwards, S., Egan, C., Ferguson, W., Finlayson, R., Forsdyke, C., Foy, L., Franic, T., Frater, A., French, M., Gleeson, D., Gold, J., Habel, P., Haig, K., Hardy, S., Holland, R., Hudson, J., Hutchison, R., Hyland, N., James, R., Johnston, C., Kelly, M., King, M., Kunkel, K., Lau, H., Leamy, J., Lester, D., Leung, J., Lohmeyer, A., Lowe, K., Macrae, K., Magness, C., Martinez, O., Maruszak, H., Medland, N., Miller, S., Murray, J., Negus, P., Newman, R., Ngieng, M., Nowlan, C., Oddy, J., Orford, N., Orth, D., Patching, J., Plummer, M., Price, S., Primrose, R., Prone, I., Ree, H., Remington, C., Richardson, R., Robinson, S., Rogers, G., Roney, J., Roth, N., Russell, D., Ryan, S., Sarangapany, J., Schmidt, T., Schneider, K., Shields, C., Silberberg, C., Shaw, D., Skett, J., Smith, D., Soo, T. M., Sowden, D., Street, A., Tee, B. K., Thomson, J., Topaz, S., Vale, R., Villella, C., Walker, A., Watson, A., Wendt, N., Williams, L., Youds, D., Aichelburg, A., Cichon, P., Gemeinhart, B., Rieger, A., Schmied, B., Touzeau-Romer, V., Vetter, N., Colebunders, R., Clumeck, N., Deroo, A., Kabeya, K., O'Doherty, E., De Wit, S., De Salles Amorim, C., Basso, C., Flint, S., Kallas, E., Levi, G., Lewi, D., Pereira, L., Da Silva, M., Souza, T., Toscano, A., Angel, J., Arsenault, M., Bast, M., Beckthold, B., Bouchard, P., Chabot, I., Clarke, R., Cohen, J., Cote, P., Ellis, M., Gagne, C., Gill, J., Houde, M., Johnston, B., Jubinville, N., Kato, C., Lamoureux, N., Latendre-Paquette, J., Lindemulder, A., Mcneil, A., Mcfarland, N., Montaner, J., Morrisseau, C., O'Neill, R., Page, G., Piche, A., Pongracz, B., Preziosi, H., Puri, L., Rachlis, A., Ralph, E., Raymond, I., Rouleau, D., Routy, J. P., Sandre, R., Seddon, T., Shafran, S., Sikora, C., Smaill, F., Stromberg, D., Trottier, S., Walmsley, S., Weiss, K., Williams, K., Zarowny, D., Baadegaard, B., Andersen, A. B., Boedker, K., Collins, P., Gerstoft, J., Jensen, L., Moller, H., Andersen, P. L., Loftheim, I., Mathiesen, L., Nielsen, H., Obel, N., Pedersen, C., Petersen, D., Jensen, L. P., Black, F. T., Aboulker, J. P., Aouba, A., Bensalem, M., Berthe, H., Blanc, C., Bornarel, D., Bouchaud, O., Boue, F., Bouvet, E., Brancon, C., Breaud, S., Brosseau, D., Brunet, A., Capitant, C., Ceppi, C., Chakvetadze, C., Cheneau, C., Chennebault, J. M., De Truchis, P., Delavalle, A. M., Delfraissy, J. F., Dellamonica, P., Dumont, C., Edeb, N., Fabre, G., Ferrando, S., Foltzer, A., Foubert, V., Gastaut, J. A., Gerbe, J., Girard, P. M., Goujard, C., Hoen, B., Honore, P., Hue, H., Hynh, T., Jung, C., Kahi, S., Katlama, C., Lang, J. M., Le Baut, V., Lefebvre, B., Leturque, N., Levy, Y., Loison, J., Maddi, G., Maignan, A., Majerholc, C., De Boever, C., Meynard, J. L., Michelet, C., Michon, C., Mole, M., Netzer, E., Pialoux, G., Poizot-Martin, I., Raffi, F., Ratajczak, M., Ravaux, I., Reynes, J., Salmon-Ceron, D., Sebire, M., Simon, A., Tegna, L., Tisne-Dessus, D., Tramoni, C., Viard, J. P., Vidal, M., Viet-Peaucelle, C., Weiss, L., Zeng, A., Zucman, D., Adam, A., Arasteh, K., Behrens, G., Bergmann, F., Bickel, M., Bittner, D., Bogner, J., Brockmeyer, N., Darrelmann, N., Deja, M., Doerler, M., Esser, S., Faetkenheuer, G., Fenske, S., Gajetzki, S., Goebel, F., Gorriahn, D., Harrer, E., Harrer, T., Hartl, H., Hartmann, M., Heesch, S., Jakob, W., Jager, H., Klinker, H., Kremer, G., Ludwig, C., Mantzsch, K., Mauss, S., Meurer, A., Niedermeier, A., Pittack, N., Plettenberg, A., Potthoff, A., Probst, M., Rittweger, M., Rockstroh, J., Ross, B., Rotty, J., Rund, E., Ruzicka, T., Schmidt, R., Schmutz, G., Schnaitmann, E., Schuster, D., Sehr, T., Spaeth, B., Staszewski, S., Stellbrink, H. J., Stephan, C., Stockey, T., Stoehr, A., Trein, A., Vaeth, T., Vogel, M., Wasmuth, J., Wengenroth, C., Winzer, R., Wolf, E., Mulcahy, F., Reidy, D., Cohen, Y., Drora, G., Eliezer, I., Godo, O., Kedem, E., Magen, E., Mamorsky, M., Pollack, S., Sthoeger, Z., Vered, H., Yust, I., Aiuti, F., Bechi, M., Bergamasco, A., Bertelli, D., Bruno, R., Butini, L., Cagliuso, M., Carosi, G., Casari, S., Chrysoula, V., Cologni, G., Conti, V., Costantini, A., Corpolongo, A., D'Offizi, G., Gaiottino, F., Di Pietro, M., Esposito, R., Filice, G., Francesco, M., Gianelli, E., Graziella, C., Magenta, L., Martellotta, F., Maserati, R., Mazzotta, F., Murdaca, G., Nardini, G., Nozza, S., Puppo, F., Pogliaghi, M., Ripamonti, D., Ronchetti, C., Rusconi, S., Rusconi, V., Sacchi, P., Silvia, N., Suter, F., Tambussi, G., Uglietti, A., Vechi, M., Vergani, B., Vichi, F., Vitiello, P., Iwamoto, A., Kikuchi, Y., Miyazaki, N., Mori, M., Nakamura, T., Odawara, T., Oka, S., Shirasaka, T., Tabata, M., Takano, M., Ueta, C., Watanabe, D., Yamamoto, Y., Erradey, I., Himmich, H., El Filali, K. M., Blok, W., Van Boxtel, R., Doevelaar, K. B. H., Van Eeden, A., Grijsen, M., Groot, M., Juttmann, J., Kuipers, M., Ligthart, S., Van Der Meulen, P., Lange, J., Langebeek, N., Reiss, P., Richter, C., Schoemaker, M., Schrijnders-Gudde, L., Septer-Bijleveld, E., Sprenger, H., Vermeulen, J., Ten Kate, R., Van De Ven, B., Bruun, J., Kvale, D., Maeland, A., Bakowska, E., Beniowski, M., Boron-Kaczmarska, A., Gasiorowski, J., Horban, A., Inglot, M., Knysz, B., Mularska, E., Parczewski, M., Pynka, M., Rymer, W., Szymczak, A., Aldir, M., Antunes, F., Baptista, C., Da Conceicao Vera, J., Doroana, M., Mansinho, K., Dos Santos, C. R. A., Valadas, E., Vaz Pinto, I., Chia, E., Foo, E., Karim, F., Lim, P. L., Panchalingam, A., Quek, A., Alcazar-Caballero, R., Arribas, J., Arrizabalaga, J., De Barron, X., Blanco, F., Bouza, E., Bravo, I., Calvo, S., Carbonero, L., Carpena, I., Castro, M., Cortes, L., Del Toro, M., Domingo, P., Elias, M., Espinosa, J., Estrada, V., Fernandez-Cruz, E., Fernandez, P., Freud, H., Fuster, M., Garcia, A., Garcia, G., Garrido, R., Gijon, P., Gonzalez-Garcia, J., Gil, I., Gonzalez, A., Gonzalez-Lahoz, J., Grosso, P. 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D., Allworth, A. M., Anderson, J. S. C., Armishaw, J., Barnes, K., Carr, A., Chiam, A., Chuah, J. C. P., Curry, M. C., Dever, R. L., Donohue, W. A., Doong, N. C., Dwyer, D. E., Dyer, J., Eu, B., Ferguson, V. W., French, M. A. H., Garsia, R. J., Hudson, J. H., Jeganathan, S., Konecny, P., Mccormack, C. L., Mcmurchie, M., Moore, R. J., Moussa, M. B., Piper, M., Read, T., Roney, J. J., Shaw, D. R., Silvers, J., Smith, D. J., Street, A. C., Vale, R. J., Wendt, N. A., Wood, H., Youds, D. W., Zillman, J., Tozeau, V., Dewit, S., De Roo, A., Leonard, P., Lynen, L., Moutschen, M., Pereira, L. C., Souza, T. N. L., Schechter, M., Zajdenverg, R., Almeida, M. M. T. B., Araujo, F., Bahia, F., Brites, C., Caseiro, M. M., Casseb, J., Etzel, A., Falco, G. G., Filho, E. C. J., Flint, S. R., Gonzales, R., Madruga, J. V. R., Passos, L. N., Reuter, T., Sidi, L. C., Toscano, A. L. C., Cherban, E., Conway, B., Dufour, C., Foster, A., Haase, D., Haldane, H., Klein, M., Lessard, B., Martel, A., Martel, C., Paradis, E., Schlech, W., Schmidt, S., Thompson, B., Vezina, S., Reyes, M. J. W., Northland, R., Ostergaard, L., Hergens, L., Loftheim, I. R., Raukas, M., Zilmer, K., Justinen, J., Ristola, M., Landman, R., Abel, S., Abgrall, S., Amat, K., Auperin, L., Barruet, R., Benalycherif, A., Benammar, N., Bentata, M., Besnier, J. M., Blanc, M., Cabie, A., Chavannet, P., Dargere, S., De La Tribonniere, X., Debord, T., Decaux, N., Delgado, J., Dupon, M., Durant, J., Frixon-Marin, V., Genet, C., Gerard, L., Gilquin, J., Jeantils, V., Kouadio, H., Leclercq, P., Lelievre, J. D., Michon, C. P., Nau, P., Pacanowski, J., Piketty, C., Salmon, D., Schmit, J. L., Serini, M. A., Tassi, S., Touam, F., Verdon, R., Weinbreck, P., Yazdanpanah, Y., Yeni, P., Fatkenheuer, G., Bitsch, S., Bogner, J. R., Goebel, F. D., Lehmann, C., Lennemann, T., Wasmuth, J. C., Wiedemeyer, K., Hatzakis, A., Touloumi, G., Antoniadou, A., Daikos, G. L., Dimitrakaki, A., Gargalianos-Kakolyris, P., Giannaris, M., Karafoulidou, A., Katsambas, A., Katsarou, O., Kontos, A. N., Kordossis, T., Lazanas, M. K., Panagopoulos, P., Panos, G., Paparizos, V., Papastamopoulos, V., Petrikkos, G., Sambatakou, H., Skoutelis, A., Tsogas, N., Xylomenos, G., Bergin, C. J., Mooka, B., Mamorksy, M. G., Agmon-Levin, N., Karplus, R., Maayan, S., Shahar, E., Turner, D., Abeli, C., Biglino, A., Bonora, S., De Gioanni, M., Di Perri, G., Montroni, M., Quirino, T., Raise, E., Honda, M., Ishisaka, M., Caplinskas, S., Uzdaviniene, V., Schmit, J. C., Staub, T., Mills, G. D., Blackmore, T., Masters, J. A., Morgan, J., Pithie, A., Brunn, J., Ormassen, V., La Rosa, A., Guerra, O., Espichan, M., Gutierrez, L., Mendo, F., Salazar, R., Knytz, B., Kwiatkowski, J., Castro, R. S., Horta, A., Miranda, A. C., Pinto, I. V., Vera, J., Rakhmanova, A., Vinogradova, E., Yakovlev, A., Zakharova, N., Wood, R., Orrel, C., Arnaiz, J. A., Carrillo, R., Dalmau, D., Jordano, Q., Knobel, H., Larrousse, M., Moreno, J. S., Oretaga, E., Pena, J. N., Hirschel, B., Spycher, R., Battegay, M., Bottone, S., Cavassini, M., Christen, A., Furrer, H. J., Gayet-Ageron, A., Genne, D., Hochstrasser, S., Moens, C., Muller, N., Nuesch, R., Ruxrungtham, K., Pumpradit, W., Dangthongdee, S., Kiertiburanakul, S., Klinbuayaem, V., Mootsikapun, P., Nonenoy, S., Piyavong, B., Prasithsirikul, W., Raksakulkarn, P., Gazzard, B. G., Ainsworth, J. G., Angus, B. J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Peters, S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, G., Youle, M., Abrams, D. I., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Crane, L. R., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, A., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Friedland, G., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Luskin-Hawk, R., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheblehall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Tedaldi, E. M., Telzak, E. E., Thompson, M. A., Thompson, S., Bong, C. T. H., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., and Pacheco, Antonio Guilherme
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Adult ,CD4-Positive T-Lymphocytes ,Male ,General Science & Technology ,Anti-HIV Agents ,T cell ,lcsh:Medicine ,Antiretroviral Therapy ,HIV Infections ,Biology ,Essential hypertension ,Logistic regression ,Malignancy ,Acquired immunodeficiency syndrome (AIDS) ,Clinical Research ,Antiretroviral Therapy, Highly Active ,microRNA ,medicine ,Genetics ,2.1 Biological and endogenous factors ,Humans ,Highly Active ,Aetiology ,lcsh:Science ,Genetic Association Studies ,Multidisciplinary ,lcsh:R ,Case-control study ,Middle Aged ,medicine.disease ,3. Good health ,Circulating MicroRNA ,MicroRNAs ,medicine.anatomical_structure ,Infectious Diseases ,Good Health and Well Being ,INSIGHT ESPRIT and SMART Study Groups ,Immunology ,HIV-1 ,HIV/AIDS ,lcsh:Q ,Female ,Infection ,Biomarkers ,Biotechnology ,Research Article - Abstract
Introduction The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR-145 correlated with nadir CD4+ T cell count. Discussion No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection.
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- 2015
17. Development and validation of a risk score for chronic kidney disease in HIV infection using prospective cohort data from the D:A:D study
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Mocroft, Amanda, Lundgren, Jens D., Ross, Michael, Law, Matthew, Reiss, Peter, Kirk, Ole, Smith, Colette, Wentworth, Deborah, Neuhaus, Jacqueline, Fux, Christoph A., Moranne, Olivier, Morlat, Phillipe, Johnson, Margaret A., Ryom, Lene, Lundgren, J. D., Powderly, B., Shortman, N., Moecklinghoff, C., Reilly, G., Franquet, X., Sabin, C. A., Phillips, A., Kirk, O., Reiss, P., Weber, R., Pradier, C., Law, M., d'Arminio Monforte, A., Dabis, F., El-Sadr, W. M., De Wit, S., Ryom, L., Kamara, D., Smith, C., Mocroft, A., Tverland, J., Mansfeld, M., Nielsen, J., Raben, D., Salbøl Brandt, R., Rickenbach, M., Fanti, I., Krum, E., Hillebregt, M., Geffard, S., Sundström, A., Delforge, M., Fontas, E., Torres, F., Mcmanus, H., Wright, S., Kjær, J., Sjøl, A., Meidahl, P., Helweg-Larsen, J., Schmidt Iversen, J., Ross, M., Fux, C. A., Morlat, P., Moranne, O., Kesselring, A. M., Kamara, D. 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L., Panchalingam, A., Quek, A., Alcázar-Caballero, R., Arribas, J., Arrizabalaga, J., de Barron, X., Blanco, F., Bouza, E., Calvo, S., Carbonero, L., Carpena, I., Castro, M., Cortes, L., del Toro, M., Elias, M., Espinosa, J., Estrada, V., Fernandez-Cruz, E., Fernández, P., Freud, H., Garcia, A., Garcia, G., Garrido, R., Gijón, P., Gonzalez- García, J., Gil, I., González, A., López Grosso, P., Guzmán, E., Iribarren, J., Jiménez, M., Juega, J., Lopez, J., Lozano, F., Martín-Carbonero, L., Mata, R., Menasalvas, A., Mirelles, C., de Miguel Prieto, J., Montes, M., Moreno, A., Moreno, J., Moreno, V., Muñoz, R., Ocampo, A., Ortega, E., Ortiz, L., Padilla, B., Parras, A., Paster, A., Pedreira, J., Peña, J., Perea, R., Portas, B., Pulido, F., Rebollar, M., de Rivera, J., Roca, V., Rodríguez- Arrondo, F., Rubio, R., Santos, J., Sanz, J., Sebastian, G., Segovia, M., Tamargo, L., Viciana, P., von Wichmann, M., Bratt, G., Hollander, A., Olov Pehrson, P., Petz, I., Sandstrom, E., Sönnerborg, A., Gurtner, V., Ampunpong, U., Auchieng, C., Bowonwatanuwong, C., Chanchai, P., Chetchotisakd, P., Chuenyan, T., Duncombe, C., Horsakulthai, M., Kantipong, P., Laohajinda, K., Phanuphak, P., Pongsurachet, V., Pradapmook, S., Ruxruntham, K., Seekaew, S., Sonjai, A., Suwanagool, S., Techasathit, W., Ubolyam, S., Wankoon, J., Alexander, I., Dockrell, D., Easterbrook, P., Edwards, B., Evans, E., Fox, R., Gazzard, B., Gilleran, G., Hand, J., Heald, L., Higgs, C., Jebakumar, S., Jendrulek, I., Johnson, S., Kinghorn, G., Kuldanek, K., Maw, R., Mckernan, S., Mclean, L., Morris, S., O'Farrell, S., Ong, E., Peters, B., Stroud, C., Wansbrough-Jones, M., White, D., Williams, I., Wiselka, M., Yee, T., Adams, S., Allegra, D., Andrews, L., Aneja, B., Anstead, G., Artz, R., Bailowitz, J., Banks, S., Baum, J., Benator, D., Black, D., Boh, D., Bonam, T., Brito, M., Brockelman, J., Bruzzese, V., Burnside, A., Cafaro, V., Casey, K., Cason, L., Childress, G., Clark, C. L., Clifford, D., Climo, M., Couey, P., Cuervo, H., Deeks, S., Dennis, M., Diaz-Linares, M., Dickerson, D., Diez, M., Di Puppo, J., Dodson, P., Dupre, D., Elion, R., Elliott, K., El-Sadr, W., Estes, M., Fabre, J., Farrough, M., Flamm, J., Follansbee, S., Foster, C., Frank, C., Franz, J., Frechette, G., Freidland, G., Frische, J., Fuentes, L., Funk, C., Geisler, C., Genther, K., Giles, M., Goetz, M., Gonzalez, M., Graeber, C., Graziano, F., Grice, D., Hahn, B., Hamilton, C., Hassler, S., Henson, A., Hopper, S., John, M., Johnson, L., Johnson, R., Jones, R., Kahn, J., Klimas, N., Kolber, M., Koletar, S., Labriola, A., Larsen, R., Lasseter, F., Lederman, M., Ling, T., Lusch, T., Macarthur, R., Machado, C., Makohon, L., Mandelke, J., Mannheimer, S., Martínez, M., Martinez, N., Mass, M., Masur, H., Mcgregor, D., Mcintyre, D., Mckee, J., Mcmullen, D., Mettinger, M., Middleton, S., Mieras, J., Mildvan, D., Miller, P., Miller, T., Mitchell, V., Mitsuyasu, R., Moanna, A., Mogridge, C., Moran, F., Murphy, R., Nahass, R., Nixon, D., O'Brien, S., Ojeda, J., Okhuysen, P., Olson, M., Osterberger, J., Owen, W., Pablovich, Sr. S., Patel, S., Pierone, G., Poblete, R., Potter, A., Preston, E., Rappoport, C., Regevik, N., Reyelt, M., Riney, L., Rodriguez-Barradas, M., Rodriguez, M., Rodriguez, J., Roland, R., Rosmarin-DeStefano, C., Rossen, W., Rouff, J., Saag, M., Santiago, S., Sarria, J., Wirtz, S., Schmidt, U., Scott, C., Sheridan, A., Shin, A., Shrader, S., Simon, G., Slowinski, D., Smith, K., Spotkov, J., Sprague, C., States, D., Suh, C., Sullivan, J., Summers, K., Sweeton, B., Tan, V., Tanner, T., Temesgen, Z., Thomas, D., Thompson, M., Tobin, C., Toro, N., Towner, W., Upton, K., Uy, J., Valenti, S., van der Horst, C., Vita, J., Voell, J., Walker, J., Walton, T., Wason, K., Watson, V., Wellons, A., Weise, J., White, M., Whitman, T., Williams, B., Williams, N., Windham, J., Witt, M., Workowski, K., Wortmann, G., Wright, T., Zelasky, C., Zwickl, B., Dietz, D., Chesson, C., Schmetter, B., Grue, L., Willoughby, M., Demers, A., Dragsted, U. 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H., Masciottra, F., Michaan, M., Ruggieri, L., Salazar, E., Sánchez, M., Hoy, J. F., Rogers, G. D., Allworth, A. M., Anderson, J. S. C., Armishaw, J., Barnes, K., Chiam, A., Chuah, J. C. P., Curry, M. C., Dever, R. L., Donohue, W. A., Doong, N. C., Dwyer, D. E., Dyer, J., Eu, B., Ferguson, V. W., French, M. A. H., Garsia, R. J., Hudson, J. H., Jeganathan, S., Konecny, P., Mccormack, C. L., Mcmurchie, M., Moore, R. J., Moussa, M. B., Piper, M., Read, T., Roney, J. J., Shaw, D. R., Silvers, J., Smith, D. J., Street, A. C., Vale, R. J., Wendt, N. A., Wood, H., Youds, D. W., Zillman, J., Tozeau, V., de Roo, A., Leonard, P., Lynen, L., Moutschen, M., Pereira, L. C., Souza, T. N. L., Schechter, M., Zajdenverg, R., Almeida, M. M. T. B., Araujo, F., Bahia, F., Brites, C., Caseiro, M. M., Casseb, J., Etzel, A., Falco, G. G., Filho, E. C. J., Flint, S. R., Gonzales, C. R., Madruga, J. V. R., Passos, L. N., Reuter, T., Sidi, L. C., Toscano, A. L. C., Cherban, E., Conway, B., Dufour, C., Foster, A., Haase, D., Haldane, H., Klein, M., Lessard, B., Martel, A., Martel, C., Paradis, E., Schlech, W., Schmidt, S., Thompson, B., Vezina, S., Wolff Reyes, M. J., Northland, R., Hergens, L., Loftheim, I. R., Raukas, M., Justinen, J., Landman, R., Abel, S., Abgrall, S., Amat, K., Auperin, L., Barruet, R., Benalycherif, A., Benammar, N., Bentata, M., Besnier, J. M., Blanc, M., Cabié, A., Chavannet, P., Dargere, S., de la Tribonniere, X., Debord, T., Decaux, N., Delgado, J., Frixon-Marin, V., Genet, C., Gérard, L., Gilquin, J., Jeantils, V., Kouadio, H., Leclercq, P., Lelièvre, J. -D., Levy, Y., Michon, C. P., Nau, P., Pacanowski, J., Piketty, C., Salmon, D., Schmit, J. L., Serini, M. A., Tassi, S., Touam, F., Verdon, R., Weinbreck, P., Yazdanpanah, Y., Yeni, P., Bitsch, S., Bogner, J. R., Goebel, F. D., Lehmann, C., Lennemann, T., Potthof, A., Wasmuth, J. C., Wiedemeyer, K., Hatzakis, A., Touloumi, G., Antoniadou, A., Daikos, G. L., Dimitrakaki, A., Gargalianos-Kakolyris, P., Giannaris, M., Karafoulidou, A., Katsambas, A., Katsarou, O., Kontos, A. N., Kordossis, T., Lazanas, M. K., Panagopoulos, P., Paparizos, V., Papastamopoulos, V., Petrikkos, G., Skoutelis, A., Tsogas, N., Bergin, C. J., Mooka, B., Mamorksy, M. G., Agmon-Levin, N., Karplus, R., Shahar, E., Biglino, A., De Gioanni, M., Montroni, M., Raise, E., Honda, M., Ishisaka, M., Caplinskas, S., Uzdaviniene, V., Schmit, J. C., Mills, G. D., Blackmore, T., Masters, J. A., Morgan, J., Pithie, A., Brunn, J., Ormasssen, V., La Rosa, A., Guerra, O., Espichan, M., Gutierrez, L., Mendo, F., Salazar, R., Knytz, B., Kwiatkowski, J., Castro, R. S., Horta, A., Miranda, A. C., Pinto, I. V., Vera, J., Vinogradova, E., Yakovlev, A., Wood, R., Orrel, C., Arnaiz, J. A., Carrillo, R., Dalmau, D., Jordano, Q., Knobel, H., Larrousse, M., Moreno, J. S., Oretaga, E., Pena, J. N., Spycher, R., Bottone, S., Christen, A., Franc, C., Furrer, H. J., Gayet-Ageron, A., Genné, D., Hochstrasser, S., Moens, C., Nüesch, R., Ruxrungtham, K., Pumpradit, W., Dangthongdee, S., Kiertiburanakul, S., Klinbuayaem, V., Mootsikapun, P., Nonenoy, S., Piyavong, B., Prasithsirikul, W., Raksakulkarn, P., Gazzard, B. G., Ainsworth, J. G., Angus, B. J., Barber, T. J., Brook, M. G., Care, C. D., Chadwick, D. R., Chikohora, M., Churchill, D. R., Cornforth, D., Dockrell, D. H., Easterbrook, P. J., Fox, P. A., Gomez, P. A., Gompels, M. M., Harris, G. M., Herman, S., Jackson, A. G. A., Jebakumar, S. P. R., Kinghorn, G. R., Kuldanek, K. A., Larbalestier, N., Lumsden, M., Maher, T., Mantell, J., Muromba, L., Orkin, C. M., Peters, B. S., Peto, T. E. A., Portsmouth, S. D., Rajamanoharan, S., Ronan, A., Schwenk, A., Slinn, M. A., Stroud, C. J., Thomas, R. C., Wansbrough-Jones, M. H., Whiles, H. J., White, D. J., Williams, E., Williams, I. G., Acosta, E. A., Adamski, A., Antoniskis, D., Aragon, D. R., Barnett, B. J., Baroni, C., Barron, M., Baxter, J. D., Beers, D., Beilke, M., Bemenderfer, D., Bernard, A., Besch, C. L., Bessesen, M. T., Bethel, J. T., Blue, S., Blum, J. D., Boarden, S., Bolan, R. K., Borgman, J. B., Brar, I., Braxton, B. K., Bredeek, U. F., Brennan, R., Britt, D. E., Bulgin-Coleman, D., Bullock, D. E., Campbell, B., Caras, S., Carroll, J., Casey, K. K., Chiang, F., Cindrich, R. B., Clark, C., Cohen, C., Coley, J., Condoluci, D. V., Contreras, R., Corser, J., Cozzolino, J., Daley, L., Dandridge, D., D'Antuono, V., Darcourt Rizo Patron, J. G., Dehovitz, J. A., Dejesus, E., Desjardin, J., Dietrich, C., Dolce, E., Erickson, D., Faber, L. L., Falbo, J., Farrough, M. J., Farthing, C. F., Ferrell-Gonzalez, P., Flynn, H., Frank, M., Freeman, K. F., French, N., Fujita, N., Gahagan, L., Gilson, I., Goetz, M. B., Goodwin, E., Guity, C. K., Gulick, P., Gunderson, E. R., Hale, C. M., Hannah, K., Henderson, H., Hennessey, K., Henry, W. K., Higgins, D. T., Hodder, S. L., Horowitz, H. W., Howe-Pittman, M., Hubbard, J., Hudson, R., Hunter, H., Hutelmyer, C., Insignares, M. T., Jackson, L., Jenny, L., Johnson, D. L., Johnson, G., Johnson, J., Kaatz, J., Kaczmarski, J., Kagan, S., Kantor, C., Kempner, T., Kieckhaus, K., Kimmel, N., Klaus, B. M., Koeppe, J. R., Koirala, J., Kopka, J., Kostman, J. R., Kozal, M. J., Kumar, A., Lampiris, H., Lamprecht, C., Lattanzi, K. M., Lee, J., Leggett, J., Long, C., Loquere, A., Loveless, K., Lucasti, C. J., Macveigh, M., Makohon, L. H., Markowitz, N. P., Marks, C., Martorell, C., Mcfeaters, E., Mcgee, B., Mcintyre, D. M., Mcmanus, E., Melecio, L. G., Melton, D., Mercado, S., Merrifield, E., Mieras, J. A., Mogyoros, M., Moran, F. M., Murphy, K., Mutic, S., Nadeem, I., Nadler, J. P., Ognjan, A., O'Hearn, M., O'Keefe, K., Okhuysen, P. C., Oldfield, E., Olson, D., Orenstein, R., Ortiz, R., Parpart, F., Pastore-Lange, V., Paul, S., Pavlatos, A., Pearce, D. D., Pelz, R., Peterson, S., Pitrak, D., Powers, S. L., Pujet, H. C., Raaum, J. W., Ravishankar, J., Reeder, J., Reilly, N. A., Reyelt, C., Riddell, J., Rimland, D., Robinson, M. L., Rodriguez, A. E., Rodriguez-Barradas, M. C., Rodriguez Derouen, V., Rosmarin, C., Rossen, W. L., Rouff, J. R., Sampson, J. H., Sands, M., Savini, C., Schrader, S., Schulte, M. M., Scott, R., Seedhom, H., Sension, M., Sheble-Hall, A., Shuter, J., Slater, L. N., Slotten, R., Smith, M., Snap, S., States, D. M., Stringer, G., Summers, K. K., Swanson, K., Sweeton, I. B., Szabo, S., Tedaldi, E. M., Telzak, E. E., Thompson, M. A., Thompson, S., Ting Hong Bong, C., Vaccaro, A., Vasco, L. M., Vecino, I., Verlinghieri, G. K., Visnegarwala, F., Wade, B. H., Weis, S. E., Weise, J. A., Weissman, S., Wilkin, A. M., Witter, J. H., Wojtusic, L., Wright, T. J., Yeh, V., Young, B., Zeana, C., Zeh, J., Savio, E., Vacarezza, M., University College of London [London] (UCL), University of Copenhagen = Københavns Universitet (KU), University of New South Wales [Sydney] (UNSW), University of Amsterdam [Amsterdam] (UvA), University of Minnesota [Twin Cities] (UMN), University of Minnesota System, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nice (CHU Nice), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Med Microbiol, Infect Dis & Infect Prev, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R4 - Health Inequities and Societal Participation, Interne Geneeskunde, Chemical Biology, Mocroft, A, Lundgren, J, Ross, M, Law, M, Reiss, P, Kirk, O, Smith, C, Wentworth, D, Neuhaus, J, Fux, C, Moranne, O, Morlat, P, Johnson, M, Ryom, L, Gori, A, Internal medicine, CCA - Innovative therapy, ICaR - Circulation and metabolism, Medical Microbiology and Infection Prevention, CCA - Disease profiling, CCA - Immuno-pathogenesis, Plastic, Reconstructive and Hand Surgery, Mocroft, Amanda, Lundgren, Jens D., Ross, Michael, Law, Matthew, Reiss, Peter, Kirk, Ole, Smith, Colette, Wentworth, Deborah, Neuhaus, Jacqueline, Fux, Christoph A., Moranne, Olivier, Morlat, Phillipe, Johnson, Margaret A., Ryom, Lene, D:a:d Study, Group, Castagna, Antonella, the Royal Free Hospital Clinic, Cohort, and the, Insight, Smart, and ESPRIT, Study, Clinicum, Department of Medicine, Herrada, Anthony, University of Copenhagen = Københavns Universitet (UCPH), AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Global Health, Other departments, Infectious diseases, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Center of Experimental and Molecular Medicine, Graduate School, Gastroenterology and Hepatology, Dermatology, ACS - Amsterdam Cardiovascular Sciences, Other Research, Anesthesiology, and Bartlett, John
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Male ,Adult ,Age Factors ,Anti-HIV Agents ,CD4 Lymphocyte Count ,Clinical Decision-Making ,Comorbidity ,Female ,HIV ,HIV Infections ,HIV Seropositivity ,Humans ,Incidence ,Kidney ,Middle Aged ,Prospective Studies ,Renal Insufficiency, Chronic ,Risk ,Risk Assessment ,Sex Factors ,urologic and male genital diseases ,Biochemistry ,0302 clinical medicine ,ANTIRETROVIRAL THERAPY ,Adult, Age Factors, Anti-HIV Agents, CD4 Lymphocyte Count, Clinical Decision-Making, Comorbidity, Female, HIV, HIV Infections, HIV Seropositivity, Humans, Incidence, Kidney, Male, Middle Aged, Prospective Studies, Renal Insufficiency, Chronic, Risk, Risk Assessment, Sex Factors ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Age Factor ,Chronic ,STAGE RENAL-DISEASE ,PROTEINURIA ,virus diseases ,11 Medical And Health Sciences ,General Medicine ,ASSOCIATION ,6. Clean water ,female genital diseases and pregnancy complications ,3. Good health ,HIV/AIDS ,Medicine ,Infection ,psychological phenomena and processes ,Human ,medicine.medical_specialty ,Renal function ,NEFROPATIAS ,chronic kidney disease ,risk score model ,12. Responsible consumption ,ESPRIT study group ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Clinical Research ,D:A:D study group ,Intensive care medicine ,medicine (all) ,Molecular Biology ,Royal Free Hospital Clinic Cohort ,Prevention ,Anti-HIV Agent ,medicine.disease ,Prospective Studie ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Immunology ,Kidney Disease ,PREDICTION ,POSITIVE PERSONS ,030232 urology & nephrology ,Sex Factor ,SDG 3 – Goede gezondheid en welzijn ,Medical and Health Sciences ,GLOMERULAR-FILTRATION-RATE ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,INSIGHT study group ,HIV Infection ,LIFE EXPECTANCY ,030212 general & internal medicine ,Renal Insufficiency ,Prospective cohort study ,Framingham Risk Score ,Incidence (epidemiology) ,adult ,age factors ,anti-hiv agents ,CD4 lymphocyte count ,clinical decision-making ,comorbidity ,female ,hiv ,hiv infections ,hiv seropositivity ,humans ,incidence ,kidney ,male ,middle aged ,prospective studies ,renal insufficiency, chronic ,risk ,risk assessment ,sex factors ,SMART study group ,6.1 Pharmaceuticals ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Patient Safety ,Risk assessment ,Biotechnology ,Research Article ,Settore MED/17 - MALATTIE INFETTIVE ,NO ,A:D study group [D] ,General & Internal Medicine ,Diabetes mellitus ,mental disorders ,medicine ,EXPOSURE ,business.industry ,Evaluation of treatments and therapeutic interventions ,Cell Biology ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,INDIVIDUALS ,Good Health and Well Being ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,3121 General medicine, internal medicine and other clinical medicine ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Kidney disease - Abstract
Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with ≥3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR ≤ 60 ml/min/1.73 m2. Poisson regression was used to develop a risk score, externally validated on two independent cohorts. In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7–6.7; median follow-up 6.1 y, range 0.3–9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was −2 (interquartile range –4 to 2). There was a 1:393 chance of developing CKD in the next 5 y in the low risk group (risk score < 0, 33 events), rising to 1:47 and 1:6 in the medium (risk score 0–4, 103 events) and high risk groups (risk score ≥ 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166–3,367); NNTH was 202 (95% CI 159–278) and 21 (95% CI 19–23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506–1462), 88 (95% CI 69–121), and 9 (95% CI 8–10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3–12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6–8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD., Editors’ Summary Background About 35 million people are currently infected with HIV, the virus that causes AIDS. HIV destroys CD4 lymphocytes and other immune system cells, leaving infected individuals susceptible to other infections. HIV infection can be controlled, but not cured, using combination antiretroviral therapy (cART), and, nowadays, the life expectancy of many HIV-positive individuals is similar to that of HIV-negative people. HIV-positive individuals nevertheless experience some illnesses more frequently than HIV-negative people do. For example, up to a third of HIV-positive individuals develop chronic kidney disease (CKD), which is associated with an increased risk of cardiovascular disease and death. Persons with CKD may have an impaired effect of the filtration units in the kidneys that remove waste products and excess water from the blood to make urine, thereby leading to a reduced blood filtration rate (the estimated glomerular filtration rate [eGFR]) and waste product accumulation in the blood. Symptoms of CKD, which rarely occur until the disease is advanced, include tiredness, swollen feet, and frequent urination. Advanced stages of CKD cannot be cured, but its progression can be slowed by, for example, controlling hypertension (high blood pressure) and diabetes (two CDK risk factors) and by adopting a healthy lifestyle. Why Was This Study Done? The burden of CKD may increase among HIV-positive individuals as they age, and clinicians need to know which individuals are at high risk of developing CKD when choosing cART regimens for their patients. In addition, clinicians need to be able to identify those HIV-positive individuals at greatest risk of CKD so that they can monitor them for early signs of kidney disease. Some antiretroviral drugs—for example, tenofovir and atazanavir/ritonavir (a boosted protease inhibitor)—are associated with kidney damage. Clinicians may need to weigh the benefits and risks of giving such potentially nephrotoxic drugs to individuals who already have a high CKD risk. Here, the researchers develop and validate a simple, widely applicable risk score (a risk prediction model) for CKD among HIV-positive individuals and investigate the relationship between CKD and potentially nephrotoxic antiretroviral drugs among individuals with different CKD risk score profiles. What Did the Researchers Do and Find? To develop their CKD risk score, the researchers used clinical and demographic data collected from 17,954 HIV-positive individuals enrolled in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study who had an eGFR > 60 ml/min/1.73 m2 and were not taking a potentially nephrotoxic antiretroviral at baseline. During 103,185 person-years of follow-up, 641 individuals developed CKD. Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease predicted CKD. The researchers included these nine factors in their risk score model (which is available online) and defined three risk groups: low (risk score < 0), medium (risk score 0–4), and high (risk score ≥ 5) risk of CKD development in the next five years. Specifically, there was a 1 in 393, 1 in 47, and 1 in 6 chance of developing CKD in the next five years in the low, medium, and high risk groups, respectively. Because some patients started to use potentially nephrotoxic antiretroviral drugs during follow-up, the researchers were able to use their risk score model to calculate how many patients would have to be treated with one of these drugs for an additional patient to develop CKD over five years in each risk group. This “number needed to harm” (NNTH) for patients starting treatment with tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor was 739, 88, and 9 in the low, medium, and high risk groups, respectively. Finally, the researchers validated the accuracy of their risk score in two independent HIV study groups. What Do These Findings Mean? These findings provide a simple, validated risk score for CKD and indicate that the NNTH when starting potentially nephrotoxic antiretrovirals was low among HIV-positive individuals at the highest risk of CKD (i.e., treating just nine individuals with nephrotoxic antiretroviral drugs will likely lead to an additional case of CKD in five years). Although various aspects of the study, including the lack of data on race, limit the accuracy of these findings, these findings highlight the need for monitoring, screening, and chronic disease prevention to minimize the risk of HIV-positive individuals developing diabetes, hypertension, or cardiovascular disease, or becoming coinfected with hepatitis C, all of which contribute to the CKD risk score. Moreover, the development of a tool for estimating an individual’s five-year risk of developing CKD with or without the addition of potentially nephrotoxic antiretroviral drugs will enable clinicians and patients to weigh the benefits of certain antiretroviral drugs against the risk of CKD and make informed decisions about treatment options. Additional Information Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001809. Information is available from the US National Institute of Allergy and Infectious Diseases on HIV infection and AIDS NAM/aidsmap provides basic information about HIV/AIDS, summaries of recent research findings on HIV care and treatment, and personal stories about living with AIDS/HIV Information is available from Avert, an international AIDS charity, on many aspects of HIV/AIDS, including personal stories about living with HIV/AIDS The World Health Organization provides information on all aspects of HIV/AIDS (in several languages), including its guidelines on the use of ART for treating and preventing HIV infection The UNAIDS World AIDS Day Report 2014 provides up-to-date information about the AIDS epidemic and efforts to halt it The UK National Health Service Choices website provides information for patients on chronic kidney disease, including some personal stories The US National Kidney Foundation, a not-for-profit organization, provides information about chronic kidney disease (in English and Spanish) A tool for calculating the CDK risk score developed in this study is available Additional information about the D:A:D study is available, Amanda Mocroft and colleagues develop and validate a model for determining risk of developing chronic kidney disease for individuals with HIV if treated with different antiretroviral therapies.
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- 2015
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18. Evaluation of factors damaging the bronchial wall in lung transplantation
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Christian Geltner, Martina Marchese, Karin M. Dunst, Hanno Ulmer, Raimund Margreiter, Ludwig C. Mueller, Guenther Laufer, and Elfriede Ruttmann
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Adult ,Graft Rejection ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Bronchi ,Anastomosis ,Bronchoscopy ,Risk Factors ,medicine ,Edema ,Humans ,Lung transplantation ,Wound Healing ,Transplantation ,Bronchus ,Lung ,medicine.diagnostic_test ,business.industry ,Anastomosis, Surgical ,Immunosuppression ,Middle Aged ,respiratory system ,respiratory tract diseases ,Surgery ,Logistic Models ,medicine.anatomical_structure ,Multivariate Analysis ,Female ,Cardiology and Cardiovascular Medicine ,Airway ,business ,Lung Transplantation - Abstract
Background Lung transplantation has become important in treating end-stage lung disease; however, bronchial complications are common. Lack of bronchial arterial circulation, ischemic time, and acute rejection episodes may damage the bronchial wall. In this study, we analyzed factors that may hamper bronchial airway healing, requiring intervention after lung transplantation. Methods We collected data from a consecutive series of 81 transplantations performed between 1993 and 2002 and evaluated recipients for bronchial complications. In 30 single and 51 sequential bilateral lung transplantations, a total of 132 anastomoses were performed. Four patients (3 bilateral and 1 single lung transplant recipients who died within the first 14 post-operative days were excluded from the analysis. Finally, 125 lung grafts remained for statistical analysis of factors influencing bronchial complications. Results Peri-operative mortality was 8.9%. Eleven patients (14.7%) experienced severe bronchial complications in 16 of 125 evaluated bronchial anastomoses (12.8%) and required surgical treatment or bronchoscopic interventional therapy. In a multivariate logistic regression model, severe reperfusion edema (adjusted odds ratio, 8.3; p = 0.002) and rejection episode within the 1st post-operative month (adjusted odds ratio, 4.1; p = 0.036) were associated with bronchial complications. Using the univariate model, we found that factors such as interleukin-2-antibody induction therapy, immunosuppression, or bronchial anastomotic technique had significant influence on bronchial healing, whereas we could not confirm this when using multivariate anasysis. Conclusions Preventing reperfusion edema with optimized lung preservation and with early and aggressive medical treatment or mechanical hemodynamical support (e.g., veno-arterial extra corporal membrane oxygenation are necessary to avoid prolonged ventilation dependence, which may result in bronchial complications. Furthermore, avoiding early rejection episodes promotes uncomplicated bronchial healing.
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- 2005
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19. Selbsteinschätzung zu Methodenkenntnissen für kommunikative Kompetenzen
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Ludwig, C, Hempel, L, Wienke, A, and Stoevesandt, D
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Fragestellung/Einleitung: Für ein gelungenes Arzt-Patienten-Gespräch braucht es neben fachlichem Wissen verschiedene kommunikative Kompetenzen. Bisher ist die theoretische Lehre zu kommunikativen Kompetenzen an der MLU Halle nach dem zweiten Semester abgeschlossen. Praktische Übungen[for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)
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- 2014
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20. Das präoperative C-reaktive Protein als unabhängiger Prädiktor postoperativer Komplikationen in der Lungenkrebschirurgie
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Ludwig, C, Riedel, R, Beckers, F, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Die chirurgische Therapie stellt immer noch die einzige kurative Option in der Behandlung des Lungenkarzinoms dar. Einige Patienten können aufgrund ihres individuellen Risikoprofils einer Operation nicht zugänglich gemacht werden. Diese Patienten zuverlässig zu detektieren[for full text, please go to the a.m. URL], 131. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2014
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21. Das interventionelle mediastinale Staging präoperativ bei nicht kleinzelligem Lungenkarzinom in Abhängigkeit von der Lokalisation des Primärtumors
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Koryllos, A., Ludwig, C., Schnell, J., and Stoelben, E.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Zielsetzung: Das konventionelle invasive mediastinale Staging (EBUS/Mediastinoskopie) bei NSCLC nimmt in der Regel keine Rücksicht auf die Lymphknotenstationen Nr. 5/6. Die im linken Oberlappen lokalisierten Tumore metastasieren lymphatisch mediastinal am häufigsten in die Stationen[for full text, please go to the a.m. URL], Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie
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- 2013
22. Das präoperative C-reaktive Protein als unabhängiger Prädiktor postoperativer Komplikationen in der Thoraxchirurgie
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Riedel, R., Ludwig, C., Beckers, F., and Stoelben, E.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Zielsetzung: Die chirurgische Therapie stellt immer noch die einzige kurative Option in der Behandlung des Lungenkarzinoms dar. Einige Patienten können aufgrund ihres individuellen Risikoprofils einer Operation nicht zugänglich gemacht werden. Diese Patienten zuverlässig zu detektieren[for full text, please go to the a.m. URL], Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie
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- 2013
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23. Simple adaptations of surgical technique to critically reduce the risk of postoperative sternal complications in patients receiving bilateral internal thoracic arteries
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Michael Grimm, Hanno Ulmer, Juliane Kilo, Elfriede Ruttmann, Ludwig C. Mueller, Roland Schistek, Adel Sakic, and Orest Chevtchik
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Sternum ,Comorbidity ,Fibrin Tissue Adhesive ,Internal thoracic artery ,Surgical Wound Dehiscence ,Postoperative Complications ,Risk Factors ,medicine.artery ,E-Comment ,Diabetes Mellitus ,Odds Ratio ,medicine ,Surgical Wound Infection ,Humans ,Risk factor ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,Chi-Square Distribution ,business.industry ,Odds ratio ,Original Articles ,Middle Aged ,medicine.disease ,Sternotomy ,Surgery ,Transplantation ,Logistic Models ,Treatment Outcome ,surgical procedures, operative ,Anesthesia ,Multivariate Analysis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Chi-squared distribution ,Bone Wires - Abstract
OBJECTIVES: Limited blood supply to the thoracic chest wall is a known risk factor for sternal wound complications after CABG. Therefore, bilateral internal thoracic arteries are still rarely utilized despite their proven superior graft patency. The aim of our study was to analyse whether modification of the surgical technique is able to limit the risk of sternal wound complications in patients receiving bilateral internal thoracic artery grafting. METHODS: All 418 non-emergent CABG patients receiving bilateral internal thoracic artery CABG procedures (BITA) from January 2001 to January 2012 were analysed for sternal wound complications. Surgical technique together with known risk factors and relevant comorbidity were analysed for their effect on the occurrence of sternal wound complications by means of multivariate logistic regression analysis. RESULTS: Sternal wound complications occurred in 25 patients (5.9%), with a sternal dehiscence rate of 2.4% (10 patients). In multivariate analysis, diabetes (odds ratio [OR]: 4.8, 95% CI: 1.9–11.7, P= 0.001), but not obesity (OR: 1.6, 95% CI: 0.7–4.2, P= 0.28) or chronic obstructive pulmonary disease (OR: 2.2, 95% CI: 0.87–5.6, P= 0.1) was a relevant comorbid condition for sternal complications. Skeletonization of ITA grafts (OR: 0.17, 95% CI: 0.06–0.5, P= 0.001) and the augmented use of sternal wires (OR: 0.24, 95% CI: 0.06–0.95, P= 0.04) were highly effective in preventing sternal complications. The use of platelet-enriched-fibrin glue (PRF) sealant, however, was associated with more superficial sternal infections (OR: 3.7, 95% CI: 1.3–10.5, P= 0.02). CONCLUSIONS: Adjusted for common risk factors, skeletonization of BITA grafts together with augmented sternal wires is effective in preventing sternal complications. The use of PRF sealant, however, increased the risk for superficial wound complications.
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- 2013
24. Relative amplitude index: a new tool for hemodynamic evaluation of periprosthetic regurgitation after transcatheter valve implantation
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Gudrun Feuchtner, Anneliese Heinz, Michael Grimm, Nikolaos Bonaros, Guy Friedrich, Silvana Mueller, Thomas Bartel, Michael DeCillia, and Ludwig C. Mueller
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Cardiac Catheterization ,Time Factors ,Systole ,medicine.medical_treatment ,Aortic Valve Insufficiency ,Hemodynamics ,Blood Pressure ,Kaplan-Meier Estimate ,Severity of Illness Index ,Aortic valve replacement ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Odds Ratio ,Humans ,Renal replacement therapy ,Dialysis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Ejection fraction ,Chi-Square Distribution ,business.industry ,Incidence ,Perioperative ,Aortic Valve Stenosis ,Middle Aged ,medicine.disease ,Blood pressure ,Treatment Outcome ,Austria ,Cardiology ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective The impact of paravalvular aortic regurgitation (PAR) on hemodynamic performance after transcatheter aortic valve implantation (TAVI) remains disputable. Common parameters such as the diastolic blood pressure or the blood pressure amplitude do not provide reproducible results. The aim of our study was to evaluate the impact of PAR on hemodynamics and outcome using the relative amplitude index (RAI). Methods PAR was prospectively evaluated by echocardiography before discharge in 110 patients. The RAI was calculated according to the formula: RAI = [(Post-TAVI BP amplitude)/(Post-TAVI SBP) − (Pre-TAVI BP amplitude)/(Pre-TAVI SBP)] × 100%, where BP is blood pressure and SBP is systolic blood pressure. Correlations of increased RAI with perioperative outcome were investigated and factors influencing mortality were isolated. Results The incidence of moderate and severe PAR after TAVI was 9% and 1%, respectively. Diastolic pressure or post-TAVI amplitude did not correlate to perioperative outcome. RAI increased from 2 when PAR was P = .006). A cut-off value of RAI ≥14 was associated with increased perioperative mortality (29 vs 5%; P = .013) and acute renal injury requiring dialysis (71 vs 18%; P = .001). RAI ≥14 was also associated with higher follow-up mortality at 1 year (57 vs 16%; P = .007). RAI ≥14 (odds ratio [OR], 3.390; 95% confidence interval [CI], 1.6-7.194; P = .00146), PAR ≥2+ (OR, 4.717; 95% CI, 1.828-12.195; P = .00135), and perioperative renal replacement therapy (OR, 12.820; 95% CI, 5.181-31.250; P = .00031) were found to be independent predictors of mortality at 1 year. Conclusions The RAI is a useful tool to predict perioperative and 1-year outcome in patients with PAR after TAVI.
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- 2013
25. Effective aortic annulus sizing by 3 d-ct is superior to 2 d-ct for reduction of paravalvular leaks after transcatheter aortic valve implantation
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Nikos Bonaros, Michael Grimm, Gudrun Feuchtner, S Mueller, Thomas Bartel, Thomas Schachner, Guy Friedrich, A Heinz, F Plank, and Ludwig C. Mueller
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Transcatheter aortic ,business.industry ,medicine.medical_treatment ,medicine ,Surgery ,Cardiac skeleton ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Reduction (orthopedic surgery) - Published
- 2013
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26. Relative amplitude index: A new tool for prediction of the impact of periprosthetic regurgitation on outcome after transcatheter aortic valve implantation
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Nikos Bonaros, Thomas Bartel, Michael Grimm, Guy Friedrich, A Heinz, Ludwig C. Mueller, S Mueller, F Plank, Thomas Schachner, and Gudrun Feuchtner
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung ,business.industry ,Incidence (epidemiology) ,Periprosthetic ,Hemodynamics ,Regurgitation (circulation) ,Perioperative ,Blood pressure ,medicine.anatomical_structure ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Relative amplitude - Abstract
Objective: The impact of paravalvular leaks (PL) on hemodynamic performance after transcatheter valve implantation (TAVI) remains disputable. Using common hemodynamic parameters such as the diastolic blood pressure or the blood pressure amplitude after the procedure has not provided reproducible results. The aim of our study was to systematically evaluate changes of hemodynamic parameters by using the relative amplitude index (RAI) and to assess its impact on outcome. Methods: PL were prospectively evaluated by echocardiography during TAVI and before discharge in 77 patients after TAVI. The RAI was retrospectively calculated according to the formula: RAI =((Post TAVI blood pressure amplitude)/(Post TAVI systolic blood pressure)- (Pre TAVI blood pressure amplitude)/(Pre TAVI systolic blood pressure)) x 100%. Univariate and multivariate analysis for risk factors for perioperative mortality was performed and an ROC analysis for RAI cut-off value was calculated. Results: The incidence of no PL mild, moderate and severe PL after TAVI was 20%, 62%, 15% and 3%, respectively. Evaluation by diastolic pressure or post TAVI amplitude did not correlate to perioperative outcome. RAI increased from 0.7 ± 7% in the abscence of PL to 5.1 ± 8% in moderate to severe regurgitation (p = 0.027). A cutoff value of RAI = 13% was associated with increased perioperative mortality. Patients with a RAI> 13 had increased perioperative mortality (27 vs. 4%, p = 0.005), cardiac (9 vs. 0%, p < 0.001), and lung complications (27 vs. 4%, p < 0.001) and acute renal injury (20 vs. 8%, p = 0.002). Increased periprocedural RAI was associated with higher cardiac (33 vs. 15%, p = 0.011), renal (50 vs. 8%, p = 0.024) and lung comlications (7 vs. 0%, p = 0.005) at 1 year. RAI< 13 was an independent predictor of perioperative mortality (RR = 3.4, (CI = 1.8 – 5.0), p = 0.017). Conclusion: The RAI is useful non-invasive, easy-to-measure tool to predict the effect of paravalvular regurgitation on perioperative and 1-year outcome in patients with PL after TAVI.
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- 2013
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27. Überprüfung einer patientenzentrierten Intervention zur Prävention chronischer post-operativer Schmerzen bei onkologischen Patienten
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Adam, E, Ludwig, C, Neugebauer, E, and Althaus, A
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chronische Schmerzen ,ddc: 610 ,Patienten-Empowerment ,610 Medical sciences ,Medicine ,postoperativer Schmerzverlauf ,Akutschmerzmanagement - Abstract
Hintergrund: Trotz beachtlicher Fortschritte in der Schmerzforschung in den letzten Jahrzehnten ist die Therapie akuter Schmerzen nach Operationen in vielen westeuropäischen Krankenhäusern suboptimal [ref:1]. Ein hoher postoperativer Akutschmerz verursacht nicht nur unnötiges[for full text, please go to the a.m. URL], 12. Deutscher Kongress für Versorgungsforschung
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- 2013
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28. TCT-314 A Bridging Solution For Hybrid Operating Suites: Periprocedural New Generation C-arm Imaging During Cardiac Interventional Procedures
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Nikos Bonaros, Guy Friedrich, Gudrun Feuchtner, Thomas Bartel, Michael Grimm, Ludwig C. Mueller, Otmar Pachinger, Thomas Schachner, and Silvana Mueller
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medicine.medical_specialty ,Bridging (networking) ,business.industry ,Heart team ,medicine ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,Aortic disease ,Intraoperative imaging ,Surgery - Abstract
Transcatheter valve interventions, hybrid coronary and aortic disease procedures require angiographic intraoperative imaging supporting a heart team approach. Facing limited financial and logistic possibilities of many medical centers, alternative periprocedural imaging strategies should be
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- 2012
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29. Atrioesophageal fistula after percutaneous transcatheter ablation of atrial fibrillation
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Florian Hintringer, Ivan Tancevski, M Stuehlinger, Ludwig C. Mueller, Eva-Maria Gassner, Johannes Mair, and Nikolaos Bonaros
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Male ,medicine.medical_specialty ,Weakness ,Percutaneous ,Fistula ,Heart Diseases ,Chest pain ,Esophageal Fistula ,Physiology (medical) ,Atrial Fibrillation ,medicine ,Humans ,Heart Atria ,business.industry ,Atrial fibrillation ,Sensory loss ,Emergency department ,Middle Aged ,medicine.disease ,Surgery ,Transcatheter ablation ,Catheter Ablation ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed - Abstract
A 45-year-old white man presented to the emergency department because of fever and fluctuating neurological symptoms including weakness and sensory loss of the right limbs. Six weeks before admittance, the patient had undergone percutaneous transcatheter ablation of drug-refractory atrial fibrillation. Laboratory examination showed markedly elevated white cell count and inflammatory markers, as well as moderately increased cardiac troponin T; however, no chest pain or gastrointestinal symptoms were reported, and the ECG was normal. Computed tomography (CT) scan of the chest revealed a fistula between the …
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- 2012
30. Ist eine neo-adjuvante Radiochemotherapie beim Lungenkarzinom eine Kontraindikation für die Manschettenresektion?
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Ludwig, C and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Fragestellung: Die Manschettenresektion ist ein Standardverfahren geworden, zur Erhaltung von Lungenparenchym, auch bei Patienten mit einer normalen Lungenfunktion. Ungefähr 25% der Patienten mit einem Lungenkarzinom benötigen eine neo-adjuvante Behandlung im Rahmen einer kurativen Therapie.[for full text, please go to the a.m. URL], 21. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie
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- 2012
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31. Pneumonektomiehöhle/Thorakostoma: Behandlung der Spätkomplikationen
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Koryllos, A, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Die Spätkomplikationen der Pneumonektomiehöhle/Thorakostomas stellen eine besondere Herausforderung für den erfahrenen Thorachirurgen dar. In der Regel bezieht sich die Problematik auf das Spätempyem/Infektionen des Hohlraums und deren operativen Sanierung. Nicht selten[for full text, please go to the a.m. URL], 21. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie
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- 2012
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32. Case-Based Reasoning: Integration dezentraler Case Bases nach dem Vorbild von IHE
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Bleuer, J.P., Fierz, W., Pharow, P., and Ludwig, C.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung/Hintergrund: In den letzten 20 Jahren haben Evidence-Based Medicine (EBM) und insbesondere Systematic Reviews einen wesentlichen Beitrag zu medizinischen Praxis und Lehre beigetragen. Wenig hilfreich ist EBM allerdings bei seltenen Fragestellungen, da hier die genügend grosse statistische[for full text, please go to the a.m. URL], Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi)
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- 2011
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33. Analyse der Morbidität und Mortalität nach anatomischer Lungenresektion stratifiziert nach der Lungenfunktion
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Beckers, F, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Zielsetzung: Die Kombination von resektablen Bronchialkarzinom (BC) und eingeschränkter Lungenfunktion ist ein häufiges klinisches Problem. Unter Berücksichtigung verschiedener klinischer Parameter (Diffusion, FEV1, VO2max) werden auch Patienten reseziert, die nach klassischen Paramet[for full text, please go to the a.m. URL], 20. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie
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- 2011
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34. Thorakoskopische Resektion des Bronchialkarzinoms im Stadium I – wann als Lobektomie und wann als Segmentresektion?
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Beckers, F, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Zielsetzung: Die thorakoskopische Resektion des Bronchialkarzinoms im Stadium I ist mittlerweile eine etablierte und akzeptierte Behandlungsmethode. Als Standardverfahren diente hier bislang die thorakoskopische Lobektomie. Im Rahmen der offenen Operationstechnik wird im Frühstadium des Bronchi[for full text, please go to the a.m. URL], 20. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie
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- 2011
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35. Bifurkationsresektion: Indikationen und Technik
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Ludwig, C, Schnell, J, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: In besonderen Fällen bei zentral lokalisierten Tumoren ist die Resektion der Bifurkation der Luftröhre notwendig. Auch hier verfolgen wir das Ziel, möglichst parenchymsparend zu operieren. Diese zentralen Tumoren erfordern eine enge Zusammenarbeit zwischen dem Anästhesisten[for full text, please go to the a.m. URL], 128. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2011
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36. Results of the SVASONA study in idiopathic normal pressure hydrocephalus
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Meier, U, Lemcke, J, Müller, C, Fritsch, MJ, Kiefer, M, Eymann, R, Kehler, U, Langer, N, Schuhmann, M, Speil, A, Weber, F, Remenez, V, Rohde, V, Ludwig, C, and Stengel, D
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Objective: The supremacy of low-pressure valves (LPV) in the therapy of patients with idiopathic normal pressure hydrocephalus (iNPH) has been proven by Dutch NPH study. The downside of LPV is the high rate of over drainage complications. The goal of this prospective randomized controlled multicenter[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)
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- 2011
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37. Prä-operatives CRP als prädiktiver Marker für die Morbidität und Mortaltität nach anatomischer Lungenresektion bei Bronchialkarzinom
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Beckers, F., Ludwig, C., and Stoelben, E.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Hintergrund: Das CRP gehört zu den Akut-Phase Proteinen. Der Zusammenhang zwischen prä-operativem CRP-Wert und peri- und postoperativer Morbidität und Mortalität ist nur in wenigen, v.a. kardiochirurgischen Arbeiten untersucht worden. Wir untersuchen diesen Zusammenhang an einem [for full text, please go to the a.m. URL], Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizer Gesellschaft für Thoraxchirurgie
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- 2010
38. Seltener Fall eines Thymoms in Kombination mit einer einseitigen Pulmonalarterienagenesie und Lungenhypoplasie
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Beckers, F, Hohls, M, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Die Kombination eines infiltrativ wachsenden Thymoms mit gleichzeitig vorliegender Agenesie der rechten Pulmonalarterie und einer Lungenhypoplasie stellt eine Rarität dar und hat Einfluss auf die Operationstaktik. Fallbeschreibung: Wir berichten über eine 45-jährige adipöse[for full text, please go to the a.m. URL], 16. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie
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- 2010
- Full Text
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39. Analyse der Morbidität und Mortalität nach Brustwandresektion
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Beckers, F, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Die Infiltration der Brustwand beim Bronchialkarzinom (BC) ist insgesamt selten (5% aller Resektionen bei BC). Über die Komplikationsraten existieren nur wenige Daten. Im Vergleich zur einfachen Lobektomie ist die Mortalität nach diesen kombinierten Eingriffen mit ca. 6%[for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2010
- Full Text
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40. Postoperativer Chylothorax: Merheimer Konzept
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Ludwig, C and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Der postoperative Chylothorax ist eine seltene Komplikation. Persistierende große Sekretmengen beeinträchtigen den Allgemeinzustande des Patientens. Aus diesem Grund ist eine wenig eingreifende und definitive Behandlung notwendig. Material und Methoden: Retrospektive Analyse[for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2010
- Full Text
- View/download PDF
41. Immunohistochemical demonstration of chromogranins A and B in neuroendocrine tumors of the lung
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Dietmar Öfner, Kurt Werner Schmid, Allan R. Gibbs, Martin Tötsch, Anton Hittmair, and Ludwig C. Müller
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endocrine system ,Cell type ,Pathology ,medicine.medical_specialty ,Lung Neoplasms ,endocrine system diseases ,Neoplasms, Nerve Tissue ,Carcinoid Tumor ,Neuroendocrine tumors ,Small-cell carcinoma ,Pathology and Forensic Medicine ,Immunoenzyme Techniques ,Chromogranins ,medicine ,Humans ,neoplasms ,Lung ,biology ,business.industry ,Chromogranin A ,medicine.disease ,digestive system diseases ,medicine.anatomical_structure ,biology.protein ,Immunohistochemistry ,Antibody ,business - Abstract
Fifty neuroendocrine tumors of the lung (16 carcinoids, two atypical carcinoids/well-differentiated neuroendocrine carcinomas [WDNCs], 13 neuroendocrine carcinomas of intermediate cell type [ICNCs], and 19 neuroendocrine carcinomas of small cell type [SCNs]) were immunohistochemically investigated with antibodies against chromogranins A and B. All carcinoids and WDNCs were positive for both chromogranins A and B, whereas in cases of ICNC and SCNC both markers were only expressed in six and five cases, respectively. One ICNC was only positive for chromogranin A. In cases of SCNC five tumors were exclusively positive for chromogranin A and six were positive only for chromogranin B. Chromogranins are therefore excellent markers for the immunohistochemical demonstration of carcinoids and WDNCs. It may be speculated that expression of chromogranins in cases of ICNC and SCNC represets a higher degree of differentiation in these tumors.
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- 1992
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42. Vesicle Formation and Endocytosis: Function, Machinery, Mechanisms, and Modeling
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Lewis E. Wedgewood, Oleg Chaga, Maria Sverdlov, Richard D. Minshall, Aaron T. Place, Belinda S. Akpa, Ludwig C. Nitsche, and Nihal S. Parkar
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Physiology ,Clinical Biochemistry ,Endocytic cycle ,Biology ,Endocytosis ,Caveolae ,Biochemistry ,Clathrin ,Models, Biological ,Exocytosis ,Cell membrane ,medicine ,Animals ,Humans ,Transport Vesicles ,Molecular Biology ,General Environmental Science ,Cell Membrane ,Cell Biology ,Receptor-mediated endocytosis ,Forum Review Articles ,Cell biology ,Endocytic vesicle ,medicine.anatomical_structure ,biology.protein ,General Earth and Planetary Sciences ,Signal Transduction - Abstract
Vesicle formation provides a means of cellular entry for extracellular substances and for recycling of membrane constituents. Mechanisms governing the two primary endocytic pathways (i.e., caveolae- and clathrin-mediated endocytosis, as well as newly emerging vesicular pathways) have become the focus of intense investigation to improve our understanding of nutrient, hormone, and drug delivery, as well as opportunistic invasion of pathogens. In this review of endocytosis, we broadly discuss the structural and signaling proteins that compose the molecular machinery governing endocytic vesicle formation (budding, invagination, and fission from the membrane), with some regard for the specificity observed in certain cell types and species. Important biochemical functions of endocytosis and diseases caused by their disruption also are discussed, along with the structures of key components of endocytic pathways and their known mechanistic contributions. The mechanisms by which principal components of the endocytic machinery are recruited to the plasma membrane, where they interact to induce vesicle formation, are discussed, together with computational approaches used to simulate simplified versions of endocytosis with the hope of clarifying aspects of vesicle formation that may be difficult to determine experimentally. Finally, we pose several unanswered questions intended to stimulate further research interest in the cell biology and modeling of endocytosis. Antioxid. Redox Signal. 11, 1301–1312.
- Published
- 2009
43. Selektion effizienter, nebenwirkungsarmer Medikamente für die Therapie gastrointestinaler Karzinome mit dem multizellulären Sphäroidmodell
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Ludwig, C., Paulick, S., Kloß, D., Joka, M., Singer, T., Jauch, K.W., and Mayer, B.
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Die dringende Notwendigkeit, realitätsnahe und aussagekräftige Testsysteme bereits in der frühen Phase der Wirkstofftestung einzusetzen, ist offensichtlich. Die vorliegende Studie vergleicht die traditionellen präklinischen Testsysteme (Monolayerkultur, Xenotransplantate[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2009
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44. Einfluss der prophylaktischen Gernebcin-Inhalation auf die Entstehung von pulmonalen Komplikationen nach anatomischer Lungenresektion
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Beckers, F, Lange, N, Ludwig, C, and Stoelben, E
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Aus der Lungentransplantationschirurgie ist das Prinzip der prophylaktischen post-operativen Gernebcin-Inhalation bekannt. Im eigenen Patientenkollektiv wird dieses Regime erfolgreich bei den Sleeve-Resektionen angewendet. Kann durch die prophylaktische Gernebcin-Inhalation nach anatomischer[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2009
- Full Text
- View/download PDF
45. Prolonged but successful weaning from left ventricular assist device after cardiac decompensation due to late-recognized coarctation of the aorta in a toddler
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Guenther Laufer, Jorrit Brunnemann, Christian Meierhofer, Juliane Kilo, Peter Mair, Herwig Antretter, Corinna Velik-Salchner, Ralf Geiger, Ulrich Schweigmann, Martin Fruehwirth, Elisabeth Schermer, Nikolaus Neu, Joerg-Ingolf Stein, and Ludwig C. Mueller
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hypertension, Pulmonary ,Biomedical Engineering ,Biophysics ,Coarctation of the aorta ,Carbazoles ,Bioengineering ,Aortic Coarctation ,Biomaterials ,Propanolamines ,Lisinopril ,Internal medicine ,medicine.artery ,Medicine ,Weaning ,Humans ,Antihypertensive Agents ,Aorta ,Device Removal ,Ultrasonography ,Heart transplantation ,Heart Failure ,business.industry ,General Medicine ,Length of Stay ,medicine.disease ,Pulmonary hypertension ,medicine.anatomical_structure ,Hydrochlorothiazide ,Treatment Outcome ,Ventricle ,Ventricular assist device ,Heart failure ,Child, Preschool ,Cardiology ,Carvedilol ,Heart-Assist Devices ,business - Abstract
A 2-year-old boy was presented with late-recognized coarctation of the aorta and pulmonary hypertension due to left ventricular failure. The coarctation was corrected at the day of admission with a good postoperative result. However, weaning from the respirator failed despite multiple drug support due to left ventricular failure. Consequently, a left ventricular assist device (LVAD) was implanted 22 days later. The further course was complicated by systemic hypertension and ongoing pulmonary hypertension requiring extensive antihypertensive therapy. The first attempt to wean from LVAD failed and the left ventricle was left completely unloaded for additional 4 weeks. The second weaning attempt, using a very smooth weaning protocol, led to a recovered left ventricle and facilitated the removal of the assist device after a total of 120 days. The patient was discharged with normal cardiac function, but he still requires antihypertensive therapy. We believe that the slow reduction of the LVAD support was the key measure that leads to the successful weaning of the patient, thereby avoiding heart transplantation.
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- 2008
46. Shunt or snare: coronary endothelial damage due to hemostatic devices for beating heart coronary surgery
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Ludwig C. Mueller, Herwig Antretter, Kristian Pfaller, Elfriede Ruttmann, and Herbert Hangler
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Pulmonary and Respiratory Medicine ,Adult ,Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Coronary Artery Bypass, Off-Pump ,Coronary Artery Disease ,Anastomosis ,Risk Assessment ,Sensitivity and Specificity ,Sampling Studies ,law.invention ,Specimen Handling ,Cohort Studies ,law ,Internal medicine ,Occlusion ,medicine ,Cardiopulmonary bypass ,Humans ,Aged ,Heart transplantation ,business.industry ,Hemostatic Techniques ,Anastomosis, Surgical ,Dilated cardiomyopathy ,Middle Aged ,medicine.disease ,Coronary Vessels ,Hemostasis, Surgical ,Surgery ,Coronary arteries ,Survival Rate ,medicine.anatomical_structure ,Cardiology ,Microscopy, Electron, Scanning ,Heart Transplantation ,Female ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business ,Artery ,Follow-Up Studies - Abstract
Occlusion of coronary arteries during off-pump coronary bypass operations bears the potential for endothelial injury. The aim of this study was to elucidate the effects of hemostatic devices on the beating heart in human coronaries by means of scanning electron microscopy.The coronary arteries of 9 patients with dilated cardiomyopathy and 13 with ischemic heart disease undergoing heart transplantation were handled with intracoronary shunts as well as external snaring techniques on a beating heart, after cannulation but before starting cardiopulmonary bypass. Adjacent noninstrumented coronary artery segments served as controls. Integrity of endothelial lining was observed with scanning electron microscopy.Nearly all coronary artery segments manipulated with a shunt exhibited a severe injury with extensive endothelial denudation. Endothelial injury was significantly higher after manipulation with intracoronary shunts compared with external occlusion devices (p0.001) or control specimens (p0.001). Plaque rupture was apparent in 3 samples.Manipulation of human coronary arteries during off-pump operations leads to endothelial denudation and plaque rupture. From this investigation we conclude that insertion of intracoronary shunts during beating heart operations leads to severe endothelial denudation in human coronary arteries. We therefore recommend using shunts selectively in cases where critical ischemia or technical difficulties due to anatomic conditions are expected during anastomosis. The clinical significance of these structural damages has to be further investigated with clinical trials.
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- 2008
47. Zygomycosis and other rare filamentous fungal infections in solid organ transplant recipients
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Nina Singh, Herwig Antretter, Christian Geltner, Ivo Graziadei, Timothy L. Pruett, Bettina Zelger, Ingrid Stelzmueller, Ludwig C. Mueller, Raimund Margreiter, Stefan Schneeberger, Cornelia Lass-Floerl, and Hugo Bonatti
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Adult ,Male ,medicine.medical_specialty ,Posaconazole ,medicine.medical_treatment ,Graft vs Host Disease ,Transplants ,Gastroenterology ,chemistry.chemical_compound ,Fatal Outcome ,Zygomycosis ,Risk Factors ,Internal medicine ,medicine ,Humans ,Renal Insufficiency ,Aged ,Retrospective Studies ,Voriconazole ,Transplantation ,biology ,business.industry ,Incidence (epidemiology) ,Immunosuppression ,Middle Aged ,biology.organism_classification ,medicine.disease ,Lymphoproliferative Disorders ,Surgery ,Pseudallescheria boydii ,Graft-versus-host disease ,chemistry ,Mycoses ,Female ,Caspofungin ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Summary Fungi cause severe infections in solid organ transplant (SOT) recipients. Recently, a shift towards non-Aspergillus filamentous fungal infections (nAFFI) was noticed. In a series of 2878 SOTs (kidney, pancreas, islets, liver, heart, lung, and bowel) performed between January 1995 and December 2006 at the Innsbruck medical university, eleven cases of nAFFI were diagnosed. The encountered species included Zygomyzetes (n = 8), and Alternaria alternate, Pseudallescheria boydii, Trichoderma spp. (one each); there were three liver and three heart, one intestinal, pancreas, lung, bilateral forearm and renal recipient each. Five patients died from nAFFI (zygomycosis: 4, Pseudallerichia boydii: 1); four were diagnosed postmortem. In five cases infection was surgically treated in combination with antifungals. Risk factors for nAFFI were renal failure (73%) and intensified immunosuppression (73%); two cases were associated with post-transplant lymphoproliferative disorder, one with graft versus host disease. An increase in the incidence of nAFFI was observed parallel to introduction of caspofungin and voriconazole (three cases until 12/2003, seven cases thereafter). NAFFI are increasingly found in SOT recipients. If diagnosed in time, the outcome seems acceptable. Intensified immunosuppression and exposure to antifungals not active against zygomycetes may be risk factors. Surgical therapy may play an important role in these infections.
- Published
- 2008
48. Single time point measurement by C2 or C3 is highly predictive in cyclosporine area under the curve estimation immediately after lung transplantation
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Johann Nagiller, Herbert Hangler, Guenther Laufer, Ludwig C. Mueller, Christian Geltner, Brigitte Bucher, and Elfriede Ruttmann
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Correlation coefficient ,Metabolic Clearance Rate ,medicine.medical_treatment ,Urology ,Predictive Value of Tests ,Linear regression ,medicine ,Lung transplantation ,Humans ,Postoperative Period ,Monitoring, Physiologic ,Transplantation ,medicine.diagnostic_test ,business.industry ,Area under the curve ,Immunosuppression ,Middle Aged ,Surgery ,Therapeutic drug monitoring ,Predictive value of tests ,Area Under Curve ,Cyclosporine ,Emulsions ,Female ,business ,Immunosuppressive Agents ,Lung Transplantation - Abstract
BACKGROUND: The two h post-dose cyclosporine (CsA) concentration has been advocated as the optimal time point measurement for CsA area under the curve (AUC) estimation after solid organ transplantation. The aim of the study was to investigate whether intensified CsA monitoring is necessary, or if a single time point measurement is accurate to estimate the AUC in the very early period following lung transplantation (LuTX). METHODS: Within the first two wk following transplantation, daily AUCs were calculated by serial CsA measurements at zero, one, two, three, four, and six h (C0-C6) in 12 consecutive lung transplant recipients. Correlation of single CsA measurements and AUC as well as linear regression analysis was performed to evaluate the most predictive single CsA blood level regarding the AUC. RESULTS: A total of 606 CsA concentration measurements were performed and the 101 corresponding AUCs were calculated for each patient. Mean AUC was 3443 +/- 1451 microg/L. C0: 361 +/- 118 microg/L, C1: 481 +/- 231 microg/L, C2: 682 +/- 314 microg/L, C3: 715 +/- 347 microg/L, C4: 658 +/- 271 microg/L, C6: 571 +/- 260 microg/L. The correlation of CsA serum levels with AUC was the lowest at trough levels (C0) with a correlation coefficient (r = 0.31) and highest at three h (C3: r = 0.89) and two h (C2: r = 0.88). CONCLUSIONS: Similar to a stable post-transplant period, CsA trough levels turned out to have poor correlation with the corresponding AUC early after LuTX. The highest correlation of C3 with the AUC may be explained by delayed intestinal resorption immediately post-operative, however C2 is a peer parameter. Optimum AUCs and corresponding C2 or C3 levels in the immediate post-operative phase however remain to be determined.
- Published
- 2008
49. Severe endocarditis in transplant recipients--an epidemiologic study
- Author
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Hugo Bonatti, Hanno Ulmer, Ludwig C. Mueller, Ingrid Stelzmueller, Raimund Margreiter, G Laufer, Elfriede Ruttmann, Herwig Antretter, and Christina Legit
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Risk Factors ,Internal medicine ,Epidemiology ,medicine ,Endocarditis ,Humans ,Cardiac Surgical Procedures ,education ,Aged ,Retrospective Studies ,Transplantation ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Immunosuppression ,Endocarditis, Bacterial ,Organ Transplantation ,Middle Aged ,medicine.disease ,Surgery ,Infective endocarditis ,Female ,Autopsy ,business - Abstract
Summary Infective endocarditis (IE) is reported with an incidence of 6/100 000 inhabitants in the general population. Even though immunosuppression predisposes to systemic infection, reports regarding IE after solid organ transplantation (SOT) are sparse. From 1989 to 2004, 2556 patients underwent SOT at the University Hospital Innsbruck. During this period, 27 transplant recipients were diagnosed IE. Nine patients (33.3%) were diagnosed at autopsy, eight patients (29.6%) were cured by antibiotic treatment and 10 patients (37.1%) underwent surgery. Overall mortality was 44.4% (12 patients). Staphylococcus was the predominant microorganism in 16 cases (59.3%), fungal infection was present in four patients (14.8%). Incidence of IE was 1% (95% CI: 0.67–1.49), indicating a 171-fold risk compared with the overall population. IE after SOT constitutes a significant problem and is associated with an excessive high mortality. Alertness to this condition is indicated, as we might diagnose more cases of IE in the future.
- Published
- 2005
50. Mitral valve repair provides improved outcome over replacement in active infective endocarditis
- Author
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Guenther Laufer, Orest Chevtchik, Marco Cottogni, Ludwig C. Mueller, Christina Legit, Hanno Ulmer, Silvana Mueller, Gerhard Poelzl, Elfriede Ruttmann, and Pachinger O
- Subjects
Pulmonary and Respiratory Medicine ,Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Disease-Free Survival ,Postoperative Complications ,Valve replacement ,Internal medicine ,Mitral valve ,medicine ,Endocarditis ,Humans ,Hospital Mortality ,Survival rate ,Septic embolism ,Heart Valve Prosthesis Implantation ,Mitral valve repair ,business.industry ,Hazard ratio ,Endocarditis, Bacterial ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Survival Rate ,medicine.anatomical_structure ,Infective endocarditis ,cardiovascular system ,Cardiology ,Mitral Valve ,Female ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objectives Mitral repair in active infective endocarditis still remains controversial. Several studies demonstrate the feasibility of mitral repair in infective endocarditis; however, superiority of repair has never been shown. The aim of the investigation was to compare valve repair and valve replacement in respect to the extent of destruction and to analyze survival, recurrent endocarditis, and reoperation (event-free survival). Methods Sixty-eight consecutive patients underwent surgical intervention for mitral endocarditis. Thirty-four (50%) patients had valve repair, and 34 (50%) patients had valve replacement. Leaflet destruction involving at least one mitral leaflet was present in 15 (44.1%) patients of the repair group and 11 (32.4%) patients of the replacement group. Repair of the mitral annulus with pericardium was performed in 4 (11.8%) patients in the repair group and 3 (8.8%) patients in the replacement group. Patients in both groups were similar concerning the progression of valvular destructions and comorbidities. Results Hospital mortality was 11.8% (8 patients). No significant differences were found in all baseline parameters, with the exception of a higher incidence of previous septic embolism and sepsis in the repair group. Actuarial event-free survival at 1 year was 88.2% in the repair group compared with 67.7% in the replacement group, and 5-year event-free survival was 80.4% in the repair group and 54.6% in the replacement group ( P = .015). Mitral valve repair remained the superior treatment regarding event-free survival in the multivariate analysis (hazard ratio, 0.33; 95% confidence interval, 0.12-0.93; P = .02). Conclusions Mitral valve repair offers excellent early and late results and is the preferable treatment option in the surgical therapy of native infective endocarditis.
- Published
- 2004
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