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741 results on '"Heuschmann P"'

157. Association of stroke lesion shape with newly detected atrial fibrillation – Results from the MonDAFIS study

Author

Pimentel, Bernardo Crespo, Ingwersen, Thies, Haeusler, Karl Georg, Schlemm, Eckhard, Forkert, Nils D, Rajashekar, Deepthi, Mouches, Pauline, Königsberg, Alina, Kirchhof, Paulus, Kunze, Claudia, Tütüncü, Serdar, Olma, Manuel C, Krämer, Michael, Michalski, Dominik, Kraft, Andrea, Rizos, Timolaos, Helberg, Torsten, Ehrlich, Sven, Nabavi, Darius G, Röther, Joachim, Laufs, Ulrich, Veltkamp, Roland, Heuschmann, Peter U, Cheng, Bastian, Endres, Matthias, and Thomalla, Götz

Abstract

Paroxysmal Atrial fibrillation (AF) is often clinically silent and may be missed by the usual diagnostic workup after ischemic stroke. We aimed to determine whether shape characteristics of ischemic stroke lesions can be used to predict AF in stroke patients without known AF at baseline. Lesion shape quantification on brain MRI was performed in selected patients from the intervention arm of the Impact of standardized MONitoring for Detection of Atrial Fibrillation in Ischemic Stroke(MonDAFIS) study, which included patients with ischemic stroke or TIA without prior AF. Multiple morphologic parameters were calculated based on lesion segmentation in acute brain MRI data. Multivariate logistic models were used to test the association of lesion morphology, clinical parameters, and AF. A stepwise elimination regression was conducted to identify the most important variables. A total of 755 patients were included. Patients with AF detected within 2 years after stroke (n= 86) had a larger overall oriented bounding box (OBB) volume (p= 0.003) and a higher number of brain lesion components (p= 0.008) than patients without AF. In the multivariate model, OBB volume (OR 1.72, 95%CI 1.29–2.35, p< 0.001), age (OR 2.13, 95%CI 1.52–3.06, p< 0.001), and female sex (OR 2.45, 95%CI 1.41–4.31, p= 0.002) were independently associated with detected AF. Ischemic lesions in patients with detected AF after stroke presented with a more dispersed infarct pattern and a higher number of lesion components. Together with clinical characteristics, these lesion shape characteristics may help in guiding prolonged cardiac monitoring after stroke.

Published
2022
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169. Schlaganfallnachsorge

Author

Schwarzbach, C. J., primary, Eichner, F. A., additional, Pankert, A., additional, Schutzmeier, M., additional, Heuschmann, P. U., additional, and Grau, A. J., additional

Published
2020
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175. Dynamics of Left Ventricular Myocardial Work in Patients Hospitalized for Acute Heart Failure.

Author

Sahiti, Floran, Morbach, Caroline, Henneges, Carsten, Stefenelli, Ulrich, Scholz, Nina, Cejka, Vladimir, Albert, Judith, Heuschmann, Peter U., Ertl, Georg, Frantz, Stefan, Angermann, Christiane E., STÖRK, Stefan, and Störk, Stefan

Abstract

Background: The left ventricular ejection fraction (LVEF) is the most commonly used measure describing pumping efficiency, but it is heavily dependent on loading conditions and therefore not well-suited to study pathophysiologic changes. The novel concept of echocardiography-derived myocardial work (MyW) overcomes this disadvantage as it is based on LV pressure-strain loops. We tracked the in-hospital changes of indices of MyW in patients admitted for acute heart failure (AHF) in relation to their recompensation status and explored the prognostic utility of MyW indices METHODS AND RESULTS: We studied 126 patients admitted for AHF (mean 73 ± 12 years, 37% female, 40% with a reduced LVEF [<40%]), providing pairs of echocardiograms obtained both on hospital admission and prior to discharge. The following MyW indices were derived: global constructive and wasted work (GCW, GWW), global work index (GWI), and global work efficiency. In patients with HF with reduced ejection fraction with decreasing N-terminal prohormone B-natriuretic peptide levels during hospitalization, the GCW and GWI improved significantly, whereas the GWW remained unchanged. In patients with HF with preserved ejection fraction, the GCW and GWI were unchanged; however, in patients with no decrease or eventual increase in N-terminal prohormone B-natriuretic peptide, we observed an increase in GWW. In all patients with AHF, higher values of GWW were associated with a higher risk of death or rehospitalization within 6 months after discharge (per 10-point increment hazard ratio 1.035, 95% confidence interval 1.005-1.065).Conclusions: Our results suggest differential myocardial responses to decompensation and recompensation, depending on the HF phenotype in patients presenting with AHF. The GWW predicted the 6-month prognosis in these patients, regardless of LVEF. Future studies in larger cohorts need to confirm our results and identify determinants of short-term and longer term changes in MyW. [ABSTRACT FROM AUTHOR]

Published
2021
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179. Reduktion von Antibiotikaresistenzen durch leitliniengerechte Behandlung von Patienten mit unkompliziertem Harnwegsinfekt in der ambulanten Versorgung – REDARES

Author

Jede, F, Bleidorn, J, Eckmanns, T, Heintze, C, Heuschmann, P, Klingeberg, A, Maun, A, Rücker, V, Schmiemann, G, Schuster, A, and Gágyor, I

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: In Deutschland werden ambulant zur Behandlung des unkomplizierten Harnwegsinfekts (HWI) in über 40% der Fälle Antibiotika der zweiten Wahl eingesetzt. Um eine Veränderung des Verordnungsverhaltens zu erreichen, sollen in REDARES Leitlinienempfehlungen zur Behandlung [zum vollständigen Text gelangen Sie über die oben angegebene URL], 53. Kongress für Allgemeinmedizin und Familienmedizin

Published
2019
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180. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry

Author

Kotseva, K. De Backer, G. De Bacquer, D. Rydén, L. Hoes, A. Grobbee, D. Maggioni, A. Marques-Vidal, P. Jennings, C. Abreu, A. Aguiar, C. Badariene, J. Bruthans, J. Castro Conde, A. Cifkova, R. Crowley, J. Davletov, K. Deckers, J. De Smedt, D. De Sutter, J. Dilic, M. Dolzhenko, M. Dzerve, V. Erglis, A. Fras, Z. Gaita, D. Gotcheva, N. Heuschmann, P. Hasan-Ali, H. Jankowski, P. Lalic, N. Lehto, S. Lovic, D. Mancas, S. Mellbin, L. Milicic, D. Mirrakhimov, E. Oganov, R. Pogosova, N. Reiner, Z. Stöerk, S. Tokgözoğlu, L. Tsioufis, C. Vulic, D. Wood, D. on behalf of the EUROASPIRE Investigators

Abstract

Aims: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods: Patients (

Published
2019

187. MRI-Detected Brain Lesions and Cognitive Function in Patients With Atrial Fibrillation Undergoing Left Atrial Catheter Ablation in the Randomized AXAFA-AFNET 5 Trial

Author

Haeusler, Karl Georg, Eichner, Felizitas A., Heuschmann, Peter U., Fiebach, Jochen B., Engelhorn, Tobias, Blank, Benjamin, Callans, David, Elvan, Arif, Grimaldi, Massimo, Hansen, Jim, Hindricks, Gerhard, Al-Khalidi, Hussein R., Mont, Lluis, Nielsen, Jens Cosedis, Piccini, Jonathan P., Schotten, Ulrich, Themistoclakis, Sakis, Vijgen, Johan, Di Biase, Luigi, and Kirchhof, Paulus

Published
2022
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190. Memorandum 'Weiterentwicklung der Gesundheitsversorgungsforschung in Bayern aus Sicht der Landesarbeitsgemeinschaft Gesundheitsversorgungsforschung: Status quo – Entwicklungspotenziale – Strategien' ; Memorandum ‘Development of Health Services Research in Bavaria from the Perspective of the Bavarian State Working Group ‘Health Services Research (LAGeV)’: Status quo – Potential – Strategies’

Author

Hollederer, A., Braun, G. E., Dahlhoff, G., Drexler, H., Engel, J., Gräßel, E., Häusler, E., Heide, H., Heuschmann, P. U., Hörl, G., Imhof, H., Kaplan, M., Kasperbauer, R., Klemperer, D., Peter Kolominsky-Rabas, Kuhn, J., Lang, M., Langejürgen, R., Lankes, A., Leidl, R., Liebl, B., Loss, J., Ludewig, K., Mansmann, U., Melcop, N., Nagels, K., Nowak, D., Pfundner, H., Reuschenbach, B., Schneider, A., Schneider, Werner, Schöffski, O., Schreiber, W., Voigtländer, S., Wildner, M., Zapf, A., and Zellner, A.

Subjects
ddc:610
Published
2018

194. Analyse des Weaningprozesses bei Intensivpatienten im Hinblick auf Dokumentation und Verlegung in weiterbehandelnde Einheiten

Author

Kippnich, Maximilian, Skazel, Tobias, Klingshirn, Hanna, Gerken, Laura, Heuschmann, Peter, Haas, Kirsten, Schutzmeier, Martha, Brandstetter, Lilly, Weismann, Dirk, Reuschenbach, Bernd, Meybohm, Patrick, and Wurmb, Thomas

Abstract

Hintergrund und Fragestellung: Die Entwöhnung von Beatmungsgeräten wird nicht immer auf der primär behandelnden Intensivstation abgeschlossen. Die Weiterverlegung in andere Behandlungseinrichtungen stellt einen sensiblen Abschnitt in der Behandlung und Rehabilitation des Weaningpatienten dar. Ziel der vorliegenden Studie war die Untersuchung des Überleitungsmanagements und des Interhospitaltransfers von Weaningpatienten unter besonderer Berücksichtigung der Dokumentationsqualität. Methodik: Es erfolge eine retrospektive Datenanalyse eines Jahrs (2018) auf 2 Intensivstationen eines Universitätsklinikums. Eingeschlossen wurden alle beatmeten Patienten mit folgenden Tracerdiagnosen: COPD, Asthma, Polytrauma, Pneumonie, Sepsis, ARDS und Reanimation (Beatmung > 24 h). Ergebnisse: Insgesamt konnten 750 Patienten in die Untersuchung eingeschlossen werden (Alter 64 [52, 8–76; Median, IQR]; 32 % weiblich). Davon waren 48 (6,4 %) Patienten zum Zeitpunkt der Verlegung nicht entwöhnt (v. a. Sepsis und ARDS). Die Routinedokumentation war bei den Abschnitten „Spontaneous Breathing Trial“, „Bewertung der Entwöhungsbereitschaft“ und „vermutete Entwöhnbarkeit“ ausreichend, um die Erfüllung der Parameter der S2k-Leitlinie „Prolongiertes Weaning“ adäquat zu beurteilen. Vorwiegend wurden diese Patienten mit Tracheostoma (76 %) in Rehabilitationskliniken (44 %) mittels spezialisierten Rettungsmitteln des arztbegleiteten Patiententransports verlegt (75 %). Diskussion: Die Verlegung nicht entwöhnter Patienten nach initialem Intensivaufenthalt ist ein relevantes Thema für den Interhospitaltransfer. Die Routinedokumentation eines strukturierten Weaningprozesses ist in Kernelementen ausreichend, um den Weaningprozess lückenlos zu beschreiben. Dies ist für die Kontinuität in der Weiterbehandlung dieser Patienten von großer Bedeutung.

Published
2022
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200. Giant intracranial aneurysms: natural history and 1-year case fatality after endovascular or surgical treatment.

Author

Dengler, Julius, Rüfenacht, Daniel, Meyer, Bernhard, Rohde, Veit, Endres, Matthias, Lenga, Pavlina, Uttinger, Konstantin, Rücker, Viktoria, Wostrack, Maria, Kursumovic, Adisa, Hong, Bujung, Mielke, Dorothee, Schmidt, Nils Ole, Burkhardt, Jan-Karl, Bijlenga, Philippe, Boccardi, Edoardo, Cognard, Christophe, Heuschmann, Peter U., and Vajkoczy, Peter

Published
2021
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