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2. Videolaryngoskopie

Author

Cavus, Erol, Dörges, Volker, Hossfeld, Björn, Helm, Matthias, Piepho, Tim, Köhne, Wiebke, Groeben, Harald, Dörges, Volker, editor, and Byhahn, Christian, editor

Published
2023
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5. Ventilation and outcomes following robotic-assisted abdominal surgery: an international, multicentre observational study

Author

Queiroz, Veronica N.F., da Costa, Luis Guilherme V., Takaoka, Flavio, Pelosi, Paolo, de Abreu, Marcelo Gama, Schultz, Marcus J., Serpa Neto, Ary, Barbosa, R.P., Canet, J., Cata, J.P., Cesar, D.S., Chaves, R.C.F., D’Orto, U.C., Da Costa, L.G.V., De Baerdemaeker, L., Galdi, J.R., Gama de Abreu, M., Gottumukkala, V., Hemmes, S.N.T., Hollmann, M.W., Kalmar, A.F., Mariano, R., Matot, I., Mazzinari, G., Mills, G.H., Pelosi, P., Posso, I.P., Queiroz, V.N.F., Schultz, M.J., Serpa Neto, A., Sprung, J., Takaoka, F., Teruya, A., Vidal Melo, M.F., Agarwala, Aalok V., Akeroyd, Louise, Andorlini, Francesco, Anicetti, Lisa, Antonelli, Massimo, Arantes, Bruno S., Ariño Irujo, Jose J., Artsi, Hanna, Babian, Renata, Barbosa, Rogerio P., Barker, Doug, Basagni, Diletta, Basso, Nicola, Beltran, Joan, Bocciero, Vittorio, Bonatti, Giulia, Boriati, Ernesto, Bravo, Mauro, Brazzi, Luca, Brearton, Chris, Brennan, Andrew, Bulinski, Adam M., Cafagna, Sara, Cardoni, Andrea, Castelló Mora, Paula, Cata, Juan P., Cesar, Daniel S., Chaves, Renato CF., Chen, Lee-Lynn, Chukkambotla, Srikanth, Ciccozzi, Alessandra, Cilia, Danae, Cope, Sean, D’Orto, Ulisses C., Da Costa, Luis Guilherme V., Dalton, Claire, Davi, Alessandra, De Bonis, Marina del Barrio, De Gaudio, Angelo Raffaele, De Luca, Lucilla, Delgado, Carlos C., Deljou, Atousa, Di Ruscio, Cecilia, Droger, Sijgje M., Duberley, Stephen, Eidelman, Leonid A., Evans, Alison, Fabiani, Constanza, Fasciano, Umberto, Firth-Gieben, Jennifer, Fitchett, Jillian, Fundarò, Angela, Galdi, Jose Roberto, Gallo, Verdiana, Gavagni, Mattia, Gottumukkala, Vijaya, Graham, Chris, Granell Gil, Manuel, Gratarola, Angelo, Grillandini, Chiara, Groeben, Harald-Thomas, Ismail, Nesrine, Jacob, Reni, Jones, Chris, Jones, Rebecca, Kalmar, Alain F., Kapoor, Ritoo, Kelliher, Leigh, Köhne, Wiebke, Koopman, Joseph SHA., Lanka, Prasad, Lee, Jae-Woo, Liban, Bernard, Livi, Francesca, Mariano, Renato, Martinez Plumed, Ruth, Matot, Idit, Mazzella, Marta, McClure, Stewart, McMonagle, Martina, Mills, Gary H., Mirabella, Lucia, Monsalve, Concepción, Moon, Angela, Morchio, Laura, Morris, Frances, Motroni, Lorenzo, Mura, Benedetta, Nerini, Alessandro, Noumedem Sonna, Elodia C., Oakes, Neil, Orlandi, Marina, Paladini, Antonella, Patil, Anita, Patil, Vishal, Patrone, Valentina, Pinder, Angela, Piroli, Alba, Posso, Irimar P., Queiroz, Veronica NF., Rabbu, Yosef S., Rabenalt, Robert, Romagnoli, Stefano, Ronen, Ariel, Rothman, Felipe, Rusagara, Patrick, Russo, Andrea, Sabov, Moldovan, Saitta, Thomas, Shah, Nirav, Smith, Neil, Sollazzi, Liliana, Sprung, Juraj, Stewart, Emma, Stones, Elizabeth, Storton, Kim, Tena, Beatriz, Terreni, Eleonora, Teruya, Alexandre, Travaglia, Chiara, Treschan, Tanja A., Vanoverschelde, Henk, Venkatesh, Harish, Vidal Melo, Marcos F., Villa, Gianluca, Vossen, Robbert, Webber, Stephen, Weingarten, Toby N., Willcocks, Matt, Winslow, Luke, and Woods, Lindsey

Published
2021
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6. EP225/#828 Difference in hemodynamic parameters in patients (PTS) with advanced epithelial ovarian cancer (EOC) undergoing primary (PDS) or interval debulking surgery (IDS)

Author

Bommert, Mareike, primary, Mospanov, Wlad, additional, Stiegler, Viviane, additional, Groeben, Harald, additional, Traut, Alexander, additional, Heitz, Florian, additional, Schneider, Stephanie, additional, Moubarak, Malak, additional, Welz, Julia, additional, Vrentas, Vasileios, additional, Harter, Philipp, additional, and Feldheiser, Aarne, additional

Published
2023
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8. Skeletal Muscle Attenuation (Sarcopenia) Predicts Reduced Overall Survival in Patients with Advanced Epithelial Ovarian Cancer Undergoing Primary Debulking Surgery

Author

Ataseven, Beyhan, Luengo, Teresa González, du Bois, Andreas, Waltering, Kai-Uwe, Traut, Alexander, Heitz, Florian, Alesina, Pier Francesco, Prader, Sonia, Meier, Beate, Schneider, Stephanie, Koch, Jens-Albrecht, Walz, Martin, Groeben, Harald-Thomas, Nina, Pauly, Brunkhorst, Violeta, Heikaus, Sebastian, and Harter, Philipp

Published
2018
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10. The KORE-INNOVATION trial, a prospective controlled multi-site clinical study to implement and assess the effects of an innovative peri-operative care pathway for patients with ovarian cancer: rationale, methods and trial design

Author

Inci, Melisa Guelhan, primary, Sehouli, Jalid, additional, Schnura, Eva, additional, Lee, Marlene, additional, Roll, Stephanie, additional, Reinhold, Thomas, additional, Klews, Julia, additional, Kaufner, Lutz, additional, Niggemann, Phil, additional, Groeben, Harald, additional, Toelkes, Julia, additional, Reisshauer, Anett, additional, Liebl, Max, additional, Daehnert, Enrico, additional, Zimmermann, Manuela, additional, Knappe-Drzikova, Barbora, additional, Rolker, Susanne, additional, Nunier, Björn, additional, Algharably, Engi, additional, Pirmorady Sehouli, Adak, additional, Zwantleitner, Lena, additional, Krull, Andrea, additional, Heitz, Florian, additional, Ataseven, Beyhan, additional, Chekerov, Radoslav, additional, Harter, Philipp, additional, and Schneider, Stephanie, additional

Published
2023
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13. Clinical outcome in patients with primary epithelial ovarian cancer and germline BRCA1/2-mutation – real life data

Author

Ataseven, Beyhan, primary, Tripon, Denise, additional, Schwameis, Richard, additional, Harter, Philipp, additional, Rhiem, Kerstin, additional, Schneider, Stephanie, additional, Heikaus, Sebastian, additional, Baert, Thaïs, additional, Francesco, Alesina Pier, additional, Heitz, Florian, additional, Traut, Alexander, additional, Groeben, Harald-Thomas, additional, Schmutzler, Rita, additional, and du Bois, Andreas, additional

Published
2021
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14. Age and bupivacaine plasma concentrations following radical cystectomy

Author

Gerou, Maria, Steves, Antonia, Musch, Michael, Wittstamm, Franz-Josef, Kropfl, Darko, and Groeben, Harald

Subjects
Bupivacaine -- Dosage and administration -- Complications and side effects, Anesthesia -- Analysis -- Complications and side effects -- Patient outcomes -- Research, Cystectomy -- Methods -- Patient outcomes -- Research, Health
Abstract

Purpose Continuous epidural analgesia with bupivacaine for postoperative analgesia can increase its plasma concentrations. Whether this effect can be aggravated with increasing age is unknown. Therefore, bupivacaine concentrations were prospectively monitored in patients undergoing radical cystectomies. Methods We analyzed plasma concentrations of bupivacaine in 38 consecutive patients scheduled for radical cystectomy. All patients received general and epidural anesthesia (10 ml bupivacaine 0.5% followed by bupivacaine 0.375% every 90 min) and postoperative continuous epidural analgesia (bupivacaine 0.25% with sufentanil 0.5 ig/ml). For 4 subsequent days, bupivacaine plasma concentrations were measured and the correlation of bupivacaine plasma concentrations with the patient's age were analyzed. Data (mean [+ or -] SD) were analyzed by 2-way ANOVA with post hoc analysis or regression analysis. Results The median age of the patients was 70 years (range 41-86). Postoperatively, bupivacaine plasma concentrations increased significantly. No correlation of plasma concentrations and age could be found. Maximal bupivacaine concentrations of the younger patients were not different from the older patients. No neurological or cardiovascular symptoms of bupivacaine intoxication were found. Conclusion In conclusion, continuous epidural administration of bupivacaine leads to increasing plasma concentrations. No age dependent differences in bupivacaine plasma concentrations could be found. Therefore, in our patients with intact liver function, we did not find a reason for an age-related restriction in the use of continuous epidural analgesia. Keywords Bupivacaine * Local anesthetic intoxication * Cystectomy * Age, Introduction Over the last 20 years, the mortality rate for radical cystectomies has markedly improved in particular in patients older than 65 years [1-3]. Overall, age is not a contraindication [...]

Published
2014
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15. The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer

Author

Yazdian, Mahtab, primary, Groeben, Harald, additional, Ataseven, Beyhan, additional, Schneider, Stephanie, additional, Baert, Thais, additional, Bommert, Mareike, additional, Traut, Alexander, additional, Elfers-Wassenhoven, Alexandra, additional, Brüß, Ulrich, additional, Schwameis, Richard, additional, du Bois, Andreas, additional, Wagner, Uwe, additional, and Harter, Philipp, additional

Published
2021
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17. Clinical outcome in patients with primary epithelial ovarian cancer and germline BRCA1/2-mutation-real life data

Author

Ataseven, Beyhan, Tripon, Denise, Schwameis, Richard, Harter, Philipp, Rhiem, Kerstin, Schneider, Stephanie, Heikaus, Sebastian, Baert, Thais, Francesco, Alesina Pier, Heitz, Florian, Traut, Alexander, Groeben, Harald-Thomas, Schmutzler, Rita, du Bois, Andreas, Ataseven, Beyhan, Tripon, Denise, Schwameis, Richard, Harter, Philipp, Rhiem, Kerstin, Schneider, Stephanie, Heikaus, Sebastian, Baert, Thais, Francesco, Alesina Pier, Heitz, Florian, Traut, Alexander, Groeben, Harald-Thomas, Schmutzler, Rita, and du Bois, Andreas

Abstract

Background. We evaluated the clinical impact of germline (g)BRCA1/2-mutation on initial disease presentation, surgical implications, surgical morbidity and survival in patients with advanced epithelial ovarian cancer (EOC) undergoing debulking surgery (DS). Methods. Data of all consecutive EOC patients with stage III/IV, high-grade serous disease and known gBRCA1/ 2 status (gBRCA; non-gBRCA), who underwent DS at our department between 01/2011 and 06/2019 were analyzed. Associations between gBRCA-status and severe postoperative complications and survival were analyzed. Results. gBRCA-status was determined in 50.1% (612/1221) of all patients. gBRCA was present in 21.9% (134/ 612). Significant differences were observed in terms of median age (p = 0.001) and histology (high-grade serous histology gBRCA: 98.5%, non-gBRCA 76.2%; p < 0.001). gBRCA-status had no impact on intraoperative disease presentation, surgical complexity or complete resection rate (gBRCA: 74.4%, non-gBRCA: 69.0%; p = 0.274). gBRCA-status was not predictive for severe postoperative complication (gBRCA: 12.0%, non-gBRCA: 19.1%; p = 0.082). Median PFS and OS was 31/22 and 71/53 months in patients with/without gBRCA-mutation, respectively. gBRCA was a significant prognostic factor for PFS (HR 0.57 p < 0.001) and for OS (HR 0.64, p = 0.048) after adjusting for established prognostic factors. Conclusions. gBRCA-status had no impact on initial disease presentation, surgical results or postoperative complications. gBRCA patients have a significantly longer PFS but the impact on the long term prognosis is unclear. Complete resection remains the most important prognostic factor in patients with EOC independent of gBRCA-status. (c) 2021 Elsevier Inc. All rights reserved.

Published
2021

27. Autorenverzeichnis

Author

Frietsch, Thomas, primary, Weiler-Lorentz, Arnulf, additional, Rogmans, Sven, additional, Benrath, Justus, additional, Büttner, Johannes, additional, Claus, Alexandra, additional, Dempfle, Carl-Erik, additional, Ellinger, Klaus, additional, Fickert, Stefan, additional, Frick, Christiane, additional, Groeben, Harald, additional, Hensel, Manfred, additional, Hinkelbein, Jochen, additional, Jester, Ingo, additional, Jámbor, Csilla, additional, Kalenka, Armin, additional, Kozek-Langenecker, Sybille, additional, Lang, Thomas, additional, Lehmann, Lars, additional, Neuburger, Michael, additional, Rapp, Hans-Jürgen, additional, Rump, Gerhard, additional, Scheele, Martin, additional, Schipplick, Martin, additional, Schmidt, René, additional, Schöler, Michael, additional, Schreiner, Ute, additional, Schüpfer, Guido, additional, Schwarz, Anke, additional, and Suttner, Stefan, additional

Published
2009
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28. Anästhesiologisches Management spezieller Altersgruppen

Author

Ellinger, Klaus, primary, Frick, Christiane G., additional, Frietsch, Thomas, additional, Groeben, Harald, additional, Hensel, Manfred, additional, Hinkelbein, Jochen, additional, Jester, Ingo, additional, Kozek-Langenecker, Sibylle, additional, Lang, Thomas, additional, Rapp, Hans-Jürgen, additional, Rump, Gerhard, additional, Schreiner, Ute, additional, and Suttner, Stefan, additional

Published
2009
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37. International multicenter observational study on assessment of ventilatory management during general anaesthesia for robotic surgery and its effects on postoperative pulmonary complication (AVATaR): study protocol and statistical analysis plan

Author

Queiroz, Veronica Neves Fialho, Da Costa, Luiz Guilherme Villares, Barbosa, Rogerio Póvoa, Takaoka, Flávio, De Baerdemaeker, Luc, Cesar, Daniel Souza, D'Orto, Ulisses Cardoso, Galdi, José Roberto, Gottumukkala, Vijaya, Cata, Juan P, Hemmes, Sabrine N T, Hollman, Markus W, Kalmar, Alain, De Moura, Lucas A B, Mariano, Renato M, Matot, Idit, Mazzinari, Guido, Mills, Gary H, Posso, Irimar De Paula, Teruya, Alexandre, Vidal Melo, Marcos Francisco, Sprung, Juraj, Weingarten, Toby N, Treschan, Tanja A, Koopman, Seppe, Eidelman, Leonid, Chen, Lee-Lynn, Lee, Jae-Woo, Ariño Irujo, Jose J, Tena, Beatriz, Groeben, Harald, Pelosi, Paolo, De Abreu, Marcelo Gama, Schultz, Marcus J, Neto, Ary Serpa, Catala, Juan, Bravo, Mauro, De Freitas, Renato Carneir, Felipe, Chaves, Bruno, Rothman, Arantes, Schuind, Hatanaka, Dina Mie, Beltran, Joan, Monsalve, Concepción, Droger, Sijgje Mari, Deljou, Atousa, Sabov, Moldovan, Rabbu, Yosef Sale, Del Barrio De Bonis, Marina, Babian, Renate, Rabenalt, Robert, Köhne, Wiebke, Ronen, Ariel, Agarwala, Aalok V., Granell, Manuel, Anesthesiology, Intensive Care Medicine, Graduate School, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, and ACS - Microcirculation

Subjects
Lung Diseases, Laparoscopic surgery, medicine.medical_specialty, PROSTATECTOMY, medicine.medical_treatment, Trendelenburg position, LAPAROSCOPIC SURGERY, Anesthesia, General, mechanical ventilation, general anesthesia, postoperative pulmonary complications, robotic surgery, Medicine (all), Anaesthesia, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Robotic Surgical Procedures, 030202 anesthesiology, Protocol, medicine, Medicine and Health Sciences, Humans, Multicenter Studies as Topic, Robotic surgery, General anaesthesia, 030212 general & internal medicine, Mechanical ventilation, Prostatectomy, business.industry, General surgery, General Medicine, Institutional review board, Respiration, Artificial, body regions, Observational Studies as Topic, Observational study, business
Abstract

IntroductionRobotic-assisted surgery (RAS) has emerged as an alternative minimally invasive surgical option. Despite its growing applicability, the frequent need for pneumoperitoneum and Trendelenburg position could significantly affect respiratory mechanics during RAS. AVATaR is an international multicenter observational study aiming to assess the incidence of postoperative pulmonary complications (PPC), to characterise current practices of mechanical ventilation (MV) and to evaluate a possible association between ventilatory parameters and PPC in patients undergoing RAS.Methods and analysisAVATaR is an observational study of surgical patients undergoing MV for general anaesthesia for RAS. The primary outcome is the incidence of PPC during the first five postoperative days. Secondary outcomes include practice of MV, effect of surgical positioning on MV, effect of MV on clinical outcome and intraoperative complications.Ethics and disseminationThis study was approved by the Institutional Review Board of the Hospital Israelita Albert Einstein. The study results will be published in peer-reviewed journals and disseminated at international conferences.Trial registration numberNCT02989415; Pre-results.

Published
2018

38. Impact of a structured quality management program on survival of patients with advanced (AOC) and relapsed ovarian cancer (ROC) treated in a dedicated tertiary gynecologic-oncology (GO) center.

Author

Harter, Philipp, primary, Heitz, Florian, additional, Ataseven, Beyhan, additional, Prader, Sonia, additional, Schneider, Stefanie, additional, Baert, Thaïs, additional, Alesina, Pier, additional, Groeben, Harald, additional, Traut, Alexander, additional, and Du Bois, Andreas, additional

Published
2019
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39. 65 YEARS OF THE DOUBLE HELIX Genetics informs precision practice in the diagnosis and management of pheochromocytoma

Author

Neumann, Hartmut P., Young, William F. Jr., Krauss, Tobias, Bayley, Jean-Pierre, Schiavi, Francesca, Opocher, Giuseppe, Boedeker, Carsten C., Tirosh, Amit, Castinetti, Frederic, Ruf, Juri, Beltsevich, Dmitry, Walz, Martin, Groeben, Harald-Thomas, von Dobschuetz, Ernst, Gimm, Oliver, Wohllk, Nelson, Pfeifer, Marija, Lourenco, Delmar M. Jr., Peczkowska, Mariola, Patocs, Attila, Ngeow, Joanne, Makay, Ozer, Shah, Nalini S., Tischler, Arthur, Leijon, Helena, Pennelli, Gianmaria, Villar Gomez de las Heras, Karina, Links, Thera P., Bausch, Birke, Eng, Charis, Neumann, Hartmut P., Young, William F. Jr., Krauss, Tobias, Bayley, Jean-Pierre, Schiavi, Francesca, Opocher, Giuseppe, Boedeker, Carsten C., Tirosh, Amit, Castinetti, Frederic, Ruf, Juri, Beltsevich, Dmitry, Walz, Martin, Groeben, Harald-Thomas, von Dobschuetz, Ernst, Gimm, Oliver, Wohllk, Nelson, Pfeifer, Marija, Lourenco, Delmar M. Jr., Peczkowska, Mariola, Patocs, Attila, Ngeow, Joanne, Makay, Ozer, Shah, Nalini S., Tischler, Arthur, Leijon, Helena, Pennelli, Gianmaria, Villar Gomez de las Heras, Karina, Links, Thera P., Bausch, Birke, and Eng, Charis

Abstract

Although the authors of the present review have contributed to genetic discoveries in the field of pheochromocytoma research, we can legitimately ask whether these advances have led to improvements in the diagnosis and management of patients with pheochromocytoma. The answer to this question is an emphatic Yes! In the field of molecular genetics, the well-established axiom that familial (genetic) pheochromocytoma represents 10% of all cases has been overturned, with amp;gt;35% of cases now attributable to germline disease-causing mutations. Furthermore, genetic pheochromocytoma can now be grouped into five different clinical presentation types in the context of the ten known susceptibility genes for pheochromocytoma-associated syndromes. We now have the tools to diagnose patients with genetic pheochromocytoma, identify germline mutation carriers and to offer gene-informed medical management including enhanced surveillance and prevention. Clinically, we now treat an entire family of tumors of the paraganglia, with the exact phenotype varying by specific gene. In terms of detection and classification, simultaneous advances in biochemical detection and imaging localization have taken place, and the histopathology of the paraganglioma tumor family has been revised by immunohistochemical-genetic classification by gene-specific antibody immunohistochemistry. Treatment options have also been substantially enriched by the application of minimally invasive and adrenal-sparing surgery. Finally and most importantly, it is now widely recognized that patients with genetic pheochromocytoma/paraganglioma syndromes should be treated in specialized centers dedicated to the diagnosis, treatment and surveillance of this rare neoplasm.

Published
2018
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40. 65 YEARS OF THE DOUBLE HELIX: Genetics informs precision practice in the diagnosis and management of pheochromocytoma

Author

Neumann, Hartmut P, primary, Young, William F, additional, Krauss, Tobias, additional, Bayley, Jean-Pierre, additional, Schiavi, Francesca, additional, Opocher, Giuseppe, additional, Boedeker, Carsten C, additional, Tirosh, Amit, additional, Castinetti, Frederic, additional, Ruf, Juri, additional, Beltsevich, Dmitry, additional, Walz, Martin, additional, Groeben, Harald-Thomas, additional, von Dobschuetz, Ernst, additional, Gimm, Oliver, additional, Wohllk, Nelson, additional, Pfeifer, Marija, additional, Lourenço, Delmar M, additional, Peczkowska, Mariola, additional, Patocs, Attila, additional, Ngeow, Joanne, additional, Makay, Özer, additional, Shah, Nalini S, additional, Tischler, Arthur, additional, Leijon, Helena, additional, Pennelli, Gianmaria, additional, Villar Gómez de las Heras, Karina, additional, Links, Thera P, additional, Bausch, Birke, additional, and Eng, Charis, additional

Published
2018
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46. Postoperative Upper Airway Obstruction After Recovery of the Train of Four Ratio of the Adductor Pollicis Muscle from Neuromuscular Blockade

Author

Eikermann, Matthias, Blobner, Manfred, Groeben, Harald, Rex, Christopher, Grote, Thomas, Neuhäuser, Markus, Beiderlinden, Martin, Peters, Jürgen, Neuh??user, Markus, and Peters, J??rgen

Subjects
Adult, Male, Spirometry, Vital capacity, Sedation, Medizin, FEV1/FVC ratio, Postoperative Complications, Humans, Medicine, Muscle, Skeletal, Aged, Maximal Expiratory Flow Rate, Neuromuscular Blockade, medicine.diagnostic_test, business.industry, Middle Aged, Airway obstruction, medicine.disease, Neuromuscular monitoring, Airway Obstruction, Anesthesiology and Pain Medicine, Anesthesia, Anesthesia Recovery Period, medicine.symptom, Airway, business
Abstract

Anesthetics, and even minimal residual neuromuscular blockade, may lead to upper airway obstruction (UAO). In this study we assessed by spirometry in patients with a train-of-four (TOF) ratio0.9 the incidence of UAO (i.e., the ratio of maximal expiratory flow and maximal inspiratory flow at 50% of vital capacity [MEF50/MIF50]1) and determined if UAO is induced by neuromuscular blockade (defined by a forced vital capacity [FVC] fade, i.e., a decrease in values of FVC from the first to the second consecutive spirometric maneuver ofor =10%). Patients received propofol and opioids for anesthesia. Spirometry was performed by a series of 3 repetitive spirometric maneuvers: the first before induction (under midazolam premedication), the second after tracheal extubation (TOF ratio: 0.9 or more), and the third 30 min later. Immediately after tracheal extubation and 30 min later, 48 and 6 of 130 patients, respectively, were not able to perform spirometry appropriately because of sedation. The incidence of UAO increased significantly (P0.01) from 82 of 130 patients (63%) at preinduction baseline to 70 of 82 patients (85%) after extubation, and subsequently decreased within 30 min to values observed at baseline (80 of 124 patients, 65%). The mean maximal expiratory flow and maximal inspiratory flow at 50% of vital capacity ratio after tracheal extubation was significantly increased from baseline (by 20%; 1.39 +/- 1.01 versus 1.73 +/- 1.02; P0.01), and subsequently decreased significantly to values observed at baseline (1.49 +/- 0.93). A statistically significant FVC fade was not present, and a FVC fade ofor =10% was observed in only 2 patients after extubation. Thus, recovery of the TOF ratio to 0.9 predicts with high probability an absence of neuromuscular blocking drug-induced UAO, but outliers, i.e., persistent effects of neuromuscular blockade on upper airway integrity despite recovery of the TOF ratio, may still occur.

Published
2006

48. Genetics informs precision practice in the diagnosis and management of pheochromocytoma.

Author

Neumann, Hartmut P., Young Jr, William F., Krauss, Tobias, Bayley, Jean-Pierre, Schiavi, Francesca, Opocher, Giuseppe, Boedeker, Carsten C., Tirosh, Amit, Castinetti, Frederic, Ruf, Juri, Beltsevich, Dmitry, Walz, Martin, Groeben, Harald-Thomas, von Dobschuetz, Ernst, Gimm, Oliver, Wohllk, Nelson, Pfeifer, Marija, Lourenço Jr, Delmar M., Peczkowska, Mariola, and Patocs, Attila

Subjects
PHEOCHROMOCYTOMA, FAMILIAL diseases, INDIVIDUALIZED medicine, MOLECULAR genetics, DISEASE susceptibility
Abstract

Although the authors of the present review have contributed to genetic discoveries in the field of pheochromocytoma research, we can legitimately ask whether these advances have led to improvements in the diagnosis and management of patients with pheochromocytoma. The answer to this question is an emphatic Yes! In the field of molecular genetics, the well-established axiom that familial (genetic) pheochromocytoma represents 10% of all cases has been overturned, with >35% of cases now attributable to germline disease-causing mutations. Furthermore, genetic pheochromocytoma can now be grouped into five different clinical presentation types in the context of the ten known susceptibility genes for pheochromocytoma-associated syndromes. We now have the tools to diagnose patients with genetic pheochromocytoma, identify germline mutation carriers and to offer gene-informed medical management including enhanced surveillance and prevention. Clinically, we now treat an entire family of tumors of the paraganglia, with the exact phenotype varying by specific gene. In terms of detection and classification, simultaneous advances in biochemical detection and imaging localization have taken place, and the histopathology of the paraganglioma tumor family has been revised by immunohistochemical-genetic classification by gene-specific antibody immunohistochemistry. Treatment options have also been substantially enriched by the application of minimally invasive and adrenal-sparing surgery. Finally and most importantly, it is now widely recognized that patients with genetic pheochromocytoma/paraganglioma syndromes should be treated in specialized centers dedicated to the diagnosis, treatment and surveillance of this rare neoplasm. [ABSTRACT FROM AUTHOR]

Published
2018
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