Publications

251 Publications visible to you, out of a total of 251

Abstract

Not specified

Authors: Holger Kirsten, Elisabeth Petit-Teixeira, Helene Hantmann, J. Reichardt, Jana Burkhardt, Frank Emmrich, François Cornelis, Peter Ahnert

Date Published: 13th Aug 2009

Publication Type: Journal article

Abstract (Expand)

OBJECTIVE\backslashr\backslashnThe purpose of this study was to review the management of anesthesia for transapical transcatheter aortic valve implantation.\backslashr\backslashnDESIGN\backslashr\backslashnRetrospective review of collected data.\backslashr\backslashnSETTING\backslashr\backslashnUniversity-affiliated heart center.\backslashr\backslashnPARTICIPANTS\backslashr\backslashnOne hundred consecutive patients with severe aortic stenosis.\backslashr\backslashnINTERVENTIONS\backslashr\backslashnGeneral anesthesia followed by an established fast-track protocol.\backslashr\backslashnMATERIALS AND METHODS\backslashr\backslashnA total of 100 patients with significant AS received transapical transcatheter aortic valve implantation. The patients were treated following a fast-track protocol. The mean arterial pressure was maintained above 65 mmHg by volume and/or inotropes during the procedure. The mean arterial pressure was increased above 75 mmHg to avoid hemodynamic deterioration before starting rapid ventricular pacing for the balloon valvuloplasty and the valve implantation. Transesophageal echocardiography was used to assess valve size and for hemodynamic monitoring. Eighty-one patients were treated completely off pump. There was a significant decline in mean arterial pressure from pre- to postvalvuloplasty (74.7 +/- 9.1 mmHg v 63.6 +/- 11.3 mmHg, p \textless 0.001) and from pre- to postimplantation (76.5 +/- 12.6 mmHg v 67.2 +/- 12.7, p \textless 0.001). The first 10 patients in the study intentionally were placed on cardiopulmonary bypass, and 9 patients required cardiopulmonary bypass because of hemodynamic deterioration.\backslashr\backslashnCONCLUSION\backslashr\backslashnA well-designed anesthetic plan as well as an understanding of the surgical procedure and the hemodynamic effects of rapid ventricular pacing are required to ensure successful outcomes in this new surgical option for high-risk patients.

Authors: Jens Fassl, Thomas Walther, Heinrich Volker Groesdonk, Joerg Kempfert, Michael Andrew Borger, Markus Scholz, Chirojit Mukherjee, Axel Linke, Gerhard Schuler, Friedrich Wilhelm Mohr, Joerg Ender

Date Published: 1st Jun 2009

Publication Type: Journal article

Abstract (Expand)

Dyslexia is a complex reading and writing disorder with a strong genetic component. In a German case-control cohort, we studied the influence of the suspected dyslexia-associated gene DCDC2. For the first time in a German cohort, we describe association of a 2445 basepair deletion, first identified in an American study. Evidence of association for three DCDC2 single nucleotide polymorphisms (rs807724, rs793862, rs807701), previously identified in German or American cohorts, was replicated. A haplotype of these polymorphisms showed evidence for association as well. Thus, our data further corroborate association of DCDC2 with dyslexia. Analysis of functional subgroups suggests association of investigated DCDC2 variants mainly with nondysphonetic, nonsevere, but probably dyseidetic (surface) dyslexia. Based on the presumed function of DCDC2, our findings point to a role of impaired neuronal migration in the etiology of the disease. Dyslexia is a complex reading and writing disorder with a strong genetic component. In a German case-control cohort, we studied the influence of the suspected dyslexia-associated gene DCDC2. For the first time in a German cohort, we describe association of a 2445 basepair deletion, first identified in an American study. Evidence of association for three DCDC2 single nucleotide polymorphisms (rs807724, rs793862, rs807701), previously identified in German or American cohorts, was replicated. A haplotype of these polymorphisms showed evidence for association as well. Thus, our data further corroborate association of DCDC2 with dyslexia. Analysis of functional subgroups suggests association of investigated DCDC2 variants mainly with nondysphonetic, nonsevere, but probably dyseidetic (surface) dyslexia. Based on the presumed function of DCDC2, our findings point to a role of impaired neuronal migration in the etiology of the disease.

Authors: Arndt Wilcke, Jana Weissfuss, Holger Kirsten, Grit Wolfram, Johannes Boltze, Peter Ahnert

Date Published: 1st Jun 2009

Publication Type: Journal article

Abstract (Expand)

The role of antiphospholipid syndrome (APS) in the pathogenesis of retinal vein occlusion has been discussed for several years. Conflicting results of the published studies are caused by small numbers of investigated patients and lack of control groups. We performed a meta-analysis of all case-control studies published up to July 2007 that investigated the prevalence of APS according to current diagnostic criteria for this syndrome.The results of meta-analysis show a significantly higher prevalence of APS in patients with retinal vein occlusion compared with controls. Patients with APS are treated with anticoagulants to reduce the risk of recurrence of thrombosis. Therefore, screening for APS seems to be indicated in all patients with retinal vein occlusion, and, in the case of a positive result, initiation of anticoagulation. For patients with retinal vein occlusion with APS, no data are currently available regarding the recurrence of thrombosis. To give a clear recommendation, a prospective randomized study is required to investigate the benefit of anticoagulation.

Authors: Matus Rehak, M. Müller, Markus Scholz, J. Wiercinska, D. Niederwieser, Peter Wiedemann

Date Published: 1st May 2009

Publication Type: Journal article

Abstract (Expand)

BACKGROUND\backslashr\backslashnIn November 2005 a complex, multimodal anesthesia fast-track protocol (FTP) was introduced for elective cardiac surgery patients in the Cardiac Center of the University of Leipzig which included changing from an opioid regime to remifentanil and postoperative treatment in a special post-anesthesia recovery and care unit. The goal was to speed up recovery times while maintaining safety and improving costs.\backslashr\backslashnMETHOD\backslashr\backslashnA total of 421 patients who underwent the FTP and were treated in the special recovery room were analyzed retrospectively. These patients were compared with patients who had been treated by a standard protocol (SP) prior to instituting the FTP. Primary outcomes were time to extubation, length of stay in the intensive care unit (ICU) and treatment costs.\backslashr\backslashnRESULTS\backslashr\backslashnThe times to extubation were significantly shorter in the FTP group with 75 min (range 45-110 min) compared to 900 min (range 600-1140 min) in the SP group. Intensive care unit stay and hospital length of stay were also significantly shorter in the FTP group (p\textless0.01). The reduction of treatment costs of intensive care for FTP patients was 53.5% corresponding to savings of EUR 738 per patient in the FTP group compared with the SP group.\backslashr\backslashnCONCLUSIONS\backslashr\backslashnThe Leipzig fast-track protocol for cardio-anesthesia including the central elements of switching opiate therapy to remifentanil and switching patient recovery to a special post-anesthesia recovery and care unit, shortened therapy times, is safe and economically effective. BACKGROUND In November 2005 a complex, multimodal anesthesia fast-track protocol (FTP) was introduced for elective cardiac surgery patients in the Cardiac Center of the University of Leipzig which included changing from an opioid regime to remifentanil and postoperative treatment in a special post-anesthesia recovery and care unit. The goal was to speed up recovery times while maintaining safety and improving costs. METHOD A total of 421 patients who underwent the FTP and were treated in the special recovery room were analyzed retrospectively. These patients were compared with patients who had been treated by a standard protocol (SP) prior to instituting the FTP. Primary outcomes were time to extubation, length of stay in the intensive care unit (ICU) and treatment costs. RESULTS The times to extubation were significantly shorter in the FTP group with 75 min (range 45-110 min) compared to 900 min (range 600-1140 min) in the SP group. Intensive care unit stay and hospital length of stay were also significantly shorter in the FTP group (p\textless0.01). The reduction of treatment costs of intensive care for FTP patients was 53.5% corresponding to savings of EUR 738 per patient in the FTP group compared with the SP group. CONCLUSIONS The Leipzig fast-track protocol for cardio-anesthesia including the central elements of switching opiate therapy to remifentanil and switching patient recovery to a special post-anesthesia recovery and care unit, shortened therapy times, is safe and economically effective.

Authors: D. Häntschel, Jens Fassl, Markus Scholz, Marcus Sommer, Anne-Kathrin Funkat, M. Wittmann, Joerg Ender

Date Published: 1st Apr 2009

Publication Type: Journal article

Abstract (Expand)

INTRODUCTION\backslashr\backslashnThe objective was to study the potential genetic contribution of Toll-like receptor (TLR) genes in rheumatoid arthritis (RA). TLRs bind to pathogen-associated molecular patterns, and TLR genes influence both proinflammatory cytokine production and autoimmune responses. Host-pathogen interactions are involved in RA physiopathology.\backslashr\backslashnMETHODS\backslashr\backslashnWe tested SNPs of five TLR genes (TLR9, TLR2, TLR6, TLR1, and TLR4) in a cohort of 100 French families with RA. Genotypes were analyzed using the transmission disequilibrium test. As TLR2, TLR6, and TLR1 are located on chromosome 4, we determined the haplotype relative risk. Analyses were performed in subgroups defined by status for rheumatoid factor, anti-cyclic citrullinated peptide autoantibodies, and erosions.\backslashr\backslashnRESULTS\backslashr\backslashnWe found no disequilibrium in allele transmission for any of the SNPs of the five TLR genes. In subgroup analyses, no associations were detected linking TLR9, TLR2, or TLR9/TLR2 to rheumatoid factor, anti-cyclic citrullinated peptide autoantibodies, or erosions. Haplotype analysis of the polymorphisms showed no haplotype associations in any of the subgroups.\backslashr\backslashnCONCLUSIONS\backslashr\backslashnWe found no evidence of major effects of TLR gene polymorphisms in RA, although we tested different TLR phenotypes. Moreover, no associations were noted with autoantibody production or erosions.

Authors: Olivier Jaen, Elisabeth Petit-Teixeira, Holger Kirsten, Peter Ahnert, Luca Semerano, Céline Pierlot, François Cornelis, Marie-Christophe Boissier, Geraldine Falgarone

Date Published: 2009

Publication Type: Journal article

Abstract

Not specified

Authors: Holger Kirsten, Jana Burkhardt, Helene Hantmann, Nico Hunzelmann, Peter Vaith, Peter Ahnert, Inga Melchers

Date Published: 2009

Publication Type: Journal article

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