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  • 1
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    Online Resource
    Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study
    Springer Science and Business Media LLC ; 2020
    In:  Annals of Intensive Care Vol. 10, No. 1 ( 2020-12)
    Details
    In: Annals of Intensive Care, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-12)
    Abstract: Acute respiratory distress syndrome (ARDS) is a life-threatening condition that often requires prolonged mechanical ventilation. Tracheostomy is a common procedure with some risks, on the other hand with potential advantages over orotracheal intubation in critically ill patients. This study investigated the association of tracheostomy with health-related quality of life (HRQoL), symptoms of psychiatric disorders and return-to-work of ARDS survivors. Methods Data were collected in the context of the prospective observational German-wide DACAPO study. Clinical and demographic patient data and treatment characteristics were obtained from the participating intensive care units (ICU). HRQoL and return-to-work were assessed using patient-reported questionnaires 3, 6 and 12 months after ICU discharge. HRQoL was measured with the Physical and Mental Component Scale of the Short-Form 12 Questionnaire (PCS-12, MCS-12). The prevalence of psychiatric symptoms (depression and post-traumatic stress disorder [PTSD]) was assessed using the Patient Health Questionnaire-9 and the Post-Traumatic Stress Syndrome-14. Physician-diagnosed anxiety and obsessive–compulsive disorder were recorded by patient self-report in the follow-up questionnaires. The associations of tracheostomy with HRQoL, psychiatric symptoms and return-to-work after 12 months were investigated by means of multivariable linear and logistic regression models. Results Primary 877 ARDS patients (mean ± standard deviation: 54 ± 16 years, 68% male) survived and were discharged from ICU. Out of these patients, 478 (54.5%) were tracheotomised during ICU treatment. After 12 months, patient-reported outcomes could be analysed of 388 (44.2%) respondents, 205 with tracheostomy and 183 without. One year after ICU discharge, tracheostomy showed no significant association with physical or mental health-related quality of life (PCS-12: − 0.73 [− 3.96, 2.51]; MCS-12: − 0.71 [− 4.92, 3.49] ), symptoms of psychiatric disorders (depression: 0.10 [− 1.43, 1.64]; PTSD: 3.31 [− 1.81, 8.43] ; anxiety: 1.26 [0.41, 3.86]; obsessive–compulsive disorder: 0.59 [0.05, 6.68] ) or return-to-work (0.71 [0.31, 1.64]) in the multivariable analysis (OR [95%-CI] ). Conclusions Up to 1 year after ICU discharge, neither HRQoL nor symptoms of psychiatric disorders nor return-to-work was affected by tracheostomy. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered)
    Type of Medium: Online Resource
    ISSN: 2110-5820
    URL: Article
    DOI: 10.1186/s13613-020-00671-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2617094-2
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  • 2
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    Incidence of early intra-cranial bleeding and ischaemia in adult veno-arterial extracorporeal membrane oxygenation and extracorporeal cardiopulmonary resuscitation patients: a retrospective analysis of risk factors
    SAGE Publications ; 2020
    In:  Perfusion Vol. 35, No. 1_suppl ( 2020-05), p. 8-17
    Details
    In: Perfusion, SAGE Publications, Vol. 35, No. 1_suppl ( 2020-05), p. 8-17
    Abstract: Cerebral complications in veno-arterial extracorporeal membrane oxygenation are known to have a strong impact on mortality and morbidity. Aim of this study is to investigate the early incidence, risk factors and in-hospital mortality of intra-cranial ischaemia and haemorrhage in adults undergoing veno-arterial extracorporeal membrane oxygenation treatment. Methods: This study is a single-centre retrospective analysis on adult patients undergoing veno-arterial extracorporeal membrane oxygenation for different indications. The inclusion criterion included patients with early routine cerebral computed tomography imaging during extracorporeal membrane oxygenation, with no clinical evidence of cerebral pathology prior to cannulation. Cerebral complications were grouped by aetiology and the territories of the brain’s supplying arteries. Results: One hundred eighty-seven adult patients with a total of 190 veno-arterial extracorporeal membrane oxygenation treatments were included. A total of 16.3% (n = 31) had evidence of either cerebral ischaemia (11.1%) or haemorrhage (5.8%); one patient suffered from both. Cerebral computed tomography scans were performed early in median on the first day after extracorporeal membrane oxygenation cannulation; in-hospital mortality of intra-cranial ischaemia and haemorrhage was 71.4% and 45.5%, respectively. Associated with an increased risk for ischaemic lesions were cannulation of the ascending aorta, higher age, presence of an autoimmune disease and cardiac surgery prior to veno-arterial extracorporeal membrane oxygenation. An association with haemorrhagic lesions was found for a lower blood PaCO 2 at 2 hours, lower blood flow through the extracorporeal membrane oxygenation device at 2 hours, higher international normalized ratio and constantly higher activated partial thromboplastin time values as well as higher mean arterial pressures until haemorrhagic lesions were evident. Conclusion: Cerebral complications are frequent in patients on veno-arterial extracorporeal membrane oxygenation and may be clinically silent events. Careful monitoring with routine neuroimaging seems to be the most appropriate diagnostic approach at present. Intra-cranial ischaemia occurs more frequent than haemorrhage and is associated with cannulation of the aorta ascendens.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659120907438
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2029611-3
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  • 3
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    Obstructive sleep apnoea but not central sleep apnoea is associated with left ventricular remodelling after acute myocardial infarction
    Springer Science and Business Media LLC ; 2021
    In:  Clinical Research in Cardiology Vol. 110, No. 7 ( 2021-07), p. 971-982
    Details
    In: Clinical Research in Cardiology, Springer Science and Business Media LLC, Vol. 110, No. 7 ( 2021-07), p. 971-982
    Abstract: Obstructive sleep apnoea (OSA) increases left ventricular transmural pressure more than central sleep apnoea (CSA) owing to negative intrathoracic pressure swings. We tested the hypothesis that the severity of OSA, and not CSA, is therefore associated with spheric cardiac remodelling after acute myocardial infarction. Methods This sub-analysis of a prospective observational study included 24 patients with acute myocardial infarction who underwent primary percutaneous coronary intervention. Spheric remodelling, calculated according to the sphericity index, was assessed by cardiac magnetic resonance imaging at baseline and 12 weeks after acute myocardial infarction. OSA and CSA [apnoea-hypopnoea index (AHI) ≥ 5/hour] were diagnosed by polysomnography. Results Within 12 weeks after acute myocardial infarction, patients with OSA exhibited a significant increase in systolic sphericity index compared to patients without sleep-disordered breathing (no SDB) and patients with CSA (OSA vs. CSA vs. no SDB: 0.05 ± 0.04 vs. 0.01 ± 0.04 vs. − 0.03 ± 0.03, p  = 0.002). In contrast to CSA, the severity of OSA was associated with an increase in systolic sphericity index after accounting for TIMI-flow before percutaneous coronary intervention, infarct size, pain-to-balloon-time and systolic blood pressure [OSA: B (95% CI) 0.443 (0.021; 0.816), p  = 0.040; CSA: 0.193 (− 0.134; 0.300), p  = 0.385]. Conclusion In contrast to CSA and no SDB, OSA is associated with spheric cardiac remodelling within the first 12 weeks after acute myocardial infarction. Data suggest that OSA-related negative intrathoracic pressure swings may contribute to this remodelling after acute myocardial infaction. Graphic abstract
    Type of Medium: Online Resource
    ISSN: 1861-0684 , 1861-0692
    URL: Article
    DOI: 10.1007/s00392-020-01684-z
    RVK:
    XA 37040
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2218331-0
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  • 4
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    Nocturnal hypoxemic burden during positive airway pressure treatment across different central sleep apnea etiologies
    Elsevier BV ; 2021
    In:  Sleep Medicine Vol. 79 ( 2021-03), p. 62-70
    Details
    In: Sleep Medicine, Elsevier BV, Vol. 79 ( 2021-03), p. 62-70
    Type of Medium: Online Resource
    ISSN: 1389-9457
    URL: Article
    DOI: 10.1016/j.sleep.2021.01.007
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2041737-8
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  • 5
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    The presence of PD-1 positive tumor infiltrating lymphocytes in triple negative breast cancers is associated with a favorable outcome of disease
    Impact Journals, LLC ; 2018
    In:  Oncotarget Vol. 9, No. 5 ( 2018-01-19), p. 6201-6212
    Details
    In: Oncotarget, Impact Journals, LLC, Vol. 9, No. 5 ( 2018-01-19), p. 6201-6212
    Type of Medium: Online Resource
    ISSN: 1949-2553
    URL: Issue
    URL: Article
    DOI: 10.18632/oncotarget.v9i5
    DOI: 10.18632/oncotarget.23717
    Language: English
    Publisher: Impact Journals, LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2560162-3
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  • 6
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    Randomized Crossover-Controlled Evaluation of Simultaneous Bilateral Transcutaneous Electrostimulation of the Posterior Tibial Nerve During Urodynamic Studies in Patients With Lower Urinary Tract Symptoms
    Korean Continence Society ; 2021
    In:  International Neurourology Journal Vol. 25, No. 4 ( 2021-12-31), p. 337-346
    Details
    In: International Neurourology Journal, Korean Continence Society, Vol. 25, No. 4 ( 2021-12-31), p. 337-346
    Abstract: Purpose: Transcutaneous tibial nerve stimulation (TTNS) has proven to be a valuable treatment option for various lower urinary tract conditions, such as overactive bladder syndrome and neurogenic detrusor overactivity. The aim of this study was to investigate acute changes in urodynamic parameters due to bilateral TTNS.Methods: Fifty-one patients (18–87 years; 61% female) with various lower urinary tract symptoms were enrolled in this study. They were single-blinded and randomly assigned to receive simultaneous bilateral TTNS either during their first urodynamic examination, followed by a second round using a placebo stimulation technique, or vice versa.Results: For subjects without signs of anatomical pathologies, the filling volume at the first desire to void (FDV) increased significantly by 54 mL (interquartile range [IQR], 26–81 mL; P 〈 0.01) under the influence of TTNS compared to placebo. The maximum cystometric capacity increased by 41 mL (IQR, 10–65 mL; P=0.02). The median micturition volume of patients with pathological postvoid residual volumes ( 〉 100 mL) increased by 76 mL compared to patients without urinary retention (IQR, 6–166 mL; P=0.03).Conclusions: Compared to placebo, simultaneous bilateral TTNS showed significant improvements in bladder functioning, such as delayed FDV, increased maximum cystometric capacity, and reduced urinary retention. Patients with signs of anatomical pathologies did not seem to benefit from TTNS. Further studies need to be conducted to compare the effectiveness of bilateral versus unilateral TTNS.
    Type of Medium: Online Resource
    ISSN: 2093-6931
    URL: Article
    DOI: 10.5213/inj.2040408.204
    Language: English
    Publisher: Korean Continence Society
    Publication Date: 2021
    detail.hit.zdb_id: 2584447-7
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  • 7
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    Sharp margin and geographic shape: systematic evaluation of two novel CT features in COVID-19 pneumonia
    British Institute of Radiology ; 2020
    In:  BJR|Open Vol. 2, No. 1 ( 2020-11), p. 20200026-
    Details
    In: BJR|Open, British Institute of Radiology, Vol. 2, No. 1 ( 2020-11), p. 20200026-
    Abstract: CT is important in the care of patients with COVID-19 pneumonia. However, specificity might be poor in the absence of a clinical and epidemiological context. The goal of this work was to systematically evaluate two novel CT features (sharp margin and geographic shape) of COVID-19 pneumonia. Methods: All patients with reverse transcription polymerase chain reaction proven COVID-19 pneumonia and chest CT between March first and April 15, 2020 were retrospectively identified from two tertiary care hospitals in Germany. The CTs were evaluated regarding the presence of typical CT signs (e.g. ground glass opacitiy, consolidation, crazy paving). Moreover, the shape of the opacifications (round, geographic, curvilinear) and their margin (unsharp, sharp) was determined. Results: The study population comprised 108 patients (64 male) with a mean age of 59.6 years. Ground glass opacities (96%) and consolidation (75%) were the most prevalent CT signs. Crazy paving was seen in 17%, bronchial dilatation in 21%, air bronchogram in 29%, vessel enlargement in 47%, cavitation in 0%, lymphadenopathy in 32%, pleural effusion in 16%. Round configuration of densities was present in 41% of CTs, geographic shape in 27% and curvilinear opacities in 44%. 79% of opacifications were at least partially sharply marginated. In almost all cases, the lung was affected bilaterally (94%). Conclusion: The CT pattern of COVID-19 pneumonia in a cohort from Germany was in accordance with prior studies. However, we identified two novel CT signs of COVID-19 pneumonia which have so far not been systematically evaluated. A sharp border and geographic shape of opacifications were frequently observed. Advances in knowledge: The newly described CT features “sharp margin” and “geographic shape” of opacifications in patients with COVID-19 pneumonia might help to increase specificity of CT.
    Type of Medium: Online Resource
    ISSN: 2513-9878
    URL: Article
    DOI: 10.1259/bjro.20200026
    Language: English
    Publisher: British Institute of Radiology
    Publication Date: 2020
    detail.hit.zdb_id: 3051447-2
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  • 8
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    Left atrial strain parameters derived by echocardiography are impaired in patients with acute myocarditis and preserved systolic left ventricular function
    Springer Science and Business Media LLC ; 2023
    In:  The International Journal of Cardiovascular Imaging Vol. 39, No. 6 ( 2023-03-24), p. 1157-1165
    Details
    In: The International Journal of Cardiovascular Imaging, Springer Science and Business Media LLC, Vol. 39, No. 6 ( 2023-03-24), p. 1157-1165
    Abstract: Purpose : Data derived by cardiac magnetic resonance (CMR) feature tracking suggest that not only left ventricular but also left atrial function is impaired in patients with acute myocarditis. Therefore, we investigated the diagnostic value of speckle tracking echocardiography of the left ventricle and left atrium in patients with acute myocarditis and normal left ventricular ejection fraction (LVEF). Methods and results : 30 patients with acute myocarditis confirmed by CMR according to the Lake Louise criteria and 20 healthy controls were analyzed including global longitudinal strain (GLS) and left atrial (LA) strain parameters. Although preserved LVEF was present in both groups, GLS was significantly lower in patients with acute myocarditis (GLS − 19.1 ± 1.8% vs. GLS − 22.1 ± 1.7%, p  〈  0.001). Further diastolic dysfunction measured by E/e’ mean was significantly deteriorated in the myocarditis group compared to the control group (E/e’ mean 6.4 ± 1.6 vs. 5.5 ± 1.0, p = 0.038). LA reservoir function (47.6 ± 10.4% vs. 55.5 ± 10.8%, p = 0.013) and LA conduit function (-33.0 ± 9.6% vs. -39.4 ± 9.5%, p = 0.024) were significantly reduced in patients with acute myocarditis compared to healthy controls. Also left atrial stiffness index (0.15 ± 0.05 vs. 0.10 ± 0.03, p = 0.003) as well as left atrial filling index (1.67 ± 0.47 vs. 1.29 ± 0.34, p = 0.004) were deteriorated in patients with myocarditis compared to the control group. Conclusion : In patients with acute myocarditis and preserved LVEF not only GLS but also LA reservoir function, LA conduit function and left atrial stiffness index as well as left atrial filling index were impaired compared to healthy controls indicating ventricular diastolic dysfunction and elevated LV filling pressures.
    Type of Medium: Online Resource
    ISSN: 1875-8312
    URL: Article
    DOI: 10.1007/s10554-023-02827-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2008950-8
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  • 9
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    Validation of a German version of the International Hip Outcome Tool (G-iHOT33) according to the COSMIN checklist: how much improvement is clinically relevant?
    Springer Science and Business Media LLC ; 2016
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 136, No. 1 ( 2016-1), p. 83-91
    Details
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 136, No. 1 ( 2016-1), p. 83-91
    Type of Medium: Online Resource
    ISSN: 0936-8051 , 1434-3916
    URL: Article
    DOI: 10.1007/s00402-015-2336-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 1458452-9
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  • 10
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    CT Features of COVID-19 Pneumonia Differ Depending on the Severity and Duration of Disease
    Georg Thieme Verlag KG ; 2021
    In:  RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren Vol. 193, No. 06 ( 2021-06), p. 672-682
    Details
    In: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Georg Thieme Verlag KG, Vol. 193, No. 06 ( 2021-06), p. 672-682
    Abstract: Background CT is important in the care of patients with COVID-19 pneumonia. However, CT morphology can change significantly over the course of the disease. To evaluate the CT morphology of RT-PCR-proven COVID-19 pneumonia in a German cohort with special emphasis on identification of potential differences of CT features depending on duration and severity of disease. Method All patients with RT-PCR-proven COVID-19 pneumonia and chest CT performed between March 1 and April 15, 2020 were retrospectively identified. The CT scans were evaluated regarding the presence of different CT features (e. g. ground glass opacity, consolidation, crazy paving, vessel enlargement, shape, and margin of opacifications), distribution of lesions in the lung and extent of parenchymal involvement. For subgroup analyses the patients were divided according to the percentage of parenchymal opacification (0–33 %, 34–66 %, 67–100 %) and according to time interval between symptom onset and CT date (0–5 d, 6–10 d, 11–15 d, 〉  15 d). Differences in CT features and distribution between subgroups were tested using the Mantel-Haenszel Chi Squared for trend. Results The frequency of CT features (ground glass opacity, consolidation, crazy paving, bronchial dilatation, vessel enlargement, lymphadenopathy, pleural effusion) as well as pattern of parenchymal involvement differed significantly depending on the duration of disease and extent of parenchymal involvement. The early phase of disease was characterized by GGO and to a lesser extent consolidation. The opacifications tended to be round and to some extent with sharp margins and a geographic configuration. The vessels within/around the opacifications were frequently dilated. Later on, the frequency of consolidation and especially crazy paving increased, and the round/geographic shape faded. After day 15, bronchial dilatation occurred, and lymphadenopathy and pleural effusion were seen more frequently than before. Conclusion The prevalence of CT features varied considerably during the course of disease and depending on the severity of parenchymal involvement. Radiologists should take into account the time interval between symptom onset and date of CT and the severity of disease when discussing the likelihood of COVID-19 pneumonia based on CT morphology. Key Points:  Citation Format
    Type of Medium: Online Resource
    ISSN: 1438-9029 , 1438-9010
    URL: Article
    DOI: 10.1055/a-1293-9163
    RVK:
    XA 10000
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2031079-1
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