bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peak and baseline concentrations of fondaparinux during prophylactic therapy
Authors: Kanagendran R. , Scheuermann J. , Ackermann H. , Kaufmann R. , Boehncke W.-H. , Ludwig R. J. , Schindewolf M. , Wolf Z. , Lindhoff-Last E. 
Published: March 2018

SummaryFondaparinux is widely approved for prophylaxis and treatment of venous thromboembolic events (VTE). However, its longer half-life time compared to heparins limits its peri-procedural use.
Aim: To investigate 3h peak and 24h baseline concentrations of fondaparinux when administered for prophylaxis (1 x 2.5 mg qd). Secondary outcome measures: incidences of VTE, bleedings, HIT, allergic skin reactions, 30 days mortality.
Patients, methods: Between 02/2010 and 03/2011, 3h peak and 24h baseline levels of fondaparinux were measured with a chromogenic anti-FXa method in 75 consecutive patients. Medical data were obtained from patients' records.
Results: The 5% and 95% percentile of the 3h peak level were 0.20 μg/ml and 0.83 μg/ml (median: 0.53 μg/ml), and of the 24h baseline level 0.08 μg/ml and 0.53 μg/ml (median 0.21 μg/ml), respectively. An inverse correlation was found between fondaparinux levels and GFRs (rho=-0.617 (3h); rho=-0.648 (24h); p=0.01). Shorter (≤5 days) or longer (≥8 days) duration of prior fondaparinux exposure showed no significantly different 3h peak/24h baseline levels (p>0.6). One progressive thrombosis occurred but no major bleedings, HIT, allergic skin reactions or fatalities.
Conclusions: After fondaparinux exposure, >75% of the patients still had relevant prophylactic 24h baseline levels. This did not coincide with a high rate of bleeding events. Due to the low patient number in this study undergoing surgery or interventions, it remains to be investigated whether or at which concentrations the bleeding risk is increased when baseline levels are within prophylactic ranges.
The effect of compression ulcer stockings on the capillary filtration rate and the formation of edema
Authors: Wolff O. , Wentel T. D. , Reeder S. W. I. , Neumann H. A. M. 
Published: March 2018

SummaryIncreased ambulatory venous pressure is the key feature of chronic venous insufficiency, and causes capillary leakage and venous edema. This capillary leakage can be measured with plethysmography and is called the capillary filtration rate (CFR).Reduction of the CFR leads to less edema formation and improves the healing of venous ulcers.
Aim: To show that the use of compression ulcer stockings reduces the CFR.
Methods: The capillary filtration rate of both legs of 17 patients, 6 with chronic venous insufficiency and 11 healthy subjects was measured with both (day and night) stockings, only the night stocking and without stockings.
Results: The reduction of the CFR was significant (p <0.0001) for the total population in the group wearing 2 stockings versus 1 stocking (CFR=0.019 vs. 0.084 ml/100 ml/min), 1 stocking versus no stocking (CFR=0.149 vs. 0.084 ml/100 ml/min) and 2 stockings versus no stockings (CFR=0.019 vs. 0.149 ml/100 ml/ min).
Conclusion: Compression ulcer stockings are highly effective in reducing CFR and thus reducing edema formation, which leads to improved healing of venous ulcers.
Perkutane transluminale Angioplastie (PTA) der Arteria femoralis superficialis
Authors: Nikol S. 
Published: March 2018

ZusammenfassungAuf dem Gebiet der peripheren arteriellen Intervention gab es in den letzten zehn bis fünfzehn Jahren einen enormen Fortschritt bezüglich verfügbarer Kathetermaterialien und Techniken. Dies trifft im besonderen Maße auf die Behandlung der Arteria femoralis super-ficialis (AFS) zu, die einen erheblichen Anteil der peripheren arteriellen Intervention ausmacht. In diesem Artikel werden gängige Kathetertechniken und moderne verfügbare Kathetermaterialien dargestellt.
Therapierefraktäre Ulcera cruris et pedis bei grotesker Fußdeformität
Authors: Hermanns A. , Waldhausen P. , Hermanns H.-J. 
Published: March 2018

ZusammenfassungUlcera der unteren Extremität und des Fußes sind in etwa 90 % der Fälle vaskulärer Genese. Nur 10 % der Ulcera haben andere, seltene Ursachen. Nach einem schweren Trauma mit Deformierung und Fehlstellung des Fußes in 90-Grad Außenrotation kam es bei einer heute 77-jährigen Patientin zur Ausbildung therapieresistenter Ulcera cruris et pedis. Durch eine Shave-Therapie mit simultaner Meshgraft-Plastik und intensiver Nachbehandlung des sekundären Lymphödems konnte eine komplette Heilung erzielt werden.
Pelvines Stauungssyndrom und periphere Varikose
Authors: Bekou V. , von Weymann A. , Bauer E.P. , Traber J. 
Published: March 2018

ZusammenfassungEinleitung: Bei Frauen im reproduktionsfähi-gen Alter können manchmal Varizen auftreten ohne dass dafür eine typische Ursache, ins-besondere eine Magnacrosseninsuffizienz, gefunden wird. Häufig leiden solche Patientinnen auch an ausgeprägten zyklusabhängi-gen Unterbauch- und Beinbeschwerden. In diesen Fällen muss an ein Beckenvenenstauungssyndrom gedacht werden.Methoden: Zwischen 1/2006 und 12/2011 wurden insgesamt 2 444 Patientinnen wegen einer Varikose im Einzugsgebiet der Mag-nacrosse mittels farbkodierter Duplexsonographie untersucht. Bei 324/2444 (13 %) konnte keine typische Ursache für die Varikose gefunden werden. 297/324 (92 %) Patientinnen waren mit einer weiterführenden Abklä-rung mittels CT und MRI einverstanden um die Frage zu klären, ob ein Reflux in die Vena ovarica (OVR) Ursache der Varikose ist. Bei Pa-tientinnen mit einem OVR erfolgte eine ausführliche Aufklärung. Als therapeutische Möglichkeiten wurde entweder ein interventioneller Verschluss mittels Coils und anschließender Phlebektomie zu einem späteren Zeitpunkt oder das laparoskopische Clipping der Vena ovarica mit gleichzeitiger Phlebektomie vorgeschlagen. Alle Teilnehmerinnen wurden 6 Wochen nach dem Eingriff nachkontrolliert.Resultate: Bei 181/297 (61%) der untersuchten Frauen wurde eindeutig ein OVR dargestellt während bei 116/297 (39 %) kein Reflux darstellbar war. Bei 98/181 (54 %) Frauen wurde die vena ovarica durch interventionelles Einbringen von Coils und bei 47/181 (26 %) durch ein laparoskopisches Clipping verschlossen. 36/181 (20 %) Frauen wollten keine der genannten Be-handlungen. Die Eingriffe verliefen durchwegs komplikationslos. Alle Patientinnen waren nach
6 Wochen beschwerdefrei.Schlussfolgerungen: Bei 7,4 % der Patientinnen mit einer Varikose im Einzugsgebiet der Mag-nacrosse konnte ein OVR nachgewiesen wer-den. Da nicht alle Patientinnen mittels Schnittbildverfahren untersucht wurden ist die Häufigkeit eines OVR eventuell sogar höher. Junge Frauen mit einer Varikose, mehr als 2 Kindern und ohne genügend plausible Magnacrosse-oder Crosserezidivinsuffizienz, sowie zyklusabhängigen Unterbauch- und Beinbeschwer-den haben eine hohe Wahrscheinlichkeit eines OVR.
Healing venous ulcers with different modalities of leg compression
Authors: Brizzio E. O. , Rossi G. , Chirinos A. , Cantero I. , Idiazabal G. , Amsler F. , Blättler W. 
Published: March 2018

Summary
Background: Compression therapy (CT) is the stronghold of treatment of venous leg ulcers. We evaluated 5 modalities of CT in a prospective open pilot study using a unique trial design. Patients and methods: A group of experienced phlebologists assigned 31 consecutive patients with 35 venous ulcers (present for 2 to 24 months with no prior CT) to 5 different modalities of leg compression, 7 ulcers to each group. The challenge was to match the modality of CT with the features of the ulcer in order to achieve as many healings as possible. Wound care used standard techniques and specifically tailored foam pads to increase local pressure. CT modalities were either stockings Sigvaris® 15-20, 20-30, 30-40 mmHg, multi-layer bandages, or CircAid® bandaging. Compression was maintained day and night in all groups and changed at weekly visits. Study endpoints were time to healing and the clinical parameters predicting the outcome. Results: The cumulative healing rates were 71%, 77%, and 83% after 3, 6, and 9 months, respectively. Univariate analysis of variables associated with nonhealing were: previous surgery, presence of insufficient perforating and/or deep veins, older age, recurrence, amount of oedema, time of presence of CVI and the actual ulcer, and ulcer size (p <0.05-<0.001). The initial ulcer size was the best predictor of the healing-time (Pearson r=0.55, p=0.002). The modality of CT played an important role also, as 19 of 21 ulcers (90%) healed with stockings but only 8 of 14 with bandages (57%; p=0.021). Regression analysis allowed to calculate a model to predict the healing time. It compensated for the fact that patients treated with low or moderate compression stockings were at lower risk of non-healing. and revealed that healing with stockings was about twice as rapid as healing with bandages. Conclusion: Three fourths of venous ulcers can be brought to healing within 3 to 6 months. Healing time can be predicted using easy to assess clinical parameters. Irrespective of the initial presentation ulcer healing appeared more rapid with the application of stockings than with bandaging. These unexpected findings contradict current believes and require confirmation in randomised trials.
Auswirkungen der Kompressionstherapie auf die dynamische Kraft der Beinmuskulatur
Authors: Hefele J. , Gerlach H.-E. 
Published: March 2018

Zusammenfassung
Ziel: Die Kompressionstherapie führt zu einer Abnahme des Beinvolumens. Wir prüften die Frage, ob dies mit einer Abnahme der Muskelkraft verbunden sei. Probanden, Methoden: 83 Beine von Patienten mit Venenproblemen C3–4wurden einer achtwöchigen Behandlung mit medizinischen Kompressionsstrümpfen (20-30 mmHg) unterzogen. 17 davon führten gleichzeitig ein tägliches Zehenstandstraining durch. 27 Beine von Patienten mit C0–2 dienten als Kontrollgruppe, wobei 7 davon das gleiche Trainingsprogramm absolvierten. Die dynamische Kraft der Unterschenkelmuskulatur wurde mit dem Cybex 6000 Gerät vor und nach der Intervention gemessen. Ergebnisse: Die Kompressionsbehandlung führte zu keiner Abnahme der dynamischen Muskelkraft. Einzelne Parameter, wie die Messung der Plantarflexion bei einer Winkelgeschwindigkeit von 30°/s, zeigten sogar eine diskrete Verbesserung (p <0,05). Schlussfolgerung: Frühere Untersuchungen an Probanden schienen die klinische Befürchtung bezüglich einer Abnahme der statischen Muskelkraft unter Kompressionstherapie zu bestätigen. Unsere Messungen der dynamischen Muskelkraft an Patienten mit einer leichten Venenerkrankung lassen solche Bedenken unbegründet erscheinen.
Acute swelling of both legs in a healthy young man
Authors: Soyer H. P. , Salmhofer W. , Kerl H. , Binder B. 
Published: March 2018

SummaryWe report a 22-year-old man suffering from exercise-induced rhabdomyolysis of both lower legs. The patient was admitted to our department for deep vein thrombosis. Clinical examination showed diffuse erythema, swelling, and pain on palpation of both calves. Ultrasonography revealed muscle alterations. Creatine kinase plasma levels were slightly elevated. Based on these findings and on the detailed history the diagnosis of exercise-induced rhabdomyolysis was made.Exercise-induced rhabdomyolysis is an important and potentially fatal disease. Although it is a rare differential diagnosis of deep vein thrombosis, it has to be taken in consideration in patients with muscle alteration visible on ultrasonography. Early recognition and appropriate treatment are of utmost importance for a good clinical outcome.
Behandlung der Erythromelalgie mit aktivem Weinkühler und Amitriptylin-Ketamin-Gel
Authors: Olges K. , Wolbergs S. , Köning Ch. , Brackertz R. , Flessenkaemper I. , Klein-Weigel P. 
Published: March 2018

ZusammenfassungDie Erythromelalgie ist ein seltenes klinisches Syndrom, das durch eine hyperämiebedingte akrale Rotverfärbung und stärkste brennende Schmerzen in den betroffenen Körperabschnitten charakterisiert ist.Wir berichten über eine 57-jährige Patientin mit primärer Erythromelalgie der Füße, die nach multiplen frustranen Therapieversuchen eine Selbstbehandlung mit aktiven Weinkühlern entwickelte. Die quälenden nächtlichen Schmerzsensationen konnten durch das Überstülpen der zuvor im Gefrierfach eingelagerten Weinkühler gelindert werden, ohne dass es zu Mazerationen oder Erfrierungen der Haut kam. Die zusätzliche Behandlung mit Amitriptylin-Ketamin-Gel führte schließlich zu einem für die Patientin befriedigenden Behandlungsergebnis.Die primäre Erythromelalgie wurde bisher überwiegend für eine primäre Mikrozirkulationsstörung gehalten. Neue Forschungsergebnisse konnten aber sowohl bei den seltenen autosomal-dominanten familiären als auch bei sporadischen Erkrankungsfällen Mutationen vornehmlich in der SCN9A-Untereinheit des spannungsabhängigen Na+-Kanalkomplexes identifizieren, die zu Reizschwellenerniedrigungen und Hochfrequenzaktivierungsmustern in sensorischen und sympathischen Neuronen und Nozizeptoren führen. Die Erythromelalgie ist somit als hereditäres neurogenes Schmerzsyndrom zu klassifizieren. Eine Vielzahl zumeist empirischer Behandlungsansätze mit zweifelhaftem Erfolg fördert Selbstbehandlungsversuche. Das verwendete Amitriptylin-Ketamin-Gel besitzt vielfältige antiexzitatorische Effekte. Die Charakterisierung der Erythromelalgie als Ionenkanalerkrankung und das bessere Verständnis ihrer molekularen Basis lässt hoffen, dass künftig effektivere und selektivere Behandlungsmöglichkeiten entwickelt werden.
Dorsal venous foot ulcer caused by an intermetatarsal perforating vein
Authors: Göstl K. , Obermayer A. 
Published: March 2018

SummaryThis case report describes a woman (age: 79 years) with a recurrent venous ulcer located on the left dorsal foot. Duplex investigation showed that this ulcer was caused by an intermetatarsal insufficient perforating vein (PV). Finally Duplex-guided sclerotherapy of the causing PV has been chosen as therapy and the ulcer was successfully healed.
Varicose veins in very young
Authors: Schubert R. , Schäfer L. , Rass K. , Frings N. 
Published: March 2018

SummaryThe prevalence of varicose veins in very young patients is rather low. However, since this is not worked out in the literature, we considered on treatment strategies and techniques in this patients. Patients and methods: We included in our study 58 patients younger than 25 years, who presented to our clinic over a one year period. 42 patients revealed primary varicose veins with 68 legs affected. The average age was 21.5 years, 28 were female, 14 male. Due to CEAP 66 legs were classified as C2–C3, and two legs as C4. In 38 legs an incompetence of the saphenofemoral or saphenopopliteal junction (SFJ/ SPJ) was found. Generally, we recommended a conservative treatment approach and to play a waiting game. An active surgical treatment has been indicated in 21 legs based on increasing discomfort despite sufficient conservative therapy, reflux of the greater or lesser saphenous vein down to the ankle (Hach stage IV and III respectively), existence of a secondary deep vein incompetence or a strong patient’s demand. Finally, 15 patients have been treated surgically by flush ligation of the saphenofermoral/popliteal junction (SFJ/SPJ)), ligation of all side branches, oversewing the stump to protect from angiogenesis and complete removal of all superficial varicose veins in tumescent local anaesthesia. Results: After an average follow-up of five months 13 patients were reexamined. All junctional regions were without reflux and recurrent varices were not observed. One minor complication occurred (afferent nerve injury). Conclusion: Although all operations were performed without major complications our strategy is different now. After failure of conservative treatment we would advise at first to an endovenous obliteration. The aim is to gain time in young patients to avoid a first to third recurrence in the age of 40 to 50 years, because even after correctly performed ligation of the SFJ/SPJ recurrences may occur by neovascularization. We would perform an operation only if recurrences after endovenous therapy might develop or when a second endovenous procedure will not be favourable.
Accuracy of the intra-operative radioauided localization of the sentinel lymph node (SLN) 24 hours after lymphoscintigraphy in patients with malignant melanoma
Authors: Stein A. , Hackert I. , Sebastian G. , Meurer M. , Griming T. , Liepe K. , Pinkert J. , Franke W.-G. , Kropp J. 
Published: March 2018

Summary
Aim: For optimized logistics for the sentinel lymph-adenectomy (SL) it might be helpful for the clinics involved if a longer time period between the lymphoscintigraphy (LS) and surgery is possible. Therefore, we investigated if a precise localization of the sentinel lymph node is possible 24 hours after LS. Methods: 78 patients with primary malignant melanoma (MM; η = 44) or with MM pre-operated by excisional biopsy (n = 34) were investigated. In 40 cases the tumor was localized on the trunk and in 38 cases on the extremities. Mean MM thickness was 2.68 mm (range: 0.29 to 12 mm). In all patients a lymphoscintigraphy (LS) with an average of 85 MBq of Tc-99m nanocolloid was performed one day prior to surgery. Immediately after tracer application dynamic data acquisition was started at a LFOV gamma camera followed by a whole body scan. With a hand-held gamma detector (C-Trak®) 2,4,6,8, and 24 hours after tracer administration the SLN was identified and the counts registered. Results: 94 SLNs were identified in 87 lymphatic basins from which 86 could be resected. Nine MM showed two draining channels. After 24 hours 15.5% (as an average) of the initial counts could be measured in the SLN. The uptake in the SLN in pre-operated versus patients with primary tumor was statistically not significant (p = 0.4). In 16 cases (20.5%) the SLN was tumor positive. Four of those patients developed distant metastases and two died within the first year. None of the patients with negative SLN developed distant metastases or died. Conclusion: The remaining activity in the SLN up to 24 hours after administration is sufficient for their intra operative localization. The method of lymphoscintigraphy and localization of the SLN by a hand-held gamma detector optimizes the intra operative identification of the SLN in patients with malignant melanoma.
Scientific publishing in the journal Nuklearmedizin: current practice
Authors: Jigalin A. , Lerch H. 
Published: March 2018

Summary
Aim: The paper reviews current scientific publishing practice in the journal Nuklearmedizin. Method: The scientific publications in the 2000 and 2001 issues of the journal were analyzed retrospectively with regard to their authors, formal content criteria and citation practice. Results: 102 articles (69 original papers, 29 case reports, 4 review articles) were published. Of a total of 561 authors, 80 first authors came from Germany, 9 from Austria, 3 from Switzerland, and 10 from other countries. In 58 out of the 102 publications, researchers from other medical specialties were co-authors. The first authors were based at university hospitals or research centers in the case of 88 out of 102 publications. The author of one article had his own practice. Of the 102 first authors, 24 were female with a statistically significantly (p = 0.04) higher proportion in case reports compared to original papers. A total of 88/98 original papers and case reports were categorized as clinical research, 2 out of 69 original papers as experimental research, and 8 as management, health policy and radiation protection. 36 out of 102 articles were in English. The 69 original papers included a median of 48 investigated patients (range 4-991). A total of 2555 other papers with a median of 19 (range 3-230) was cited, comprising 212 citations of the journal Nuklearmedizin, i. e. 8.3% (range 0-56%). Conclusion: The number of authors per paper documents the tendency to team work with a major participation of other specialties; university hospitals and research centers are represented more often. There is a predominance of clinical research with a high average number of patients per study. The percentage of first female authors are proportionate to their percentage membership in the learned societies. The relatively high percentage of papers in English raises the potential to increase the scientific response to publication of the content.
First experiences with a new radiopharmaceutical for sentinel lymph node detection in malignant melanoma
Authors: Schmid R. A. , Kunte C. , Konz B. , Hahn K. , Weiss M. 
Published: March 2018

Summary
Aim of this study was to localize the sentinel lymph node by lymphoscintigraphy using technetium-99m colloidal rhenium sulphide (Nanocis®), a new commercially available radiopharmaceutical. Due to the manufacturers’ instructions it is licensed for lymphoscintigraphy. Patients, methods: 35 consecutive patients with histologically proved malignant melanoma, but without clinical evidence of metastases, were preoperatively examined by injecting 20-40 MBq Nanocis® with (mean particle size: 100 nm; range: 50-200 nm) intradermally around the lesion. Additionally blue dye was injected intaoperatively. A hand-held gamma probe guided sentinel node biopsy. Results: During surgery, the preoperatively scintigraphically detected sentinel lymph nodes were identified in 34/35 (97%) patients. The number of sentinel nodes per patient ranged from one to four (mean: n = 1.8). Histologically, metastatic involvement of the sentinel lymph node was found in 12/35 (34%) patients; the sentinel lymph node positive-rate (14/63 SLN) was 22%. Thus, it is comparable to the findings of SLN-mapping using other technetium-99m-labeled nanocolloides. Conclusion: 99mTc-bound colloidal rhenium sulphide is also suitable for sentinel node mapping.
Mixed Micells: A New Problem-Free Solution for co-123I-Heptadecanoic Acid in Comparison
Authors: Argentini M. , Bläuenstein P. , Lerch R. , Schubiger P. A. 
Published: March 2018

SummaryThe most commonly used reagents for solubilization of 123I fatty acids have very serious drawbacks. Human serum albumin solubilizes the fatty acid only slowly and TWEEN 80 is not free of stability problems. Furthermore adverse reactions in human applications cannot be excluded. In comparison, the newly introduced mixed micells look very favourable: fast solubilization, good stability and no adverse reactions. Biodistribution experiments on rats show an adequate performance of the micells. Hitherto this solution has been applied in more than 200 patients without any complication.
Die quantitative Äquilibrium-Radionuklid-Ventrikulographie in Ruhe zur Beurteilung des Schweregrades einer koronaren Herzerkrankung
Authors: Kleinhans E. , Seiderer M. , Dolivva R. , Büll U. , Knesewitsch P. 
Published: March 2018

ZusammenfassungDie Ergebnisse von Untersuchungen mittels quantitativer Äquilibrium-Radionuklid-Szintigraphie (qÄRNV) an 373 Patienten wurden in einem Datenbanksystem gespeichert und statistisch ausgewertet. Zur Beurteilung wurden folgende linksventrikuläre Parameter herangezogen: Globale und fünf regionale Auswurffraktionen (gAF, rAFl-rAF5) sowie Volumengrößen (EDV, ESV, SV, HMV, HI). Es zeigte sich, daß bei Patienten mit koronaren Herzkrankheiten der Stadien I und II die isolierte Beurteilung der Parameter gAF, EDV und ESV unter Ruhebedingungen zur sicheren Erkennung der Erkrankung nicht genügt. Signifikante Änderungen (p <0.025) dieser Parameter gegenüber dem Normalkollektiv treten erst bei den KHK-Schweregraden III und IV, bzw. bei Patienten mit Infarktanamnese auf. Die zusätzliche Beurteilung der regionalen Auswurffraktion bringt jedoch eine wesentliche Erhöhung (im Falle der KHK I und II um +25%) der Sensitivität der qÄRNV bei der Diagnostik der koronaren Herzerkrankung.