bluuebunny/crossref_metadata_2025_split huggingface dataset:
Belastungs-EKG induziert kein erhöhtes thromboembolisches Risiko bei Patienten mit koronarer Herzerkrankung
Authors: Steffens C. C. , Bastian A. , Bruhn H. D. , Lins M. 
Published: June 2018

ZusammenfassungEine Steigerung der Gerinnungsaktivierung, wie sie durch körperliche Aktivität hervorgerufen werden kann, ist für Patienten mit koronarer Herzerkrankung von besonderer Bedeutung, da sie durch thromboembolische Ereignisse besonders gefährdet sind. Zur Frage, ob eine definierte Fahrradergometrie mit einem erhöhten thromboembolischen Risiko verbunden ist, wurden bei 49 Patienten (Gruppe 1) mit und 51 Patienten (Gruppe 2) ohne KHK vor und nach Belastung verschiedene Parameter des Hämostasesystems bestimmt. Die ermittelten Parameter ließen keine signifikanten Unterschiede zwischen den Gruppen vor und nach Belastung erkennen. Es fanden sich jedoch signifikante Änderungen innerhalb der Gruppen: Die Faktor-VIIl-Aktivität stieg in Gruppe 1 von 132 auf 156% und in Gruppe 2 von 106 auf 136%. Der Von-Willebrand-Faktor stieg in Gruppe 1 von 230 auf 249% und in Gruppe 2 von 228 auf 247%. Als Zeichen einer gesteigerten Fibrinolyse fand sich eine Steigerung des Plasmin-alpha-2-Antiplasmin-Komplexes in Gruppe 1 von 251 auf 401 μg/l und in Gruppe 2 von 247 auf 350 μg/l. Damit geht für Patienten mit KHK von einer Fahrradergometrie, durchgeführt in standardisierter Form und in aerober Stoffwechsellage kein erhöhtes thromboembolisches Risiko aus.
Analyse des Thrombin-Markers F 1+2 in der Einstellungsphase der oralen Antikoagulation
Authors: Lins M. , Bruhn H. D. , Steffens C.-C. 
Published: June 2018

ZusammenfassungIn der initialen Behandlungsphase der oralen Antikoagulation kommt es, abhängig von der gewählten Aufsättigungsdosis, zu Verschiebungen im Hämostase-gleichgewicht. In der stabilen Phase der oralen Antikoagulation ist die INR ein verläßlicher Parameter für die Einstellung. In der initialen Einstellungsphase aber, in der es 2-4 Tage nach Erreichen des angestrebten INR durch Protein-C-Ab-fall noch zur Hyperkoagulabilität kommen kann, ist das Prothrombinfragment F 1 +2 ein zusätzlicher wertvoller Parameter, um abzuschätzen, in wie weit eine Gerinnungsaktivierung vorliegt. In dieser Phase, in der die INR schon im angestrebten Bereich liegt, F 1 +2 aber noch erhöht ist, kann es zu Thrombosen kommen. Der zu diesem Zeitpunkt noch nicht im angestrebten Bereich befindliche Prothrombinfragmentspiegel sollte dann dazu veranlassen die überlappende Heparinisierung noch fortzusetzen.
Hemmung der Staphylokokken-Koagulase durch Taurolin
Authors: Mutschier W. , Meyer H. , Reinmüller J. 
Published: June 2018

ZusammenfassungTaurolin, ein Chemotherapeutikum mit bakteriziden und antitoxischen Eigenschaften, wird in der Chirurgie zur Therapie bakterieller Infektionen - insbesondere der chronischen Osteitis - erfolgreich eingesetzt. Die antitoxische Wirkung wurde bisher jedoch überwiegend in bezug auf die Endotoxine gramnegativer Erreger beschrieben. Wir konnten jetzt zeigen, daß Taurolin die thrombogene Wirkung von Staphylokoagulase auf Zitrat-Plasma hemmt. Staphylokoagulase ist ein Faktor mit Toxinwirkung, der von dem grampositiven Keim Staphylococcus aureus (Staph, aureus) ausgeschieden wird. Die Hemmwirkung ist abhängig von der Taurolin-Konzentration und ist bereits unterhalb der minimalen Hemmkonzentration für Staph, aureus nachweisbar. Weiterhin ist die Inaktivierung der Staphylokoagulase abhängig von der Einwirkungsdauer des Taurolins. Diese Beobachtung ist mit der Vorstellung vereinbar, daß Taurolin durch Übertragung von Methylol-Gruppen die Inaktivierung bakterieller Toxine bewirkt. Da die Staphylokoagulase ein entscheidendes Pathogenitätsmerkmal von Staph, aureus darstellt, gehen wir davon aus, daß deren Inaktivierung ein wesentlicher Bestandteil der Wirkung des Taurolins bei der Behandlung staphylogener Infekte ist.
Effects of Glycoprotein IIb/IIIa Inhibitors on Platelet Function
Authors: Kirchmaier C. M. , Breddin H. K. , Harder S. 
Published: June 2018

SummaryWe have studied the effect of two monoclonal antibodies against the G PI Ib/IIIa-receptor (abciximab and YM 337) on different platelet functions in healthy male volunteers. Platelet aggregation (1, 5 and 20 μM ADP), platelet adhesion, fibrinogen binding, bleeding time and platelet induced thrombin generation (PITT) were studied after an i.v. bolus of different doses of YM337 and after a bolus (0.35 mg/kg) plus 6 h infusion at different dose levels of YM337 or after a bolus of 0.25 mg/kg abciximab followed by a six hour infusion of 0,125 μg/kg/min. After 0.2 mg/kg and 0.4 mg/kg bolus of YM337 fibrinogen binding was reduced by >80%, coinciding with a prolongation of bleeding time to approx. 60 min. Platelet aggregation returned to normal within 24 h and adhesion within 48 h. Bleeding times returned to normal already 4 h after cessation of the infusion. YM337 and abciximab effectively inhibit GPIIb/IIIa mediated platelet aggregation and adhesion in volunteers. In parallel, platelet induced thrombin generation is markedly reduced. The best method to monitor treatment with GPIIb/IIIa inhibitors still has to be defined.
Screening-Methoden in der Hämostase
Authors: Barthels Monika 
Published: June 2018

ZusammenfassungScreening-Teste der Blutgerinnung sind dadurch charakterisiert, daß sie stets einen Teilbereich der Hämostase umfassen im Gegensatz zu den hochspezifischen Bestimmungen einzelner Komponenten des Gerinnungssystems. Ihr scheinbar einfaches Konzept beinhaltet jedoch komplexe enzymatische Reaktionen. Screening-Teste sind auch heutzutage noch unentbehrlich, da sie eine rationelle Diagnostik erlauben mit primärer Zuordnung der Hämostasestörung in einen bestimmten Teilbereich. Ferner können sie Hinweise auf gegebenenfalls bis dahin unbekannte Komponenten der Hämostase geben, die mit der Summe aller bekannten Faktoren nicht erfaßt werden. Mit dem Quick-Test (Thromboplastinzeit), der APTT und der Thrombinzeit wird das plasmatische Gerinnungssystem mit Ausnahme des Faktors XIII und des fibrinolytischen Systems erfaßt. Durch den zusätzlichen Einsatz des Vollblut-Thrombelastogramms kann die Kinetik der Fibrinbildung und die Stabilität des Fibringerinnsels sichtbar gemacht werden. Ferner können Interaktionen zwischen Plättchen und plasmatischem Gerinnungssystem wie z. B. bei der Thrombasthenie Glanzmann, ausgeprägte Hyper-fibrinolysen und ausgeprägte Faktor-Xlll-Mangelzustände aufgedeckt werden.
Einsatz des ProC®-Global-Tests zum Thrombophiliescreening
Authors: Vorberg B. , Siegemund Th. , Voigt H. , Wittig Ina , Berrouschot J. , Kalischewski Petra , Thomas M. , Scheel H. , Siegemund Annelie 
Published: June 2018

ZusammenfassungHereditäre und erworbene Defekte im Protein-C-System führen zu einem erhöhten Thromboserisiko. Mit ProC® Global steht seit Ί997 ein Screeningtest für das gesamte Protein-C-System zur Verfügung, bei dem das Zusammenwirken der einzelnen Komponenten (Protein C, Protein S, APC-Resistenz, erhöhte Faktor-VIII : C-Spiegel und zum gegenwärtigen Zeitpunkt noch unbekannte Risikofaktoren) erfaßt werden. Dieser Assay wurde unter Routinebedingungen an über 4000 Patienten evaluiert. Als indirekt diesen Test beeinflussende Größen wurden Lupus-Antikoagulans, Hyperhomocysteinämie, das Auftreten der Pro-thrombinmutation 20210G→A und der Einfluß von Reaktionen der Akutphase unmittelbar postoperativ untersucht. Die Auswertung erfolgte jeweils getrennt nach Patienten mit arteriellen und venösen Thrombosen. Als wichtigstes Resultat wurde gefunden: ProC® Global ist als rationeller Screeningtest für das Protein-C-System einsetzbar. Das Zusammenwirken aller Komponenten in diesem Test liefert teilweise wertvollere Aussagen als hämostaseologische Einzelfaktoren-Tests.
Neue Plasminogen-Aktivatoren: eine klinische Übersicht
Authors: Ross A. M. 
Published: June 2018

ZusammenfassungDer Schlüssel zum Erhalt von Myokardgewebe und einer höheren Überlebensrate bei akutem Herzinfarkt ist eine rasche Wiederherstellung der Durchgängigkeit der Infarktarterie. Das Verständnis dieses Zusammenhangs war Ausgangspunkt für die Anwendung der Gentechnik zur Entwicklung neuer Plasminogen-Aktivatoren mit speziellen klinischen Eigenschaften. Diese neuartigen Aktivatoren sollten zu einer rascheren und auch vollständigeren Perfusion führen und gleichzeitig ein geringeres Risiko für Blutungen und intrazerebrale Blutungen aufweisen. In diesem Übersichtsbeitrag werden die pharmakologischen Profile und die klinischen Eigenschaften verschiedener neuer Plasminogen-Aktivatoren, die gentechnisch hergestellt werden und von humanem Gewebe-Plasminogen-Aktivator bzw. aus tierischen oder bakteriellen Proteinen abgeleitet sind, dargelegt.
Fayers’ conjecture and the socles of cyclotomic Weyl modules
Authors: Hu Jun , Mathas Andrew 
Published: June 2018

Gordon James proved that the socle of a Weyl module of a classical Schur algebra is a sum of simple modules labelled by

p
p

-restricted partitions. We prove an analogue of this result in the very general setting of “Schur pairs”. As an application we show that the socle of a Weyl module of a cyclotomic

q
q

-Schur algebra is a sum of simple modules labelled by Kleshchev multipartitions and we use this result to prove a conjecture of Fayers that leads to an efficient LLT algorithm for the higher level cyclotomic Hecke algebras of type

A
A

. Finally, we prove a cyclotomic analogue of the Carter-Lusztig theorem.
Increasing Clindamycin and Trimethoprim-Sulfamethoxazole Resistance in Pediatric Staphylococcus aureus Infections
Authors: Khamash Dina F , Voskertchian Annie , Tamma Pranita D , Akinboyo Ibukunoluwa C , Carroll Karen C , Milstone Aaron M 
Published: June 2018

AbstractThe epidemiology of Staphylococcus aureus infection in children is dynamic. We conducted a retrospective observational study on pediatric clinical cultures, performed between 2005 and 2017, that grew S aureus to determine temporal trends in antibiotic resistance. Although methicillin resistance declined, clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly, especially among community-onset isolates.
Minimally invasive Dega acetabuloplasty for the treatment of neuromuscular hip dysplasia
Authors: Kappa Jason E. , Shore Benjamin J. , Allar Benjamin G. , Bruce Robert W. , Fletcher Nicholas D. 
Published: June 2018

Background:
Dega acetabuloplasty is used in the management of neuromuscular hip dysplasia. A minimally invasive technique may decrease perioperative morbidity while allowing for adequate reduction and ensuring stability. We sought to determine the impact of a minimally invasive Dega acetabuloplasty (MID) on hip stability after neuromuscular hip reconstructions.

Methods:
A retrospective review was performed of consecutive patients with cerebral palsy (GMFCS IV/V) and neuromuscular hip dysplasia undergoing bony reconstruction including a varus derotational osteotomy (VDRO) of the femur and a Dega acetabuloplasty. Clinical records were reviewed to evaluate preoperative comordibities and clinical complications. Review of pelvic radiographs preoperatively and at follow-up evaluated correction of acetabular index, migration percentage, and the presence of an intact Shenton’s arc.

Results:
Forty-two patients (45 hips) underwent MID surgery as part of a reconstructive approach for neuromuscular hip subluxation or dislocation. Preoperative migration percentage averaged 61.1±4.0% (range, 39-100%). In addition to bony reconstructions, 91.4% of hips had soft-tissue balancing. Patients had an average estimated blood loss of 102±69.9 cc, mean operative time of 165±44 min, and an average length of stay of 3.2±1.3 days. No patient required reoperation. Operative intervention resulted in a mean migration percentage of 12.1%±2.5 and residual acetabular index of 16.0±8.7 degrees with 84.4% (38 of 45) of hips having an intact Shenton’s arc at 1-year of follow-up.

Conclusions:
The MID provides acceptable rates of postoperative hip stability at 1 yr with low blood loss, surgical time, length of stay, and postoperative medical complications.

Level of Evidence:
Level IV.
Evaluation of the Effectiveness of Cross-Linking Combined With Photorefractive Keratectomy for Treatment of Keratoconus
Authors: Iqbal Mohammed , Elmassry Ahmed , Tawfik Ahmed , Elgharieb Mervat Elshabrawy , El Deen Al Nahrawy Osama Mohiey , Soliman Ashraf Hassan , Saad Hisham A. , Ibrahim Elzembely Hosam A. , Saeed Ahmed Mohamed , Mohammed Osama Ali , Kamel Ahmed Gad , El Saman Islam Saad 
Published: June 2018

Purpose:
To evaluate the effectiveness and safety of combined epithelium-off cross-linking (CXL) with photorefractive keratectomy (CXL Plus) for correction of the myopic and astigmatic components of keratoconus.

Methods:
Seventy-nine eyes of 46 patients who underwent CXL Plus were enrolled in this retrospective, multicenter, noncomparative clinical study. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, and pachymetry measurements were recorded preoperatively and at 3, 6, 12, and 18 months during follow-up.

Results:
The mean (±SD) preoperative uncorrected distance visual acuity and corrected distance visual acuity were 1.00 ± 0.22 logarithm of the minimum angle of resolution (logMAR) and 0.62 ± 0.38 logMAR, respectively, and improved to 0.71 ± 0.36 logMAR and 0.32 ± 0.18 logMAR postoperatively. The mean k value, mean corneal thickness at the thinnest location, and mean myopic and astigmatic components decreased from 46.58 ± 0.97 D, 473 ± 29 μm, 3.65 ± 1.72 D, and 1.83 ± 0.69 D preoperatively to 43.79 ± 1.17 D, 431 ± 38 μm, 1.02 ± 0.78 D, and 1.15 ± 0.26 D, respectively, during follow-up. Eleven eyes had delayed epithelial healing, 2 had stromal opacities, 1 had primary herpes simplex keratitis, and 5 showed progression of keratoconus.

Conclusions:
CXL Plus improved the refractive status of keratoconus during 18 months of follow-up, despite its potential early postoperative complications of delayed epithelial healing and corneal haze. CXL Plus reduced the myopic component more than the astigmatic component of keratoconus. However, the safety and stability of the procedure were offset by longer-term postoperative complications and a high rate of postoperative progression of keratoconus.
Juvenile Open Angle Glaucoma With Nonbullous Congenital Ichthyosiform Erythroderma
Authors: Ichhpujani Parul , Thakur Sahil , Kumar Suresh , Singh Rohan B. 
Published: June 2018

Introduction:
Glaucoma in patients with nonbullous congenital ichthyosiform erythroderma (NBCIE) is a rare entity that has not been described in a histologically confirmed case. We present a unique case of coexisting glaucoma, ichthyosis, and dwarfism that has not been previously described.

Methods:
We present a case of NBCIE with glaucoma and dwarfism that presented to our outpatient department. The patient was referred for watering and photophobia that were due to an epithelial defect that was subsequently managed conservatively. Investigations revealed the existence of a constellation of findings that are presented here.

Results:
NBCIE, glaucoma, and dwarfism represent a spectrum of diseases that seem to have a syndromic association. More gene linkage–based analysis are, however, needed to further confirm our observations.

Conclusions:
NBCIE, glaucoma, and dwarfism can often occur together and need to be assessed and managed individually. Early diagnosis of this spectrum can help improve patient management and quality of life. Dermatologists must get an ocular examination conducted for icthyoses patients.
The PRECISION Survey: Preferences of Physicians Regarding Ultrasound-Guided Intra-Articular Injections
Authors: Ekhtiari Seper , Horner Nolan S. , Simunovic Nicole , Ayeni Olufemi R. 
Published: June 2018

Objective:
The objectives of this survey study were to: (1) determine practice patterns, (2) assess beliefs and attitudes toward ultrasound-guided intra-articular injections (UGIIs), (3) identify barriers to the use of UGII, and (4) determine any differences in beliefs and attitudes based on age or specialty.

Methods:
A survey was developed using a focus group including physicians who perform intra-articular injections of the knee, shoulder, and/or hip. After validation by the focus group, the final survey (28 questions) was e-mailed to members of the Canadian Academy of Sport and Exercise Medicine (N = 632).

Results:
A total of 168 responses were received (26.6%). Nearly half of respondents rarely/never had access to UGII equipment (48.5%), and over half did not have adequate training in UGIIs (56.8%-68.8%). About half of respondents agreed that UGII improves accuracy in knee injections (50.9%); only 35.4% agreed there was evidence to support UGII over non–ultrasound-guided intra-articular injections (NGIIs) of the knee. Physicians younger than 50 years were significantly more likely to use UGII for the knee and hip if they had better access to equipment (P < 0.0005 for both); they were more likely to use UGII for the knee if it was less time-consuming (P = 0.001).

Conclusions:
The majority of respondents are not using UGII for the knee or shoulder. Physicians may overestimate their accuracy in performing NGIIs. The biggest barriers to UGII were identified as: (1) inadequate training; (2) lack of access to equipment; and (3) lack of time. Younger physicians seem more open to adopting UGII if barriers are addressed.
Encouraging Patients to Speak up About Problems in Cancer Care
Authors: Mazor Kathleen M. , Kamineni Aruna , Roblin Douglas W. , Anau Jane , Robinson Brandi E. , Dunlap Benjamin , Firneno Cassandra , Gallagher Thomas H. 
Published: June 2018

Objectives
Many patients with cancer believe that something has gone wrong in their care but are reluctant to speak up. This pilot study sought to evaluate the impact of an intervention of active outreach to patients undergoing cancer treatment, wherein patients were encouraged to speak up if they had concerns about their care and to describe the types of concerns patients reported.

Methods
Patients receiving cancer care at two sites were randomly assigned to an intervention or control group. Intervention patients received a brochure encouraging them to speak up about any concerns and an outreach telephone call during which the interviewer explicitly asked about concerns. Participants in both groups received baseline and follow-up questionnaires assessing their perceptions of their care and whether anything had “gone wrong” and provided ratings of health care providers’ communication and responsiveness. Qualitative content coding was used to categorize patient-reported concerns collected through the baseline and follow-up questionnaires (both groups) and during telephone outreach (intervention patients only). The primary outcome was the number of patients reporting a concern about their care. Communication and responsiveness ratings for intervention and control group patients were compared using t tests.

Results
Of the 60 patients in the intervention group, 34 (56.7%) reported at least one problem or concern, compared with 16 (29.1%) of the 55 patients in the control group (P = 0.003). The telephone outreach in particular resulted in more than half of those reached reporting a new concern (55.3%). We detected no impact of the intervention on patients’ ratings of communication or support for speaking up.

Conclusions
Patients in this study reported a variety of concerns in response to active outreach, demonstrating that active outreach to patients can provide healthcare teams and systems the opportunity to offer a real-time response to the patient, identify where system improvements are needed, and implement policies, procedures, or programs to prevent recurrences.
The Association Between Professional Burnout and Engagement With Patient Safety Culture and Outcomes: A Systematic Review
Authors: Mossburg Sarah E. , Dennison Himmelfarb Cheryl 
Published: June 2018

Objectives
In the last 20 years, there have been numerous successful efforts to improve patient safety, although recent research still shows a significant gap. Researchers have begun exploring the impact of individual level factors on patient safety culture and safety outcomes. This review examines the state of the science exploring the impact of professional burnout and engagement on patient safety culture and safety outcomes.

Methods
A systematic search was conducted in CINAHL, PubMed, and Embase. Studies included reported on the relationships among burnout or engagement and safety culture or safety outcomes.

Results
Twenty-two studies met inclusion criteria. Ten studies showed a relationship between both safety culture and clinical errors with burnout. Two of 3 studies reported an association between burnout and patient outcomes. Fewer studies focused on engagement. Most studies exploring engagement and safety culture found a moderately strong positive association. The limited evidence on the relationship between engagement and errors depicts inconsistent findings. Only one study explored engagement and patient outcomes, which failed to find a relationship.

Conclusions
The burnout/safety literature should be expanded to a multidisciplinary focus. Mixed results of the relationship between burnout and errors could be due to a disparate relationship with perceived versus observed errors. The engagement/safety literature is immature, although high engagement seems to be associated with high safety culture. Extending this science into safety outcomes would be meaningful, especially in light of the recent focus on an abundance-based approach to safety.
Maximizing Utilization in Pancreas Transplantation: Phenotypic Characteristics Differentiating Aggressive From Nonaggressive Transplant Centers
Authors: Serrano Oscar Kenneth , Vock David M. , Dunn Ty B. , Kandaswamy Raja , Finger Erik B. 
Published: June 2018

Background
Maximizing pancreas utilization requires a balance between judicious donor selection and transplant center aggressiveness. We sought to determine how such aggressiveness affects transplant outcomes.

Methods
Using the Scientific Registry of Transplant Recipients, we studied 28 487 deceased-donor adult pancreas transplants. Donor and recipient demographic factors indicative of aggressiveness were used to score center aggressiveness. We compared outcomes of low (> 1 SD below mean), medium (± 1 SD from mean), and high (> 1 SD above mean) aggressiveness centers using bivariate and multivariable regressions.

Results
Donor and recipient aggressiveness demonstrated a roughly linear relationship (R
2 = 0.20). Center volume correlated moderately with donor (r
s = 0.433) and recipient (r
s = 0.270) aggressiveness. In bivariate analysis, there was little impact of donor selection aggressiveness on graft survival. Further, for simultaneous pancreas and kidney transplants, centers with greater recipient aggressiveness selection had better graft survival. High-volume centers had better graft survival than low-volume centers. In multivariable analysis, donor aggressiveness did not have an effect on graft survival, whereas graft survival for medium (hazard ratio [HR], 0.66, 95% confidence interval [95% CI], 0.53-0.83) and high (HR, 0.67; CI, 0.51-0.86) recipient aggressiveness performed better than low-aggressiveness centers. There was a clear volume effect, with high-volume centers (>20 transplants/year; HR, 0.69; CI, 0.61-0.79) performing better than low-volume centers.

Conclusions
Center practice patterns using higher-risk donors and recipients did not negatively affect outcomes. This effect is likely mediated through efficiencies gained with the increased transplant volumes at these centers.