Search

Your search keyword '"Hinz José"' showing total 239 results
Start Over Author "Hinz José"
239 results on '"Hinz José"'

1. Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Author

Büttner Benedikt, Schwarz Alexander, Mewes Caspar, Kristof Katalin, Hinz José, Quintel Michael, Mansur Ashham, and Bergmann Ingo

Subjects
popliteal sciatic nerve block, subparaneural injection, intraneural injection, ultrasound-guidance, magnetic resonance imaging, Medicine
Abstract

Intraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath.

Published
2019
Full Text
View/download PDF

3. Ketamine in outpatient arthroscopic shoulder surgery: Effects on postoperative pain, hemodynamic stability and process times

Author

Schotola Hanna, Kirsch Karl-Christian, Höcker Jan, Egan Michael, Büttner Benedikt, Wiese Christoph, Mansur Ashham, Hinz José Maria, and Bergmann Ingo

Subjects
Ketamine, outpatient, day surgery, postoperative pain, general anaesthesia, Medicine
Abstract

Background: Pain after arthroscopic shoulder surgery is often severe, and establishing a pain treatment regimen that does not delay discharge can be challenging. The reported ability of ketamine to prevent opioid-induced hyperalgesia has not been investigated in this particular setting.

Published
2015
Full Text
View/download PDF

4. Attitudes towards terminal sedation: an empirical survey among experts in the field of medical ethics

Author

Hinz José, Kar Magdalene, Simon Alfred, and Beck Dietmar

Subjects
Special situations and conditions, RC952-1245
Abstract

Abstract Background "Terminal sedation" regarded as the use of sedation in (pre-)terminal patients with treatment-refractory symptoms is controversially discussed not only within palliative medicine. While supporters consider terminal sedation as an indispensable palliative medical treatment option, opponents disapprove of it as "slow euthanasia". Against this background, we interviewed medical ethics experts by questionnaire on the term and the moral acceptance of terminal sedation in order to find out how they think about this topic. We were especially interested in whether experts with a professional medical and nursing background think differently about the topic than experts without this background. Methods The survey was carried out by questionnaire; beside the provided answering options free text comments were possible. As test persons we chose the 477 members of the German Academy for Ethics in Medicine, an interdisciplinary society for medical ethics. Results 281 completed questionnaires were returned (response rate = 59%). The majority of persons without medical background regarded "terminal sedation" as an intentional elimination of consciousness until the patient's death occurs; persons with a medical background generally had a broader understanding of the term, including light or intermittent forms of sedation. 98% of the respondents regarded terminal sedation in dying patients with treatment-refractory physical symptoms as acceptable. Situations in which the dying process has not yet started, in which untreatable mental symptoms are the indication for terminal sedation or in which life-sustaining measures are withdrawn during sedation were evaluated as morally difficult. Conclusion The survey reveals a great need for research and discussion on the medical indication as well as on the moral evaluation of terminal sedation. Prerequisite for this is a more precise terminology which describes the circumstances of the sedation.

Published
2007
Full Text
View/download PDF

6. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Klimscha, Walter, Konecny, Regina, Luntzer, Robert, Morawk-Wintersperger, Ulrike, Neiger, Franz, Rustemeyer, Lydia, Breschan, Christian, Frey, Denise, Platzer, Manuela, Germann, Reinhard, Oeding, Joachim, Stoegermüller, Birgit, Ziegler, Bernhard, Brotatsch, Philipp, Gutmann, Anton, Mausser, Gerlinde, Messerer, Brigitte, Toller, Wolfgang, Vittinghoff, Maria, Zangl, Gregor, Seidel-Ahyai, Natascha, Hochhold, Christoph, Kroess, Ruth, Paal, Peter, Cnudde, Steven, Coucke, Patricia, Loveniers, Birgit, Mitchell, John, Kahn, David, Pirotte, Thierry, Pregardien, Caroline, Veyckemans, Francis, Coppens, Marc, De Hert, Stefan, Heyse, Björn, Neckebroek, Martine, Parashchanka, Aliaksandra, Van Limmen, Jurgen, Van Den Eynde, Nancy, Vanpeteghem, Caroline, Wyffels, Piet, Lalot, Michaël, Lechat, Jean-Paul, Stevens, France, Casaer, Sari, De Groote, Françoise, De Pooter, Françoise, De Villé, Andrée, Gerin, Marc, Magasich, Natalia, Sanchez Torres, Cristel, Van Deenen, Denise, Berghmans, Johan, Himpe, Dirk, Roofthooft, Eva, Joukes, Ellen, Smitz, Carine, Van Reeth, Veronique, Huygens, Christel, Lauweryns, Julie, De Smet, Karen, Najafi, Nadia, Poelaert, Jan, Van de Velde, Anne, Van Mossevelde, Veerle, Bekavac, Ivan, Butkovic, Diana, Heli Litvic, Dubravka, Kerovec Soric, Ivana, Maretic, Hrvoje, Moscatello, Djurdjica, Popovic, Ljiljana, Micici, Slobodan, Stuck Tus, Ivana, Kalagac Fabris, Lada, Simurina, Tatjana, Sulen, Nina, Kesic-Valpotic, Gordana, Djapic, Dajana, Žurek, Jirí, Jureckova, Lucie, Mackova, Iveta, Skacel, Monika, Weinlichova, Stanislava, Divák, Jan, Frelich, Michal, Urbanec, René, Biskupova, Vera, Mixa, Vladimir, Pavlickova, Jana, Afshari, Arash, Bøttger, Morten, Ellekvist, Marguerite B., Johansen, Mathias, Ingeborg Madsen, Birgitte, Christian Nilsson, Jens, Schousboe, Birgitte MB, Clausen, Nicola G., Hansen, Tom G., Phaff Steen, Nick, Ilmoja, Mari-Liis, Tonise, Virge, Karjagin, Juri, Kikas, Reet, Isohanni, Mika, Lyly, Anniina, Takala, Annika, Happo, Johanna, Kiviluoma, Kai, Martikainen, Kati, Aantaa, Riku, Manner, Tuula, Vilo, Sanna, Amory, Catherine, Ludot, Hugues, Lambotte, Patricia, Busche, René, Jacqmarcq, Olivier, Lejus, Corinne, Corouge, Julien, Erb, Christian, Garrigue, Delphine, Gillet, Patricia, Laffargue, Anne, Lambelin, Veronique, Le Freche, Hélène, Peresbota, Daliana, Richart, Pierre, Berton, Jerome, Chapotte, Catherine, Colbus, Laurent, Lehousse, Thierry, Monrigal, Jean, Baujard, Catherine, Roulleau, Philippe, Staiti, Giuseppe, Batoz, Hélène, Bordes, Maryline, Didier, Anne, Hamonic, Yann, Lagarde, Sylvaine, Nouette-Gaulain, Karine, Semjen, François, Zaghet, Brigitte, Dekens, Jacky, Delcuze, Axelle, Dupont, Hervé, Legrand, Aurélien, Raffoflandreur, Celine, Audren, Noémie, Camus, Blandine, Cartal, Marielle, Chazelet, Chantal, Davin, Isabelle, Guillier, Marion, Desjeux, Luc, Larcher, Claire, Grein, Elodie, Leclercq, Mickeal, Levitchi, Roxana, Rosu, Lilica, Simon, Dominique, Zang, Aurélien, Migeon, Anne, Gagey, Anne-Charlotte, Bourdaud, Nathalie, Carre, Anne-Charlotte, Duflo, Frédéric, Riche, Jean-Claude, Robert, Philippe, Druot, Emilie, Maupain, Olivier, Orliaguet, Gilles, Sabau, Lucie, Taright, Hanna, Uhrig, Lynn, Verchere-Montmayeur, Juliette, Debrabant, Lise, Pilla, Clotaire, Podvin, Alexandre, Roth, Benjamin, Dahmani, Souhayl, Julien-Marsollier, Florence, Sabourdin, Nada, Alexandri, Bogdan, Brezac, Gilles, de la Brière, Francois, Hayem, Catherine, Lhubat, Elizabeth, Paul Mission, Jean, Rémond, Charlotte, Dadure, Christophe, Maniora, Maud, Marie, Anais, Pirat, Philippe, Saour, Anne-Charlotte, Sola, Chrystelle, Ecoffey, Claude, Wodey, Eric, Adam, Christian, Standl, Thomas, Schindler, Ehrenfried, Yamamoto, Tomohiro, Brackhahn, Michael, Eich, Christoph Bernhard, Guericke, Holger, Kindermann, Petra, Laschat, Michael, Schink, Cornel, Wappler, Frank, Hoehne, Claudia, Skordou, Natalia, Ulrici, Johanna, Jetzek-Zader, Martin, Kienbaum, Peter, Meyer-Treschan, Tanja, Picker, Olaf, Schaefer, Maximilian S., Mielke, Golo, Baethge, Sabine, Ramminger, Axel, Bauer, Martin, Bollinger, Matthias, Hinz, José, Quintel, Michael, Russo, Sebastian G., Bauer, Michael, Geil, Dfominik, Kortgen, Andreas, Preussler, Niels-Peter, Hofmann, Ulrich, Raber, Manfred, Reindl, Doris, Becke, Karin, Oppenrieder, Karin, Schierlinger, Bettina, Roth, Jens, Funk, Wolfgang, Fischer, Thomas, Gernoth, Christian, Wiefelspütz, Christina, Volger, Hauke, Zederer, Nicole, Diers, Anja, Huber, Matthias, Schorer, Clemens, Weyland, Andreas, Schwarzkopf, Konrad, Grau, Catharina, Roth, Winfried, Holy, Rolf, Mader, Thomas, Peter, Laura, Supthut, Hauke, Kuehhirt, Thomas, Milde, Alexander, Fiedler, Fritz, Isselhorst, Carsten, Grundmann, Ulrich, Pattar, Alexander, Reinert, Jennifer, Ehm, Birgit, Fritzsche, Katrin, Gaebler, Ralf, Meybohm, Patrick, Hein, Maximilian, Guzman, Ines, Jokinen, Johanna, Kranke, Peter, Goebel, Ulrich, Harris, Sarah, Eisner, Christoph, Ochsenreiter, Miriam, Schoeler, Michael, Thil, Elke, Ellerkmann, Richard, Hoeft, Andreas, Neumann, Claudia, Weber, Stefan, Keilhauer, Julia, Kloessing, Jan, Schramm, Michael, Trieschmann, Uwe, Knauss, Kristina, Sinner, Barbara, Steinmann, Johannes, Koessler, Herbert, Kalliardou, Evagelia, Malisiova, Anna, Tsiotou, Adelais, Chloropoulou, Pelagia, Chrysi, Mpratzou, Iordanidou, Despoina, Ntavlis, Merkourios, Boda, Krisztina B, Guerin, Christilynn, Irwin, Janice, Magner, Claire, Nakhjavani, Solmaz, O'Hare, Brendan, Galvin, Deborah, Jamil, Yosry, Lesmes, Carlos, Barak, Yuri, Fisher, Haran, Kachko, Ludmyla, Katz, Jacob, Kirilov, Dmitry, Levinzon, Michael, Manevich, Yair, Nekrasov, Konstantin, Peled, Elia, Sanko, Elena, Schmain, Dmitri, Sheinkin, Olga, Simhi, Eliahu, Tarabikin, Alex, Trabkin, Evelina, Yagudaev, Irena, Zeitlin, Yelena, Zunser, Igor, Cerutti, Elisabetta, Maddalena Schellino, Maria, Valzan, Silvia, Lucia Pinciroli, Rosa, Bortone, Luciano, Cerati, Giorgia, Salici, Fabiana, Bussolin, Leonardo, Rizzo, Giuliana, Rossetti, Francesca, Marchesini, Laura, Tesoro, Simonetta, De Lorenzo, Brita, Guarracino, Fabio, Kuppers, Beate, Astuto, Marinella, Pitino, Sofia, Scalisi, Rita, Scordo, Lucia, D'Alessandro, Sandra, Dei Giudici, Luigi, Farinelli, Ivano, Lofino, Giuseppe, Marchetti, Giuliano, Giuseppe Picardo, Sergio, Reali, Simone, Vittori, Alessandro, Antonio Idone, Francesco, Sammartino, Maria, Sbaraglia, Fabio, Barbera, Cinzia, Bevilacqua, Michela, Cento, Valeria, Disma, Nicola, Kotzeva, Svetlana, Mameli, Leila, Montobbio, Giovanni, Passariello, Leandro, Punzo, Cinzia, Sileo, Rosanna, Viacava, Rosanna, Volpe, Claudia, Zanaboni, Clelia, Calderini, Edoardo, Genco, Daniele, Neri, Simona, Ottolina, Davide, Camporesi, Anna, Izzo, Francesca, Salvo, Ida, Wolfler, Andrea, Sanna, Andrea, Sciascia, Angela, Stoia, Paolo, Guddo, Annamaria, Lapi, Maria, Ivani, Giorgio, Longobardo, Annalisa, Mossetti, Valeria, Pedrotti, Dino, Grazzini, Maurizia, Meneghini, Luisa, Metrangolo, Salvatore, Michelon, Stefania, Minardi, Carmelo, Tognon, Costanza, Zadra, Nicola, Busi, Ilaria, Khotcholava, Magda, Guido Locatelli, Bruno, Sonzogni, Valter, Starita, Giusi, Almenrader, Nicole, Aurilio, Caterina, Sansone, Pasquale, Albarello, Raffaella, Bracci, Paolo, Cecini, Mariateresa, Cristina Mondardini, Maria, Pasini, Lorena, Vason, Milo, Zani, Gianluca, Zoppellari, Roberto, Pistidda, Laura, Cortegiani, Andrea, Maurizio Raineri, Santi, Hasani, Antigona, Hashimi, Medita, Ancupans, Agris, Barzdina, Arta, Straume, Zane, Zundane, Anda, Chlopin, Mikhail, Gestautaite, Dalia, Lukosiene, Laura, Paliokaite, Evelina, Razlevice, Ilona, Armoniene, Inesa, Bernotiene, Aurelija, Daugelavicius, Vidunas, Dockiene, Ilona, Gaidelyte, Lina, Saviciene, Nijole, Krikstaponiene, Jolita, Sidlovskaite-Baltake, Dominika, Stasevski, Vladyslav, Vaitoskaite, Agne, Gatt, David, Mifsud, Stephanie, Zammit, Simone, Allison, Celia, Aslami, Hamid, Eberl, Susanne, van Stijn, Mireille F M, Stevens, Markus F, Punt, Kees, van Osch, Rob, Bauwman, Arthur, Scholten, Harm, Svircevic, Vesna, Adriaens, Veronique, Dirckx, Maaike, Dogger, Jaap, Dons-Sinke, Ilse, Machotta, Andreas, Moors, Xavier, Rad, Mandana, Staals, Lonneke, van der Knijff - van Dortmont, Anouk, van der Marel, Caroline, Sieben, Anne, van der Zwan, Tim, Veldhuizen, Marianne, Alders, David, Buhre, Wolfgang, Vermeulen, Petronella M, Engel, Nicole, Vossen, Carine, Mahadewsing, Ravin, Meijer, Patrick, Gerling, Volker, van der Schatte Olivier, Roelof, van Doorn, Thea, Vons Mark Hendriks, Kristy, Lako, Sandra, jan Scheffer, Gert, Tielens, Luc, Voet, Marieke, Absalom, Anthony, Bergsma, Margot, Spanjer, Vera, Spanjersberg, Rob, van de Riet, Yvette, Volkers, Martin, de Graaff, Jurgen C., Hopman, Geranne A.J., Kappen, Teus H., Hannie, J., Megens, A.M., Numan, Sandra C., Schouten, Anton N.J., Turner, Nigel M., Van Der Werff, Désirée B.M., Wensing, Renee T.M., Ephraim, Erik, Nolte, Claire, Reikvam, Tore, Fredrik Lund, Ole, Skaaden, Lene, Marthe Ballovarre, Kari, Bakken Boerke, Wenche, Grindheim, Guro, Lindenskov, Pal H H, Beate Solas, Anne, Sponheim, Sjur, Ullensvang, Kyrre, Viken, Oddbjorn, Marie Drage, Inger, Gymoese Berthelsen, Kasper, Anders Kroken, Bjørn, Bergland, Unni, Pryzmont, Miroslaw, Talalaj, Mariola, Wasiluk, Malgorzata, Zalewska, Dorota, Damps, Maria, Siemek-Mitela, Jadzia, Wieczorek, Pawel, Juzwa, Magdalena, Rosada-Kurasinska, Jowita, Bartkowska-Sniatkowska, Alicja, Cettler, Maciej, Kopycinska, Renata, Rudewicz, Iwona, Sobczyk, Jaek, Wojciechowski, Dariusz, Baranowski, Artur, Basiewicz, Ewa, Mierzewska-Schmidt, Magdalena, Retka, Wlodzimierz, Sawicki, Piotr, Checinska, Magdalena, Zielinska, Marzena, Zurawska, Magdalena, Leal, Teresa, Mascarenhas, Catia, Pedro Pina, António, Joao Susano, Maria, Moniz, Antonio, Teresa Rocha, Maria, Calvao Santos, Carolina, Domingas Patuleia, M, Pereira, Ricardo, Roxo, Helena, Amaral, Rosa, Guedes, Isabel, Gomes, Cristina, Gonçalves, Marta, Salgado, Helena, Santos, Maria, Rodrigues, Sara, Sa, Angela, Machado, Elvira, Pé d'Arca, Sandra, Seabra, Manuel, Mihaela Gheorghe, Ligia, Ivascu, Constantin, Moraru-Draghici, Lucia, Suvejan, Mirela, Babici, Remus, Eniko, Kovacs, Hogea, Cristiana, Mihaela, Dubau, Nicoleta, Daraban, Barbunc, Danut, Maria Nistor, Alina, Stefan, Violeta, Catalina Ionescu, Gabriela, Davidescu, Irina, Teodora Nastase, Alina, Dumitru Rusu, Florin, Badarau, Victoria, Cindea, Iulia, Moscaliuc, Melania, Olteanu, Dana, Petrescu, Luxita, Ceuca, Daniela, Galinescu, Irena, Badeti, Rodica, Capusan, Alin, Cucui-Cozma, Cosmina, Popescu, Barbura, Cimpeanu, Luminita, Birliba, Mihaela-Petronela, Miulescu, Magdalena, Balamat, Stefania, Gurita, Adriana, Ilie, Luminita, Mocioiu, Gabriel, Pick, Darina, Sirghie, Rodica, Tabacaru, Radu, Trante, Irinel, Horhota, Lucian, Bandrabur, Daniela, Ciobanu, Tudor, Cuciuc, Veaceslav, Munteanu, Valentin, Olaru, Valentin, Paiu, Corneliu, Savu, Anca, Trifan, Oana, Elena Malos, Anca, Glazunov, Anton, Ivanov, Alexander, Poduskov, Evgeny, Popov, Alexander, Guskov, Igor, Lugovoy, Alexander, Nechaev, Vladislav, Ovezov, Alexey, Basov, Mikhail, Kochkin, Vladimir, Lazarev, Vladimir, Chizhov, Dmitri, Ostreikov, Ivan, Tolasov, Konstantin, Budic, Ivana, Marjanovic, Vesna, Draskovic, Biljana, Pandurov, Marina, Simin, Jovana, Dolinaj, Vladimir, Janjevic, Dusanka, Mandras, Ana, Mircetic, Maja, Petrovic, Sladjana, Rebac, Vlatka, Slavkovic, Bojana, Stevanovic, Vesna, Velcev, Ana, Knezevic, Mirjana, Milojevic, Irina, Puric, Selena, Simic, Irena, Stevic, Marija, Stranjanac, Vladimir, Simic, Dusica, Cabanova, Barbora, Hanula, Miloslav, Grynyuk, Andry, Berger, Jelena, Cerne, Uros, Nastran, Andraz, Pirc, Dejan, Popic, Rok, Stupnik, Spela, Rubio, Paloma, del Río, Cristina, Benito, Pilar, Pino, Gema, Gutierrez, Ignacio, Gutierrez Valcarcel, Andrea, León Carsi, Irene, Perez Garcia, Anibal, López Galera, Sílvia, Marco Valls, Joan, Ricol Lainez, Laura, Vallejo Tarrat, Andrea, Artes, David, Banus, Ester, Chirichiello, Luca, De Abreu, Leidy, De Josemaria, Belen, Helena Gaitan, M, Garces, Antonio, Lazaro, Juan J, Manen Berga, Ferran, Molies, Dolors, Monclus, Enric, Navaro, Montserrat, Pamies, Carmen, Perelló, Marina, Prat, Mar, Ribo, Laura, Angeles Sanz, M, Serrano, Silvia, Sola Ruiz, Eva, Anuncia Escontrela Rodríguez, Blanca, Maria Gago Martinez, Andrea, Martínez Ruiz, Alberto, De La Cruz Benito, Fausto, Gabilondo Garcia, Gustavo, Martinez Maldonado, Ever, Noriega, Bryant, Oller Duque, Lara, Olmos Mendez, Alberto, Perez- Ferrer, Antonio, Reinoso Barbero, Francisco, Acevedo Bambaren, Ismael, Domínguez, Fernando, Franco, Teresa, Jiménez, Anabel, Melero, Alicia, Feliu, Montserrat, García, Irene, Montferrer, Núria, Munar, Francisca, Muro, Cristina, Nuño, Rosario, Perera, Remel, Schmucker, Erika, Börjesson, Glenda, Gillberg, Lars, Castellheim, Albert, Sandström, Kerstin, Bauer, Annette, Roos, Torbjörn, Hedlund, Lars, Boegli, Yann, Dolci, Mirko, Marcucci, Carine, Spahr-Schopfer, Isabelle, Habre, Walid, Pellegrini, Michel, Book, Malte, Errass, Loreen, Riggenbach, Christine, Casutt, Mattias, Hölzle, Martin, Hurni, Thomas, Jöhr, Martin, Mauch, Jacqueline, Anselmi, Luciano, Anselmi, Irene, Jacomet, Alfred, Oberhauser, Markus, Wossner, Stephanie, Zettl, Angelika, Erb, Thomas, Mackiewicz, Tomasz, Simitzes, Helena, Ozer, Yetkin, Takil, Arzu, Alanoglu, Zekeriyya, Bermede, Onat, Cakar Turhan, K.Sanem, Alkis, Neslihan, Yildirim Guclu, Cigdem, Ceyda Meco, Basak, Hatipoglu, Zehra, Ozcengiz, Dilek, Begec, Zekine, Ilksen Toprak, Huseyin, Kendigelen, Pinar, Cigdem Tütüncü, Ayse, Karadeniz, Meltem Savran, Seyhan Ozkan, Tulay, Sivrikoz, Nuket, Kemal Arslantas, Mustafa, Hizal, Ayse, Tore Altun, Gülbin, Umuroglu, Tumay, Baris, Sibel, Kazak Bengisun, Zuleyha, Goncharenko, Galyna, Khrapak, Maksym, Klymenko, Tetyana, Pavlenko, Vitaliy, Prysiazhniuk, Dmytro, Rudio, Olga, Varyvoda, Mykhailo, Vodianytskyi, Sergii, Boryshkevych, Ivanna, Kyselova, Iryna, Trikash, Nikolay, Albokrinov, Andrew, Perova-Sharonova, Valentina, Sklyar, Vitaliy, Surkov, Denis, Abdelaal, Amr, Barber, Nicola, Checuti, Sarah, Godsiff, Leisha, Johanne, Lynch, Simpson, Joanna, Underhill, Helen, Diwan, Rishi, Kelgeri, Nivedita, Masip, Nuria, Ravi, Radha, Roberts, Steve, Cillis, Annagrazia, Marcus, Ritchie, Merella, Federica, Love, David, Baraggia, Paolo, Bird, Victoria, Hussey, Joseph, Alderson, Peter, Bartholomew, Karen, Moncreiff, Michael, Davidson, Sarah, Hare, Alison, Kotecha, Ami, Lee, Corina, Liyanage, Ganga, Patel, Shivali, Samani, Amee, Abou-Samra, Mark, Boyd, Matthew, Hullatt, Laurence, Levy, David, Pauling, Mark, Sharman, Sarah-Jane, Smith, Natalie, Rutherford, John, Cavalier, Alison, Locke, Christie, Sage, Frederic, Bapat, Smita, Hammerschlag, Jacinda, Ioannou, Ioannis, King, Stephanie, Pegg, Rachel, Salota, Vishal, Sketcher, Jonathan, Thadsad, Muthu, Zeitlin, Deborah, Jack, Ewan, Lang, Colin, Ahmed, Samira, Ayyash, Reema, Bari, Francoise, Bell, Sarah J, Elizabeth Biercamp, Claire, Briggs, Sandra, Gabriella Elena Clement, Maria, Dalton, Mark, Ali Eissa Eid, Mohamed, Gandhi, Monica, Harmen Herrema, Idse, Khaffaf, Ranj, Jeng Min Law, Savio, McClintock, Joanna, Ireland, Nicholas, Majid Saleem, Mohammed, Smith, Fiona, Cohen, Marc, Lee, Clover-Ann, O'Donahue, Lizanne, Powell, Alex, Rawlinson, Ellen, Snoek, Aarjan, Weiss, Katja, Wellesley, Hugo, Crawford, Michael, Abdel-Hafiz, Mostafa, Day, Alexandra, Rajamani, Balaji, Saha, Rita, Wright, Dave, Chee, Lew-Chin, Bew, Stephanie, Homer, Rachel, Malarkkan, Nalini, Wolfe Barry, Juliet, Angadi, Pradeep, Cagney, Brid, De Melo, Eric, Dekker, Elsa, Helm, Emma, Jones, Gareth, Peiris, Kawshala, Russell, William, Slater, Patricia, Sodhi, Puja, Browning, Mike, Phillips, Trudie, Van Hecke, Rachel, Muir, Vimty, Singh, Piyush, Soskova, Tereza, Cumming, Craig, Farquharson, Pamela, Pearson, Karen, Shaw, Neil, Whiteside, Jonathan, Whyte, Emma, Byers, Gordon, Davies, Kay, Engelhardt, Thomas, Faliszewski, Isabella, Johnston, Graham, Kaufmann, Nils, Kusnirikova, Zuzana, Wilson, Graham, Carachi, Peter, Makin, Andrew, Foster, Brian, Lipczynski, Dariusz, Mawer, Rebecca, Rutherford, William, Rogerson, David, Rushman, Sarah, Taylor, Christopher, Tomlinson, William, Dix, Philippa, Woodward, Tom, Bell, Graham, Boyle, David, Cloherty, Marianne, Cullen, Julia, Cullen, Pauline, Fairgrieve, Ross, Ghent, Robert, Glasgow, Russell, Gordeeva, Elena, Harden, Alison, Hivey, Sarah, Jerome, Kevin, McKee, Lesley, Morton, Neil, Pribul, Vicky, Sinclair, John, Steiner, Maria, Steward, Heather, Sweeney, Lorraine, Thomson, Wendy, Whiteside, Jeanette, Dalton, Andrew, Ross, Mark, Smith, Carolyn, Allen, Claire, Anders, Nicola, Barlow, Victoria, Bassett, Mike, Darwin, Leanne, Davison, Rachel, Diacono, Jacques, Hobbs, Amy, Hutchinson, Adel, Lomas, Bernadette, Lonsdale, Hannah, Nasser, Leila, Oshan, Vimmi, Patel, Pradip, Raistrick, Christopher, Scott-Warren, Victoria, Talbot, Laura, Wai, Carolynn, Childs, Sophie, Dickinson, Matthew, Bloomfield, Tom, Garrioch, Sweyn, Watson, Karen, Gaynor, James, Harrison, Richard, Lee, Juliette, Blythe, Elizabeth, Dorman, Teresa, Eissa, Ayman, Ellwood, James, Gooch, Ingrid, Hearn, Robert, Hodgetts, Vanessa, John, Robert, Kirton, Christine, Ladak, Nadia, Morgan, Judith, Plant, Nina, Shepherd, Elizabeth, Short, Judith, Stack, Charles, Steel, Simon, Taylor, Matthew, Thomas, Deborah, Wilson, Catharine, Wilson-Smith, Elaine, Bradbury, Carol L., Hussain, Nageena, Mayell, Antonia, Mesbah, Ahmed, Qureshi, Arif, Vaidyanath, Chandra, Geary, Tim, Hawksworth, Chris, Parasuraman, Tamaraichelvi, Perry, Nicole, Banerjee, Indrani, Barr, Katharine, Butler, Patrick, Davies, Jack, Flewin, Lisa, Gande, Richard, Montague, James, Plumb, James, Pratt, Thomas, Sutherland, Paul, Vail, Hannah, Wilkins, Andrew, Hunter, Catherine, Russell, Susan, Thomas, Alun, Mifsud, Mark, Strachan, Dominic, Leva, Brigitte, Plichon, Benoit, Harlet, Pierre, Virag, Katalin, Hansen, Tom G, Morton, Neil S, and Boda, Krisztina

Published
2017
Full Text
View/download PDF

8. Berichtswesen

Author

Raetzell, Malte, Hinz, José, Bauer, Martin, Wäschle, Reiner M., Welk, Ina, editor, and Bauer, Martin, editor

Published
2011
Full Text
View/download PDF

14. Effect of the Lymphocyte Activation Gene 3 Polymorphism rs951818 on Mortality and Disease Progression in Patients with Sepsis—A Prospective Genetic Association Study

Author

Mewes, Caspar, Alexander, Tessa, Büttner, Benedikt, Hinz, José, Alpert, Ayelet, Popov, Aron-F., Beißbarth, Tim, Tzvetkov, Mladen, Grade, Marian, Quintel, Michael, Bergmann, Ingo, and Mansur, Ashham

Subjects
sepsis, LAG-3, single nucleotide polymorphism, genetic association study, lymphocyte-activation gene 3, Medicine, mortality, Article
Abstract

(1) Background: Sepsis is a leading cause of death and a global public health problem. Accordingly, deciphering the underlying molecular mechanisms of this disease and the determinants of its morbidity and mortality is pivotal. This study examined the effect of the rs951818 SNP of the negative costimulatory lymphocyte-activation gene 3 (LAG-3) on sepsis mortality and disease severity. (2) Methods: 707 consecutive patients with sepsis were prospectively enrolled into the present study from three surgical ICUs at University Medical Center Goettingen. Both 28- and 90-day mortality were analyzed as the primary outcome, while parameters of disease severity served as secondary endpoints. (3) Results: In the Kaplan–Meier analysis LAG-3 rs951818 AA-homozygote patients showed a significantly lower 28-day mortality (17.3%) compared to carriers of the C-allele (23.7%, p = 0.0476). In addition, these patients more often received invasive mechanical ventilation (96%) during the course of disease than C-allele carriers (92%, p = 0.0466). (4) Conclusions: Genetic profiling of LAG-3 genetic variants alone or in combination with other genetic biomarkers may represent a promising approach for risk stratification of patients with sepsis. Patient-individual therapeutic targeting of immune checkpoints, such as LAG-3, may be a future component of sepsis therapy. Further detailed investigations in clinically relevant sepsis models are necessary.

Published
2021

17. Gene Expression–Based Diagnosis of Infections in Critically Ill Patients—Prospective Validation of the SepsisMetaScore in a Longitudinal Severe Trauma Cohort

Author

Thair, Simone, primary, Mewes, Caspar, additional, Hinz, José, additional, Bergmann, Ingo, additional, Büttner, Benedikt, additional, Sehmisch, Stephan, additional, Meissner, Konrad, additional, Quintel, Michael, additional, Sweeney, Timothy E., additional, Khatri, Purvesh, additional, and Mansur, Ashham, additional

Published
2021
Full Text
View/download PDF

18. TIM-3 Genetic Variants Are Associated with Altered Clinical Outcome and Susceptibility to Gram-Positive Infections in Patients with Sepsis

Author

Mewes, Caspar, Alexander, Tessa, Büttner, Benedikt, Hinz, José, Alpert, Ayelet, Popov, Aron-F., Ghadimi, Michael, Beißbarth, Tim, Tzvetkov, Mladen, Grade, Marian, Quintel, Michael, Bergmann, Ingo, and Mansur, Ashham

Subjects
Adult, Male, Heterozygote, Genotype, TIM-3, sepsis, single nucleotide polymorphism (SNP), mortality, predictor, Gram-positive infections, Kaplan-Meier Estimate, Polymorphism, Single Nucleotide, Severity of Illness Index, Article, lcsh:Chemistry, Gene Frequency, Humans, Genetic Predisposition to Disease, Hepatitis A Virus Cellular Receptor 2, lcsh:QH301-705.5, Alleles, Genetic Association Studies, Aged, Homozygote, Middle Aged, lcsh:Biology (General), lcsh:QD1-999, Case-Control Studies, Female
Abstract

Background: Previous studies have reported the fundamental role of immunoregulatory proteins in the clinical phenotype and outcome of sepsis. This study investigated two functional single nucleotide polymorphisms (SNPs) of T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), which has a negative stimulatory function in the T cell immune response. Methods: Patients with sepsis (n = 712) were prospectively enrolled from three intensive care units (ICUs) at the University Medical Center Goettingen since 2012. All patients were genotyped for the TIM-3 SNPs rs1036199 and rs10515746. The primary outcome was 28-day mortality. Disease severity and microbiological findings were secondary endpoints. Results: Kaplan&ndash, Meier survival analysis demonstrated a significantly lower 28-day mortality for TIM-3 rs1036199 AA homozygous patients compared to C-allele carriers (18% vs. 27%, p = 0.0099) and TIM-3 rs10515746 CC homozygous patients compared to A-allele carriers (18% vs. 26%, p = 0.0202). The TIM-3 rs1036199 AA genotype and rs10515746 CC genotype remained significant predictors for 28-day mortality in the multivariate Cox regression analysis after adjustment for relevant confounders (adjusted hazard ratios: 0.67 and 0.70). Additionally, patients carrying the rs1036199 AA genotype presented more Gram-positive and Staphylococcus epidermidis infections, and rs10515746 CC homozygotes presented more Staphylococcus epidermidis infections. Conclusion: The studied TIM-3 genetic variants are associated with altered 28-day mortality and susceptibility to Gram-positive infections in sepsis.

Published
2020

19. Favorable 90-Day Mortality in Obese Caucasian Patients with Septic Shock According to the Sepsis-3 Definition

Author

Mewes, Caspar, Böhnke, Carolin, Alexander, Tessa, Büttner, Benedikt, Hinz, José, Popov, Aron-Frederik, Ghadimi, Michael, Beißbarth, Tim, Raddatz, Dirk, Meissner, Konrad, Quintel, Michael, Bergmann, Ingo, and Mansur, Ashham

Subjects
obesity, 90-day mortality, Sepsis-3 definition, Survival predictors, risk stratification, septic shock, lcsh:R, lcsh:Medicine, Article
Abstract

Septic shock is a frequent life-threatening condition and a leading cause of mortality in intensive care units (ICUs). Previous investigations have reported a potentially protective effect of obesity in septic shock patients. However, prior results have been inconsistent, focused on short-term in-hospital mortality and inadequately adjusted for confounders, and they have rarely applied the currently valid Sepsis-3 definition criteria for septic shock. This investigation examined the effect of obesity on 90-day mortality in patients with septic shock selected from a prospectively enrolled cohort of septic patients. A total of 352 patients who met the Sepsis-3 criteria for septic shock were enrolled in this study. Body-mass index (BMI) was used to divide the cohort into 24% obese (BMI &ge, 30 kg/m2) and 76% non-obese (BMI &lt, 30 kg/m2) patients. Kaplan-Meier survival analysis revealed a significantly lower 90-day mortality (31% vs. 43%, p = 0.0436) in obese patients compared to non-obese patients. Additional analyses of baseline characteristics, disease severity, and microbiological findings outlined further statistically significant differences among the groups. Multivariate Cox regression analysis estimated a significant protective effect of obesity on 90-day mortality after adjustment for confounders. An understanding of the underlying physiologic mechanisms may improve therapeutic strategies and patient prognosis.

Published
2020

25. Lack of an Association between the Functional Polymorphism TREM-1 rs2234237 and the Clinical Course of Sepsis among Critically Ill Caucasian Patients—A Monocentric Prospective Genetic Association Study

Author

Runzheimer, Julius, Mewes, Caspar, Büttner, Benedikt, Hinz, José, Popov, Aron-Frederik, Ghadimi, Michael, Kristof, Katalin, Beissbarth, Tim, Schamroth, Joel, Tzvetkov, Mladen, Schmack, Bastian, Quintel, Michael, Bergmann, Ingo, and Mansur, Ashham

Subjects
sepsis, TREM-1, 90-day mortality, single nucleotide polymorphism, survival analysis, lcsh:R, lcsh:Medicine, Article
Abstract

Sepsis is a life-threatening condition and a significant challenge for those working in intensive care, where it remains one of the leading causes of mortality. According to the sepsis-3 definition, sepsis is characterized by dysregulation of the host response to infection. The TREM-1 gene codes for the triggering receptor expressed on myeloid cells 1, which is part of the pro-inflammatory response of the immune system. This study aimed to determine whether the functional TREM-1 rs2234237 single nucleotide polymorphism was associated with mortality in a cohort of 649 Caucasian patients with sepsis. The 90-day mortality rate was the primary outcome, and disease severity and microbiological findings were analyzed as secondary endpoints. TREM-1 rs2234237 TT homozygous patients were compared to A-allele carriers for this purpose. Kaplan&ndash, Meier survival analysis revealed no association between the clinically relevant TREM-1 rs2234237 single nucleotide polymorphism and the 90-day or 28-day survival rate in this group of septic patients. In addition, the performed analyses of disease severity and the microbiological findings did not show significant differences between the TREM-1 rs2234237 genotypes. The TREM-1 rs2234237 genotype was not significantly associated with sepsis mortality and sepsis disease severity. Therefore, it was not a valuable prognostic marker for the survival of septic patients in the studied cohort.

Published
2019

26. Subparaneural injection in popliteal sciatic nerve blocks evaluated by MRI

Author

Büttner, Benedikt, Schwarz, Alexander, Mewes, Caspar, Kristof, Katalin, Hinz, José, Quintel, Michael, Mansur, Ashham, and Bergmann, Ingo

Subjects
nervous system, popliteal sciatic nerve block, intraneural injection, Popliteal sciatic nerve block, Subparaneural injection, Intraneural injection, Ultrasound-guidance, Magnetic resonance imaging, magnetic resonance imaging, Medicine, subparaneural injection, ultrasound-guidance, Research Article
Abstract

Intraneural injection of a local anesthetic can damage the nerve, yet it occurs frequently during distal sciatic block with no neurological sequelae. This has led to a controversy about the optimal needle tip placement that results from the particular anatomy of the sciatic nerve with its paraneural sheath. The study population included patients undergoing lower extremity surgery under popliteal sciatic nerve block. Ultrasound-guidance was used to position the needle tip subparaneurally and to monitor the injection of the local anesthetic. Sonography and magnetic resonance imaging were used to assess the extent of the subparaneural injection. Twenty-two patients participated. The median sciatic cross-sectional area increased from 57.8 mm2 pre-block to 110.8 mm2 immediately post-block. An intraneural injection according to the current definition was seen in 21 patients. Two patients had sonographic evidence of an intrafascicular injection, which was confirmed by MRI in one patient (the other patient refused further examinations). No patient reported any neurological symptoms. A subparaneural injection in the popliteal segment of the distal sciatic nerve is actually rarely intraneural, i.e. intrafascicular. This may explain the discrepancy between the conventional sonographic evidence of an intraneural injection and the lack of neurological sequelae. Open-Access-Publikationsfonds 2019 peerReviewed

Published
2019

27. CTLA-4 Genetic Variants Predict Survival in Patients with Sepsis

Author

Mewes, Caspar, Büttner, Benedikt, Hinz, José, Alpert, Ayelet, Popov, Aron-Frederik, Ghadimi, Michael, Beissbarth, Tim, Tzvetkov, Mladen, Jensen, Ole, Runzheimer, Julius, Quintel, Michael, Shen-Orr, Shai, Bergmann, Ingo, and Mansur, Ashham

Subjects
haplotypes, lcsh:R, lcsh:Medicine, CTLA-4, predictors, sepsis, single nucleotide polymorphisms, survival, hemic and immune systems, chemical and pharmacologic phenomena, biological factors, Article
Abstract

Cytotoxic T lymphocyte-associated protein 4 (CTLA-4) is a coinhibitory checkpoint protein expressed on the surface of T cells. A recent study by our working group revealed that the rs231775 single nucleotide polymorphism (SNP) in the CTLA-4 gene was associated with the survival of patients with sepsis and served as an independent prognostic variable. To further investigate the impact of CTLA-4 genetic variants on sepsis survival, we examined the effect of two functional SNPs, CTLA-4 rs733618 and CTLA-4 rs3087243, and inferred haplotypes, on the survival of 644 prospectively enrolled septic patients. Kaplan&ndash, Meier survival analysis revealed significantly lower 90-day mortality for rs3087243 G allele carriers (n = 502) than for AA-homozygous (n = 142) patients (27.3% vs. 40.8%, p = 0.0024). Likewise, lower 90-day mortality was observed for TAA haplotype-negative patients (n = 197, compound rs733618 T/rs231775 A/rs3087243 A) than for patients carrying the TAA haplotype (n = 447, 24.4% vs. 32.9%, p = 0.0265). Carrying the rs3087243 G allele hazard ratio (HR): 0.667, 95% confidence interval (CI): 0.489&ndash, 0.909, p = 0.0103) or not carrying the TAA haplotype (HR: 0.685, 95% CI: 0.491&ndash, 0.956, p = 0.0262) remained significant covariates for 90-day survival in the multivariate Cox regression analysis and thus served as independent prognostic variables. In conclusion, our findings underscore the significance of CTLA-4 genetic variants as predictors of survival of patients with sepsis.

Published
2019

29. Prehospital ultrasound-guided nerve blocks improve reduction-feasibility of dislocated extremity injuries compared to systemic analgesia. A randomized controlled trial

Author

Büttner, Benedikt, Mansur, Ashham, Kalmbach, Matthias, Hinz, José, Volk, Thomas, Szalai, Karoly, Roessler, Markus, and Bergmann, Ingo

Subjects
Male, Critical Care and Emergency Medicine, Trauma Surgery, Joint Dislocations, lcsh:Medicine, Surgical and Invasive Medical Procedures, Drug Therapy, Anesthesiology, Medicine and Health Sciences, Pain Management, Humans, Anesthesia, Prospective Studies, Anesthetics, Local, lcsh:Science, Trauma Medicine, Anesthetics, Ultrasonography, Pharmacology, Analgesics, Pain, Postoperative, Pharmaceutics, lcsh:R, Drugs, Nerve Block, Extremities, Middle Aged, Feasibility Studies, Female, lcsh:Q, Local and Regional Anesthesia, Analgesia, Traumatic Injury, Research Article
Abstract

Background Out-of-hospital analgosedation in trauma patients is challenging for emergency physicians due to associated complications. We compared peripheral nerve block (PNB) with analgosedation (AS) as an analgetic approach for patients with isolated extremity injury, assuming that prehospital required medical interventions (e.g. reduction, splinting of dislocation injury) using PNB are less painful and more feasible compared to AS. Methods Thirty patients (aged 18 or older) were randomized to receive either ultrasound-guided PNB (10 mL prilocaine 1%, 10 mL ropivacaine 0.2%) or analgosedation (midazolam combined with s-ketamine or with fentanyl). Reduction-feasibility was classified (easy, intermediate, impossible) and pain scores were assessed using numeric rating scales (NRS 0–10). Results Eighteen patients were included in the PNB-group and twelve in the AS-group; 15 and 9 patients, respectively, suffered dislocation injury. In the PNB-group, reduction was more feasible (easy: 80.0%, impossible: 20.0%) compared to the AS-group (easy: 22.2%, intermediate: 22.2%, impossible: 55.6%; p = 0.01). During medical interventions, 5.6% [1/18] of the PNB-patients and 58.3% [7/12] of the AS-patients experienced pain (p

Published
2018

30. Favorable 90-Day Mortality in Obese Caucasian Patients with Septic Shock According to the Sepsis-3 Definition

Author

Mewes, Caspar, primary, Böhnke, Carolin, additional, Alexander, Tessa, additional, Büttner, Benedikt, additional, Hinz, José, additional, Popov, Aron-Frederik, additional, Ghadimi, Michael, additional, Beißbarth, Tim, additional, Raddatz, Dirk, additional, Meissner, Konrad, additional, Quintel, Michael, additional, Bergmann, Ingo, additional, and Mansur, Ashham, additional

Published
2019
Full Text
View/download PDF

31. CTLA-4 Genetic Variants Predict Survival in Patients with Sepsis

Author

Mewes, Caspar, primary, Büttner, Benedikt, additional, Hinz, José, additional, Alpert, Ayelet, additional, Popov, Aron-Frederik, additional, Ghadimi, Michael, additional, Beissbarth, Tim, additional, Tzvetkov, Mladen, additional, Jensen, Ole, additional, Runzheimer, Julius, additional, Quintel, Michael, additional, Shen-Orr, Shai, additional, Bergmann, Ingo, additional, and Mansur, Ashham, additional

Published
2019
Full Text
View/download PDF

33. Effects of Workflow Optimization in Endovascularly Treated Stroke Patients - A Pre-Post Effectiveness Study

Author

Schregel, Katharina, Behme, Daniel, Tsogkas, Ioannis, Knauth, Michael, Maier, Ilko, Karch, André, Mikolajczyk, Rafael, Hinz, José, Liman, Jan, Psychogios, Marios-Nikos, Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany., and Baron, Jean-Claude

Subjects
Optimization, Critical Care and Emergency Medicine, Time Factors, Imaging Techniques, Cerebrovascular Diseases, lcsh:Medicine, Neuroimaging, Cardiovascular Medicine, Research and Analysis Methods, Efficiency, Organizational, Vascular Medicine, Diagnostic Radiology, Time-to-Treatment, Workflow, Fibrinolytic Agents, Diagnostic Medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Humans, Thrombolytic Therapy, Cardiovascular Imaging, lcsh:Science, Tomography, Ischemic Stroke, Aged, Aged, 80 and over, Radiology and Imaging, Endovascular Procedures, lcsh:R, Angiography, Biology and Life Sciences, Middle Aged, Magnetic Resonance Imaging, Computed Axial Tomography, Cerebral Angiography, Stroke, Treatment Outcome, Neurology, Tissue Plasminogen Activator, Reperfusion, Physical Sciences, lcsh:Q, Computed axial tomography, Magnetic resonance imaging, Ischemic stroke, Mathematics, Research Article, Neuroscience
Abstract

Endovascular treatment of acute ischemic stroke has become standard of care for patients with large artery occlusion. Early restoration of blood flow is crucial for a good clinical outcome. We introduced an interdisciplinary standard operating procedure (SOP) between neuroradiologists, neurologists and anesthesiologists in order to streamline patient management. This study analyzes the effect of optimized workflow on periprocedural timings and its potential influence on clinical outcome. Data were extracted from a prospectively maintained university hospital stroke database. The standard operating procedure was established in February 2014. Of the 368 acute stroke patients undergoing endovascular treatment between 2008 and 2015, 278 patients were treated prior to and 90 after process optimization. Outcome measures were periprocedural time intervals and residual functional impairment. After implementation of the SOP, time from symptom onset to reperfusion was significantly reduced (median 264 min prior and 211 min after SOP-introduction (IQR 228–32 min and 161–278 min, respectively); P

Published
2016

35. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Habre, Walid, primary, Disma, Nicola, additional, Virag, Katalin, additional, Becke, Karin, additional, Hansen, Tom G, additional, Jöhr, Martin, additional, Leva, Brigitte, additional, Morton, Neil S, additional, Vermeulen, Petronella M, additional, Zielinska, Marzena, additional, Boda, Krisztina, additional, Veyckemans, Francis, additional, Klimscha, Walter, additional, Konecny, Regina, additional, Luntzer, Robert, additional, Morawk-Wintersperger, Ulrike, additional, Neiger, Franz, additional, Rustemeyer, Lydia, additional, Breschan, Christian, additional, Frey, Denise, additional, Platzer, Manuela, additional, Germann, Reinhard, additional, Oeding, Joachim, additional, Stoegermüller, Birgit, additional, Ziegler, Bernhard, additional, Brotatsch, Philipp, additional, Gutmann, Anton, additional, Mausser, Gerlinde, additional, Messerer, Brigitte, additional, Toller, Wolfgang, additional, Vittinghoff, Maria, additional, Zangl, Gregor, additional, Seidel-Ahyai, Natascha, additional, Hochhold, Christoph, additional, Kroess, Ruth, additional, Paal, Peter, additional, Cnudde, Steven, additional, Coucke, Patricia, additional, Loveniers, Birgit, additional, Mitchell, John, additional, Kahn, David, additional, Pirotte, Thierry, additional, Pregardien, Caroline, additional, Coppens, Marc, additional, De Hert, Stefan, additional, Heyse, Björn, additional, Neckebroek, Martine, additional, Parashchanka, Aliaksandra, additional, Van Limmen, Jurgen, additional, Van Den Eynde, Nancy, additional, Vanpeteghem, Caroline, additional, Wyffels, Piet, additional, Lalot, Michaël, additional, Lechat, Jean-Paul, additional, Stevens, France, additional, Casaer, Sari, additional, De Groote, Françoise, additional, De Pooter, Françoise, additional, De Villé, Andrée, additional, Gerin, Marc, additional, Magasich, Natalia, additional, Sanchez Torres, Cristel, additional, Van Deenen, Denise, additional, Berghmans, Johan, additional, Himpe, Dirk, additional, Roofthooft, Eva, additional, Joukes, Ellen, additional, Smitz, Carine, additional, Van Reeth, Veronique, additional, Huygens, Christel, additional, Lauweryns, Julie, additional, De Smet, Karen, additional, Najafi, Nadia, additional, Poelaert, Jan, additional, Van de Velde, Anne, additional, Van Mossevelde, Veerle, additional, Bekavac, Ivan, additional, Butkovic, Diana, additional, Heli Litvic, Dubravka, additional, Kerovec Soric, Ivana, additional, Maretic, Hrvoje, additional, Moscatello, Djurdjica, additional, Popovic, Ljiljana, additional, Micici, Slobodan, additional, Stuck Tus, Ivana, additional, Kalagac Fabris, Lada, additional, Simurina, Tatjana, additional, Sulen, Nina, additional, Kesic-Valpotic, Gordana, additional, Djapic, Dajana, additional, Žurek, Jirí, additional, Jureckova, Lucie, additional, Mackova, Iveta, additional, Skacel, Monika, additional, Weinlichova, Stanislava, additional, Divák, Jan, additional, Frelich, Michal, additional, Urbanec, René, additional, Biskupova, Vera, additional, Mixa, Vladimir, additional, Pavlickova, Jana, additional, Afshari, Arash, additional, Bøttger, Morten, additional, Ellekvist, Marguerite B., additional, Johansen, Mathias, additional, Ingeborg Madsen, Birgitte, additional, Christian Nilsson, Jens, additional, Schousboe, Birgitte MB, additional, Clausen, Nicola G., additional, Hansen, Tom G., additional, Phaff Steen, Nick, additional, Ilmoja, Mari-Liis, additional, Tonise, Virge, additional, Karjagin, Juri, additional, Kikas, Reet, additional, Isohanni, Mika, additional, Lyly, Anniina, additional, Takala, Annika, additional, Happo, Johanna, additional, Kiviluoma, Kai, additional, Martikainen, Kati, additional, Aantaa, Riku, additional, Manner, Tuula, additional, Vilo, Sanna, additional, Amory, Catherine, additional, Ludot, Hugues, additional, Lambotte, Patricia, additional, Busche, René, additional, Jacqmarcq, Olivier, additional, Lejus, Corinne, additional, Corouge, Julien, additional, Erb, Christian, additional, Garrigue, Delphine, additional, Gillet, Patricia, additional, Laffargue, Anne, additional, Lambelin, Veronique, additional, Le Freche, Hélène, additional, Peresbota, Daliana, additional, Richart, Pierre, additional, Berton, Jerome, additional, Chapotte, Catherine, additional, Colbus, Laurent, additional, Lehousse, Thierry, additional, Monrigal, Jean, additional, Baujard, Catherine, additional, Roulleau, Philippe, additional, Staiti, Giuseppe, additional, Batoz, Hélène, additional, Bordes, Maryline, additional, Didier, Anne, additional, Hamonic, Yann, additional, Lagarde, Sylvaine, additional, Nouette-Gaulain, Karine, additional, Semjen, François, additional, Zaghet, Brigitte, additional, Dekens, Jacky, additional, Delcuze, Axelle, additional, Dupont, Hervé, additional, Legrand, Aurélien, additional, Raffoflandreur, Celine, additional, Audren, Noémie, additional, Camus, Blandine, additional, Cartal, Marielle, additional, Chazelet, Chantal, additional, Davin, Isabelle, additional, Guillier, Marion, additional, Desjeux, Luc, additional, Larcher, Claire, additional, Grein, Elodie, additional, Leclercq, Mickeal, additional, Levitchi, Roxana, additional, Rosu, Lilica, additional, Simon, Dominique, additional, Zang, Aurélien, additional, Migeon, Anne, additional, Gagey, Anne-Charlotte, additional, Bourdaud, Nathalie, additional, Carre, Anne-Charlotte, additional, Duflo, Frédéric, additional, Riche, Jean-Claude, additional, Robert, Philippe, additional, Druot, Emilie, additional, Maupain, Olivier, additional, Orliaguet, Gilles, additional, Sabau, Lucie, additional, Taright, Hanna, additional, Uhrig, Lynn, additional, Verchere-Montmayeur, Juliette, additional, Debrabant, Lise, additional, Pilla, Clotaire, additional, Podvin, Alexandre, additional, Roth, Benjamin, additional, Dahmani, Souhayl, additional, Julien-Marsollier, Florence, additional, Sabourdin, Nada, additional, Alexandri, Bogdan, additional, Brezac, Gilles, additional, de la Brière, Francois, additional, Hayem, Catherine, additional, Lhubat, Elizabeth, additional, Paul Mission, Jean, additional, Rémond, Charlotte, additional, Dadure, Christophe, additional, Maniora, Maud, additional, Marie, Anais, additional, Pirat, Philippe, additional, Saour, Anne-Charlotte, additional, Sola, Chrystelle, additional, Ecoffey, Claude, additional, Wodey, Eric, additional, Adam, Christian, additional, Standl, Thomas, additional, Schindler, Ehrenfried, additional, Yamamoto, Tomohiro, additional, Brackhahn, Michael, additional, Eich, Christoph Bernhard, additional, Guericke, Holger, additional, Kindermann, Petra, additional, Laschat, Michael, additional, Schink, Cornel, additional, Wappler, Frank, additional, Hoehne, Claudia, additional, Skordou, Natalia, additional, Ulrici, Johanna, additional, Jetzek-Zader, Martin, additional, Kienbaum, Peter, additional, Meyer-Treschan, Tanja, additional, Picker, Olaf, additional, Schaefer, Maximilian S., additional, Mielke, Golo, additional, Baethge, Sabine, additional, Ramminger, Axel, additional, Bauer, Martin, additional, Bollinger, Matthias, additional, Hinz, José, additional, Quintel, Michael, additional, Russo, Sebastian G., additional, Bauer, Michael, additional, Geil, Dfominik, additional, Kortgen, Andreas, additional, Preussler, Niels-Peter, additional, Hofmann, Ulrich, additional, Raber, Manfred, additional, Reindl, Doris, additional, Oppenrieder, Karin, additional, Schierlinger, Bettina, additional, Roth, Jens, additional, Funk, Wolfgang, additional, Fischer, Thomas, additional, Gernoth, Christian, additional, Wiefelspütz, Christina, additional, Volger, Hauke, additional, Zederer, Nicole, additional, Diers, Anja, additional, Huber, Matthias, additional, Schorer, Clemens, additional, Weyland, Andreas, additional, Schwarzkopf, Konrad, additional, Grau, Catharina, additional, Roth, Winfried, additional, Holy, Rolf, additional, Mader, Thomas, additional, Peter, Laura, additional, Supthut, Hauke, additional, Kuehhirt, Thomas, additional, Milde, Alexander, additional, Fiedler, Fritz, additional, Isselhorst, Carsten, additional, Grundmann, Ulrich, additional, Pattar, Alexander, additional, Reinert, Jennifer, additional, Ehm, Birgit, additional, Fritzsche, Katrin, additional, Gaebler, Ralf, additional, Meybohm, Patrick, additional, Hein, Maximilian, additional, Guzman, Ines, additional, Jokinen, Johanna, additional, Kranke, Peter, additional, Goebel, Ulrich, additional, Harris, Sarah, additional, Eisner, Christoph, additional, Ochsenreiter, Miriam, additional, Schoeler, Michael, additional, Thil, Elke, additional, Ellerkmann, Richard, additional, Hoeft, Andreas, additional, Neumann, Claudia, additional, Weber, Stefan, additional, Keilhauer, Julia, additional, Kloessing, Jan, additional, Schramm, Michael, additional, Trieschmann, Uwe, additional, Knauss, Kristina, additional, Sinner, Barbara, additional, Steinmann, Johannes, additional, Koessler, Herbert, additional, Kalliardou, Evagelia, additional, Malisiova, Anna, additional, Tsiotou, Adelais, additional, Chloropoulou, Pelagia, additional, Chrysi, Mpratzou, additional, Iordanidou, Despoina, additional, Ntavlis, Merkourios, additional, Boda, Krisztina B, additional, Guerin, Christilynn, additional, Irwin, Janice, additional, Magner, Claire, additional, Nakhjavani, Solmaz, additional, O'Hare, Brendan, additional, Galvin, Deborah, additional, Jamil, Yosry, additional, Lesmes, Carlos, additional, Barak, Yuri, additional, Fisher, Haran, additional, Kachko, Ludmyla, additional, Katz, Jacob, additional, Kirilov, Dmitry, additional, Levinzon, Michael, additional, Manevich, Yair, additional, Nekrasov, Konstantin, additional, Peled, Elia, additional, Sanko, Elena, additional, Schmain, Dmitri, additional, Sheinkin, Olga, additional, Simhi, Eliahu, additional, Tarabikin, Alex, additional, Trabkin, Evelina, additional, Yagudaev, Irena, additional, Zeitlin, Yelena, additional, Zunser, Igor, additional, Cerutti, Elisabetta, additional, Maddalena Schellino, Maria, additional, Valzan, Silvia, additional, Lucia Pinciroli, Rosa, additional, Bortone, Luciano, additional, Cerati, Giorgia, additional, Salici, Fabiana, additional, Bussolin, Leonardo, additional, Rizzo, Giuliana, additional, Rossetti, Francesca, additional, Marchesini, Laura, additional, Tesoro, Simonetta, additional, De Lorenzo, Brita, additional, Guarracino, Fabio, additional, Kuppers, Beate, additional, Astuto, Marinella, additional, Pitino, Sofia, additional, Scalisi, Rita, additional, Scordo, Lucia, additional, D'Alessandro, Sandra, additional, Dei Giudici, Luigi, additional, Farinelli, Ivano, additional, Lofino, Giuseppe, additional, Marchetti, Giuliano, additional, Giuseppe Picardo, Sergio, additional, Reali, Simone, additional, Vittori, Alessandro, additional, Antonio Idone, Francesco, additional, Sammartino, Maria, additional, Sbaraglia, Fabio, additional, Barbera, Cinzia, additional, Bevilacqua, Michela, additional, Cento, Valeria, additional, Kotzeva, Svetlana, additional, Mameli, Leila, additional, Montobbio, Giovanni, additional, Passariello, Leandro, additional, Punzo, Cinzia, additional, Sileo, Rosanna, additional, Viacava, Rosanna, additional, Volpe, Claudia, additional, Zanaboni, Clelia, additional, Calderini, Edoardo, additional, Genco, Daniele, additional, Neri, Simona, additional, Ottolina, Davide, additional, Camporesi, Anna, additional, Izzo, Francesca, additional, Salvo, Ida, additional, Wolfler, Andrea, additional, Sanna, Andrea, additional, Sciascia, Angela, additional, Stoia, Paolo, additional, Guddo, Annamaria, additional, Lapi, Maria, additional, Ivani, Giorgio, additional, Longobardo, Annalisa, additional, Mossetti, Valeria, additional, Pedrotti, Dino, additional, Grazzini, Maurizia, additional, Meneghini, Luisa, additional, Metrangolo, Salvatore, additional, Michelon, Stefania, additional, Minardi, Carmelo, additional, Tognon, Costanza, additional, Zadra, Nicola, additional, Busi, Ilaria, additional, Khotcholava, Magda, additional, Guido Locatelli, Bruno, additional, Sonzogni, Valter, additional, Starita, Giusi, additional, Almenrader, Nicole, additional, Aurilio, Caterina, additional, Sansone, Pasquale, additional, Albarello, Raffaella, additional, Bracci, Paolo, additional, Cecini, Mariateresa, additional, Cristina Mondardini, Maria, additional, Pasini, Lorena, additional, Vason, Milo, additional, Zani, Gianluca, additional, Zoppellari, Roberto, additional, Pistidda, Laura, additional, Cortegiani, Andrea, additional, Maurizio Raineri, Santi, additional, Hasani, Antigona, additional, Hashimi, Medita, additional, Ancupans, Agris, additional, Barzdina, Arta, additional, Straume, Zane, additional, Zundane, Anda, additional, Chlopin, Mikhail, additional, Gestautaite, Dalia, additional, Lukosiene, Laura, additional, Paliokaite, Evelina, additional, Razlevice, Ilona, additional, Armoniene, Inesa, additional, Bernotiene, Aurelija, additional, Daugelavicius, Vidunas, additional, Dockiene, Ilona, additional, Gaidelyte, Lina, additional, Saviciene, Nijole, additional, Krikstaponiene, Jolita, additional, Sidlovskaite-Baltake, Dominika, additional, Stasevski, Vladyslav, additional, Vaitoskaite, Agne, additional, Gatt, David, additional, Mifsud, Stephanie, additional, Zammit, Simone, additional, Allison, Celia, additional, Aslami, Hamid, additional, Eberl, Susanne, additional, van Stijn, Mireille F M, additional, Stevens, Markus F, additional, Punt, Kees, additional, van Osch, Rob, additional, Bauwman, Arthur, additional, Scholten, Harm, additional, Svircevic, Vesna, additional, Adriaens, Veronique, additional, Dirckx, Maaike, additional, Dogger, Jaap, additional, Dons-Sinke, Ilse, additional, Machotta, Andreas, additional, Moors, Xavier, additional, Rad, Mandana, additional, Staals, Lonneke, additional, van der Knijff - van Dortmont, Anouk, additional, van der Marel, Caroline, additional, Sieben, Anne, additional, van der Zwan, Tim, additional, Veldhuizen, Marianne, additional, Alders, David, additional, Buhre, Wolfgang, additional, Engel, Nicole, additional, Vossen, Carine, additional, Mahadewsing, Ravin, additional, Meijer, Patrick, additional, Gerling, Volker, additional, van der Schatte Olivier, Roelof, additional, van Doorn, Thea, additional, Vons Mark Hendriks, Kristy, additional, Lako, Sandra, additional, jan Scheffer, Gert, additional, Tielens, Luc, additional, Voet, Marieke, additional, Absalom, Anthony, additional, Bergsma, Margot, additional, Spanjer, Vera, additional, Spanjersberg, Rob, additional, van de Riet, Yvette, additional, Volkers, Martin, additional, de Graaff, Jurgen C., additional, Hopman, Geranne A.J., additional, Kappen, Teus H., additional, Hannie, J., additional, Megens, A.M., additional, Numan, Sandra C., additional, Schouten, Anton N.J., additional, Turner, Nigel M., additional, Van Der Werff, Désirée B.M., additional, Wensing, Renee T.M., additional, Ephraim, Erik, additional, Nolte, Claire, additional, Reikvam, Tore, additional, Fredrik Lund, Ole, additional, Skaaden, Lene, additional, Marthe Ballovarre, Kari, additional, Bakken Boerke, Wenche, additional, Grindheim, Guro, additional, Lindenskov, Pal H H, additional, Beate Solas, Anne, additional, Sponheim, Sjur, additional, Ullensvang, Kyrre, additional, Viken, Oddbjorn, additional, Marie Drage, Inger, additional, Gymoese Berthelsen, Kasper, additional, Anders Kroken, Bjørn, additional, Bergland, Unni, additional, Pryzmont, Miroslaw, additional, Talalaj, Mariola, additional, Wasiluk, Malgorzata, additional, Zalewska, Dorota, additional, Damps, Maria, additional, Siemek-Mitela, Jadzia, additional, Wieczorek, Pawel, additional, Juzwa, Magdalena, additional, Rosada-Kurasinska, Jowita, additional, Bartkowska-Sniatkowska, Alicja, additional, Cettler, Maciej, additional, Kopycinska, Renata, additional, Rudewicz, Iwona, additional, Sobczyk, Jaek, additional, Wojciechowski, Dariusz, additional, Baranowski, Artur, additional, Basiewicz, Ewa, additional, Mierzewska-Schmidt, Magdalena, additional, Retka, Wlodzimierz, additional, Sawicki, Piotr, additional, Checinska, Magdalena, additional, Zurawska, Magdalena, additional, Leal, Teresa, additional, Mascarenhas, Catia, additional, Pedro Pina, António, additional, Joao Susano, Maria, additional, Moniz, Antonio, additional, Teresa Rocha, Maria, additional, Calvao Santos, Carolina, additional, Domingas Patuleia, M, additional, Pereira, Ricardo, additional, Roxo, Helena, additional, Amaral, Rosa, additional, Guedes, Isabel, additional, Gomes, Cristina, additional, Gonçalves, Marta, additional, Salgado, Helena, additional, Santos, Maria, additional, Rodrigues, Sara, additional, Sa, Angela, additional, Machado, Elvira, additional, Pé d'Arca, Sandra, additional, Seabra, Manuel, additional, Mihaela Gheorghe, Ligia, additional, Ivascu, Constantin, additional, Moraru-Draghici, Lucia, additional, Suvejan, Mirela, additional, Babici, Remus, additional, Eniko, Kovacs, additional, Hogea, Cristiana, additional, Mihaela, Dubau, additional, Nicoleta, Daraban, additional, Barbunc, Danut, additional, Maria Nistor, Alina, additional, Stefan, Violeta, additional, Catalina Ionescu, Gabriela, additional, Davidescu, Irina, additional, Teodora Nastase, Alina, additional, Dumitru Rusu, Florin, additional, Badarau, Victoria, additional, Cindea, Iulia, additional, Moscaliuc, Melania, additional, Olteanu, Dana, additional, Petrescu, Luxita, additional, Ceuca, Daniela, additional, Galinescu, Irena, additional, Badeti, Rodica, additional, Capusan, Alin, additional, Cucui-Cozma, Cosmina, additional, Popescu, Barbura, additional, Cimpeanu, Luminita, additional, Birliba, Mihaela-Petronela, additional, Miulescu, Magdalena, additional, Balamat, Stefania, additional, Gurita, Adriana, additional, Ilie, Luminita, additional, Mocioiu, Gabriel, additional, Pick, Darina, additional, Sirghie, Rodica, additional, Tabacaru, Radu, additional, Trante, Irinel, additional, Horhota, Lucian, additional, Bandrabur, Daniela, additional, Ciobanu, Tudor, additional, Cuciuc, Veaceslav, additional, Munteanu, Valentin, additional, Olaru, Valentin, additional, Paiu, Corneliu, additional, Savu, Anca, additional, Trifan, Oana, additional, Elena Malos, Anca, additional, Glazunov, Anton, additional, Ivanov, Alexander, additional, Poduskov, Evgeny, additional, Popov, Alexander, additional, Guskov, Igor, additional, Lugovoy, Alexander, additional, Nechaev, Vladislav, additional, Ovezov, Alexey, additional, Basov, Mikhail, additional, Kochkin, Vladimir, additional, Lazarev, Vladimir, additional, Chizhov, Dmitri, additional, Ostreikov, Ivan, additional, Tolasov, Konstantin, additional, Budic, Ivana, additional, Marjanovic, Vesna, additional, Draskovic, Biljana, additional, Pandurov, Marina, additional, Simin, Jovana, additional, Dolinaj, Vladimir, additional, Janjevic, Dusanka, additional, Mandras, Ana, additional, Mircetic, Maja, additional, Petrovic, Sladjana, additional, Rebac, Vlatka, additional, Slavkovic, Bojana, additional, Stevanovic, Vesna, additional, Velcev, Ana, additional, Knezevic, Mirjana, additional, Milojevic, Irina, additional, Puric, Selena, additional, Simic, Irena, additional, Stevic, Marija, additional, Stranjanac, Vladimir, additional, Simic, Dusica, additional, Cabanova, Barbora, additional, Hanula, Miloslav, additional, Grynyuk, Andry, additional, Berger, Jelena, additional, Cerne, Uros, additional, Nastran, Andraz, additional, Pirc, Dejan, additional, Popic, Rok, additional, Stupnik, Spela, additional, Rubio, Paloma, additional, del Río, Cristina, additional, Benito, Pilar, additional, Pino, Gema, additional, Gutierrez, Ignacio, additional, Gutierrez Valcarcel, Andrea, additional, León Carsi, Irene, additional, Perez Garcia, Anibal, additional, López Galera, Sílvia, additional, Marco Valls, Joan, additional, Ricol Lainez, Laura, additional, Vallejo Tarrat, Andrea, additional, Artes, David, additional, Banus, Ester, additional, Chirichiello, Luca, additional, De Abreu, Leidy, additional, De Josemaria, Belen, additional, Helena Gaitan, M, additional, Garces, Antonio, additional, Lazaro, Juan J, additional, Manen Berga, Ferran, additional, Molies, Dolors, additional, Monclus, Enric, additional, Navaro, Montserrat, additional, Pamies, Carmen, additional, Perelló, Marina, additional, Prat, Mar, additional, Ribo, Laura, additional, Angeles Sanz, M, additional, Serrano, Silvia, additional, Sola Ruiz, Eva, additional, Anuncia Escontrela Rodríguez, Blanca, additional, Maria Gago Martinez, Andrea, additional, Martínez Ruiz, Alberto, additional, De La Cruz Benito, Fausto, additional, Gabilondo Garcia, Gustavo, additional, Martinez Maldonado, Ever, additional, Noriega, Bryant, additional, Oller Duque, Lara, additional, Olmos Mendez, Alberto, additional, Perez- Ferrer, Antonio, additional, Reinoso Barbero, Francisco, additional, Acevedo Bambaren, Ismael, additional, Domínguez, Fernando, additional, Franco, Teresa, additional, Jiménez, Anabel, additional, Melero, Alicia, additional, Feliu, Montserrat, additional, García, Irene, additional, Montferrer, Núria, additional, Munar, Francisca, additional, Muro, Cristina, additional, Nuño, Rosario, additional, Perera, Remel, additional, Schmucker, Erika, additional, Börjesson, Glenda, additional, Gillberg, Lars, additional, Castellheim, Albert, additional, Sandström, Kerstin, additional, Bauer, Annette, additional, Roos, Torbjörn, additional, Hedlund, Lars, additional, Boegli, Yann, additional, Dolci, Mirko, additional, Marcucci, Carine, additional, Spahr-Schopfer, Isabelle, additional, Habre, Walid, additional, Pellegrini, Michel, additional, Book, Malte, additional, Errass, Loreen, additional, Riggenbach, Christine, additional, Casutt, Mattias, additional, Hölzle, Martin, additional, Hurni, Thomas, additional, Mauch, Jacqueline, additional, Anselmi, Luciano, additional, Anselmi, Irene, additional, Jacomet, Alfred, additional, Oberhauser, Markus, additional, Wossner, Stephanie, additional, Zettl, Angelika, additional, Erb, Thomas, additional, Mackiewicz, Tomasz, additional, Simitzes, Helena, additional, Ozer, Yetkin, additional, Takil, Arzu, additional, Alanoglu, Zekeriyya, additional, Bermede, Onat, additional, Cakar Turhan, K.Sanem, additional, Alkis, Neslihan, additional, Yildirim Guclu, Cigdem, additional, Ceyda Meco, Basak, additional, Hatipoglu, Zehra, additional, Ozcengiz, Dilek, additional, Begec, Zekine, additional, Ilksen Toprak, Huseyin, additional, Kendigelen, Pinar, additional, Cigdem Tütüncü, Ayse, additional, Karadeniz, Meltem Savran, additional, Seyhan Ozkan, Tulay, additional, Sivrikoz, Nuket, additional, Kemal Arslantas, Mustafa, additional, Hizal, Ayse, additional, Tore Altun, Gülbin, additional, Umuroglu, Tumay, additional, Baris, Sibel, additional, Kazak Bengisun, Zuleyha, additional, Goncharenko, Galyna, additional, Khrapak, Maksym, additional, Klymenko, Tetyana, additional, Pavlenko, Vitaliy, additional, Prysiazhniuk, Dmytro, additional, Rudio, Olga, additional, Varyvoda, Mykhailo, additional, Vodianytskyi, Sergii, additional, Boryshkevych, Ivanna, additional, Kyselova, Iryna, additional, Trikash, Nikolay, additional, Albokrinov, Andrew, additional, Perova-Sharonova, Valentina, additional, Sklyar, Vitaliy, additional, Surkov, Denis, additional, Abdelaal, Amr, additional, Barber, Nicola, additional, Checuti, Sarah, additional, Godsiff, Leisha, additional, Johanne, Lynch, additional, Simpson, Joanna, additional, Underhill, Helen, additional, Diwan, Rishi, additional, Kelgeri, Nivedita, additional, Masip, Nuria, additional, Ravi, Radha, additional, Roberts, Steve, additional, Cillis, Annagrazia, additional, Marcus, Ritchie, additional, Merella, Federica, additional, Love, David, additional, Baraggia, Paolo, additional, Bird, Victoria, additional, Hussey, Joseph, additional, Alderson, Peter, additional, Bartholomew, Karen, additional, Moncreiff, Michael, additional, Davidson, Sarah, additional, Hare, Alison, additional, Kotecha, Ami, additional, Lee, Corina, additional, Liyanage, Ganga, additional, Patel, Shivali, additional, Samani, Amee, additional, Abou-Samra, Mark, additional, Boyd, Matthew, additional, Hullatt, Laurence, additional, Levy, David, additional, Pauling, Mark, additional, Sharman, Sarah-Jane, additional, Smith, Natalie, additional, Rutherford, John, additional, Cavalier, Alison, additional, Locke, Christie, additional, Sage, Frederic, additional, Bapat, Smita, additional, Hammerschlag, Jacinda, additional, Ioannou, Ioannis, additional, King, Stephanie, additional, Pegg, Rachel, additional, Salota, Vishal, additional, Sketcher, Jonathan, additional, Thadsad, Muthu, additional, Zeitlin, Deborah, additional, Jack, Ewan, additional, Lang, Colin, additional, Ahmed, Samira, additional, Ayyash, Reema, additional, Bari, Francoise, additional, Bell, Sarah J, additional, Elizabeth Biercamp, Claire, additional, Briggs, Sandra, additional, Gabriella Elena Clement, Maria, additional, Dalton, Mark, additional, Ali Eissa Eid, Mohamed, additional, Gandhi, Monica, additional, Harmen Herrema, Idse, additional, Khaffaf, Ranj, additional, Jeng Min Law, Savio, additional, McClintock, Joanna, additional, Ireland, Nicholas, additional, Majid Saleem, Mohammed, additional, Smith, Fiona, additional, Cohen, Marc, additional, Lee, Clover-Ann, additional, O'Donahue, Lizanne, additional, Powell, Alex, additional, Rawlinson, Ellen, additional, Snoek, Aarjan, additional, Weiss, Katja, additional, Wellesley, Hugo, additional, Crawford, Michael, additional, Abdel-Hafiz, Mostafa, additional, Day, Alexandra, additional, Rajamani, Balaji, additional, Saha, Rita, additional, Wright, Dave, additional, Chee, Lew-Chin, additional, Bew, Stephanie, additional, Homer, Rachel, additional, Malarkkan, Nalini, additional, Wolfe Barry, Juliet, additional, Angadi, Pradeep, additional, Cagney, Brid, additional, De Melo, Eric, additional, Dekker, Elsa, additional, Helm, Emma, additional, Jones, Gareth, additional, Peiris, Kawshala, additional, Russell, William, additional, Slater, Patricia, additional, Sodhi, Puja, additional, Browning, Mike, additional, Phillips, Trudie, additional, Van Hecke, Rachel, additional, Muir, Vimty, additional, Singh, Piyush, additional, Soskova, Tereza, additional, Cumming, Craig, additional, Farquharson, Pamela, additional, Pearson, Karen, additional, Shaw, Neil, additional, Whiteside, Jonathan, additional, Whyte, Emma, additional, Byers, Gordon, additional, Davies, Kay, additional, Engelhardt, Thomas, additional, Faliszewski, Isabella, additional, Johnston, Graham, additional, Kaufmann, Nils, additional, Kusnirikova, Zuzana, additional, Wilson, Graham, additional, Carachi, Peter, additional, Makin, Andrew, additional, Foster, Brian, additional, Lipczynski, Dariusz, additional, Mawer, Rebecca, additional, Rutherford, William, additional, Rogerson, David, additional, Rushman, Sarah, additional, Taylor, Christopher, additional, Tomlinson, William, additional, Dix, Philippa, additional, Woodward, Tom, additional, Bell, Graham, additional, Boyle, David, additional, Cloherty, Marianne, additional, Cullen, Julia, additional, Cullen, Pauline, additional, Fairgrieve, Ross, additional, Ghent, Robert, additional, Glasgow, Russell, additional, Gordeeva, Elena, additional, Harden, Alison, additional, Hivey, Sarah, additional, Jerome, Kevin, additional, McKee, Lesley, additional, Morton, Neil, additional, Pribul, Vicky, additional, Sinclair, John, additional, Steiner, Maria, additional, Steward, Heather, additional, Sweeney, Lorraine, additional, Thomson, Wendy, additional, Whiteside, Jeanette, additional, Dalton, Andrew, additional, Ross, Mark, additional, Smith, Carolyn, additional, Allen, Claire, additional, Anders, Nicola, additional, Barlow, Victoria, additional, Bassett, Mike, additional, Darwin, Leanne, additional, Davison, Rachel, additional, Diacono, Jacques, additional, Hobbs, Amy, additional, Hutchinson, Adel, additional, Lomas, Bernadette, additional, Lonsdale, Hannah, additional, Nasser, Leila, additional, Oshan, Vimmi, additional, Patel, Pradip, additional, Raistrick, Christopher, additional, Scott-Warren, Victoria, additional, Talbot, Laura, additional, Wai, Carolynn, additional, Childs, Sophie, additional, Dickinson, Matthew, additional, Bloomfield, Tom, additional, Garrioch, Sweyn, additional, Watson, Karen, additional, Gaynor, James, additional, Harrison, Richard, additional, Lee, Juliette, additional, Blythe, Elizabeth, additional, Dorman, Teresa, additional, Eissa, Ayman, additional, Ellwood, James, additional, Gooch, Ingrid, additional, Hearn, Robert, additional, Hodgetts, Vanessa, additional, John, Robert, additional, Kirton, Christine, additional, Ladak, Nadia, additional, Morgan, Judith, additional, Plant, Nina, additional, Shepherd, Elizabeth, additional, Short, Judith, additional, Stack, Charles, additional, Steel, Simon, additional, Taylor, Matthew, additional, Thomas, Deborah, additional, Wilson, Catharine, additional, Wilson-Smith, Elaine, additional, Bradbury, Carol L., additional, Hussain, Nageena, additional, Mayell, Antonia, additional, Mesbah, Ahmed, additional, Qureshi, Arif, additional, Vaidyanath, Chandra, additional, Geary, Tim, additional, Hawksworth, Chris, additional, Parasuraman, Tamaraichelvi, additional, Perry, Nicole, additional, Banerjee, Indrani, additional, Barr, Katharine, additional, Butler, Patrick, additional, Davies, Jack, additional, Flewin, Lisa, additional, Gande, Richard, additional, Montague, James, additional, Plumb, James, additional, Pratt, Thomas, additional, Sutherland, Paul, additional, Vail, Hannah, additional, Wilkins, Andrew, additional, Hunter, Catherine, additional, Russell, Susan, additional, Thomas, Alun, additional, Mifsud, Mark, additional, Strachan, Dominic, additional, Plichon, Benoit, additional, and Harlet, Pierre, additional

Published
2017
Full Text
View/download PDF

36. Perioperative Blood Glucose Levels 150 mg/dL are Associated With Improved 5-Year Survival in Patients Undergoing On-Pump Cardiac Surgery: A Prospective, Observational Cohort Study

Author

Mansur, Ashham, Popov, Aron Frederik, Hanna, Ameen Abu, Bergmann, Ingo, Brandes, Ivo Florian, Beissbarth, Tim, Bauer, Martin, and Hinz, José

Subjects
Adult, Aged, 80 and over, Blood Glucose, Male, Age Factors, Observational Study, Comorbidity, Kaplan-Meier Estimate, Length of Stay, Middle Aged, Sex Factors, Risk Factors, Germany, Hyperglycemia, Humans, Female, Hospital Mortality, Prospective Studies, Cardiac Surgical Procedures, Perioperative Period, Propensity Score, Research Article, APACHE, Aged
Abstract

Hyperglycemia is common during and after Coronary Artery Bypass Graft Surgery (CABGS) and has been shown to be associated with poor clinical outcomes. In this study, we hypothesized that a moderate perioperative mean blood glucose level of

Published
2015

37. Perioperative Blood Glucose Levels <150 mg/dL are Associated With Improved 5-Year Survival in Patients Undergoing On-Pump Cardiac Surgery: A Prospective, Observational Cohort Study

Author

Mansur, Ashham, Popov, Aron Frederik, Abu Hanna, Ameen, Bergmann, Ingo, Brandes, Ivo Florian, Beissbarth, Tim, Bauer, Martin, Hinz, José, Amsterdam Public Health, and Medical Informatics

Subjects
Blood Glucose, Cardiac Surgery
Abstract

Hyperglycemia is common during and after Coronary Artery Bypass Graft Surgery (CABGS) and has been shown to be associated with poor clinical outcomes. In this study, we hypothesized that a moderate perioperative mean blood glucose level of

Published
2015

38. Impact of statin therapy on mortality in patients with sepsis-associated acute respiratory distress syndrome (ARDS) depends on ARDS severity: a prospective observational cohort study

Author

Mansur, Ashham, Steinau, Maximilian, Popov, Aron Frederik, Ghadimi, Michael, Beissbarth, Tim, Bauer, Martin, and Hinz, José

Subjects
Medicine(all), 28-day survival, Adult, Male, Respiratory Distress Syndrome, Acute respiratory distress syndrome, 3-hydroxy-3-methylglutaryl CoA reductase inhibitor, Intensive care unit, Statins, Respiratory Distress Syndrome, Adult, Kaplan-Meier Estimate, Middle Aged, Cohort Studies, Sepsis, Humans, Female, Prospective Studies, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Propensity Score, Research Article, Aged, Proportional Hazards Models
Abstract

Background Previous investigations have presumed a potential therapeutic effect of statin therapy in patients with acute respiratory distress syndrome (ARDS). Statins are expected to attenuate inflammation in the lungs of patients with ARDS due to their anti-inflammatory effects. Clinical investigations of the role of statin therapy have revealed contradictory results. This study aimed to investigate whether pretreatment and continuous therapy with statins in patients with sepsis-associated ARDS are associated with 28-day survival according to disease severity (mild, moderate, or severe). Methods Patients with sepsis-associated ARDS from the surgical intensive care were enrolled in this prospective observational investigation. ARDS was classified into three groups (mild, moderate, and severe); 28-day mortality was recorded as the primary outcome variable and organ failure was recorded as secondary outcome variable. Sequential Organ Failure Assessment scores and the requirements for organ support were evaluated throughout the observational period to assess organ failure. Results 404 patients with sepsis-associated ARDS were enrolled in this investigation. The distribution of the ARDS subgroups was 13 %, 59 %, and 28 % for mild, moderate, and severe disease, respectively. Statin therapy improved 28-day survival exclusively in the patients with severe ARDS compared with patients without statin therapy (88.5 % and 62.5 %, respectively; P = 0.0193). To exclude the effects of several confounders, we performed multivariate Cox regression analysis, which showed that statin therapy remained a significant covariate for mortality (hazard ratio, 5.46; 95 % CI, 1.38–21.70; P = 0.0156). Moreover, after carrying a propensity score-matching in the severe ARDS cohort, Kaplan-Meier survival analysis confirmed the improved 28-day survival among patients with statin therapy (P = 0.0205). Patients with severe ARDS who received statin therapy had significantly more vasopressor-free days compared with those without statin therapy (13 ± 7 and 9 ± 7, respectively; P = 0.0034), and they also required less extracorporeal membrane oxygenation (ECMO) therapy and had more ECMO-free days (18 ± 9 and 15 ± 9, respectively; P = 0.0873). Conclusions This investigation suggests a beneficial effect of continuous statin therapy in patients with severe sepsis-associated ARDS and a history of prior statin therapy. Further study is warranted to elucidate this potential effect. Electronic supplementary material The online version of this article (doi:10.1186/s12916-015-0368-6) contains supplementary material, which is available to authorized users.

Published
2015

39. Genetic Polymorphisms in Endothelin-1 as Predictors for Long-Term Survival and the Cardiac Index in Patients Undergoing On-Pump Cardiac Surgery

Author

Mansur, Ashham, Steinau, Maximilian, Popov, Aron Frederik, Milenovic, Sinisa, Bireta, Christian, Weymann, Alexander, Schotola, Hanna, Wiese, Christoph H., Beissbarth, Tim, Tzvetkov, Mladen, and Hinz, José

Subjects
Endothelin-1, lcsh:R, lcsh:Medicine, Kaplan-Meier Estimate, Prognosis, Polymorphism, Single Nucleotide, Haplotypes, Cardiac surgery, Death rates, Blood pressure, Cardiopulmonary bypass, Human genetics, Surgical and invasive medical procedures, Variant genotypes, Humans, lcsh:Q, Hospital Mortality, Postoperative Period, Cardiac Surgical Procedures, lcsh:Science, Research Article
Abstract

Genetic variants within the endothelin-1 gene (EDN1) have been associated with several cardiovascular diseases and may act as genetic prognostic markers. Here, we explored the overall relevance of EDN1 polymorphisms for long-term survival in patients undergoing on-pump cardiac surgery. A prospectively collected cohort of 455 Caucasian patients who underwent cardiac surgery with cardiopulmonary bypass was followed up for 5 years. The obtained genotypes and inferred haplotypes were analyzed for their associations with the five-year mortality rate (primary endpoint). The EDN1 T-1370G and K198N genotype distributions did not deviate from Hardy-Weinberg equilibrium and the major allele frequencies were 83% and 77%, respectively. The cardiovascular risk factors were equally distributed in terms of the different genotypes and haplotypes associated with the two polymorphisms. The five-year mortality rate did not differ among the different EDN1 T-1370G and K198N genotypes and haplotypes. Haplotype analysis revealed that carriers of the G-T (compound EDN1 T-1370G G/K198N T) haplotype had a higher cardiac index than did non-carriers (p = 0.0008); however, this difference did not reach significance after adjusting for multiple testing. The results indicate that common variations in EDN1 do not act as prognostic markers for long-term survival in patients undergoing on-pump cardiac surgery. Open-Access Publikationsfonds 2015 peerReviewed

Published
2015

40. The CD14 rs2569190 TT Genotype Is Associated with an Improved 30-Day Survival in Patients with Sepsis: A Prospective Observational Cohort Study

Author

Mansur, Ashham, Liese, Benjamin, Steinau, Maximilian, Ghadimi, Michael, Bergmann, Ingo, Tzvetkov, Mladen, Popov, Aron Frederik, Beissbarth, Tim, Bauer, Martin, and Hinz, José

Subjects
Adult, Male, Polymorphism, Genetic, Homozygote, lcsh:R, Lipopolysaccharide Receptors, lcsh:Medicine, Disease-Free Survival, Survival Rate, Risk Factors, Sepsis, CD14 rs2569190 TT, Genotype, Humans, Female, lcsh:Q, Prospective Studies, lcsh:Science, Alleles, Research Article
Abstract

According to previous investigations, CD14 is suggested to play a pivotal role in initiating and perpetuating the pro-inflammatory response during sepsis. A functional polymorphism within the CD14 gene, rs2569190, has been shown to impact the pro-inflammatory response upon stimulation with lipopolysaccharide, a central mediator of inflammation in sepsis. In this study, we hypothesized that the strong pro-inflammatory response induced by the TT genotype of CD14 rs2569190 may have a beneficial effect on survival (30-day) in patients with sepsis. A total of 417 adult patients with sepsis (and of western European descent) were enrolled into this observational study. Blood samples were collected for rs2569190 genotyping. Patients were followed over the course of their stay in the ICU, and the 30-day mortality risk was recorded as the primary outcome parameter. Sepsis-related organ failure assessment (SOFA) scores were quantified at sepsis onset and throughout the observational period to monitor organ failure as a secondary variable. Moreover, organ support-free days were evaluated as a secondary outcome parameter. TT-homozygous patients were compared to C-allele carriers. Kaplan-Meier survival analysis revealed a higher 30-day mortality risk among C-allele carriers compared with T homozygotes (p = 0.0261). To exclude the effect of potential confounders (age, gender, BMI and type of infection) and covariates that varied at baseline with a p-value < 0.2 (e.g., comorbidities), we performed multivariate Cox regression analysis to examine the survival time. The CD14 rs2569190 C allele remained a significant covariate for the 30-day mortality risk in the multivariate analysis (hazard ratio, 2.11; 95% CI, 1.08-4.12; p = 0.0282). The 30-day mortality rate among C allele carriers was 23%, whereas the T homozygotes had a mortality rate of 13%. Additionally, an analysis of organ-specific SOFA scores revealed a significantly higher SOFA-Central nervous system score among patients carrying the C allele compared with T-homozygous patients (1.9±1.1 and 1.6±1.0, respectively; p = 0.0311). In conclusion, CD14 rs2569190 may act as a prognostic variable for the short-term outcome (30-day survival) in patients with sepsis. Open Access Publikationsfonds 2015 peerReviewed

Published
2015

41. The regulatory toll-like receptor 4 genetic polymorphism rs11536889 is associated with renal, coagulation and hepatic organ failure in sepsis patients

Author

Mansur, Ashham, Gruben, Luisa von, Popov, Aron F, Steinau, Maximilian, Bergmann, Ingo, Ross, Daniel, Ghadimi, Michael, Beissbarth, Tim, Bauer, Martin, and Hinz, José

Subjects
Medicine(all), Biochemistry, Genetics and Molecular Biology(all)
Abstract

Background Toll-like receptor 4 (TLR4), a lipopolysaccharide (LPS) receptor complex signal-transducing molecule, plays a crucial role in sensing LPS from gram-negative bacteria. TLR4 signaling pathway activation by LPS plays a major role in sepsis pathogenesis. A single nucleotide polymorphism, rs11536889, in the 3’-untranslated region of the TLR4 gene is thought to affect TLR4 translation. This study aimed to investigate whether organ failure in sepsis patients is related to the TLR4 rs11536889 genotype. Methods Adult Caucasian patients with sepsis from the intensive care unit of a university medical center were followed up for 90 days, and organ failure was recorded as the primary outcome variable. Blood samples were collected at enrollment for TLR4 rs11536889 genotyping. Sepsis-related organ failure assessment (SOFA) scores were quantified at sepsis onset and throughout the observational period to monitor organ failure. Results A total of 210 critically ill patients with sepsis were enrolled into this study. Wild-type GG was compared to GC/CC. During their stay in the intensive care unit, GG patients presented significantly higher SOFA scores than did C allele carriers (7.9 ± 4.5 and 6.8 ± 4.2, respectively; p = 0.0005). Analysis of organ-specific SOFA sub-scores revealed significant differences in three organ systems: renal, coagulation and hepatic (p = 0.0005, p = 0.0245 and p

Published
2014

42. The effect of changing the sequence of cuff inflation and device fixation with the LMA-Supreme® on device position, ventilatory complications, and airway morbidity: a clinical and fiberscopic study

Author

Bergmann, Ingo, Crozier, Thomas Allen, Roessler, Markus, Schotola, Hanna, Mansur, Ashham, Büttner, Benedikt, Hinz, José Maria, and Bauer, Martin

Subjects
Anesthesiology and Pain Medicine, supraglottic airway device, LMA-Supreme, sequence, respiratory system
Abstract

BACKGROUND: The conventional sequence when using supraglottic airway devices is insertion, cuff inflation and fixation. Our hypothesis was that a tighter fit of the cuff and tip could be achieved with a consequently lower incidence of air leak, better separation of gastrointestinal and respiratory tracts and less airway morbidity if the device were first affixed and the cuff then inflated. METHODS: Our clinical review board approved the study (public registry number DRKS00003174). An LMA Supreme® was inserted into 184 patients undergoing lower limb arthroscopy in propofol-remifentanil anaesthesia who were randomly assigned to either the control (inflation then fixation; n = 92) or study group (fixation then inflation; n = 92). The cuff was inflated to 60 cmH2O. The patients' lungs were ventilated in pressure-controlled mode with 5 cmH2O PEEP, Pmax to give 6 ml kg-1 tidal volume, and respiratory rate adjusted to end-tidal CO2 of 4.8 and 5.6 kPa. Correct cuff and tip position were determined by leak detection, capnometry trace, oropharyngeal leak pressure, suprasternal notch test, and lube-tube test. Bowl and cuff position and the presence of glottic narrowing were assessed by fiberscopic examination. Postoperative dysphagia, hoarseness and sore throat were assessed with a questionnaire. Ventilatory impairment was defined as a tidal volume

Published
2014

45. The eNOS 894G/T gene polymorphism and its influence on early and long-term mortality after on-pump cardiac surgery

Author

Hinz, José, Schöndorf, Daniel, Bireta, Christian, Lipke, Christina, Moerer, Onnen, Bergmann, Ingo, Wiese, Christoph Herman, Mansur, Ashham, Schotola, Hanna, Sabashnikov, Anton, Quintel, Michael, Schoendube, Friedrich Albert, and Popov, Aron Frederik

Subjects
Surgery, Cardiology and Cardiovascular Medicine
Abstract

Background The eNOS 894G/T polymorphism (GG, GT, and TT) is associated with cardiovascular mortality and may influence cardiovascular diseases as a genetic risk factor. Moreover, this polymorphism has an impact on intraoperative hemodynamics during cardiac surgery with cardiopulmonary bypass (CPB). In this study, we analyzed the influence of this gene polymorphism on early clinical outcome in patients who underwent cardiac surgery with CPB. Also, we performed a 5-year follow-up, assessing the impact of this polymorphism on long-term mortality. Method 500 patients who underwent cardiac surgery with CPB between 2006 and 2007 were included in this prospective single centre study. Genotyping for the eNOS gene polymorphism was performed by polymerase chain reaction amplification. Results Genotype distribution of 894G/T was: GG 50.2%; GT 42.2%; TT 7.8%. Cardiovascular risk factors were equally distributed between the different genotypes of the eNOS 894G/T polymorphism. No significant difference among the groups was shown regarding Euroscore, SAPS II and APACHE II. Perioperative characteristics were also not affected by the genotypes, except for the consumption of norepinephrine (p = 0.03) and amiodarone (p = 0.01) which was higher in the GT allele carrier. The early postoperative course was quite uniform across the genotypes, except for mean intensive care unit length of stay which was significantly prolonged in GT carriers (p = 0.001). The five-year follow-up was 100% complete and showed no significant differences regarding mortality between the groups. Conclusion Our results show that the eNOS 894G /T polymorphism is not associated with early and late clinical outcome after cardiac surgery. Thus, this polymorphism can actually not help to identify high risk groups in the heterogeneous population of individuals who undergo cardiac surgery with CPB. Open-Access-Publikationsfonds 2013 peerReviewed

Published
2013

46. Cost analysis of two anaesthetic machines: 'Primus(R)' and 'Zeus(R)'

Author

Hinz, José, Rieske, Nadine, Schwien, Bernd, Popov, Aron F., Mohite, Prashant N., Radke, Oliver, Bartsch, Armin, Quintel, Michael, and Züchner, Klaus

Abstract

Background Two anaesthetic machines, the "Primus®" and the "Zeus®" (Draeger AG, Lübeck, Germany), were subjected to a cost analysis by evaluating the various expenses that go into using each machine. Methods These expenses included the acquisition, maintenance, training and device-specific accessory costs. In addition, oxygen, medical air and volatile anaesthetic consumption were determined for each machine. Results Anaesthesia duration was 278 ± 140 and 208 ± 112 minutes in the Primus® and the Zeus®, respectively. The purchase cost was €3.28 and €4.58 per hour of operation in the Primus® and the Zeus®, respectively. The maintenance cost was €0.90 and €1.20 per hour of operation in the Primus® and the Zeus®, respectively. We found that the O2 cost was €0.015 ± 0.013 and €0.056 ± 0.121 per hour of operation in the Primus® and the Zeus®, respectively. The medical air cost was €0.005 ± 0.003 and €0.016 ± 0.027 per hour of operation in the Primus® and the Zeus®, respectively. The volatile anaesthetic cost was €2.40 ± 2.40 and €4.80 ± 4.80 per hour of operation in the Primus® and the Zeus®, respectively. Conclusion This study showed that the "Zeus®" generates a higher cost per hour of operation compared to the "Primus®". Open-Access-Publikationsfonds 2012 peerReviewed

Published
2012

49. Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs

Author

Popov, Aron Frederik, Dorge, Hilmar, Hinz, José, Schmitto, Jan Dieter, Stojanovic, Tomislav, Seipelt, Ralf, Didilis, Vassilios, and Schoendube, Friedrich Albert

Subjects
44.85, cardiovascular system, 44.65
Abstract

Background: More than 50% of aortocoronary saphenous vein grafts are occluded 10 years after surgery. Intimal hyperplasia is the initial critical step in the progression toward occlusion. Internal mammary veins, which are physiologically prone to less hydrostatic pressure, may undergo an accelerated progression to intimal hyperplasia and thus be suitable for investigation of the mechanisms of aortocoronary vein graft disease. Methods: Six minipigs underwent aortocoronary bypass grafting using standard cardiopulmonary bypass and cardioplegic arrest. Mammary vein were grafted in a reversed manner from ascending aorta to left anterior descending coronary artery (LAD). The proximal LAD was ligated, rendering the anterior left ventricle vein graft-dependent. Minipigs were killed after 4 weeks, and vein grafts were harvested. Histological and immunohistological investigation were performed with respect to morphometric analysis, endothelial damage/dysfunction (v-Willebrand-factor (vWF)), smooth muscle cells (?-smooth actin) and proliferation rate (proliferation marker Ki 67). Results: Mean intimal area of vein grafts was increased compared to ungrafted mammary veins. Intimal hyperplasia in vein grafts was characterized by massive accumulation of smooth muscle cells with a high proliferation rate and endothelial perturbation. Significant (p = 0.001) intimal hyperplasia of the grafted mammary vein compared to the ungrafted mammary vein was found. These changes were absent in ungrafted mammary veins. Conclusion: The present study demonstrates a pig model of aortocoronary vein graft intimal hyperplasia which is characterized by an accelerated progression within internal mammary veins. The model is suitable to investigate the pathophysiology of aortocoronary vein graft intimal hyperplasia as well as therapeutic approaches. peerReviewed

Published
2008

Catalog

Books, media, physical & digital resources
See catalog results