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Orthopadie (Heidelb) 2022 Jul 25;51(7):595-606. Epub 2022 May 25.

Vienna Bone and Growth Center, Wien, Österreich.

Osteogenesis imperfecta (OI) describes a group of rare diseases which are associated with an increased tendency to bone fractures. In addition to the main symptom of fractures, OI is characterized by a variety of pediatric, pediatric orthopedic and anesthesiological challenges. The multidisciplinary expertise is mostly concentrated at specialized centers. Read More

Ann Surg 2022 Jun 28. Epub 2022 Jun 28.

Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Objective: To evaluate whether patients of Black race are at higher risk of losing the ability to live independently after surgery, and if a higher prevalence of severe diabetes mellitus and hypertension are contributing.

Summary Background Data: It is unclear whether a patient's race predicts adverse discharge to a nursing home after surgery, and if preexisting diseases are contributing.

Methods: 368,360 adults undergoing surgery between 2007 and 2020 across two academic healthcare networks in New England were included. Read More

Gesundheitswesen 2022 Jun 23. Epub 2022 Jun 23.

Anästhesiologie und Intensivmedizin, Universitätsklinikum Ulm, Ulm, Germany.

The positive side of the Covid-19 pandemic is that it has provided a stimulation for innovations. As an example, we discuss the Pragmatic Controlled Trial (PCT), a twin study that can be used to confirm the real-world effectiveness (RWE) of health services under the non-standardized conditions of everyday care. Proof of the RWE could generally be important for health services with conditional approval. Read More

Zentralbl Chir 2022 Jun 22. Epub 2022 Jun 22.

Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland.

In modern perioperative care concepts, multimodal ERAS (Enhanced Recovery After Surgery) is a multimodal perioperative treatment concept for improving postoperative recovery of surgical patients after an operation. This is managed by the so-called ERAS Society and through which hospitals can also be officially certified. The focus of the ERAS concept is on uniform patient care from admission to discharge, with the aim of improving perioperative processes by implementing evidence-based protocols involving a multidisciplinary treatment team. Read More

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022 Jun 20. Epub 2022 Jun 20.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Lay resuscitation is one of the most important measures to increase the survival rate of patients after out-of-hospital cardiac arrest. While European countries, and especially Scandinavian countries, achieve lay resuscitation rates of over 80%, the rate in Germany is only around 40%. The 2021 Resuscitation Guidelines updated by the European Resuscitation Council give special weight to Systems Saving Lives and focus on resuscitation by laypersons. Read More

Nervenarzt 2022 Jun 15. Epub 2022 Jun 15.

Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.

Med Klin Intensivmed Notfmed 2022 Jun 15. Epub 2022 Jun 15.

Klinik für Herz- und Thoraxchirurgie, Universitätsklinikum Jena, Jena, Deutschland.

Tierarztl Prax Ausg K Kleintiere Heimtiere 2022 Jun 14. Epub 2022 Jun 14.

Klinik für Kleintiere, Abteilung für Anästhesiologie und Intensivmedizin, Veterinärmedizinische Fakultät der Universität Leipzig.

Objective: The Leipzig Veterinary Risk-Index - "LeiV-Risk-Index" is a multifactorial risk index developed to enable an improved objective assessment of the anesthetic risk in dogs. The scoring system is based on 10 risk factors affecting perioperative mortality. The aim of this study was to evaluate the applicability of the LeiV-Risk-Index and its risk factors as well as to perform a direct comparison with the ASA-classification. Read More

J Intensive Care Med 2022 Jun 12:8850666221107839. Epub 2022 Jun 12.

Department of Anesthesiology, 2013Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.

Objective: In many institutions, intensive care unit (ICU) nurses assess their patients' muscle function as part of their routine bedside examination. We tested the research hypothesis that this subjective examination of muscle function prior to extubation predicts tracheostomy requirement.

Methods: Adult, mechanically ventilated patients admitted to 7 ICUs at Beth Israel Deaconess Medical Center (BIDMC) between 2008 and 2019 were included in this observational study. Read More

Br J Anaesth 2022 Jun 8. Epub 2022 Jun 8.

Department of Anaesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Centre, Boston, MA, USA; Center for Anaesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Centre, Boston, MA, USA; Department of Anaesthesiology, Düsseldorf University Hospital, Dusseldorf, Germany. Electronic address:

Background: The impact of high vs low intraoperative tidal volumes on postoperative respiratory complications remains unclear. We hypothesised that the effect of intraoperative tidal volume on postoperative respiratory complications is dependent on respiratory system elastance.

Methods: We retrospectively recorded tidal volume (Vt; ml kg ideal body weight [IBW]) in patients undergoing elective, non-cardiothoracic surgery from hospital registry data. Read More

Schmerz 2022 06 31;36(3):155-156. Epub 2022 May 31.

Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.

Viruses 2022 04 23;14(5). Epub 2022 Apr 23.

Department of Virology, Paul-Ehrlich-Institut, Paul-Ehrlich Strass 51-59, 63225 Langen, Germany.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has now been continuing for more than two years. The infection causes COVID-19, a disease of the respiratory and cardiovascular system of variable severity. Here, the humoral immune response of 80 COVID-19 patients from the University Hospital Frankfurt/Main, Germany, was characterized longitudinally. Read More

Redox Biol 2022 07 7;53:102332. Epub 2022 May 7.

Ruhr University Bochum, Institute of Biochemistry and Pathobiochemistry, Microbial Biochemistry, Bochum, Germany. Electronic address:

Under physiological conditions, Escherichia coli RidA is an enamine/imine deaminase, which promotes the release of ammonia from reactive enamine/imine intermediates. However, when modified by hypochlorous acid (HOCl), it turns into a potent chaperone-like holdase that can effectively protect E. coli's proteome during oxidative stress. Read More

Notf Rett Med 2022 May 13:1-10. Epub 2022 May 13.

Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland.

Background: High quality of care in prehospital emergency medicine is characterized by guideline-based therapy. The basic prerequisite for this therapy is the availability of the required drugs in accordance with the current guideline recommendations. It is currently unclear whether this is guaranteed nationwide. Read More

HNO 2022 May 17. Epub 2022 May 17.

Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Ludwig-Maximilians-Universität München (LMU)-Klinikum, Marchioninistr. 15, 81377, München, Deutschland.

We report the case of an 11-year-old girl with difficultly speaking and a history of singular, self-limiting oral bleeding. Clinical and radiological examination in the emergency room showed a vascularized tumor of the base of the tongue, which almost completely occluded the oropharynx. After complex anesthesiologic preparation and endoluminal embolization, the tumor was safely removed by transoral laser microsurgery. Read More

Front Med (Lausanne) 2022 29;9:878823. Epub 2022 Apr 29.

Institut für Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum Ulm, Ulm, Germany.

Background: Sodium thiosulfate (STS) is a recognized drug with antioxidant and HS releasing properties. We recently showed that STS attenuated organ dysfunction and injury during resuscitation from trauma-and-hemorrhage in CSE-ko mice, confirming its previously described organ-protective and anti-inflammatory properties. The role of HS in diabetes mellitus type 1 (DMT1) is controversial: genetic DMT1 impairs HS biosynthesis, which has been referred to contribute to endothelial dysfunction and cardiomyopathy. Read More

Front Mol Neurosci 2022 25;15:832490. Epub 2022 Apr 25.

Institut für Biochemie, Emil-Fischer-Zentrum, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Glycine receptors (GlyRs) are the primary mediators of fast inhibitory transmission in the mammalian spinal cord, where they modulate sensory and motor signaling. Mutations in GlyR genes as well as some other genes underlie the hereditary disorder hyperekplexia, characterized by episodic muscle stiffness and exaggerated startle responses. Here, we have investigated pain-related behavior and GlyR expression in the spinal cord of the GlyR deficient mutant mouse (). Read More

Anaesthesist 2022 05 4;71(5):362-372. Epub 2022 May 4.

Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.

Background: Practical experiences in clinical traineeships can shape the later specialty choice of medical students.

Key Question: The following study aimed to find factors in anesthesiological clinical traineeship that encourage students to specialize in the field.

Material And Methods: As part of a nationwide online survey conducted by the working group for education of the German Association for Orthopedics and Trauma Surgery (Deutsche Gesellschaft für Orthopädie und Unfallchirurgie, DGOU), study participants (n = 479) answered questions about their minimum 4‑week traineeship in anesthesiology. Read More

Anaesthesist 2022 May 4. Epub 2022 May 4.

Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.

Background: While many hospitals in Germany perform thoracic surgery, anesthetic techniques and methods that are actually used are usually only known for individual departments. This study describes the general anesthetic management of three typical thoracic surgical procedures across multiple institutions.

Material And Methods: The German Thoracic Registry recorded 4614 patients in 5 institutions between 2016 and 2019. Read More

PLoS One 2022 3;17(5):e0265720. Epub 2022 May 3.

Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands.

Background: Repeated rotation of empiric antibiotic treatment strategies is hypothesized to reduce antibiotic resistance. Clinical rotation studies failed to change unit-wide prevalence of antibiotic resistant bacteria (ARB) carriage, including an international cluster-randomized crossover study. Unit-wide effects may differ from individual effects due to "ecological fallacy". Read More

Z Herz Thorax Gefasschir 2022 Apr 26:1-5. Epub 2022 Apr 26.

Klinik für Herzchirurgie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Deutschland.

Background: The novel coronavirus disease 2019 (COVID-19) can cause a severe and therapy-refractory acute respiratory distress syndrome. Temporary mechanical assistance by veno-venous extracorporeal membrane oxygenation (v.v. Read More

Med Klin Intensivmed Notfmed 2022 Apr 28. Epub 2022 Apr 28.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland.

At the time of admission to an intensive or intermediate care unit, assessment of the patients' nutritional status may have both prognostic and therapeutic relevance with regard to the planning of individualized medical nutrition therapy (MNT). MNT has definitely no priority in the initial treatment of a critically ill patient, but is often also neglected during the course of the disease. Especially with prolonged length of stay, there is an increasing risk of malnutrition with considerable prognostic macro- and/or micronutrient deficit. Read More

Orthopade 2022 Apr 27. Epub 2022 Apr 27.

Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München-Harlaching, München, Deutschland.

Background: Neuro-osteoarthropathy of the foot (CN) is divided into an active and inactive stage, with impact on the further treatment. The histopathological Charcot score (HCS) can be used, to grade the inflammatory activity in tissue samples.

Research Question: This study aims to clarify whether successful bony healing after arthrodesis is related to inflammatory activity of the disease. Read More

Anaesthesist 2022 Apr 25. Epub 2022 Apr 25.

Klinik für Anästhesie und Intensivtherapie Universitätsklinikum Marburg, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland.

One of the main limitations concerning the use of local anesthetics is due to their restricted duration of action. In recent years, liposomal formulations with prolonged release kinetics have been developed to extend the pharmacological duration of action of the 1‑stage peripheral regional anesthesia (single-shot procedure) and thus bring about a longer duration of action. The focus here is particularly on achieving postoperative freedom from pain for at least 24 h (or even better 48 h) and thus early mobilization of patients using on-demand medication causing (at most) minor local sensory blockade without causing motor impairments (at least that is the ideal). Read More

Med Klin Intensivmed Notfmed 2022 May;117(4):312-320

Medizinrecht und Strafrecht, Kanzlei Ulsenheimer Friederich, München, Deutschland.

Medical liability is booming. Malpractice can entail both civil and criminal consequences. Besides financial and custodial penalties, at worst the license to practice medicine can be withdrawn. Read More

Diagnostics (Basel) 2022 Mar 23;12(4). Epub 2022 Mar 23.

Abteilung für Neuroradiologie, Universitätsklinik und Poliklinik für Radiologie, Universitätsklinikum Halle (Saale) Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.

Acutely manifesting radicular pain syndromes associated with degenerations of the lower spine are frequent ailments with a high rate of recurrence. Part of the conservative management are periradicular infiltrations of analgesics and steroids. The purpose of this study is to evaluate the dependence of the clinical efficacy of CT-guided periradicular injections on the pattern of contrast distribution and to identify the best distribution pattern that is associated with the most effective pain relief. Read More

Ophthalmologe 2022 Apr 22. Epub 2022 Apr 22.

Klinik für Augenheilkunde, Heinrich-Heine-Universität, Düsseldorf, Deutschland.

The climate crisis is threatening the health of current and future generations and represents a particular challenge for healthcare systems. To address man-made climate change, comprehensive adaptation and mitigation strategies are crucial. Medicine and ophthalmology offer various opportunities to reduce the CO (carbon dioxide) footprint - these should be implemented and politically encouraged. Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2022 Apr 21;57(4):246-262. Epub 2022 Apr 21.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel.

Goal directed hemodynamic monitoring and the balance in goal directed therapy between adequate fluid/volume therapy and the application of vasoactive or inotropic drugs are the basic elements of modern perioperative therapy.Surgical procedures should be accompanied by as few side effects and complications as possible. Nevertheless, the number of postoperative complications remains surprisingly high, despite of the modern surgical procedures. Read More

Phys Chem Chem Phys 2022 May 4;24(17):9964-9977. Epub 2022 May 4.

Klinikum Nürnberg Medical School, CPPB, Institute of Physiology, Pathophysiology and Biophysics, Nuremberg, Germany.

Gating of the voltage-gated proton channel H1 is strongly controlled by pH. There is evidence that this involves the sidechains of titratable amino acids that change their protonation state with changes of the pH. Despite experimental investigations to identify the amino acids involved in pH sensing only few progress has been made, including one histidine at the cytoplasmic side of the channel that is involved in sensing cellular pH. Read More

Anaesthesist 2022 Apr 20. Epub 2022 Apr 20.

Medizinische Klinik, und Poliklinik 1, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.