TY - JOUR A1 - Kheiroddin, Parastoo A1 - Schöberl, Patricia A1 - Althammer, Michael A1 - Cibali, Ezgi A1 - Würfel, Thea A1 - Wein, Hannah A1 - Kulawik, Birgit A1 - Buntrock-Döpke, Heike A1 - Weigl, Eva A1 - Gran, Silvia A1 - Gründl, Magdalena A1 - Langguth, Jana A1 - Lampl, Benedikt A1 - Judex, Guido A1 - Niggel, Jakob A1 - Pagel, Philipp A1 - Schratzenstaller, Thomas A1 - Schneider-Brachert, Wulf A1 - Gastiger, Susanne A1 - Bodenschatz, Mona A1 - Konrad, Maike A1 - Levchuk, Artem A1 - Roth, Cornelius A1 - Schöner, David A1 - Schneebauer, Florian A1 - Rohrmanstorfer, René A1 - Burkovski, Andreas A1 - Ambrosch, Andreas A1 - Wagner, Thomas A1 - Kabesch, Michael ED - Buonsenso, Danilo T1 - Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests JF - Frontiers in Pediatrics N2 - Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary. Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project. Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008). Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs. KW - children KW - COVID-19 KW - Germany KW - PCR KW - pooling KW - gargle KW - schools KW - pandemic KW - Covid-19 KW - Polymerase-Kettenreaktion KW - Nachweis KW - Schulkind KW - Deutschland Y1 - 2021 U6 - https://doi.org/10.3389/fped.2021.721518 SN - 2296-2360 VL - 9 PB - frontiers ER - TY - JOUR A1 - Kieninger, Martin A1 - Schneider, Corinna A1 - Auer, Simon A1 - Reinker, Lukas A1 - Adler, Ina A1 - Dendorfer, Sebastian A1 - Rosenberger, Johanna A1 - Popp, Daniel A1 - Eissnert, Christoph A1 - Ludsteck, Dominik A1 - Cyrus, Christopher A1 - Hoffmann, Johannes A1 - Morag, Sarah A1 - Graf, Bernhard A1 - Kieninger, Bärbel T1 - Transport von schwer verletzten Traumapatienten im Rettungswagen mit und ohne starre Halsorthese: vergleichende biomechanische Messungen JF - Die Anaesthesiologie N2 - Hintergrund: Der tatsächliche Stellenwert der prähospitalen Immobilisation der Halswirbelsäule (HWS) bei schwer verletzten Traumapatienten ist weiterhin unklar. In Anbetracht möglicher negativer Implikationen durch das Anbringen einer starren HWS-Orthese muss deren Anwendung während der gesamten prähospitalen Phase kritisch hinterfragt werden. Ziel der Arbeit: Es sollten vergleichende biomechanische Messungen zur Beweglichkeit der HWS bei Immobilisation mittels Vakuummatratze mit und ohne zusätzliches Anbringen einer starren HWS-Orthese nach Lagerung auf der Trage durchgeführt werden. Material und Methoden: Die Bewegungen der HWS beim Ein- und Ausladeprozess in einen modernen RTW sowie während der Fahrt entlang eines vordefinierten Parkours wurden mit einem Motion-Capture-System aufgezeichnet. Die Probandin, an der die Messungen durchgeführt wurden, wurde auf einer Vakuummatratze mit der Möglichkeit zur seitlichen Fixierung des Kopfes sowie Kinn- und Stirngurt auf einer elektrohydraulischen Fahrtrage immobilisiert. Bei der einen Hälfte der Versuche erfolgte die zusätzliche Immobilisation der HWS mittels starrer Orthese, bei der anderen wurde auf die Anwendung einer HWS-Orthese verzichtet. Ergebnisse: Statistisch signifikante Unterschiede ergaben sich nur bei einigen biomechanischen Parametern in der sagittalen Ebene (Flexion und Extension). Für die anderen Bewegungsrichtungen (axiale Rotation, laterale Beugung) wurden keine signifikanten Unterschiede für die gemessenen Parameter ermittelt. Generell wurden sowohl bei den Versuchen mit HWS-Orthese als auch ohne HWS-Orthese nur sehr geringe Winkelauslenkungen (im Mittel bei axialer Rotation und Flexion/Extension im Bereich von einem bis 2 Grad, bei der lateralen Beugung höchstens 3 Grad) gemessen. Schlussfolgerung: Bei einer korrekt durchgeführten Immobilisation mittels einer Vakuummatratze mit der Möglichkeit zur seitlichen Stabilisierung des Kopfes sowie Kinn- und Stirngurt auf einer elektrohydraulischen Fahrtrage mit Beladesystem ergeben sich für den Ein- und Ausladeprozess sowie während der Fahrt in einem modernen RTW mit luftgefederter Tragenlagerung und Luftfederung der Hinterachse keine relevanten Vorteile bezüglich der Einschränkung der Bewegung der HWS durch die zusätzliche Verwendung einer starren HWS-Orthese. T2 - Transport of severely injured trauma patients in an ambulance with and without a rigid neck orthosis: comparative biomechanical measurements KW - Notfallmedizin KW - Immobilisation KW - Vakuummatratze KW - Zervikalstütze · KW - Halswirbelsäule Y1 - 2024 U6 - https://doi.org/10.1007/s00101-024-01462-w VL - 73 IS - 10 SP - 668 EP - 675 PB - Springer Nature ER - TY - GEN A1 - Krefting, Dagmar A1 - Zaunseder, Sebastian A1 - Säring, Dennis A1 - Wittenberg, Thomas A1 - Palm, Christoph A1 - Schiecke, Karin A1 - Krenkel, Lars A1 - Hennemuth, Anja A1 - Schnell, Susanne A1 - Spicher, Nicolai T1 - Blutdruck, Hämodynamik und Gefäßzustand: Innovative Erfassung und Bewertung – Schwerpunkt bildbasierte Verfahren T2 - 66. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 12. Jahreskongress der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e. V. (TMF), 26. - 30.09.2021, online N2 - Einleitung: Blutdruck gilt als sogenannter Vitalparameter als einer der grundlegenden Indikatoren für den Gesundheitszustand einer Person. Sowohl zu niedriger als auch zu hoher Blutdruck kann lebensbedrohend sein, letzerer ist darüber hinaus ein Risikofaktor insbesondere für Herz-Kreislauferkrankungen, die trotz wichtiger Fortschritte in der Behandlung immer noch die häufigste Todesursache in Deutschland darstellen. Die Hämodynamik, also die raumzeitliche Dynamik des Blutflusses, und der Gefäßzustand sind eng verbunden mit dem Blutdruck und ebenfalls von hoher klinischer Relevanz, u.a. zur Identifikation von Durchblutungsstörungen und ungünstigen Druckverteilungen der Gefäßwand. Innovationen in der Messtechnik als auch in der Datenanalyse bieten heute neue Möglichkeiten der Erfassung und Bewertung von Blutdruck, Hämodynamik und Gefäßzustand [1], [2], [3], [4]. Methodik: In einer gemeinsamen Workshopserie der AG Medizinische Bild- und Signalverarbeitung der GMDS und des Fachausschusses Biosignale der DGBMT werden wir neue Ansätze und Lösungen für Mess- und Analyseverfahren zu Blutdruck und -fluss sowie zum Gefäßzustand vorstellen und diskutieren. Dabei stehen im ersten Workshop auf der GMDS Jahrestagung Bildbasierte Verfahren im Zentrum, während der zweite Workshop auf der DGBMT Jahrestagung den Fokus auf Biosignalbasierten Verfahren legt. Es werden aktuelle Forschungsergebnisse vorgestellt und diskutiert. Es sind jeweils mehrere Vorträge geplant mit ausreichend Zeit zur Diskussion. Folgende Vorträge sind geplant (Arbeitstitel): Sebastian Zaunseder: Videobasierte Erfassung des Blutdrucks Anja Hennemuth: A Visualization Toolkit for the Analysis of Aortic Anatomy and Pressure Distribution Lars Krenkel: Numerische Analyse der Rupturwahrscheinlichkeit zerebraler Aneurysmata Susanne Schnell: Messung des Blutflusses und hämodynamischer Parameter mit 4D flow MRI: Möglichkeiten und Herausforderungen Ergebnisse: Ziel des Workshops ist die Identifikation von innovativen Ansätzen und neuen Methoden zur qualitativen und quantitativen Bestimmung von hämodynamischen Parametern sowie deren kritische Bewertung durch die Community für die Eignung in der klinischen Entscheidungsunterstützung. Diskussion: Der Workshop leistet inhaltlich einen Beitrag zu zentralen Aspekten für die Herz-Kreislauf-Medizin. Er bringt dabei Expertise aus verschiedenen Bereichen zusammen und schlägt die Brücke zwischen Kardiologie, Medizininformatik und Medizintechnik. Schlussfolgerung: Innovative Technologien aus Medizintechnik und Informatik ermöglichen zunehmend einfache und raumzeitlich aufgelöste Erfassung und Bewertung wichtiger Informationen zur Unterstützung von Diagnose und Therapieverfolgung. [1] Zaunseder S, Trumpp A, Wedekind D, Malberg H. Cardiovascular assessment by imaging photoplethysmography - a review. Biomed Tech (Berl). 2018 Oct 25;63(5):617–34. [2] Huellebrand M, Messroghli D, Tautz L, Kuehne T, Hennemuth A. An extensible software platform for interdisciplinary cardiovascular imaging research. Comput Methods Programs Biomed. 2020 Feb;184:105277. [3] Schmitter S, Adriany G, Waks M, Moeller S, Aristova M, Vali A, et al. Bilateral Multiband 4D Flow MRI of the Carotid Arteries at 7T. Magn Reson Med. 2020 Oct;84(4):1947–60. [4] Birkenmaier C, and Krenkel, L. Flow in Artificial Lungs. In: New Results in Numerical and Experimental Fluid Mechanics XIII. Contributions to the 22nd STAB/DGLR Symposium. Springer; 2021. KW - Bildbasierte Verfahren KW - Blutdruck KW - Hämodynamik KW - Blutgefäß KW - Bildgebendes Verfahren Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-21gmds0167 ER - TY - GEN A1 - Krenkel, Lars T1 - Maskenpflicht für Aerosole – wie wir medizinisches Personal in der Pandemie schützen T2 - TRIOKON Digital 2021 : Zukunft Ostbayern, 29.09.2021, Weiden, Deutschland KW - Aerosole KW - Pandemie KW - SARS-CoV-2 Y1 - 2021 UR - https://www.youtube.com/watch?v=bYRFpp_Xxvc ER - TY - GEN A1 - Krenkel, Lars T1 - Relevanz von Aerosolen im klinischen Kontext T2 - Innovationstag Hygiene 2021, Continental Arena, Regensburg, Deutschland Y1 - 2021 ER - TY - GEN A1 - Krenkel, Lars A1 - Michel, Johanna A1 - Keil, Niklas A1 - Daschner, Jan T1 - Experimental Investigation of Logitudinal Folds in Endotracheal Tube Cuffs and their Correlation to Silent Breathing T2 - 23. DGLR Fach-Symposium Strömungen mit Ablösung, 09./10. November 2022, Berlin, Deutschland N2 - Air leakage past High-Volume-Low-Pressure (HVLP) endotracheal tube (ETT) cuffs creates a potential infection risk for health care professionals during ventilation of patients suffering from contagious airborne diseases. However, unlike silent aspiration, a phenomenon where fluids enter the airways of intubated patients, the aspect of aerosol emergence through cuff folds -what we called accordingly “silent breathing” (SB)- has not been investigated in detail so far. This study investigates air leakage past HVLP cuffs with varying cuff pressures under realistic artificial breathing scenarios experimentally and in addition numerically. The focus was laid on the parametric investigation of the occurrence and furthermore on different influencing factors of silent breathing. The morphology of the folds responsible for the leakage was captured using high-resolution 3D microcomputed tomography (μCT). For the numerical investigations (Com-putational Fluid Dynamics - CFD), the commercial CFD Software package FLUENT 2021 R2 (ANSYS, Inc., Canonsburg, PA, US), as well as the DLR in-house research code THETA has been used. KW - Silent Breathing KW - Aerosols KW - CFD KW - Endotracheal Intubation Y1 - 2022 UR - https://www.dlr.de/as/Portaldata/5/Resources/dokumente/veranstaltungen/stab_workshop/Jahresbericht2022.pdf CY - Göttingen ER - TY - CHAP A1 - Krenkel, Lars A1 - Wagner, Claus A1 - Wolf, Ursula A1 - Scholz, Alexander-Wigbert K. A1 - Terekhov, Maxim A1 - Rivoire, Julien A1 - Schreiber, W. ED - Hirschel, Ernst Heinrich ED - Schröder, Wolfgang ED - Fujii, Kozo ED - Haase, Werner ED - Leer, Bram ED - Leschziner, Michael A. ED - Pandolfi, Maurizio ED - Periaux, Jacques ED - Rizzi, Arthur ED - Roux, Bernard ED - Shokin, Yurii I. ED - Dillmann, Andreas ED - Heller, Gerd ED - Klaas, Michael ED - Kreplin, Hans-Peter ED - Nitsche, Wolfgang T1 - Protective Artificial Lung Ventilation: Impact of an Endotracheal Tube on the Flow in a Generic Trachea T2 - New Results in Numerical and Experimental Fluid Mechanics VII : Contributions to the 16th STAB/DGLR Symposium Aachen, Germany 2008 N2 - Computational Fluid Dynamics (CFD) and experimental investigations on a generic model of the trachea have been carried out focusing on the impact of an endotracheal tube (ETT) on the resulting flow regime. It could be shown that detailed modelling of the airway management devices is essential for proper flow prediction, but secondary details as Murphy Eyes can be neglected. Models with bending and connector promote the formation of stronger secondary flows and disturbances which persist for a longer time. KW - computational fluid dynamics KW - Computational Fluid Dynamics Simulation KW - Endotracheal Tube KW - Particle Image Velocimetry KW - Turbulent Kinetic Energy Y1 - 2010 SN - 978-3-642-14242-0 U6 - https://doi.org/10.1007/978-3-642-14243-7_62 SP - 505 EP - 512 PB - Springer Berlin Heidelberg CY - Berlin, Heidelberg ER - TY - CHAP A1 - Kubowitsch, Simone A1 - Dendorfer, Sebastian T1 - Psychologie und Biomechanik – Integrierte Betrachtung von Muskelrekrutierung BT - Erkenntnisse und Ableitungen für Biofeedback T2 - Jahrestagung der Deutschen Gesellschaft für Biofeedback e. V., Regensburg, 2018 Y1 - 2018 ER - TY - GEN A1 - Kubowitsch, Simone A1 - Süß, Franz A1 - Jansen, Petra A1 - Dendorfer, Sebastian T1 - Effect of dual tasking on muscular imbalances T2 - European Society of Biomechanics meeting 2019, Vienna, Austria Y1 - 2019 UR - https://owncloud.tuwien.ac.at/index.php/s/dovqqcj02VeZHze ER - TY - CHAP A1 - Kubowitsch, Simone A1 - Süß, Franz A1 - Jansen, Petra A1 - Dendorfer, Sebastian T1 - Comparison of dynamic muscular imbalances in back pain patients and healthy controls T2 - World Congress Biomechanics Dublin, 2018 Y1 - 2018 ER - TY - CHAP A1 - Kubowitsch, Simone A1 - Süß, Franz A1 - Jansen, Petra A1 - Dendorfer, Sebastian T1 - Muscular imbalances during experimentally induced stress T2 - 23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017 Y1 - 2017 ER - TY - JOUR A1 - Kummerlin, Jana A1 - Fabro, Hannah Katharina A1 - Pedersen, Peter Heide A1 - Jensen, Kenneth Krogh A1 - Pedersen, Dennis A1 - Andersen, Michael Skipper T1 - Measuring Knee Joint Laxity in Three Degrees-of-Freedom In Vivo Using a Robotics- and Image-Based Technology JF - Journal of Biomechanical Engineering N2 - Accurate and reliable information about three-dimensional (3D) knee joint laxity can prevent misdiagnosis and avoid incorrect treatments. Nevertheless, knee laxity assessments presented in the literature suffer from significant drawbacks such as soft tissue artifacts, restricting the knee within the measurement, and the absence of quantitative knee ligament property information. In this study, we demonstrated the applicability of a novel methodology for measuring 3D knee laxity, combining robotics- and image-based technology. As such technology has never been applied to healthy living subjects, the aims of this study were to develop novel technology to measure 3D knee laxity in vivo and to provide proof-of-concept 3D knee laxity measurements. To measure tibiofemoral movements, four healthy subjects were placed on a custom-built arthrometer located inside a low dose biplanar X-ray system with an approximately 60 deg knee flexion angle. Anteroposterior and mediolateral translation as well as internal and external rotation loads were subsequently applied to the unconstrained leg, which was placed inside a pneumatic cast boot. Bone contours were segmented in the obtained X-rays, to which subject-specific bone geometries from magnetic resonance imaging (MRI) scans were registered. Afterward, tibiofemoral poses were computed. Measurements of primary and secondary laxity revealed considerable interpersonal differences. The method differs from those available by the ability to accurately track secondary laxity of the unrestricted knee and to apply coupled forces in multiple planes. Our methodology can provide reliable information for academic knee ligament research as well as for clinical diagnostics in the future. KW - ANTERIOR CRUCIATE LIGAMENT KW - COMPLEX KW - COORDINATE SYSTEM KW - INJURY KW - INSTABILITY KW - MOTION KW - OSTEOARTHRITIS KW - QUANTIFICATION KW - STIFFNESS Y1 - 2022 U6 - https://doi.org/10.1115/1.4053792 SN - 1528-8951 VL - 144 IS - 8 PB - The American Society of Mechanical Engineers (ASME) ER - TY - JOUR A1 - Köck, Hannah A1 - Striegl, Birgit A1 - Kraus, Annalena A1 - Zborilova, Magdalena A1 - Christiansen, Silke H. A1 - Schäfer, Nicole A1 - Grässel, Susanne A1 - Hornberger, Helga T1 - In Vitro Analysis of Human Cartilage Infiltrated by Hydrogels and Hydrogel-Encapsulated Chondrocytes JF - Bioengineering N2 - Osteoarthritis (OA) is a degenerative joint disease causing loss of articular cartilage and structural damage in all joint tissues. Given the limited regenerative capacity of articular cartilage, methods to support the native structural properties of articular cartilage are highly anticipated. The aim of this study was to infiltrate zwitterionic monomer solutions into human OA-cartilage explants to replace lost proteoglycans. The study included polymerization and deposition of methacryloyloxyethyl-phosphorylcholine- and a novel sulfobetaine-methacrylate-based monomer solution within ex vivo human OA-cartilage explants and the encapsulation of isolated chondrocytes within hydrogels and the corresponding effects on chondrocyte viability. The results demonstrated that zwitterionic cartilage–hydrogel networks are formed by infiltration. In general, cytotoxic effects of the monomer solutions were observed, as was a time-dependent infiltration behavior into the tissue accompanied by increasing cell death and penetration depth. The successful deposition of zwitterionic hydrogels within OA cartilage identifies the infiltration method as a potential future therapeutic option for the repair/replacement of OA-cartilage extracellular suprastructure. Due to the toxic effects of the monomer solutions, the focus should be on sealing the OA-cartilage surface, instead of complete infiltration. An alternative treatment option for focal cartilage defects could be the usage of monomer solutions, especially the novel generated sulfobetaine-methacrylate-based monomer solution, as bionic for cell-based 3D bioprintable hydrogels. KW - osteoarthritis KW - human articular cartilage KW - chondrocytes KW - hydrogels KW - zwitterionic monomers KW - infiltration Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-61235 N1 - Corresponding author: Helga Hornberger VL - 10 SP - 1 EP - 21 PB - MDPI ER - TY - GEN A1 - Kögler, Michael A1 - Ismail, Khaled M. A1 - Rusavy, Zdenek A1 - Kalis, Vladimir A1 - Süß, Franz A1 - Dendorfer, Sebastian T1 - Influence of bed height and stance on accoucheurs lower back and glenohumeral load during simulated childbirth T2 - 31st meeting of Czech Urogynaecological Society, Prague, 2022 Y1 - 2022 ER - TY - JOUR A1 - Lazarev, Igor A. A1 - Riabokon, P. V. A1 - Haller, M. A1 - Dendorfer, Sebastian T1 - Effect of the Displacement of Calcaneal Bone Peripheral Fragment in its Fracture on the Function of the Three-Headed Calf Muscle JF - TRAUMA N2 - In the structure of musculoskeletal injuries, calcaneal fractures account for up to 4 % of all skeletal fractures and up to 60 % of hindfoot fractures. The effect of the displacement of the peripheral fragment of the calcaneus on the calf muscles’s reaction forces at the time of the adoption of the simplified squatting position was investigated by modeling in AnyBody Modeling System 6.0 software. M.gastrocnemius (lateralis et medialis) in the initial phase of motion in all variants of the peripheral fragment displacement did not develop sufficient muscular effort in comparison to the intact calcaneus. M.soleus medialis et lateralis showed significant increase in muscle activity rates in the initial phase of motion (41.87 ± 1.90 H and 52.07 ± 2.10 H) before reaching its maximum values, as compared with those of the intact calcaneus. In the final phase of the movement, upon muscle reaches its maximum length, muscular strength indicators of the m.soleus returned to their original values or were significantly below them. The decline in muscle strength was due to shortening of the moment arm or muscle excursion in case of convergence of muscle attachment points. When the peripheral fragment is displaced, due to putting down the heel to the surface of the support in terms of anatomical muscle lengthening, it takes extra effort to achieve rest length and its maximum power. In all types of the displacement of the peripheral fragment, the function of three-headed calf muscle is disturbed with involvement of additional muscular effort and energy expenditure. This fact should motivate the surgeon on the need for accurate repositioning of bone fragments in calcaneal fractures with the displacement of the peripheral fragment. Y1 - 2016 U6 - https://doi.org/10.22141/1608-1706.2.16.2015.80247 VL - 16 IS - 2 SP - 20 EP - 24 PB - Zaslavsky ER - TY - JOUR A1 - Lazarev, Igor A. A1 - Ryabokon, P.V. A1 - Haller, M. A1 - Dendorfer, Sebastian T1 - Effect of the fractured calcaneus's peripheral fragment displacement on the triceps surae function JF - ЖУРНАЛ «ТРАВМА» Ukrainian Trauma Journal Y1 - 2015 VL - 2, TOM 16 ER - TY - JOUR A1 - Lehle, Karla A1 - Philipp, Alois A1 - Krenkel, Lars A1 - Gruber, Michael A1 - Hiller, Karl-Anton A1 - Müller, Thomas A1 - Lubnow, Matthias T1 - Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia JF - ASAIO Journal N2 - Contact of blood with artificial surfaces triggers platelet activation. The aim was to compare platelet kinetics after venovenous extracorporeal membrane oxygenation (V-V ECMO) start and after system exchange in different etiologies of acute lung failure. Platelet counts and coagulation parameters were analyzed from adult patients with long and exchange-free (≥8 days) ECMO runs (n = 330) caused by bacterial (n = 142), viral (n = 76), or coronavirus disease 2019 (COVID-19) (n = 112) pneumonia. A subpopulation requiring a system exchange and with long, exchange-free runs of the second oxygenator (≥7 days) (n = 110) was analyzed analogously. Patients with COVID-19 showed the highest platelet levels before ECMO implantation. Independent of the underlying disease and ECMO type, platelet counts decreased significantly within 24 hours and reached a steady state after 5 days. In the subpopulation, at the day of a system exchange, platelet counts were lower compared with ECMO start, but without differences between underlying diseases. Subsequently, platelets remained unchanged in the bacterial pneumonia group, but increased in the COVID-19 and viral pneumonia groups within 2–4 days, whereas D-dimers decreased and fibrinogen levels increased. Thus, overall platelet counts on V-V ECMO show disease-specific initial dynamics followed by an ongoing consumption by the ECMO device, which is not boosted by new artificial surfaces after a system exchange. Y1 - 2025 U6 - https://doi.org/10.1097/MAT.0000000000002383 SN - 1058-2916 SN - 1538-943X PB - Wolters Kluwer ER - TY - JOUR A1 - Lenich, Andreas A1 - Bachmeier, S. A1 - Dendorfer, Sebastian A1 - Mayr, E. A1 - Nerlich, Michael A1 - Füchtmeier, Bernd T1 - Development of a test system to analyze different hip fracture osteosyntheses under simulated walking JF - Biomedizinische Technik. Biomedical engineering N2 - The mechanical complications of osteosyntheses after hip fractures are previously investigated by mostly static or dynamic uniaxial loading test systems. However, the physiologic loading of the hip joint during a normal gait is a multiplanar, dynamic movement. Therefore, we constructed a system to test osteosyntheses for hip fractures under physiologic multiplanar loading representative of normal gait. To evaluate the testing system, 12 femora pairs were tested under 25,000 cycles with two standard osteosyntheses (Proximal Femoral Nail Antirotation/Gamma3 Nail). For angular movement, the varus collapse to cut out (∝CO) (∝CO=4.8°±2.1° for blade and ∝CO=7.8°±3.8° for screw) was the dominant failure mode, and only slight rotational angle shifts (∝Rot) (∝Rot=1.7°±0.4° for blade and ∝Rot=2.4°±0.3° for screw) of the femoral head around the implant axis were observed. Angular displacements in varus direction and rotation were higher in specimens reinforced with screws. Hence, the cut out model and the migration directions showed a distinction between helical blade and hip screw. However, there were no significant differences between the different implants. The new setup is able to create clinical failures and allows to give evidence about the anchorage stability of different implant types under dynamic gait motion pattern. KW - biomechanical implant test KW - dynamic multiplanar loading KW - hip fractureg KW - implant migration KW - patient specific loading KW - Hüftgelenk KW - Knochenbruch KW - Osteosynthese KW - Bewegungsanalyse KW - Simulation Y1 - 2012 U6 - https://doi.org/10.1515/bmt-2011-0999 VL - 57 IS - 2 SP - 113 EP - 119 ER - TY - JOUR A1 - Lichtenauer, Norbert A1 - Ettl, Katrin A1 - Mohr, Christa A1 - Weber, Karsten A1 - Meussling-Sentpali, Annette T1 - Der Pflegeroboter für zu Hause JF - Die Schwester, der Pfleger N2 - Ein interdisziplinäres Forschungsprojekt der Ostbayerischen Hochschule Regensburg untersucht, inwiefern Telemedizin und digitale Anwendungen die Therapie und Pflege von Menschen mit Schlaganfall in ihrem häuslichen Umfeld unterstützen, ihre Lebensqualität beeinflussen und die intersektorale Versorgung verbessern kann. Y1 - 2021 UR - https://www.bibliomed-pflege.de/sp/artikel/44176-der-pflegeroboter-fuer-zu-hause VL - 11 IS - 21 SP - 48 EP - 52 PB - Bibliomed-Medizinische Verlagsgesellschaft mbH ER - TY - JOUR A1 - Lingel, Maximilian P. A1 - Haus, Moritz A1 - Paschke, Lukas A1 - Foltan, Maik A1 - Lubnow, Matthias A1 - Gruber, Michael A1 - Krenkel, Lars A1 - Lehle, Karla T1 - Clinical relevance of cell-free DNA during venovenous extracorporeal membrane oxygenation JF - Artificial organs N2 - BACKGROUND: Thrombosis remains a critical complication during venovenous extracorporeal membrane oxygenation (VV ECMO). The involvement of neutrophil extracellular traps (NETs) in thrombogenesis has to be discussed. The aim was to verify NETs in the form of cell-free DNA (cfDNA) in the plasma of patients during ECMO. METHODS: A fluorescent DNA-binding dye (QuantifFluor®, Promega) was used to detect cell-free DNA in plasma samples. cfDNA concentrations from volunteers (n = 21) and patients (n = 9) were compared and correlated with clinical/technical data before/during support, ECMO end and time of a system exchange. RESULTS: Before ECMO, patients with a median (IQR) age of 59 (51/63) years, SOFA score of 11 (10/15), and ECMO run time of 9.0 (7.0/19.5) days presented significantly higher levels of cfDNA compared to volunteers (6.4 (5.8/7.9) ng/μL vs. 5.9 (5.4/6.3) ng/μL; p = 0.044). Within 2 days after ECMO start, cfDNA, inflammatory, and hemolysis parameters remained unchanged, while platelets decreased (p = 0.005). After ECMO removal at the end of therapy, cfDNA, inflammation, and coagulation data (except antithrombin III) remained unchanged. The renewal of a system resulted in known alterations in fibrinogen, d-dimers, and platelets, while cfDNA remained unchanged. CONCLUSION: Detection of cfDNA in plasma of ECMO patients was not an indicator of acute and circuit-induced thrombogenesis. KW - blood KW - cell- free DNA KW - coagulation KW - ECMO KW - inflammation KW - neutrophil extracellular traps Y1 - 2023 U6 - https://doi.org/10.1111/aor.14616 SN - 1525-1594 VL - 47 IS - 11 SP - 1720 EP - 1731 PB - Wiley ER -